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Kaur N, Goyal G, Garg R, Tapasvi C, Demirbaga U. Ensemble for evaluating diagnostic efficacy of non-invasive indices in predicting liver fibrosis in untreated hepatitis C virus population. World J Methodol 2024; 14:91058. [DOI: 10.5662/wjm.v14.i3.91058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/28/2024] [Accepted: 03/21/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection progresses through various phases, starting with inflammation and ending with hepatocellular carcinoma. There are several invasive and non-invasive methods to diagnose chronic HCV infection. The invasive methods have their benefits but are linked to morbidity and complications. Thus, it is important to analyze the potential of non-invasive methods as an alternative. Shear wave elastography (SWE) is a non-invasive imaging tool widely validated in clinical and research studies as a surrogate marker of liver fibrosis. Liver fibrosis determination by invasive liver biopsy and non-invasive SWE agree closely in clinical studies and therefore both are gold standards.
AIM To analyzed the diagnostic efficacy of non-invasive indices [serum fibronectin, aspartate aminotransferase to platelet ratio index (APRI), alanine aminotransferase ratio (AAR), and fibrosis-4 (FIB-4)] in relation to SWE. We have used an Artificial Intelligence method to predict the severity of liver fibrosis and uncover the complex relationship between non-invasive indices and fibrosis severity.
METHODS We have conducted a hospital-based study considering 100 untreated patients detected as HCV positive using a quantitative Real-Time Polymerase Chain Reaction assay. We performed statistical and probabilistic analyses to determine the relationship between non-invasive indices and the severity of fibrosis. We also used standard diagnostic methods to measure the diagnostic accuracy for all the subjects.
RESULTS The results of our study showed that fibronectin is a highly accurate diagnostic tool for predicting fibrosis stages (mild, moderate, and severe). This was based on its sensitivity (100%, 92.2%, 96.2%), specificity (96%, 100%, 98.6%), Youden’s index (0.960, 0.922, 0.948), area under receiver operating characteristic curve (0.999, 0.993, 0.922), and Likelihood test (LR+ > 10 and LR- < 0.1). Additionally, our Bayesian Network analysis revealed that fibronectin (> 200), AAR (> 1), APRI (> 3), and FIB-4 (> 4) were all strongly associated with patients who had severe fibrosis, with a 100% probability.
CONCLUSION We have found a strong correlation between fibronectin and liver fibrosis progression in HCV patients. Additionally, we observed that the severity of liver fibrosis increases with an increase in the non-invasive indices that we investigated.
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Affiliation(s)
- Navneet Kaur
- Department of Biochemistry, Guru Gobind Singh Medical College and Hospital, Faridkot 151203, Punjab, India
| | - Gitanjali Goyal
- Department of Biochemistry, All India Institute of Medical Sciences, Bathinda 151005, Punjab, India
| | - Ravinder Garg
- Department of Medicine, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot 151203, Punjab, India
| | - Chaitanya Tapasvi
- Department of Radiodiagnosis, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot 151203, India
| | - Umit Demirbaga
- Department of Computer Engineering, Bartin University, Bartin 74100, Türkiye
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- European Bioinformatics Institute, Wellcome Genome, Cambridge CB10 1SD, United Kingdom
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2
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Kirby J, Kim K, Zivkovic M, Wang S, Garg V, Danavar A, Li C, Chen N, Garg A. Uncovering the burden of hidradenitis suppurativa misdiagnosis and underdiagnosis: a machine learning approach. FRONTIERS IN MEDICAL TECHNOLOGY 2024; 6:1200400. [PMID: 38591045 PMCID: PMC10999681 DOI: 10.3389/fmedt.2024.1200400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 03/05/2024] [Indexed: 04/10/2024] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory follicular skin condition that is associated with significant psychosocial and economic burden and a diminished quality of life and work productivity. Accurate diagnosis of HS is challenging due to its unknown etiology, which can lead to underdiagnosis or misdiagnosis that results in increased patient and healthcare system burden. We applied machine learning (ML) to a medical and pharmacy claims database using data from 2000 through 2018 to develop a novel model to better understand HS underdiagnosis on a healthcare system level. The primary results demonstrated that high-performing models for predicting HS diagnosis can be constructed using claims data, with an area under the curve (AUC) of 81%-82% observed among the top-performing models. The results of the models developed in this study could be input into the development of an impact of inaction model that determines the cost implications of HS diagnosis and treatment delay to the healthcare system.
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Affiliation(s)
- Joslyn Kirby
- Department of Dermatology, Penn State Health, Hershey, PA, United States
| | - Katherine Kim
- Value and Evidence, AbbVie, Inc., North Chicago, IL, United States
| | - Marko Zivkovic
- Technology and Innovation, Genesis Research, Hoboken, NJ, United States
| | - Siwei Wang
- Technology and Innovation, Genesis Research, Hoboken, NJ, United States
| | - Vishvas Garg
- Value and Evidence, AbbVie, Inc., North Chicago, IL, United States
| | - Akash Danavar
- Value and Evidence, AbbVie, Inc., North Chicago, IL, United States
| | - Chao Li
- Value and Evidence, AbbVie, Inc., North Chicago, IL, United States
| | - Naijun Chen
- Value and Evidence, AbbVie, Inc., North Chicago, IL, United States
| | - Amit Garg
- Department of Dermatology, Northwell Health, New Hyde Park, NY, United States
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3
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Moulaei K, Sharifi H, Bahaadinbeigy K, Haghdoost AA, Nasiri N. Machine learning for prediction of viral hepatitis: A systematic review and meta-analysis. Int J Med Inform 2023; 179:105243. [PMID: 37806178 DOI: 10.1016/j.ijmedinf.2023.105243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/21/2023] [Accepted: 10/01/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Lack of accurate and timely diagnosis of hepatitis poses obstacles to effective treatment, disease progression prevention, complication reduction, and life-saving interventions of patients. Utilizing machine learning can greatly enhance the achievement of timely and precise disease diagnosis. Therefore, we carried out this systematic review and meta-analysis to explore the performance of machine learning algorithms in predicting viral hepatitis. METHODS Using an extensive literature search in PubMed, Scopus, and Web of Science databases until June 15, 2023, English publications on hepatitis prediction using machine learning algorithms were included. Two authors independently extracted pertinent information from the selected studies. The PRISMA 2020 checklist was followed for study selection and result reporting. The risk of bias was checked using the International Journal of Medical Informatics (IJMEDI) checklist. Data were analyzed using the 'metandi' command in Stata 17. RESULTS Twenty-one original studies were included, covering 82 algorithms. Sixteen studies utilized five algorithms to predict hepatitis B. Ten studies used five algorithms for hepatitis C prediction. For hepatitis B prediction, the SVM algorithms demonstrated the highest sensitivity (90.0%; 95% confidence interval (CI): 77.0%-96.0%), specificity (94%; 95% CI: 90.0%-97.0%), and a diagnostic odds ratio (DOR) of 145 (95% CI: 37.0-559.0). In the case of hepatitis C, the KNN algorithms exhibited the highest sensitivity (80%; 95% CI:30.0%-97.0%), specificity (95%; 95% CI: 58.0%-99.0%), and DOR (72; 95% CI: 3.0-1644.0) for prediction. CONCLUSION SVM and KNN demonstrated superior performance in predicting hepatitis. The proper algorithm along with clinical practice could improve hepatitis prediction and management.
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Affiliation(s)
- Khadijeh Moulaei
- Department of Health Information Technology, Faculty of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Naser Nasiri
- School of Public Health, Jiroft University of Medical Sciences, Jiroft, Kerman, Iran.
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Ajuwon BI, Awotundun ON, Richardson A, Roper K, Sheel M, Rahman N, Salako A, Lidbury BA. Machine learning prediction models for clinical management of blood-borne viral infections: a systematic review of current applications and future impact. Int J Med Inform 2023; 179:105244. [PMID: 37820561 DOI: 10.1016/j.ijmedinf.2023.105244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/08/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Machine learning (ML) prediction models to support clinical management of blood-borne viral infections are becoming increasingly abundant in medical literature, with a number of competing models being developed for the same outcome or target population. However, evidence on the quality of these ML prediction models are limited. OBJECTIVE This study aimed to evaluate the development and quality of reporting of ML prediction models that could facilitate timely clinical management of blood-borne viral infections. METHODS We conducted narrative evidence synthesis following the synthesis without meta-analysis guidelines. We searched PubMed and Cochrane Central Register of Controlled Trials for all studies applying ML models for predicting clinical outcomes associated with hepatitis B virus (HBV), human immunodeficiency virus (HIV), or hepatitis C virus (HCV). RESULTS We found 33 unique ML prediction models aiming to support clinical decision making. Overall, 12 (36.4%) focused on HBV, 10 (30.3%) on HCV, 10 on HIV (30.3%) and two (6.1%) on co-infection. Among these, six (18.2%) addressed the diagnosis of infection, 16 (48.5%) the prognosis of infection, eight (24.2%) the prediction of treatment response, two (6.1%) progression through a cascade of care, and one (3.03%) focused on the choice of antiretroviral therapy (ART). Nineteen prediction models (57.6%) were developed using data from high-income countries. Evaluation of prediction models was limited to measures of performance. Detailed information on software code accessibility was often missing. Independent validation on new datasets and/or in other institutions was rarely done. CONCLUSION Promising approaches for ML prediction models in blood-borne viral infections were identified, but the lack of robust validation, interpretability/explainability, and poor quality of reporting hampered their clinical relevance. Our findings highlight important considerations that can inform standard reporting guidelines for ML prediction models in the future (e.g., TRIPOD-AI), and provides critical data to inform robust evaluation of the models.
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Affiliation(s)
- Busayo I Ajuwon
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Acton, Australian Capital Territory, Australia; Department of Biosciences and Biotechnology, Faculty of Pure and Applied Sciences, Kwara State University, Malete, Nigeria.
| | - Oluwatosin N Awotundun
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Alice Richardson
- Statistical Support Network, The Australian National University, Acton, ACT, Australia
| | - Katrina Roper
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Acton, Australian Capital Territory, Australia
| | - Meru Sheel
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Nurudeen Rahman
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Abideen Salako
- Department of Clinical Sciences, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Brett A Lidbury
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Acton, Australian Capital Territory, Australia
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Frascarelli C, Bonizzi G, Musico CR, Mane E, Cassi C, Guerini Rocco E, Farina A, Scarpa A, Lawlor R, Reggiani Bonetti L, Caramaschi S, Eccher A, Marletta S, Fusco N. Revolutionizing Cancer Research: The Impact of Artificial Intelligence in Digital Biobanking. J Pers Med 2023; 13:1390. [PMID: 37763157 PMCID: PMC10532470 DOI: 10.3390/jpm13091390] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Biobanks are vital research infrastructures aiming to collect, process, store, and distribute biological specimens along with associated data in an organized and governed manner. Exploiting diverse datasets produced by the biobanks and the downstream research from various sources and integrating bioinformatics and "omics" data has proven instrumental in advancing research such as cancer research. Biobanks offer different types of biological samples matched with rich datasets comprising clinicopathologic information. As digital pathology and artificial intelligence (AI) have entered the precision medicine arena, biobanks are progressively transitioning from mere biorepositories to integrated computational databanks. Consequently, the application of AI and machine learning on these biobank datasets holds huge potential to profoundly impact cancer research. METHODS In this paper, we explore how AI and machine learning can respond to the digital evolution of biobanks with flexibility, solutions, and effective services. We look at the different data that ranges from specimen-related data, including digital images, patient health records and downstream genetic/genomic data and resulting "Big Data" and the analytic approaches used for analysis. RESULTS These cutting-edge technologies can address the challenges faced by translational and clinical research, enhancing their capabilities in data management, analysis, and interpretation. By leveraging AI, biobanks can unlock valuable insights from their vast repositories, enabling the identification of novel biomarkers, prediction of treatment responses, and ultimately facilitating the development of personalized cancer therapies. CONCLUSIONS The integration of biobanking with AI has the potential not only to expand the current understanding of cancer biology but also to pave the way for more precise, patient-centric healthcare strategies.
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Affiliation(s)
- Chiara Frascarelli
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20139 Milan, Italy; (C.F.); (E.M.); (E.G.R.); (N.F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Giuseppina Bonizzi
- Biobank for Translational and Digital Medicine, IEO, European Institute of Oncology IRCCS, 20139 Milan, Italy; (G.B.); (C.R.M.); (C.C.)
| | - Camilla Rosella Musico
- Biobank for Translational and Digital Medicine, IEO, European Institute of Oncology IRCCS, 20139 Milan, Italy; (G.B.); (C.R.M.); (C.C.)
| | - Eltjona Mane
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20139 Milan, Italy; (C.F.); (E.M.); (E.G.R.); (N.F.)
| | - Cristina Cassi
- Biobank for Translational and Digital Medicine, IEO, European Institute of Oncology IRCCS, 20139 Milan, Italy; (G.B.); (C.R.M.); (C.C.)
| | - Elena Guerini Rocco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20139 Milan, Italy; (C.F.); (E.M.); (E.G.R.); (N.F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Annarosa Farina
- Central Information Systems and Technology Directorate, IEO, European Institute of Oncology IRCCS, 20139 Milan, Italy;
| | - Aldo Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy; (A.S.); (S.M.)
| | - Rita Lawlor
- ARC-Net Research Centre and Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Luca Reggiani Bonetti
- Section of Pathology, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, University Hospital of Modena, 41121 Modena, Italy; (L.R.B.); (S.C.)
| | - Stefania Caramaschi
- Section of Pathology, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, University Hospital of Modena, 41121 Modena, Italy; (L.R.B.); (S.C.)
| | - Albino Eccher
- Section of Pathology, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, University Hospital of Modena, 41121 Modena, Italy; (L.R.B.); (S.C.)
| | - Stefano Marletta
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy; (A.S.); (S.M.)
- Division of Pathology, Humanitas Cancer Center, 95045 Catania, Italy
| | - Nicola Fusco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20139 Milan, Italy; (C.F.); (E.M.); (E.G.R.); (N.F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
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Rigg J, Doyle O, McDonogh N, Leavitt N, Ali R, Son A, Kreter B. Finding undiagnosed patients with hepatitis C virus: an application of machine learning to US ambulatory electronic medical records. BMJ Health Care Inform 2023; 30:bmjhci-2022-100651. [PMID: 36639190 PMCID: PMC9843171 DOI: 10.1136/bmjhci-2022-100651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/04/2022] [Indexed: 01/15/2023] Open
Abstract
AIMS To develop and validate a machine learning (ML) algorithm to identify undiagnosed hepatitis C virus (HCV) patients, in order to facilitate prioritisation of patients for targeted HCV screening. METHODS This retrospective study used ambulatory electronic medical records (EMR) from January 2015 to February 2020. A Gradient Boosting Trees algorithm was trained using patient records to predict initial HCV diagnosis and was validated on a temporally independent held-out cross-section of the data. The fold improvement in precision (proportion of patients identified by the algorithm who are HCV positive) over universal screening was examined and compared with risk-based screening. RESULTS 21 508 positive (HCV diagnosed) and 28.2M unlabelled (lacking evidence of HCV diagnosis) patients met the inclusion criteria for the study. After down-sampling unlabelled patients to aid the algorithm's learning process, 16.2M unlabelled patients entered the analysis. Performance of the algorithm was compared with universal screening on the held-out cross-section, which had an incidence of HCV diagnoses of 0.02%. The algorithm achieved a 101.0 ×, 18.0 × and 5.1 × fold improvement in precision over universal screening at 5%, 20% and 50% levels of recall. When compared with risk-based screening, the algorithm required fewer patients to be screened and improved precision. CONCLUSIONS This study presents strong evidence towards the use of ML on EMR data for the prioritisation of patients for targeted HCV testing with potential to improve efficiency of resource utilisation, thereby reducing the workload for clinicians and saving healthcare costs. A prospective interventional study would allow for further validation before use in a clinical setting.
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Affiliation(s)
- John Rigg
- AI for Healthcare & MedTech, IQVIA Inc, London, UK
| | - Orla Doyle
- AI for Healthcare & MedTech, IQVIA Inc, London, UK
| | | | - Nadea Leavitt
- AI for Healthcare & MedTech, IQVIA, Plymouth Meeting, Pennsylvania, USA
| | - Rehan Ali
- AI for Healthcare & MedTech, IQVIA Inc, London, UK
| | - Annie Son
- Medical Affairs, Gilead Sciences Inc, Foster City, California, USA
| | - Bruce Kreter
- Medical Affairs, Gilead Sciences Inc, Foster City, California, USA
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Gagnon-Sanschagrin P, Schein J, Urganus A, Serra E, Liang Y, Musingarimi P, Cloutier M, Guérin A, Davis LL. Identifying individuals with undiagnosed post-traumatic stress disorder in a large United States civilian population - a machine learning approach. BMC Psychiatry 2022; 22:630. [PMID: 36171558 PMCID: PMC9519190 DOI: 10.1186/s12888-022-04267-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The proportion of patients with post-traumatic stress disorder (PTSD) that remain undiagnosed may be substantial. Without an accurate diagnosis, these patients may lack PTSD-targeted treatments and experience adverse health outcomes. This study used a machine learning approach to identify and describe civilian patients likely to have undiagnosed PTSD in the US commercial population. METHODS The IBM® MarketScan® Commercial Subset (10/01/2015-12/31/2018) was used. A random forest machine learning model was developed and trained to differentiate between patients with and without PTSD using non-trauma-based features. The model was applied to patients for whom PTSD status could not be confirmed to identify individuals likely and unlikely to have undiagnosed PTSD. Patient characteristics, symptoms and complications potentially related to PTSD, treatments received, healthcare costs, and healthcare resource utilization were described separately for patients with PTSD (Actual Positive PTSD cohort), patients likely to have PTSD (Likely PTSD cohort), and patients without PTSD (Without PTSD cohort). RESULTS A total of 44,342 patients were classified in the Actual Positive PTSD cohort, 5683 in the Likely PTSD cohort, and 2,074,471 in the Without PTSD cohort. While several symptoms/comorbidities were similar between the Actual Positive and Likely PTSD cohorts, others, including depression and anxiety disorders, suicidal thoughts/actions, and substance use, were more common in the Likely PTSD cohort, suggesting that certain symptoms may be exacerbated among those without a formal diagnosis. Mean per-patient-per-6-month healthcare costs were similar between the Actual Positive and Likely PTSD cohorts ($11,156 and $11,723) and were higher than those of the Without PTSD cohort ($3616); however, cost drivers differed between cohorts, with the Likely PTSD cohort experiencing more inpatient admissions and less outpatient visits than the Actual Positive PTSD cohort. CONCLUSIONS These findings suggest that the lack of a PTSD diagnosis and targeted management of PTSD may result in a greater burden among undiagnosed patients and highlights the need for increased awareness of PTSD in clinical practice and among the civilian population.
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Affiliation(s)
- Patrick Gagnon-Sanschagrin
- Analysis Group, Inc., 1190 avenue des Canadiens-de-Montréal, 1190 avenue des Canadiens-de-Montréal, Tour Deloitte, Suite 1500, Montréal, QC, H3B 0G7, Canada.
| | - Jeff Schein
- grid.419943.20000 0004 0459 5953Otsuka Pharmaceutical Development & Commercialization, Inc., 508 Carnegie Center, Princeton, NJ 08540 USA
| | - Annette Urganus
- grid.419796.4Lundbeck LLC, 6 Parkway North, Deerfield, IL 60015 USA
| | - Elizabeth Serra
- Analysis Group, Inc., 1190 avenue des Canadiens-de-Montréal, 1190 avenue des Canadiens-de-Montréal, Tour Deloitte, Suite 1500, Montréal, QC H3B 0G7 Canada
| | - Yawen Liang
- Analysis Group, Inc., 1190 avenue des Canadiens-de-Montréal, 1190 avenue des Canadiens-de-Montréal, Tour Deloitte, Suite 1500, Montréal, QC H3B 0G7 Canada
| | - Primrose Musingarimi
- grid.424580.f0000 0004 0476 7612H. Lundbeck A/S, Ottiliavej 9, Valby, Copenhagen, Denmark
| | - Martin Cloutier
- Analysis Group, Inc., 1190 avenue des Canadiens-de-Montréal, 1190 avenue des Canadiens-de-Montréal, Tour Deloitte, Suite 1500, Montréal, QC H3B 0G7 Canada
| | - Annie Guérin
- Analysis Group, Inc., 1190 avenue des Canadiens-de-Montréal, 1190 avenue des Canadiens-de-Montréal, Tour Deloitte, Suite 1500, Montréal, QC H3B 0G7 Canada
| | - Lori L. Davis
- grid.416817.d0000 0001 0240 3901Research Service, Tuscaloosa Veterans Affairs Medical Center, 3701 Loop Rd East, Tuscaloosa, AL 35404 USA ,grid.265892.20000000106344187Department of Psychiatry and Behavioral Neurobiology, University of Alabama Heersink School of Medicine, 1720 7th Avenue South, Birmingham, AL 35233 USA
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Cheheltani R, King N, Lee S, North B, Kovarik D, Evans-Molina C, Leavitt N, Dutta S. Predicting misdiagnosed adult-onset type 1 diabetes using machine learning. Diabetes Res Clin Pract 2022; 191:110029. [PMID: 35940302 PMCID: PMC10631495 DOI: 10.1016/j.diabres.2022.110029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 11/27/2022]
Abstract
AIMS It is now understood that almost half of newly diagnosed cases of type 1 diabetes are adult-onset. However, type 1 and type 2 diabetes are difficult to initially distinguish clinically in adults, potentially leading to ineffective care. In this study a machine learning model was developed to identify type 1 diabetes patients misdiagnosed as type 2 diabetes. METHODS In this retrospective study, a machine learning model was developed to identify misdiagnosed type 1 diabetes patients from a population of patients with a prior type 2 diabetes diagnosis. Using Ambulatory Electronic Medical Records (AEMR), features capturing relevant information on age, demographics, risk factors, symptoms, treatments, procedures, vitals, or lab results were extracted from patients' medical history. RESULTS The model identified age, BMI/weight, therapy history, and HbA1c/blood glucose values among top predictors of misdiagnosis. Model precision at low levels of recall (10 %) was 17 %, compared to <1 % incidence rate of misdiagnosis at the time of the first type 2 diabetes encounter in AEMR. CONCLUSIONS This algorithm shows potential for being translated into screening guidelines or a clinical decision support tool embedded directly in an EMR system to reduce misdiagnosis of adult-onset type 1 diabetes and implement effective care at the outset.
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Affiliation(s)
- Rabee Cheheltani
- Predictive Analytics, Real World Solutions, IQVIA, Wayne, PA, USA
| | - Nicholas King
- Predictive Analytics, Real World Solutions, IQVIA, Wayne, PA, USA
| | - Suyin Lee
- Predictive Analytics, Real World Solutions, IQVIA, Wayne, PA, USA
| | - Benjamin North
- Predictive Analytics, Real World Solutions, IQVIA, Wayne, PA, USA
| | | | - Carmella Evans-Molina
- Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nadejda Leavitt
- Predictive Analytics, Real World Solutions, IQVIA, Wayne, PA, USA
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Gunasekharan A, Jiang J, Nickerson A, Jalil S, Mumtaz K. Application of artificial intelligence in non-alcoholic fatty liver disease and viral hepatitis. Artif Intell Gastroenterol 2022; 3:46-53. [DOI: 10.35712/aig.v3.i2.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/18/2022] [Accepted: 04/28/2022] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) and chronic viral hepatitis are among the most significant causes of liver-related mortality worldwide. It is critical to develop reliable methods of predicting progression to fibrosis, cirrhosis, and decompensated liver disease. Current screening methods such as biopsy and transient elastography are limited by invasiveness and observer variation in analysis of data. Artificial intelligence (AI) provides a unique opportunity to more accurately diagnose NAFLD and viral hepatitis, and to identify patients at high risk for disease progression. We conducted a literature review of existing evidence for AI in NAFLD and viral hepatitis. Thirteen articles on AI in NAFLD and 14 on viral hepatitis were included in our analysis. We found that machine learning algorithms were comparable in accuracy to current methods for diagnosis and fibrosis prediction (MELD-Na score, liver biopsy, FIB-4 score, and biomarkers). They also reliably predicted hepatitis C treatment failure and hepatic encephalopathy, for which there are currently no established prediction tools. These studies show that AI could be a helpful adjunct to existing techniques for diagnosing, monitoring, and treating both NAFLD and viral hepatitis.
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Affiliation(s)
| | - Joanna Jiang
- Department of Medicine, Ohio State University, Columbus, OH 43210, United States
| | - Ashley Nickerson
- Department of Medicine, Ohio State University, Columbus, OH 43210, United States
| | - Sajid Jalil
- Department of Medicine, Ohio State University, Columbus, OH 43210, United States
| | - Khalid Mumtaz
- Department of Medicine, Ohio State University, Columbus, OH 43210, United States
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10
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Tanaka J, Kurisu A, Ohara M, Ouoba S, Ohisa M, Sugiyama A, Wang ML, Hiebert L, Kanto T, Akita T. Burden of chronic hepatitis B and C infections in 2015 and future trends in Japan: A simulation study. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2022; 22:100428. [PMID: 35637862 PMCID: PMC9142742 DOI: 10.1016/j.lanwpc.2022.100428] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Determining the number of chronic hepatitis B (HBV) and C virus (HCV) infections is essential to assess the progress towards the World Health Organization 2030 viral hepatitis elimination goals. Using data from the Japanese National Database (NDB), we calculated the number of chronic HBV and HCV infections in 2015 and predicted the trend until 2035. Methods NDB and first-time blood donors data were used to calculate the number of chronic HBV and HCV infections in 2015. A Markov simulation was applied to predict chronic infections until 2035 using transition probabilities calculated from NDB data. Findings The total number of chronic HBV and HCV infections in 2015 in Japan was 1,905,187–2,490,873 (HCV:877,841–1,302,179, HBV:1,027,346–1,188,694), of which 923,661–1,509,347 were undiagnosed or diagnosed but not linked to care (“not engaged in care”), and 981,526 were engaged in care. Chronic HBV and HCV infections are expected to be 923,313–1,304,598 in 2030, and 739,118–1,045,884 in 2035. Compared to 2015, by 2035, the number of persons with HCV not engaged in care will decline by 59·8 – 76·1% and 86·5% for patients in care. For HBV, a 47·3 – 49·3% decrease is expected for persons not engaged in care and a decline of 26·0% for patients engaged in care. Interpretation Although the burden of HBV and HCV is expected to decrease by 2035, challenges in controlling hepatitis remain. Improved and innovative screening strategies with linkage to care for HCV cases, and a functional cure for HBV are needed. Funding Japan Ministry of Health, Labour and Welfare.
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Affiliation(s)
- Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
- Corresponding authors at: Department of Epidemiology, Infectious Disease Control and Prevention, Graduate school of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-shi 734-8551, Japan.
| | - Akemi Kurisu
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
| | - Masatsugu Ohara
- Department of Gastroenterology and Hepatology, National Hospital Organization Hokkaido Medical Center, Hokkaido, Japan
- Department of Gastroenterology and Hepatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Serge Ouoba
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Unité de Recherche Clinique de Nanoro (URCN), Institut de Recherche en Science de la Santé (IRSS), Nanoro, Burkina Faso
| | - Masayuki Ohisa
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
| | - Aya Sugiyama
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
| | - Michelle L. Wang
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, USA
| | - Lindsey Hiebert
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Decatur, GA, USA
| | - Tatsuya Kanto
- The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan
- Corresponding authors at: Department of Epidemiology, Infectious Disease Control and Prevention, Graduate school of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-shi 734-8551, Japan.
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11
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Yasar O, Long P, Harder B, Marshall H, Bhasin S, Lee S, Delegge M, Roy S, Doyle O, Leavitt N, Rigg J. Machine learning using longitudinal prescription and medical claims for the detection of non-alcoholic steatohepatitis (NASH). BMJ Health Care Inform 2022; 29:bmjhci-2021-100510. [PMID: 35354641 PMCID: PMC8968511 DOI: 10.1136/bmjhci-2021-100510] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/13/2022] [Indexed: 12/26/2022] Open
Abstract
Objectives To develop and evaluate machine learning models to detect patients with suspected undiagnosed non-alcoholic steatohepatitis (NASH) for diagnostic screening and clinical management. Methods In this retrospective observational non-interventional study using administrative medical claims data from 1 463 089 patients, gradient-boosted decision trees were trained to detect patients with likely NASH from an at-risk patient population with a history of obesity, type 2 diabetes mellitus, metabolic disorder or non-alcoholic fatty liver (NAFL). Models were trained to detect likely NASH in all at-risk patients or in the subset without a prior NAFL diagnosis (at-risk non-NAFL patients). Models were trained and validated using retrospective medical claims data and assessed using area under precision recall curves and receiver operating characteristic curves (AUPRCs and AUROCs). Results The 6-month incidences of NASH in claims data were 1 per 1437 at-risk patients and 1 per 2127 at-risk non-NAFL patients. The model trained to detect NASH in all at-risk patients had an AUPRC of 0.0107 (95% CI 0.0104 to 0.0110) and an AUROC of 0.84. At 10% recall, model precision was 4.3%, which is 60× above NASH incidence. The model trained to detect NASH in the non-NAFL cohort had an AUPRC of 0.0030 (95% CI 0.0029 to 0.0031) and an AUROC of 0.78. At 10% recall, model precision was 1%, which is 20× above NASH incidence. Conclusion The low incidence of NASH in medical claims data corroborates the pattern of NASH underdiagnosis in clinical practice. Claims-based machine learning could facilitate the detection of patients with probable NASH for diagnostic testing and disease management.
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Affiliation(s)
| | - Patrick Long
- Real World Solutions, IQVIA, Plymouth Meeting, Pennsylvania, USA
| | - Brett Harder
- Real World Solutions, IQVIA, Plymouth Meeting, Pennsylvania, USA
| | - Hanna Marshall
- Real World Solutions, IQVIA, Plymouth Meeting, Pennsylvania, USA
| | - Sanjay Bhasin
- Real World Solutions, IQVIA, Plymouth Meeting, Pennsylvania, USA
| | - Suyin Lee
- Real World Solutions, IQVIA, Plymouth Meeting, Pennsylvania, USA
| | - Mark Delegge
- Therapeutic Center of Excellence, IQVIA, Durham, North Carolina, USA
| | - Stephanie Roy
- Real World Solutions, IQVIA, Plymouth Meeting, Pennsylvania, USA
| | | | - Nadea Leavitt
- Real World Solutions, IQVIA, Plymouth Meeting, Pennsylvania, USA
| | - John Rigg
- Real World Solutions, IQVIA, London, UK
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12
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Wilton J, Wong S, Purssell R, Abdia Y, Chong M, Karim ME, MacInnes A, Bartlett SR, Balshaw RF, Gomes T, Yu A, Alvarez M, Dart RC, Krajden M, Buxton JA, Janjua NZ. Association Between Prescription Opioid Therapy for Noncancer Pain and Hepatitis C Virus Seroconversion. JAMA Netw Open 2022; 5:e2143050. [PMID: 35019983 PMCID: PMC8756332 DOI: 10.1001/jamanetworkopen.2021.43050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Initiation of injection drug use may be more frequent among people dispensed prescription opioid therapy for noncancer pain, potentially increasing the risk of hepatitis C virus (HCV) acquisition. OBJECTIVE To assess the association between medically dispensed long-term prescription opioid therapy for noncancer pain and HCV seroconversion among individuals who were initially injection drug use-naive. DESIGN, SETTING, AND PARTICIPANTS A population-based, retrospective cohort study of individuals tested for HCV in British Columbia, Canada, with linkage to outpatient pharmacy dispensations, was conducted. Individuals with an initial HCV-negative test result followed by 1 additional test between January 1, 2000, and December 31, 2017, and who had no history of substance use at baseline (first HCV-negative test), were included. Participants were followed up from baseline to the last HCV-negative test or estimated date of seroconversion (midpoint between HCV-positive and the preceding HCV-negative test). EXPOSURES Episodes of prescription opioid use for noncancer pain were defined as acute (<90 days) or long-term (≥90 days). Prescription opioid exposure status (long-term vs prescription opioid-naive/acute) was treated as time-varying in survival analyses. In secondary analyses, long-term exposure was stratified by intensity of use (chronic vs. episodic) and by average daily dose in morphine equivalents (MEQ). MAIN OUTCOMES AND MEASURES Multivariable Cox regression models were used to assess the association between time-varying prescription opioid status and HCV seroconversion. RESULTS A total of 382 478 individuals who had more than 1 HCV test were included, of whom more than half were female (224 373 [58.7%]), born before 1974 (201 944 [52.8%]), and younger than 35 years at baseline (196 298 [53.9%]). Participants were followed up for 2 057 668 person-years and 1947 HCV seroconversions occurred. Of the participants, 41 755 people (10.9%) were exposed to long-term prescription opioid therapy at baseline or during follow-up. The HCV seroconversion rate per 1000 person-years was 0.8 among the individuals who were prescription opioid-naive/acute (1489 of 1947 [76.5%] seroconversions; 0.4% seroconverted within 5 years) and 2.1 with long-term prescription opioid therapy (458 of 1947 [23.5%] seroconversions; 1.1% seroconverted within 5 years). In multivariable analysis, exposure to long-term prescription opioid therapy was associated with a 3.2-fold (95% CI, 2.9-3.6) higher risk of HCV seroconversion (vs prescription opioid-naive/acute). In separate Cox models, long-term chronic use was associated with a 4.7-fold higher risk of HCV seroconversion (vs naive/acute use 95% CI, 3.9-5.8), and long-term higher-dose use (≥90 MEQ) was associated with a 5.1-fold higher risk (vs naive/acute use 95% CI, 3.7-7.1). CONCLUSIONS AND RELEVANCE In this cohort study of people with more than 1 HCV test, long-term prescription opioid therapy for noncancer pain was associated with a higher risk of HCV seroconversion among individuals who were injection drug use-naive at baseline or at prescription opioid initiation. These results suggest injection drug use initiation risk is higher among people dispensed long-term therapy and may be useful for informing approaches to identify and prevent HCV infection. These findings should not be used to justify abrupt discontinuation of long-term therapy, which could increase risk of harms.
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Affiliation(s)
- James Wilton
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Stanley Wong
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Roy Purssell
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Younathan Abdia
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mei Chong
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Mohammad Ehsanul Karim
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation & Outcome Sciences, St Paul's Hospital Vancouver, British Columbia, Canada
| | - Aaron MacInnes
- Pain Management Clinic, Jim Pattison Outpatient Care & Surgical Centre, Fraser Health Authority, Surrey, British Columbia, Canada
- Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sofia R. Bartlett
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Rob F. Balshaw
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tara Gomes
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Amanda Yu
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Maria Alvarez
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Richard C. Dart
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, Colorado
- Department of Emergency Medicine, University of Colorado Health Sciences Center, Denver
| | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jane A. Buxton
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Naveed Z. Janjua
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation & Outcome Sciences, St Paul's Hospital Vancouver, British Columbia, Canada
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13
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Liu W, Liu X, Peng M, Chen GQ, Liu PH, Cui XW, Jiang F, Dietrich CF. Artificial intelligence for hepatitis evaluation. World J Gastroenterol 2021; 27:5715-5726. [PMID: 34629796 PMCID: PMC8473592 DOI: 10.3748/wjg.v27.i34.5715] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/28/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
Recently, increasing attention has been paid to the application of artificial intelligence (AI) to the diagnosis of diverse hepatic diseases, which comprises traditional machine learning and deep learning. Recent studies have shown the possible value of AI based data mining in predicting the incidence of hepatitis, classifying the different stages of hepatitis, diagnosing or screening for hepatitis, forecasting the progression of hepatitis, and predicting response to antiviral drugs in chronic hepatitis C patients. More importantly, AI based on radiology has been proven to be useful in predicting hepatitis and liver fibrosis as well as grading hepatocellular carcinoma (HCC) and differentiating it from benign liver tumors. It can predict the risk of vascular invasion of HCC, the risk of hepatic encephalopathy secondary to hepatitis B related cirrhosis, and the risk of liver failure after hepatectomy in HCC patients. In this review, we summarize the application of AI in hepatitis, and identify the challenges and future perspectives.
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Affiliation(s)
- Wei Liu
- Department of Medical Ultrasound, The Second Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Xue Liu
- Department of Medical Ultrasound, The Second Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Mei Peng
- Department of Medical Ultrasound, The Second Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Gong-Quan Chen
- Department of Medical Ultrasound, Minda Hospital of Hubei Minzu University, Enshi 445000, Hubei Province, China
| | - Peng-Hua Liu
- Department of Medical Ultrasound, The First Affiliated Hospital of Shaoyang University, Shaoyang 422000, Hunan Province, China
| | - Xin-Wu Cui
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Fan Jiang
- Department of Medical Ultrasound, The Second Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern 3626, Switzerland
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14
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Secinaro S, Calandra D, Secinaro A, Muthurangu V, Biancone P. The role of artificial intelligence in healthcare: a structured literature review. BMC Med Inform Decis Mak 2021; 21:125. [PMID: 33836752 PMCID: PMC8035061 DOI: 10.1186/s12911-021-01488-9] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/INTRODUCTION Artificial intelligence (AI) in the healthcare sector is receiving attention from researchers and health professionals. Few previous studies have investigated this topic from a multi-disciplinary perspective, including accounting, business and management, decision sciences and health professions. METHODS The structured literature review with its reliable and replicable research protocol allowed the researchers to extract 288 peer-reviewed papers from Scopus. The authors used qualitative and quantitative variables to analyse authors, journals, keywords, and collaboration networks among researchers. Additionally, the paper benefited from the Bibliometrix R software package. RESULTS The investigation showed that the literature in this field is emerging. It focuses on health services management, predictive medicine, patient data and diagnostics, and clinical decision-making. The United States, China, and the United Kingdom contributed the highest number of studies. Keyword analysis revealed that AI can support physicians in making a diagnosis, predicting the spread of diseases and customising treatment paths. CONCLUSIONS The literature reveals several AI applications for health services and a stream of research that has not fully been covered. For instance, AI projects require skills and data quality awareness for data-intensive analysis and knowledge-based management. Insights can help researchers and health professionals understand and address future research on AI in the healthcare field.
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Affiliation(s)
| | - Davide Calandra
- Department of Management, University of Turin, Turin, Italy.
| | | | - Vivek Muthurangu
- Institute of Child Health, University College London, London, UK
| | - Paolo Biancone
- Department of Management, University of Turin, Turin, Italy
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