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Harris AHS, Shotqara A, Meerwijk EL, Tamang SR, Eddington H, Logan D, Massarweh NN. Automated Versus Semi-automated Lab Value Extraction for the VA Cardiac Surgical Quality Improvement Program. J Surg Res 2024; 302:47-52. [PMID: 39083905 DOI: 10.1016/j.jss.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/03/2024] [Accepted: 07/03/2024] [Indexed: 08/02/2024]
Abstract
INTRODUCTION The Veterans Affairs Surgical Quality Improvement Program (VASQIP) trains surgical quality nurses (SQNs) at each Veterans Affairs (VA) hospital to extract or verify 187 variables from the medical record for all cardiac surgical cases. For ten preoperative laboratory values, VASQIP has a semiautomated (SA) system in which local lab values are automatically extracted, verified by SQNs, and lab values recorded at other VA facilities are manually extracted. The objective of this study was to develop and validate a method to automate the extraction of these ten preoperative laboratory values and compare results with the current SA method. MATERIALS AND METHODS We developed methods to extract ten preoperative laboratory values and measurement dates from the VA Corporate Data Warehouse using Logical Observation Identifiers Names and Codes. Automated (A) versus SA information extraction was compared in terms of agreement, conformance to data definitions, proximity to surgery, and missingness. RESULTS For surgeries with both A and SA lab values, the intraclass correlation coefficients for the ten variables ranged from 0.90 to 0.98. For several variables, the A method resulted in much lower rates of missing data (e.g., 2.4% versus 22.5% missing data for high-density lipoprotein) and eliminated out-of-date-range entries. CONCLUSIONS Although SQN-extracted data are widely considered the gold standard within National Surgical Quality Improvement Programs, there may be advantages to fully automating extraction of lab values, including high congruence with SA SQN-extracted or verified values and lower rates of missingness and out-of-date-range data.
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Affiliation(s)
- Alex H S Harris
- Veterans Affairs Health Services Research, Development Center for Innovation to Implementation, Palo Alto Veterans Affairs Health Care System, Palo Alto, California; Department of Surgery, Stanford University, Palo Alto, California.
| | - Asqar Shotqara
- Veterans Affairs Health Services Research, Development Center for Innovation to Implementation, Palo Alto Veterans Affairs Health Care System, Palo Alto, California
| | - Esther L Meerwijk
- Veterans Affairs Health Services Research, Development Center for Innovation to Implementation, Palo Alto Veterans Affairs Health Care System, Palo Alto, California
| | - Suzanne R Tamang
- Veterans Affairs Health Services Research, Development Center for Innovation to Implementation, Palo Alto Veterans Affairs Health Care System, Palo Alto, California; Department of Surgery, Stanford University, Palo Alto, California
| | - Hyrum Eddington
- Department of Surgery, Stanford University, Palo Alto, California
| | - Daniel Logan
- Department of Surgery, Stanford University, Palo Alto, California
| | - Nader N Massarweh
- Atlanta VA Health Care System, Surgical and Perioperative Care, Decatur, Georgia; Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia; Department of Surgery, Morehouse School of Medicine, Atlanta, Georgia
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Park C, Tavakoli-Tabasi S, Sharafkhaneh A, Seligman BJ, Hicken B, Amos CI, Chou A, Razjouyan J. Inflammatory Biomarkers Differ among Hospitalized Veterans Infected with Alpha, Delta, and Omicron SARS-CoV-2 Variants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2987. [PMID: 36833680 PMCID: PMC9959816 DOI: 10.3390/ijerph20042987] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 05/14/2023]
Abstract
Mortality due to COVID-19 has been correlated with laboratory markers of inflammation, such as C-reactive protein (CRP). The lower mortality during Omicron variant infections could be explained by variant-specific immune responses or host factors, such as vaccination status. We hypothesized that infections due to Omicron variant cause less inflammation compared to Alpha and Delta, correlating with lower mortality. This was a retrospective cohort study of veterans hospitalized for COVID-19 at the Veterans Health Administration. We compared inflammatory markers among patients hospitalized during Omicron infection with those of Alpha and Delta. We reported the adjusted odds ratio (aOR) of the first laboratory results during hospitalization and in-hospital mortality, stratified by vaccination status. Of 2,075,564 Veterans tested for COVID-19, 29,075 Veterans met the criteria: Alpha (45.1%), Delta (23.9%), Omicron (31.0%). Odds of abnormal CRP in Delta (aOR = 1.85, 95% CI:1.64-2.09) and Alpha (aOR = 1.94, 95% CI:1.75-2.15) were significantly higher compared to Omicron. The same trend was observed for Ferritin, Alanine aminotransferase, Aspartate aminotransferase, Lactate dehydrogenase, and Albumin. The mortality in Delta (aOR = 1.92, 95% CI:1.73-2.12) and Alpha (aOR = 1.68, 95% CI:1.47-1.91) were higher than Omicron. The results remained significant after stratifying the outcomes based on vaccination status. Veterans infected with Omicron showed milder inflammatory responses and lower mortality than other variants.
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Affiliation(s)
- Catherine Park
- VA’s Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Big Data Scientist Training Enhancement Program, VA Office of Research and Development, Washington, DC 20420, USA
- VA Quality Scholars Coordinating Center, IQuESt, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| | | | - Amir Sharafkhaneh
- VA’s Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Benjamin J. Seligman
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Bret Hicken
- VHA Office of Rural Health, Veterans Rural Health Resource Center, Salt Lake City, UT 84148, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | | | - Andrew Chou
- VA’s Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Javad Razjouyan
- VA’s Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Big Data Scientist Training Enhancement Program, VA Office of Research and Development, Washington, DC 20420, USA
- VA Quality Scholars Coordinating Center, IQuESt, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
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Elevated Risk of Chronic Respiratory Conditions within 60 Days of COVID-19 Hospitalization in Veterans. Healthcare (Basel) 2022; 10:healthcare10020300. [PMID: 35206914 PMCID: PMC8872176 DOI: 10.3390/healthcare10020300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 11/25/2022] Open
Abstract
SARS-CoV-2 infection prominently affects the respiratory system, and patients hospitalized with COVID-19 are at an increased risk of developing respiratory conditions. We examined the risk of new respiratory conditions of COVID-19 among hospitalized patients in the national Veterans Health Administration between 15 February 2020 and 16 June 2021. The study cohort included all COVID-19-tested, hospitalized individuals who survived the index admission and did not have any previously diagnosed chronic respiratory conditions (asthma, bronchitis, chronic lung disease, chronic obstructive pulmonary disease (COPD), emphysema, or venous thromboembolism) before SARS-CoV-2 testing. Of 373,048 patients hospitalized after SARS-CoV-2 testing, 18,686 positive and 37,372 negative patients met the inclusion/exclusion criteria and were matched by age, sex, and race using propensity score matching. The results showed that the SARS-CoV-2 positive group had a greater risk of developing asthma (adjusted odds ratio (aOR) = 1.37), bronchitis (aOR = 2.81), chronic lung disease (aOR = 2.14), COPD (aOR = 1.56), emphysema (aOR = 1.52), and venous thromboembolism (aOR = 1.92) within 60 days after the index COVID date of testing. These findings could inform that the clinical care team considers a risk of new respiratory conditions and address these conditions in the post-hospitalization management of the patient, which could potentially lead to reduce the risk of complications and optimize recovery.
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Hauser RG, Esserman D, Beste LA, Ong SY, Colomb DG, Bhargava A, Wadia R, Rose MG. A Machine Learning Model to Successfully Predict Future Diagnosis of Chronic Myelogenous Leukemia With Retrospective Electronic Health Records Data. Am J Clin Pathol 2021; 156:1142-1148. [PMID: 34184028 DOI: 10.1093/ajcp/aqab086] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Chronic myelogenous leukemia (CML) is a clonal stem cell disorder accounting for 15% of adult leukemias. We aimed to determine if machine learning models could predict CML using blood cell counts prior to diagnosis. METHODS We identified patients with a diagnostic test for CML (BCR-ABL1) and at least 6 consecutive prior years of differential blood cell counts between 1999 and 2020 in the largest integrated health care system in the United States. Blood cell counts from different time periods prior to CML diagnostic testing were used to train, validate, and test machine learning models. RESULTS The sample included 1,623 patients with BCR-ABL1 positivity rate 6.2%. The predictive ability of machine learning models improved when trained with blood cell counts closer to time of diagnosis: 2 to 5 years area under the curve (AUC), 0.59 to 0.67, 0.5 to 1 years AUC, 0.75 to 0.80, at diagnosis AUC, 0.87 to 0.92. CONCLUSIONS Blood cell counts collected up to 5 years prior to diagnostic workup of CML successfully predicted the BCR-ABL1 test result. These findings suggest a machine learning model trained with blood cell counts could lead to diagnosis of CML earlier in the disease course compared to usual medical care.
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Affiliation(s)
- Ronald G Hauser
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Denise Esserman
- Yale School of Public Health, Department of Biostatistics, New Haven, CT, USA
| | - Lauren A Beste
- Veterans Affairs Puget Sound Healthcare System, Seattle, WA, USA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Shawn Y Ong
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Denis G Colomb
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Department of Medical Informatics, Yale School of Medicine, New Haven, CT, USA
| | - Ankur Bhargava
- Department of Preventive Medicine, University of Kentucky, Lexington, KY, USA
| | - Roxanne Wadia
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Michal G Rose
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Department of Cancer Center, Yale School of Medicine, New Haven, CT, USA
- Department of Section of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
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Razjouyan J, Helmer DA, Lynch KE, Hanania NA, Klotman PE, Sharafkhaneh A, Amos CI. Smoking Status and Factors associated with COVID-19 In-hospital Mortality among U.S. Veterans. Nicotine Tob Res 2021; 24:785-793. [PMID: 34693967 PMCID: PMC8586728 DOI: 10.1093/ntr/ntab223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 10/20/2021] [Indexed: 11/17/2022]
Abstract
Introduction The role of smoking in risk of death among patients with COVID-19 remains unclear. We examined the association between in-hospital mortality from COVID-19 and smoking status and other factors in the United States Veterans Health Administration (VHA). Methods This is an observational, retrospective cohort study using the VHA COVID-19 shared data resources for February 1 to September 11, 2020. Veterans admitted to the hospital who tested positive for SARS-CoV-2 and hospitalized by VHA were grouped into Never (as reference, NS), Former (FS), and Current smokers (CS). The main outcome was in-hospital mortality. Control factors were the most important variables (among all available) determined through a cascade of machine learning. We reported adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) from logistic regression models, imputing missing smoking status in our primary analysis. Results Out of 8 667 996 VHA enrollees, 505 143 were tested for SARS-CoV-2 (NS = 191 143; FS = 240 336; CS = 117 706; Unknown = 45 533). The aOR of in-hospital mortality was 1.16 (95%CI 1.01, 1.32) for FS vs. NS and 0.97 (95%CI 0.78, 1.22; p > .05) for CS vs. NS with imputed smoking status. Among other factors, famotidine and nonsteroidal anti-inflammatory drugs (NSAID) use before hospitalization were associated with lower risk while diabetes with complications, kidney disease, obesity, and advanced age were associated with higher risk of in-hospital mortality. Conclusions In patients admitted to the hospital with SARS-CoV-2 infection, our data demonstrate that FS are at higher risk of in-hospital mortality than NS. However, this pattern was not seen among CS highlighting the need for more granular analysis with high-quality smoking status data to further clarify our understanding of smoking risk and COVID-19-related mortality. Presence of comorbidities and advanced age were also associated with increased risk of in-hospital mortality. Implications Veterans who were former smokers were at higher risk of in-hospital mortality compared to never smokers. Current smokers and never smokers were at similar risk of in-hospital mortality. The use of famotidine and nonsteroidal anti-inflammatory drugs (NSAIDs) before hospitalization were associated with lower risk while uncontrolled diabetes mellitus, advanced age, kidney disease, and obesity were associated with higher risk of in-hospital mortality.
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Affiliation(s)
- Javad Razjouyan
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- VA Quality Scholars Coordinating Center, IQuESt, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Big Data Scientist Training Enhancement Program (BD-STEP), VA Office of Research and Development, Washington, DC, USA
- Corresponding Author: Javad Razjouyan, Ph.D., Baylor College of Medicine, Implementation Science & Innovation Core, Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, 2450 Holcombe Blvd Suite 01Y, Houston, TX 77021, USA. Telephone: (713)798-7928; Fax: (713)798-3658; E-mail: ;
| | - Drew A Helmer
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Kristine E Lynch
- VA Salt Lake City Health Care System and Division of Epidemiology, University of Utah, Salt Lake City, UT, USA
| | - Nicola A Hanania
- VA Salt Lake City Health Care System and Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Paul E Klotman
- Integrative Molecular and Biomedical Sciences Program, Baylor College of Medicine, Houston, TX,USA
- Margaret M. and Albert B. Alkek Department of Medicine, Nephrology, Baylor College of Medicine, Houston, TX,USA
| | - Amir Sharafkhaneh
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Medical Care Line, Section of Pulmonary, Critical Care and Sleep Medicine, Michael E. DeBakey VA Medical Center, Houston, TX,USA
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Baxter SL, Lee AY. Gaps in standards for integrating artificial intelligence technologies into ophthalmic practice. Curr Opin Ophthalmol 2021; 32:431-438. [PMID: 34231531 PMCID: PMC8373825 DOI: 10.1097/icu.0000000000000781] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an overview of healthcare standards and their relevance to multiple ophthalmic workflows, with a specific emphasis on describing gaps in standards development needed for improved integration of artificial intelligence technologies into ophthalmic practice. RECENT FINDINGS Healthcare standards are an essential component of data exchange and critical for clinical practice, research, and public health surveillance activities. Standards enable interoperability between clinical information systems, healthcare information exchange between institutions, and clinical decision support in a complex health information technology ecosystem. There are several gaps in standards in ophthalmology, including relatively low adoption of imaging standards, lack of use cases for integrating apps providing artificial intelligence -based decision support, lack of common data models to harmonize big data repositories, and no standards regarding interfaces and algorithmic outputs. SUMMARY These gaps in standards represent opportunities for future work to develop improved data flow between various elements of the digital health ecosystem. This will enable more widespread adoption and integration of artificial intelligence-based tools into clinical practice. Engagement and support from the ophthalmology community for standards development will be important for advancing this work.
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Affiliation(s)
- Sally L. Baxter
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA
| | - Aaron Y. Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
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Differences in COVID-19-Related Testing and Healthcare Utilization by Race and Ethnicity in the Veterans Health Administration. J Racial Ethn Health Disparities 2021; 9:519-526. [PMID: 33694124 PMCID: PMC7945621 DOI: 10.1007/s40615-021-00982-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 11/21/2022]
Abstract
Importance Recent reports indicate differences in COVID-19-related care and outcomes between Black and White Americans. Objective We examine the COVID-19-related healthcare utilization and mortality by race and ethnicity of patients tested for SARS-CoV-2 in the Veterans Health Administration (VHA). Design A retrospective cohort study. Setting We used the VHA COVID-19 shared data resources between February 1 and June 30, 2020. Participants Veterans tested for SARS-CoV-2 virus by VHA. Exposure(s) Three racial-ethnicity groups of Black, Hispanic, and White (as reference) veterans. Main Outcome(s) and Measure(s) Main outcomes are testing rate, positivity rate, hospitalization rate, ICU admission rate, and in-hospital mortality. Controlling for sex, age, and Elixhauser comorbidity index, we report adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) from logistic regression models. Results Of the 8,667,996 active veteran enrollees, 252,702 were tested by VHA from February to June, 2020, with 20,500 positive results and 4,790 hospitalizations. The testing rate was 4.4% among Black and 4.7% among Hispanic veterans compared to White veterans, 2.8%. The testing positivity rate was similarly elevated among Black (12.2%) and Hispanic (11.6%) veterans compared to White veterans (6.0%). The aORs of hospitalization in Black veterans (1.88; 95% CI 1.74, 2.03) and Hispanic veterans (1.41; 95% CI 1.25, 1.60) were higher compared to White veterans. No significant differences by race and ethnicity were observed in OR or aOR of ICU admission and in-hospital death among hospitalized patients. Conclusions and Relevance On a national level, the VHA was more likely to test and hospitalize Black and Hispanic veterans compared to White veterans, but there were no significant differences in ICU admission or in-hospital mortality among those hospitalized. This pattern of differences may relate to social determinants of health, factors affecting access to non-VHA care, or preferences for VHA care affecting initial care seeking, but not in-hospital outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-00982-0.
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Use of LOINC for interoperability between organisations poses a risk to safety. LANCET DIGITAL HEALTH 2020; 2:e569. [PMID: 33328084 DOI: 10.1016/s2589-7500(20)30244-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/08/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022]
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Humphreys BL, Del Fiol G, Xu H. The UMLS knowledge sources at 30: indispensable to current research and applications in biomedical informatics. J Am Med Inform Assoc 2020; 27:1499-1501. [PMID: 33059366 DOI: 10.1093/jamia/ocaa208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Indexed: 01/22/2023] Open
Affiliation(s)
| | - Guilherme Del Fiol
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
| | - Hua Xu
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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Gatta R, Vallati M, Fernandez-Llatas C, Martinez-Millana A, Orini S, Sacchi L, Lenkowicz J, Marcos M, Munoz-Gama J, Cuendet MA, de Bari B, Marco-Ruiz L, Stefanini A, Valero-Ramon Z, Michielin O, Lapinskas T, Montvila A, Martin N, Tavazzi E, Castellano M. What Role Can Process Mining Play in Recurrent Clinical Guidelines Issues? A Position Paper. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6616. [PMID: 32932877 PMCID: PMC7557817 DOI: 10.3390/ijerph17186616] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 01/28/2023]
Abstract
In the age of Evidence-Based Medicine, Clinical Guidelines (CGs) are recognized to be an indispensable tool to support physicians in their daily clinical practice. Medical Informatics is expected to play a relevant role in facilitating diffusion and adoption of CGs. However, the past pioneering approaches, often fragmented in many disciplines, did not lead to solutions that are actually exploited in hospitals. Process Mining for Healthcare (PM4HC) is an emerging discipline gaining the interest of healthcare experts, and seems able to deal with many important issues in representing CGs. In this position paper, we briefly describe the story and the state-of-the-art of CGs, and the efforts and results of the past approaches of medical informatics. Then, we describe PM4HC, and we answer questions like how can PM4HC cope with this challenge? Which role does PM4HC play and which rules should be employed for the PM4HC scientific community?
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Affiliation(s)
- Roberto Gatta
- Dipartimento di Scienze Cliniche e Sperimentali dell’Università degli Studi di Brescia, 25128 Brescia, Italy;
| | - Mauro Vallati
- School of Computing and Engineering, University of Huddersfield, Huddersfield HD13DH, UK;
| | - Carlos Fernandez-Llatas
- PM4Health-SABIEN-ITACA, Universitat Politècnica de València, 46022 València, Spain; (C.F.-L.); (A.M.-M.); (Z.V.-R.)
- Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Antonio Martinez-Millana
- PM4Health-SABIEN-ITACA, Universitat Politècnica de València, 46022 València, Spain; (C.F.-L.); (A.M.-M.); (Z.V.-R.)
| | - Stefania Orini
- Alzheimer Operative Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25128 Brescia, Italy;
| | - Lucia Sacchi
- Department of Electrical, Computer and Biomedical Engineering, Università di Pavia, 27100 Pavia, Italy;
| | - Jacopo Lenkowicz
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy;
| | - Mar Marcos
- Department of Computer Engineering and Science, Universitat Jaume I, 12071 Castelló de la Plana, Spain;
| | - Jorge Munoz-Gama
- Human & Process Research Lab (HAPLAB), Department of Computer Science, School of Engineering, Pontificia Universidad Católica de Chile, 3580000 Santiago, Chile;
| | - Michel A. Cuendet
- Department of Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (M.C.); (O.M.); (E.T.)
- Swiss Institute of Bioinformatics, UNIL Sorge, 1015 Lausanne, Switzerland
| | - Berardino de Bari
- Radiation Oncology, Réseau Hospitalier Neuchâtelois, 2000 La Chaux-de-Fonds, Switzerland;
- Department of Oncology, Lausanne University Hospital, University of Lausanne, 1015 Lausanne, Switzerland
| | - Luis Marco-Ruiz
- Norwegian Centre for E-health Research, University Hospital of North Norway, 7439 Tromsø, Norway;
| | - Alessandro Stefanini
- Dipartimento di Ingegneria dell’energia dei sistemi del territorio e delle costruzioni, Università degli Studi di Pisa, 56126 Pisa, Italy;
| | - Zoe Valero-Ramon
- PM4Health-SABIEN-ITACA, Universitat Politècnica de València, 46022 València, Spain; (C.F.-L.); (A.M.-M.); (Z.V.-R.)
| | - Olivier Michielin
- Department of Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (M.C.); (O.M.); (E.T.)
- Swiss Institute of Bioinformatics, UNIL Sorge, 1015 Lausanne, Switzerland
| | - Tomas Lapinskas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Antanas Montvila
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Niels Martin
- Data Analytics Laboratory, Vrije Universiteit Brussel, 1050 Ixelles, Belgium;
- Research Foundation Flanders (FWO), 1000 Brussel, Belgium
- Hasselt University, 3500 Hasselt, Belgium
| | - Erica Tavazzi
- Department of Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (M.C.); (O.M.); (E.T.)
- Department of Information Engineering, Università degli Studi di Padova, 35122 Padova, Italy
| | - Maurizio Castellano
- Dipartimento di Scienze Cliniche e Sperimentali dell’Università degli Studi di Brescia, 25128 Brescia, Italy;
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Orthuber W. Information Is Selection-A Review of Basics Shows Substantial Potential for Improvement of Digital Information Representation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2975. [PMID: 32344760 PMCID: PMC7215605 DOI: 10.3390/ijerph17082975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
Any piece of information is a selection from a set of possibilities. In this paper, this set is called a "domain". Digital information consists of number sequences, which are selections from a domain. At present, these number sequences are defined contextually in a very variable way, which impairs their comparability. Therefore, global uniformly defined "domain vectors" (DVs), with a structure containing a "Uniform Locator" ("UL"), referred to as "UL plus number sequence", are proposed. The "UL" is an efficient global pointer to the uniform online definition of the subsequent number sequence. DVs are globally defined, identified, comparable, and searchable by criteria which users can define online. In medicine, for example, patients, doctors, and medical specialists can define DVs online and can, therefore, form global criteria which are important for certain diagnoses. This allows for the immediate generation of precise diagnostic specific statistics of "similar medical cases", in order to discern the best therapy. The introduction of a compact DV data structure may substantially improve the digital representation of medical information.
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Affiliation(s)
- Wolfgang Orthuber
- Department of Orthodontics, UKSH, Kiel University, 24105 Kiel, Germany
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