A Review of Ontology-Driven Big Data Analytics in Healthcare: Challenges, Tools, and Applications

Exponential growth in heterogeneous healthcare data arising from electronic health records (EHRs), medical imaging, wearable sensors, and biomedical research has accelerated the adoption of data lakes and centralized architectures capable of handling the Volume, Variety, and Velocity of Big Data for advanced analytics. However, without effective governance, these repositories risk devolving into disorganized data swamps. Ontology-driven semantic data management offers a robust solution by linking metadata to healthcare knowledge graphs, thereby enhancing semantic interoperability, improving data discoverability, and enabling expressive, domain-aware access. This review adopts a systematic research strategy, formulating key research questions and conducting a structured literature search across major academic databases, with selected studies analyzed and classified into six categories of ontology-driven healthcare analytics: (i) ontology-driven integration frameworks, (ii) semantic modeling for metadata enrichment, (iii) ontology-based data access (OBDA), (iv) basic semantic data management, (v) ontology-based reasoning for decision support, and (vi) semantic annotation for unstructured data. We further examine the integration of ontology technologies with Big Data frameworks such as Hadoop, Spark, Kafka, and so on, highlighting their combined potential to deliver scalable and intelligent healthcare analytics. For each category, recent techniques, representative case studies, technical and organizational challenges, and emerging trends such as artificial intelligence, machine learning, the Internet of Things (IoT), and real-time analytics are reviewed to guide the development of sustainable, interoperable, and high-performance healthcare data ecosystems.