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Articles 1 - 30 of 41
Full-Text Articles in Data Science
Validation Of A Risk Score For Cancer-Associated Thrombosis Using Nationwide Ehr Data, Ang Li, Omid Jafari, Barbara D Lam, Jun Y Jiang, Rock Bum Kim, Shengling Ma, Emily Zhou, Joyce W Tiong, Elizabeth C Chiang, Justine Ryu, Christopher I Amos, Jennifer La, Nathanael R Fillmore
Validation Of A Risk Score For Cancer-Associated Thrombosis Using Nationwide Ehr Data, Ang Li, Omid Jafari, Barbara D Lam, Jun Y Jiang, Rock Bum Kim, Shengling Ma, Emily Zhou, Joyce W Tiong, Elizabeth C Chiang, Justine Ryu, Christopher I Amos, Jennifer La, Nathanael R Fillmore
Faculty, Staff and Student Publications
Importance: Venous thromboembolism (VTE) is associated with increased mortality and morbidity in patients with cancer. Existing risk prediction models are typically validated within individual sites, a fragmented approach that limits clinical adoption.
Objective: To validate the electronic health record cancer-associated thrombosis (EHR-CAT) score compared with the benchmark Khorana score in a contemporary cohort of patients with cancer across the nation, before and after treatment, excluding those at high risk of bleeding.
Design, setting, and participants: This prognostic study included patients in a nationwide longitudinal EHR database from January 2018 to December 2023 with follow-up continuing to April 2025. Patients with …
Smarter Disease Detection From Electronic Health Record Data: An End-To-End Ai-Augmented Pipeline For Computable Phenotyping, Dylan Owens
Statistical Science Theses and Dissertations
Electronic Health Records (EHR) contain a wealth of structured and unstructured patient data that can be leveraged for computable phenotyping, the process of algorithmically identifying patient cohorts with specific diseases or conditions. Traditional rule-based phenotyping approaches, while interpretable, often struggle with scalability, portability across institutions, and effective use of unstructured clinical narratives. Recent advances in large language models (LLMs) present new opportunities for synthesizing complex free-text information into concise, clinically meaningful representations. However, integrating LLMs into phenotyping workflows requires careful design to maintain transparency, interpretability, and measurable uncertainty—features essential for clinical adoption and downstream applications such as decision support.
We …
Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald
Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald
All Dissertations
Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …
Precision Phenotyping For Curating Research Cohorts Of Patients With Unexplained Post-Acute Sequelae Of Covid-19, Alaleh Azhir, Jonas Hügel, Jiazi Tian, Jingya Cheng, Ingrid V Bassett, Douglas S Bell, Elmer V Bernstam, Maha R Farhat, Darren W Henderson, Emily S Lau, Michele Morris, Yevgeniy R Semenov, Virginia A Triant, Shyam Visweswaran, Zachary H Strasser, Jeffrey G Klann, Shawn N Murphy, Hossein Estiri
Precision Phenotyping For Curating Research Cohorts Of Patients With Unexplained Post-Acute Sequelae Of Covid-19, Alaleh Azhir, Jonas Hügel, Jiazi Tian, Jingya Cheng, Ingrid V Bassett, Douglas S Bell, Elmer V Bernstam, Maha R Farhat, Darren W Henderson, Emily S Lau, Michele Morris, Yevgeniy R Semenov, Virginia A Triant, Shyam Visweswaran, Zachary H Strasser, Jeffrey G Klann, Shawn N Murphy, Hossein Estiri
Faculty, Staff and Student Publications
BACKGROUND: Scalable identification of patients with post-acute sequelae of COVID-19 (PASC) is challenging due to a lack of reproducible precision phenotyping algorithms, which has led to suboptimal accuracy, demographic biases, and underestimation of the PASC.
METHODS: In a retrospective case-control study, we developed a precision phenotyping algorithm for identifying cohorts of patients with PASC. We used longitudinal electronic health records data from over 295,000 patients from 14 hospitals and 20 community health centers in Massachusetts. The algorithm employs an attention mechanism to simultaneously exclude sequelae that prior conditions can explain and include infection-associated chronic conditions. We performed independent chart reviews …
De-Identification Is Not Enough: A Comparison Between De-Identified And Synthetic Clinical Notes, Atiquer Rahman Sarkar, Yao-Shun Chuang, Noman Mohammed, Xiaoqian Jiang
De-Identification Is Not Enough: A Comparison Between De-Identified And Synthetic Clinical Notes, Atiquer Rahman Sarkar, Yao-Shun Chuang, Noman Mohammed, Xiaoqian Jiang
Faculty, Staff and Student Publications
For sharing privacy-sensitive data, de-identification is commonly regarded as adequate for safeguarding privacy. Synthetic data is also being considered as a privacy-preserving alternative. Recent successes with numerical and tabular data generative models and the breakthroughs in large generative language models raise the question of whether synthetically generated clinical notes could be a viable alternative to real notes for research purposes. In this work, we demonstrated that (i) de-identification of real clinical notes does not protect records against a membership inference attack, (ii) proposed a novel approach to generate synthetic clinical notes using the current state-of-the-art large language models, (iii) evaluated …
Question Answering For Electronic Health Records: Scoping Review Of Datasets And Models, Jayetri Bardhan, Kirk Roberts, Daisy Zhe Wang
Question Answering For Electronic Health Records: Scoping Review Of Datasets And Models, Jayetri Bardhan, Kirk Roberts, Daisy Zhe Wang
Faculty, Staff and Student Publications
Background: Question answering (QA) systems for patient-related data can assist both clinicians and patients. They can, for example, assist clinicians in decision-making and enable patients to have a better understanding of their medical history. Substantial amounts of patient data are stored in electronic health records (EHRs), making EHR QA an important research area. Because of the differences in data format and modality, this differs greatly from other medical QA tasks that use medical websites or scientific papers to retrieve answers, making it critical to research EHR QA.
Objective: This study aims to provide a methodological review of existing works on …
Design And Implementation Of An Opioid Scorecard For Hospital System-Wide Peer Comparison Of Opioid Prescribing Habits: Observational Study, Benjamin Slovis, Soonyip Huang, Melanie Mcarthur, Cara Martino, Tasia Beers, Meghan Labella, Jeffrey Riggio, Edmund Pribitkin
Design And Implementation Of An Opioid Scorecard For Hospital System-Wide Peer Comparison Of Opioid Prescribing Habits: Observational Study, Benjamin Slovis, Soonyip Huang, Melanie Mcarthur, Cara Martino, Tasia Beers, Meghan Labella, Jeffrey Riggio, Edmund Pribitkin
Jefferson Hospital Staff Papers and Presentations
BACKGROUND: Reductions in opioid prescribing by health care providers can lead to a decreased risk of opioid dependence in patients. Peer comparison has been demonstrated to impact providers' prescribing habits, though its effect on opioid prescribing has predominantly been studied in the emergency department setting.
OBJECTIVE: The purpose of this study is to describe the development of an enterprise-wide opioid scorecard, the architecture of its implementation, and plans for future research on its effects.
METHODS: Using data generated by the author's enterprise vendor-based electronic health record, the enterprise analytics software, and expertise from a dedicated group of informaticists, physicians, and …
Improving Large Language Models For Clinical Named Entity Recognition Via Prompt Engineering, Yan Hu, Qingyu Chen, Jingcheng Du, Xueqing Peng, Vipina Kuttichi Keloth, Xu Zuo, Yujia Zhou, Zehan Li, Xiaoqian Jiang, Zhiyong Lu, Kirk Roberts, Hua Xu
Improving Large Language Models For Clinical Named Entity Recognition Via Prompt Engineering, Yan Hu, Qingyu Chen, Jingcheng Du, Xueqing Peng, Vipina Kuttichi Keloth, Xu Zuo, Yujia Zhou, Zehan Li, Xiaoqian Jiang, Zhiyong Lu, Kirk Roberts, Hua Xu
Faculty, Staff and Student Publications
IMPORTANCE: The study highlights the potential of large language models, specifically GPT-3.5 and GPT-4, in processing complex clinical data and extracting meaningful information with minimal training data. By developing and refining prompt-based strategies, we can significantly enhance the models' performance, making them viable tools for clinical NER tasks and possibly reducing the reliance on extensive annotated datasets.
OBJECTIVES: This study quantifies the capabilities of GPT-3.5 and GPT-4 for clinical named entity recognition (NER) tasks and proposes task-specific prompts to improve their performance.
MATERIALS AND METHODS: We evaluated these models on 2 clinical NER tasks: (1) to extract medical problems, treatments, …
Special Supplement Issue On Quality Assurance And Enrichment Of Biological And Biomedical Ontologies And Terminologies, Licong Cui, Ankur Agrawal
Special Supplement Issue On Quality Assurance And Enrichment Of Biological And Biomedical Ontologies And Terminologies, Licong Cui, Ankur Agrawal
Faculty, Staff and Student Publications
Ontologies and terminologies serve as the backbone of knowledge representation in biomedical domains, facilitating data integration, interoperability, and semantic understanding across diverse applications. However, the quality assurance and enrichment of these resources remain an ongoing challenge due to the dynamic nature of biomedical knowledge. In this editorial, we provide an introductory summary of seven articles included in this special supplement issue for quality assurance and enrichment of biological and biomedical ontologies and terminologies. These articles span a spectrum of topics, such as development of automated quality assessment frameworks for Resource Description Framework (RDF) resources, identification of missing concepts in SNOMED …
Patient-Centered Clinical Decision Support Challenges And Opportunities Identified From Workflow Execution Models, Dean F Sittig, Aziz Boxwala, Adam Wright, Courtney Zott, Nicole A Gauthreaux, James Swiger, Edwin A Lomotan, Prashila Dullabh
Patient-Centered Clinical Decision Support Challenges And Opportunities Identified From Workflow Execution Models, Dean F Sittig, Aziz Boxwala, Adam Wright, Courtney Zott, Nicole A Gauthreaux, James Swiger, Edwin A Lomotan, Prashila Dullabh
Faculty, Staff and Student Publications
OBJECTIVE: To use workflow execution models to highlight new considerations for patient-centered clinical decision support policies (PC CDS), processes, procedures, technology, and expertise required to support new workflows.
METHODS: To generate and refine models, we used (1) targeted literature reviews; (2) key informant interviews with 6 external PC CDS experts; (3) model refinement based on authors' experience; and (4) validation of the models by a 26-member steering committee.
RESULTS AND DISCUSSION: We identified 7 major issues that provide significant challenges and opportunities for healthcare systems, researchers, administrators, and health IT and app developers. Overcoming these challenges presents opportunities for new …
Improvements In Appropriate Placement Of Dental Sealants After Implementation Of A Clinical Decision Support System, Joanna Mullins, Ryan Brandon, Nicholas Skourtes, Elsbeth Kalenderian, Muhammad Walji
Improvements In Appropriate Placement Of Dental Sealants After Implementation Of A Clinical Decision Support System, Joanna Mullins, Ryan Brandon, Nicholas Skourtes, Elsbeth Kalenderian, Muhammad Walji
Faculty, Staff and Student Publications
BACKGROUND: Dental sealants are effective for the prevention of caries in children at elevated risk levels, and increasing the proportion of children and adolescents who have dental sealants on 1 or more molars is a Healthy People 2030 objective. Electronic health record (EHR)-based clinical decision support systems (CDSSs) have the ability to improve patient care. A dental quality measure related to dental sealant placement for children at elevated risk of caries was targeted for improvement using a CDSS.
METHODS: A validated dental quality measure was adapted to assess a patient's need for dental sealant placement. A CDSS was implemented to …
Development And Validation Of A Rule-Based Algorithm To Identify Periodontal Diagnosis Using Structured Electronic Health Record Data, Bunmi Tokede, Ryan Brandon, Chun-Teh Lee, Guo-Hao Lin, Joel White, Alfa Yansane, Xiaoqian Jiang, Elsbeth Kalenderian, Muhammad Walji
Development And Validation Of A Rule-Based Algorithm To Identify Periodontal Diagnosis Using Structured Electronic Health Record Data, Bunmi Tokede, Ryan Brandon, Chun-Teh Lee, Guo-Hao Lin, Joel White, Alfa Yansane, Xiaoqian Jiang, Elsbeth Kalenderian, Muhammad Walji
Faculty, Staff and Student Publications
AIM: To develop and validate an automated electronic health record (EHR)-based algorithm to suggest a periodontal diagnosis based on the 2017 World Workshop on the Classification of Periodontal Diseases and Conditions.
MATERIALS AND METHODS: Using material published from the 2017 World Workshop, a tool was iteratively developed to suggest a periodontal diagnosis based on clinical data within the EHR. Pertinent clinical data included clinical attachment level (CAL), gingival margin to cemento-enamel junction distance, probing depth, furcation involvement (if present) and mobility. Chart reviews were conducted to confirm the algorithm's ability to accurately extract clinical data from the EHR, and then …
Representation Learning For Generative Models With Applications To Healthcare, Astronautics, And Aviation, Van Minh Nguyen
Representation Learning For Generative Models With Applications To Healthcare, Astronautics, And Aviation, Van Minh Nguyen
Theses and Dissertations
This dissertation explores applications of representation learning and generative models to challenges in healthcare, astronautics, and aviation.
The first part investigates the use of Generative Adversarial Networks (GANs) to synthesize realistic electronic health record (EHR) data. An initial attempt at training a GAN on the MIMIC-IV dataset encountered stability and convergence issues, motivating a deeper study of 1-Lipschitz regularization techniques for Auxiliary Classifier GANs (AC-GANs). An extensive ablation study on the CIFAR-10 dataset found that Spectral Normalization is key for AC-GAN stability and performance, while Weight Clipping fails to converge without Spectral Normalization. Analysis of the training dynamics provided further …
Deep Learning Model For Personalized Prediction Of Positive Mrsa Culture Using Time-Series Electronic Health Records, Masayuki Nigo, Laila Rasmy, Bingyu Mao, Bijun Sai Kannadath, Ziqian Xie, Degui Zhi
Deep Learning Model For Personalized Prediction Of Positive Mrsa Culture Using Time-Series Electronic Health Records, Masayuki Nigo, Laila Rasmy, Bingyu Mao, Bijun Sai Kannadath, Ziqian Xie, Degui Zhi
Faculty, Staff and Student Publications
Methicillin-resistant Staphylococcus aureus (MRSA) poses significant morbidity and mortality in hospitals. Rapid, accurate risk stratification of MRSA is crucial for optimizing antibiotic therapy. Our study introduced a deep learning model, PyTorch_EHR, which leverages electronic health record (EHR) time-series data, including wide-variety patient specific data, to predict MRSA culture positivity within two weeks. 8,164 MRSA and 22,393 non-MRSA patient events from Memorial Hermann Hospital System, Houston, Texas are used for model development. PyTorch_EHR outperforms logistic regression (LR) and light gradient boost machine (LGBM) models in accuracy (AUROC
Spec: A Soft Prompt-Based Calibration On Performance Variability Of Large Language Model In Clinical Notes Summarization, Yu-Neng Chuang, Ruixiang Tang, Xiaoqian Jiang, Xia Hu
Spec: A Soft Prompt-Based Calibration On Performance Variability Of Large Language Model In Clinical Notes Summarization, Yu-Neng Chuang, Ruixiang Tang, Xiaoqian Jiang, Xia Hu
Faculty, Staff and Student Publications
Electronic health records (EHRs) store an extensive array of patient information, encompassing medical histories, diagnoses, treatments, and test outcomes. These records are crucial for enabling healthcare providers to make well-informed decisions regarding patient care. Summarizing clinical notes further assists healthcare professionals in pinpointing potential health risks and making better-informed decisions. This process contributes to reducing errors and enhancing patient outcomes by ensuring providers have access to the most pertinent and current patient data. Recent research has shown that incorporating instruction prompts with large language models (LLMs) substantially boosts the efficacy of summarization tasks. However, we show that this approach also …
Generalizable Pipeline For Constructing Hiv Risk Prediction Models Across Electronic Health Record Systems, Sarah B May, Thomas P Giordano, Assaf Gottlieb
Generalizable Pipeline For Constructing Hiv Risk Prediction Models Across Electronic Health Record Systems, Sarah B May, Thomas P Giordano, Assaf Gottlieb
Faculty, Staff and Student Publications
OBJECTIVE: The HIV epidemic remains a significant public health issue in the United States. HIV risk prediction models could be beneficial for reducing HIV transmission by helping clinicians identify patients at high risk for infection and refer them for testing. This would facilitate initiation on treatment for those unaware of their status and pre-exposure prophylaxis for those uninfected but at high risk. Existing HIV risk prediction algorithms rely on manual construction of features and are limited in their application across diverse electronic health record systems. Furthermore, the accuracy of these models in predicting HIV in females has thus far been …
An Open Natural Language Processing (Nlp) Framework For Ehr-Based Clinical Research: A Case Demonstration Using The National Covid Cohort Collaborative (N3c), Sijia Liu, Andrew Wen, Liwei Wang, Huan He, Sunyang Fu, Robert Miller, Andrew Williams, Daniel Harris, Ramakanth Kavuluru, Mei Liu, Noor Abu-El-Rub, Dalton Schutte, Rui Zhang, Masoud Rouhizadeh, John D Osborne, Yongqun He, Umit Topaloglu, Stephanie S Hong, Joel H Saltz, Thomas Schaffter, Emily Pfaff, Christopher G Chute, Tim Duong, Melissa A Haendel, Rafael Fuentes, Peter Szolovits, Hua Xu, Hongfang Liu
An Open Natural Language Processing (Nlp) Framework For Ehr-Based Clinical Research: A Case Demonstration Using The National Covid Cohort Collaborative (N3c), Sijia Liu, Andrew Wen, Liwei Wang, Huan He, Sunyang Fu, Robert Miller, Andrew Williams, Daniel Harris, Ramakanth Kavuluru, Mei Liu, Noor Abu-El-Rub, Dalton Schutte, Rui Zhang, Masoud Rouhizadeh, John D Osborne, Yongqun He, Umit Topaloglu, Stephanie S Hong, Joel H Saltz, Thomas Schaffter, Emily Pfaff, Christopher G Chute, Tim Duong, Melissa A Haendel, Rafael Fuentes, Peter Szolovits, Hua Xu, Hongfang Liu
Faculty, Staff and Student Publications
Despite recent methodology advancements in clinical natural language processing (NLP), the adoption of clinical NLP models within the translational research community remains hindered by process heterogeneity and human factor variations. Concurrently, these factors also dramatically increase the difficulty in developing NLP models in multi-site settings, which is necessary for algorithm robustness and generalizability. Here, we reported on our experience developing an NLP solution for Coronavirus Disease 2019 (COVID-19) signs and symptom extraction in an open NLP framework from a subset of sites participating in the National COVID Cohort (N3C). We then empirically highlight the benefits of multi-site data for both …
Developing Electronic Clinical Quality Measures To Assess The Cancer Diagnostic Process, Daniel R Murphy, Andrew J Zimolzak, Divvy K Upadhyay, Li Wei, Preeti Jolly, Alexis Offner, Dean F Sittig, Saritha Korukonda, Riyaa Murugaesh Rekha, Hardeep Singh
Developing Electronic Clinical Quality Measures To Assess The Cancer Diagnostic Process, Daniel R Murphy, Andrew J Zimolzak, Divvy K Upadhyay, Li Wei, Preeti Jolly, Alexis Offner, Dean F Sittig, Saritha Korukonda, Riyaa Murugaesh Rekha, Hardeep Singh
Faculty, Staff and Student Publications
OBJECTIVE: Measures of diagnostic performance in cancer are underdeveloped. Electronic clinical quality measures (eCQMs) to assess quality of cancer diagnosis could help quantify and improve diagnostic performance.
MATERIALS AND METHODS: We developed 2 eCQMs to assess diagnostic evaluation of red-flag clinical findings for colorectal (CRC; based on abnormal stool-based cancer screening tests or labs suggestive of iron deficiency anemia) and lung (abnormal chest imaging) cancer. The 2 eCQMs quantified rates of red-flag follow-up in CRC and lung cancer using electronic health record data repositories at 2 large healthcare systems. Each measure used clinical data to identify abnormal results, evidence of …
Identifying Contributing Factors Associated With Dental Adverse Events Through A Pragmatic Electronic Health Record-Based Root Cause Analysis, Elsbeth Kalenderian, Suhasini Bangar, Alfa Yansane, Duong Tran, Emily Sedlock, Yan Xiao, Janelle Urata, Greg Olson, Amy Franklin, Krishna Kookal, Ana Ibarra-Noriega, Sayali Tungare, Oluwabunmi Tokede, Heiko Spallek, Joel M White, Muhammad F Walji
Identifying Contributing Factors Associated With Dental Adverse Events Through A Pragmatic Electronic Health Record-Based Root Cause Analysis, Elsbeth Kalenderian, Suhasini Bangar, Alfa Yansane, Duong Tran, Emily Sedlock, Yan Xiao, Janelle Urata, Greg Olson, Amy Franklin, Krishna Kookal, Ana Ibarra-Noriega, Sayali Tungare, Oluwabunmi Tokede, Heiko Spallek, Joel M White, Muhammad F Walji
Faculty, Staff and Student Publications
OBJECTIVE: This study assessed contributing factors associated with dental adverse events (AEs).
METHODS: Seven electronic health record-based triggers were deployed identifying potential AEs at 2 dental institutions. From 4106 flagged charts, 2 reviewers examined 439 charts selected randomly to identify and classify AEs using our dental AE type and severity classification systems. Based on information captured in the electronic health record, we analyzed harmful AEs to assess potential contributing factors; harmful AEs were defined as those that resulted in temporary moderate to severe harm, required hospitalization, or resulted in permanent moderate to severe harm. We classified potential contributing factors according …
Quehry: A Question Answering System To Query Electronic Health Records, Sarvesh Soni, Surabhi Datta, Kirk Roberts
Quehry: A Question Answering System To Query Electronic Health Records, Sarvesh Soni, Surabhi Datta, Kirk Roberts
Faculty, Staff and Student Publications
OBJECTIVE: We propose a system, quEHRy, to retrieve precise, interpretable answers to natural language questions from structured data in electronic health records (EHRs).
MATERIALS AND METHODS: We develop/synthesize the main components of quEHRy: concept normalization (MetaMap), time frame classification (new), semantic parsing (existing), visualization with question understanding (new), and query module for FHIR mapping/processing (new). We evaluate quEHRy on 2 clinical question answering (QA) datasets. We evaluate each component separately as well as holistically to gain deeper insights. We also conduct a thorough error analysis for a crucial subcomponent, medical concept normalization.
RESULTS: Using gold concepts, the precision of quEHRy …
Toward A Neural Semantic Parsing System For Ehr Question Answering, Sarvesh Soni, Kirk Roberts
Toward A Neural Semantic Parsing System For Ehr Question Answering, Sarvesh Soni, Kirk Roberts
Faculty, Staff and Student Publications
Clinical semantic parsing (SP) is an important step toward identifying the exact information need (as a machine-understandable logical form) from a natural language query aimed at retrieving information from electronic health records (EHRs). Current approaches to clinical SP are largely based on traditional machine learning and require hand-building a lexicon. The recent advancements in neural SP show a promise for building a robust and flexible semantic parser without much human effort. Thus, in this paper, we aim to systematically assess the performance of two such neural SP models for EHR question answering (QA). We found that the performance of these …
A Multi-Site Randomized Trial Of A Clinical Decision Support Intervention To Improve Problem List Completeness, Adam Wright, Richard Schreiber, David W Bates, Skye Aaron, Angela Ai, Raja Arul Cholan, Akshay Desai, Miguel Divo, David A Dorr, Thu-Trang Hickman, Salman Hussain, Shari Just, Brian Koh, Stuart Lipsitz, Dustin Mcevoy, Trent Rosenbloom, Elise Russo, David Yut-Chee Ting, Asli Weitkamp, Dean F Sittig
A Multi-Site Randomized Trial Of A Clinical Decision Support Intervention To Improve Problem List Completeness, Adam Wright, Richard Schreiber, David W Bates, Skye Aaron, Angela Ai, Raja Arul Cholan, Akshay Desai, Miguel Divo, David A Dorr, Thu-Trang Hickman, Salman Hussain, Shari Just, Brian Koh, Stuart Lipsitz, Dustin Mcevoy, Trent Rosenbloom, Elise Russo, David Yut-Chee Ting, Asli Weitkamp, Dean F Sittig
Faculty, Staff and Student Publications
OBJECTIVE: To improve problem list documentation and care quality.
MATERIALS AND METHODS: We developed algorithms to infer clinical problems a patient has that are not recorded on the coded problem list using structured data in the electronic health record (EHR) for 12 clinically significant heart, lung, and blood diseases. We also developed a clinical decision support (CDS) intervention which suggests adding missing problems to the problem list. We evaluated the intervention at 4 diverse healthcare systems using 3 different EHRs in a randomized trial using 3 predetermined outcome measures: alert acceptance, problem addition, and National Committee for Quality Assurance Healthcare …
Prediction Of Brain Metastases Development In Patients With Lung Cancer By Explainable Artificial Intelligence From Electronic Health Records, Zhao Li, Rongbin Li, Yujia Zhou, Laila Rasmy, Degui Zhi, Ping Zhu, Antonio Dono, Xiaoqian Jiang, Hua Xu, Yoshua Esquenazi, W Jim Zheng
Prediction Of Brain Metastases Development In Patients With Lung Cancer By Explainable Artificial Intelligence From Electronic Health Records, Zhao Li, Rongbin Li, Yujia Zhou, Laila Rasmy, Degui Zhi, Ping Zhu, Antonio Dono, Xiaoqian Jiang, Hua Xu, Yoshua Esquenazi, W Jim Zheng
Faculty, Staff and Student Publications
PURPOSE: Early detection of brain metastases (BMs) is critical for prompt treatment and optimal control of the disease. In this study, we seek to predict the risk of developing BM among patients diagnosed with lung cancer on the basis of electronic health record (EHR) data and to understand what factors are important for the model to predict BM development through explainable artificial intelligence approaches accurately.
MATERIALS AND METHODS: We trained a recurrent neural network model, REverse Time AttentIoN (RETAIN), to predict the risk of developing BM using structured EHR data. To interpret the model's decision process, we analyzed the attention …
Identifying A Clinical Informatics Or Electronic Health Record Expert Witness For Medical Professional Liability Cases, Dean F Sittig, Adam Wright
Identifying A Clinical Informatics Or Electronic Health Record Expert Witness For Medical Professional Liability Cases, Dean F Sittig, Adam Wright
Faculty, Staff and Student Publications
BACKGROUND: The health care field is experiencing widespread electronic health record (EHR) adoption. New medical professional liability (i.e., malpractice) cases will likely involve the review of data extracted from EHRs as well as EHR workflows, audit logs, and even the potential role of the EHR in causing harm.
OBJECTIVES: Reviewing printed versions of a patient's EHRs can be difficult due to differences in printed versus on-screen presentations, redundancies, and the way printouts are often grouped by document or information type rather than chronologically. Simply recreating an accurate timeline often requires experts with training and experience in designing, developing, using, and …
Mining For Equitable Health: Assessing The Impact Of Missing Data In Electronic Health Records, Emily Getzen, Lyle Ungar, Danielle Mowery, Xiaoqian Jiang, Qi Long
Mining For Equitable Health: Assessing The Impact Of Missing Data In Electronic Health Records, Emily Getzen, Lyle Ungar, Danielle Mowery, Xiaoqian Jiang, Qi Long
Faculty, Staff and Student Publications
Electronic health records (EHR) are collected as a routine part of healthcare delivery, and have great potential to be utilized to improve patient health outcomes. They contain multiple years of health information to be leveraged for risk prediction, disease detection, and treatment evaluation. However, they do not have a consistent, standardized format across institutions, particularly in the United States, and can present significant analytical challenges- they contain multi-scale data from heterogeneous domains and include both structured and unstructured data. Data for individual patients are collected at irregular time intervals and with varying frequencies. In addition to the analytical challenges, EHR …
Hemoglobin Concentration Impacts Viscoelastic Hemostatic Assays In Icu Admitted Patients, David J Roh, Tiffany R Chang, Aditya Kumar, Devin Burke, Glenda Torres, Katherine Xu, Winni Yang, Azzurra Cottarelli, Ernest Moore, Angela Sauaia, Kirk Hansen, Angela Velazquez, Amelia Boehme, Athina Vrosgou, Shivani Ghoshal, Soojin Park, Sachin Agarwal, Jan Claassen, E Sander Connolly, Gebhard Wagener, Richard O Francis, Eldad Hod
Hemoglobin Concentration Impacts Viscoelastic Hemostatic Assays In Icu Admitted Patients, David J Roh, Tiffany R Chang, Aditya Kumar, Devin Burke, Glenda Torres, Katherine Xu, Winni Yang, Azzurra Cottarelli, Ernest Moore, Angela Sauaia, Kirk Hansen, Angela Velazquez, Amelia Boehme, Athina Vrosgou, Shivani Ghoshal, Soojin Park, Sachin Agarwal, Jan Claassen, E Sander Connolly, Gebhard Wagener, Richard O Francis, Eldad Hod
Faculty, Staff and Student Publications
Objectives: Low hemoglobin concentration impairs clinical hemostasis across several diseases. It is unclear whether hemoglobin impacts laboratory functional coagulation assessments. We evaluated the relationship of hemoglobin concentration on viscoelastic hemostatic assays in intracerebral hemorrhage (ICH) and perioperative patients admitted to an ICU.
Design: Observational cohort study and separate in vitro laboratory study.
Setting: Multicenter tertiary referral ICUs.
Patients: Two acute ICH cohorts receiving distinct testing modalities: rotational thromboelastometry (ROTEM) and thromboelastography (TEG), and a third surgical ICU cohort receiving ROTEM were evaluated to assess the generalizability of findings across disease processes and testing platforms. A separate in vitro ROTEM laboratory …
Large Language Models For Healthcare Data Augmentation: An Example On Patient-Trial Matching, Jiayi Yuan, Ruixiang Tang, Xiaoqian Jiang, Xia Hu
Large Language Models For Healthcare Data Augmentation: An Example On Patient-Trial Matching, Jiayi Yuan, Ruixiang Tang, Xiaoqian Jiang, Xia Hu
Faculty, Staff and Student Publications
The process of matching patients with suitable clinical trials is essential for advancing medical research and providing optimal care. However, current approaches face challenges such as data standardization, ethical considerations, and a lack of interoperability between Electronic Health Records (EHRs) and clinical trial criteria. In this paper, we explore the potential of large language models (LLMs) to address these challenges by leveraging their advanced natural language generation capabilities to improve compatibility between EHRs and clinical trial descriptions. We propose an innovative privacy-aware data augmentation approach for LLM-based patient-trial matching (LLM-PTM), which balances the benefits of LLMs while ensuring the security …
Contextual Variation Of Clinical Notes Induced By Ehr Migration, Kurt Miller, Sungrim Moon, Sunyang Fu, Hongfang Liu
Contextual Variation Of Clinical Notes Induced By Ehr Migration, Kurt Miller, Sungrim Moon, Sunyang Fu, Hongfang Liu
Faculty, Staff and Student Publications
The structure and semantics of clinical notes vary considerably across different Electronic Health Record (EHR) systems, sites, and institutions. Such heterogeneity hampers the portability of natural language processing (NLP) models in extracting information from the text for clinical research or practice. In this study, we evaluate the contextual variation of clinical notes by measuring the semantic and syntactic similarity of the notes of two sets of physicians comprising four medical specialties across EHR migrations at two Mayo Clinic sites. We find significant semantic and syntactic variation imposed by the context of the EHR system and between medical specialties whereas only …
Split Learning For Distributed Collaborative Training Of Deep Learning Models In Health Informatics, Zhuohang Li, Chao Yan, Xinmeng Zhang, Gharib Gharibi, Zhijun Yin, Xiaoqian Jiang, Bradley A Malin
Split Learning For Distributed Collaborative Training Of Deep Learning Models In Health Informatics, Zhuohang Li, Chao Yan, Xinmeng Zhang, Gharib Gharibi, Zhijun Yin, Xiaoqian Jiang, Bradley A Malin
Faculty, Staff and Student Publications
Deep learning continues to rapidly evolve and is now demonstrating remarkable potential for numerous medical prediction tasks. However, realizing deep learning models that generalize across healthcare organizations is challenging. This is due, in part, to the inherent siloed nature of these organizations and patient privacy requirements. To address this problem, we illustrate how split learning can enable collaborative training of deep learning models across disparate and privately maintained health datasets, while keeping the original records and model parameters private. We introduce a new privacy-preserving distributed learning framework that offers a higher level of privacy compared to conventional federated learning. We …
Sensitive Data Detection With High-Throughput Machine Learning Models In Electrical Health Records, Kai Zhang, Xiaoqian Jiang
Sensitive Data Detection With High-Throughput Machine Learning Models In Electrical Health Records, Kai Zhang, Xiaoqian Jiang
Faculty, Staff and Student Publications
In the era of big data, there is an increasing need for healthcare providers, communities, and researchers to share data and collaborate to improve health outcomes, generate valuable insights, and advance research. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law designed to protect sensitive health information by defining regulations for protected health information (PHI). However, it does not provide efficient tools for detecting or removing PHI before data sharing. One of the challenges in this area of research is the heterogeneous nature of PHI fields in data across different parties. This variability makes rule-based …