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1.
J Biomed Inform ; 150: 104598, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-38253228

RESUMEN

OBJECTIVES: We aimed to investigate how errors from automatic speech recognition (ASR) systems affect dementia classification accuracy, specifically in the "Cookie Theft" picture description task. We aimed to assess whether imperfect ASR-generated transcripts could provide valuable information for distinguishing between language samples from cognitively healthy individuals and those with Alzheimer's disease (AD). METHODS: We conducted experiments using various ASR models, refining their transcripts with post-editing techniques. Both these imperfect ASR transcripts and manually transcribed ones were used as inputs for the downstream dementia classification. We conducted comprehensive error analysis to compare model performance and assess ASR-generated transcript effectiveness in dementia classification. RESULTS: Imperfect ASR-generated transcripts surprisingly outperformed manual transcription for distinguishing between individuals with AD and those without in the "Cookie Theft" task. These ASR-based models surpassed the previous state-of-the-art approach, indicating that ASR errors may contain valuable cues related to dementia. The synergy between ASR and classification models improved overall accuracy in dementia classification. CONCLUSION: Imperfect ASR transcripts effectively capture linguistic anomalies linked to dementia, improving accuracy in classification tasks. This synergy between ASR and classification models underscores ASR's potential as a valuable tool in assessing cognitive impairment and related clinical applications.


Asunto(s)
Enfermedad de Alzheimer , Disfunción Cognitiva , Percepción del Habla , Humanos , Habla , Lenguaje , Enfermedad de Alzheimer/diagnóstico
2.
J Biomed Inform ; 126: 103998, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35063668

RESUMEN

Formal thought disorder (ThD) is a clinical sign of schizophrenia amongst other serious mental health conditions. ThD can be recognized by observing incoherent speech - speech in which it is difficult to perceive connections between successive utterances and lacks a clear global theme. Automated assessment of the coherence of speech in patients with schizophrenia has been an active area of research for over a decade, in an effort to develop an objective and reliable instrument through which to quantify ThD. However, this work has largely been conducted in controlled settings using structured interviews and depended upon manual transcription services to render audio recordings amenable to computational analysis. In this paper, we present an evaluation of such automated methods in the context of a fully automated system using Automated Speech Recognition (ASR) in place of a manual transcription service, with "audio diaries" collected in naturalistic settings from participants experiencing Auditory Verbal Hallucinations (AVH). We show that performance lost due to ASR errors can often be restored through the application of Time-Series Augmented Representations for Detection of Incoherent Speech (TARDIS), a novel approach that involves treating the sequence of coherence scores from a transcript as a time-series, providing features for machine learning. With ASR, TARDIS improves average AUC across coherence metrics for detection of severe ThD by 0.09; average correlation with human-labeled derailment scores by 0.10; and average correlation between coherence estimates from manual and ASR-derived transcripts by 0.29. In addition, TARDIS improves the agreement between coherence estimates from manual transcripts and human judgment and correlation with self-reported estimates of AVH symptom severity. As such, TARDIS eliminates a fundamental barrier to the deployment of automated methods to detect linguistic indicators of ThD to monitor and improve clinical care in serious mental illness.


Asunto(s)
Esquizofrenia , Habla , Alucinaciones , Humanos , Lingüística , Aprendizaje Automático
3.
Arch Phys Med Rehabil ; 103(10): 2001-2008, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35569640

RESUMEN

OBJECTIVE: To examine the frequency of postacute sequelae of SARS-CoV-2 (PASC) and the factors associated with rehabilitation utilization in a large adult population with PASC. DESIGN: Retrospective study. SETTING: Midwest hospital health system. PARTICIPANTS: 19,792 patients with COVID-19 from March 10, 2020, to January 17, 2021. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Descriptive analyses were conducted across the entire cohort along with an adult subgroup analysis. A logistic regression was performed to assess factors associated with PASC development and rehabilitation utilization. RESULTS: In an analysis of 19,792 patients, the frequency of PASC was 42.8% in the adult population. Patients with PASC compared with those without had a higher utilization of rehabilitation services (8.6% vs 3.8%, P<.001). Risk factors for rehabilitation utilization in patients with PASC included younger age (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98-1.00; P=.01). In addition to several comorbidities and demographics factors, risk factors for rehabilitation utilization solely in the inpatient population included male sex (OR, 1.24; 95% CI, 1.02-1.50; P=.03) with patients on angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers 3 months prior to COVID-19 infections having a decreased risk of needing rehabilitation (OR, 0.80; 95% CI, 0.64-0.99; P=.04). CONCLUSIONS: Patients with PASC had higher rehabilitation utilization. We identified several clinical and demographic factors associated with the development of PASC and rehabilitation utilization.


Asunto(s)
COVID-19 , Adulto , Inhibidores de la Enzima Convertidora de Angiotensina , Angiotensinas , COVID-19/epidemiología , Humanos , Masculino , Estudios Retrospectivos , SARS-CoV-2
4.
BMC Med Inform Decis Mak ; 22(Suppl 1): 153, 2022 07 07.
Artículo en Inglés | MEDLINE | ID: mdl-35799177

RESUMEN

BACKGROUND: Dietary supplements (DS) have been widely used by consumers, but the information around the efficacy and safety of DS is disparate or incomplete, thus creating barriers for consumers to find information effectively. Conversational agent (CA) systems have been applied to healthcare domain, but there is no such system to answer consumers regarding DS use, although widespread use of DS. In this study, we develop the first CA system for DS use. METHODS: Our CA system for DS use developed on the MindMeld framework, consists of three components: question understanding, DS knowledge base, and answer generation. We collected and annotated 1509 questions to develop a natural language understanding module (e.g., question type classifier, named entity recognizer) which was then integrated into MindMeld framework. CA then queries the DS knowledge base (i.e., iDISK) and generates answers using rule-based slot filling techniques. We evaluated the algorithms of each component and the CA system as a whole. RESULTS: CNN is the best question classifier with an F1 score of 0.81, and CRF is the best named entity recognizer with an F1 score of 0.87. The system achieves an overall accuracy of 81% and an average score of 1.82 with succ@3 + score of 76.2% and succ@2 + of 66% approximately. CONCLUSION: This study develops the first CA system for DS use using the MindMeld framework and iDISK domain knowledge base.


Asunto(s)
Algoritmos , Procesamiento de Lenguaje Natural , Suplementos Dietéticos , Humanos , Lenguaje
5.
BMC Med Inform Decis Mak ; 19(1): 183, 2019 09 07.
Artículo en Inglés | MEDLINE | ID: mdl-31493797

RESUMEN

BACKGROUND: Medical data sharing is a big challenge in biomedicine, which often hinders collaborative research. Due to privacy concerns, clinical notes cannot be directly shared. A lot of efforts have been dedicated to de-identifying clinical notes but it is still very challenging to accurately locate and scrub all sensitive elements from notes in an automatic manner. An alternative approach is to remove sentences that might contain sensitive terms related to personal information. METHODS: A previous study introduced a frequency-based filtering approach that removes sentences containing low frequency bigrams to improve the privacy protection without significantly decreasing the utility. Our work extends this method to consider clinical notes from distributed sources with security and privacy considerations. We developed a novel secure protocol based on private set intersection and secure thresholding to identify uncommon and low-frequency terms, which can be used to guide sentence filtering. RESULTS: As the computational cost of our proposed framework mostly depends on the cardinality of the intersection of the sets and the number of data owners, we evaluated the framework in terms of these two factors. Experimental results demonstrate that our proposed method is scalable in various experimental settings. In addition, we evaluated our framework in terms of data utility. This evaluation shows that the proposed method is able to retain enough information for data analysis. CONCLUSION: This work demonstrates the feasibility of using homomorphic encryption to develop a secure and efficient multi-party protocol.


Asunto(s)
Artefactos , Seguridad Computacional , Difusión de la Información , Registros Electrónicos de Salud , Humanos
6.
Alzheimers Dement ; 15(8): 1107-1114, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31229433

RESUMEN

Unexpected cognitive lucidity and communication in patients with severe dementias, especially around the time of death, have been observed and reported anecdotally. Here, we review what is known about this phenomenon, related phenomena that provide insight into potential mechanisms, ethical implications, and methodologic considerations for systematic investigation. We conclude that paradoxical lucidity, if systematically confirmed, challenges current assumptions and highlights the possibility of network-level return of cognitive function in cases of severe dementias, which can provide insight into both underlying neurobiology and future therapeutic possibilities.


Asunto(s)
Enfermedad de Alzheimer , Cognición/fisiología , Demencia , Humanos
7.
Bioinformatics ; 32(23): 3635-3644, 2016 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-27531100

RESUMEN

MOTIVATION: Automatically quantifying semantic similarity and relatedness between clinical terms is an important aspect of text mining from electronic health records, which are increasingly recognized as valuable sources of phenotypic information for clinical genomics and bioinformatics research. A key obstacle to development of semantic relatedness measures is the limited availability of large quantities of clinical text to researchers and developers outside of major medical centers. Text from general English and biomedical literature are freely available; however, their validity as a substitute for clinical domain to represent semantics of clinical terms remains to be demonstrated. RESULTS: We constructed neural network representations of clinical terms found in a publicly available benchmark dataset manually labeled for semantic similarity and relatedness. Similarity and relatedness measures computed from text corpora in three domains (Clinical Notes, PubMed Central articles and Wikipedia) were compared using the benchmark as reference. We found that measures computed from full text of biomedical articles in PubMed Central repository (rho = 0.62 for similarity and 0.58 for relatedness) are on par with measures computed from clinical reports (rho = 0.60 for similarity and 0.57 for relatedness). We also evaluated the use of neural network based relatedness measures for query expansion in a clinical document retrieval task and a biomedical term word sense disambiguation task. We found that, with some limitations, biomedical articles may be used in lieu of clinical reports to represent the semantics of clinical terms and that distributional semantic methods are useful for clinical and biomedical natural language processing applications. AVAILABILITY AND IMPLEMENTATION: The software and reference standards used in this study to evaluate semantic similarity and relatedness measures are publicly available as detailed in the article. CONTACT: pakh0002@umn.eduSupplementary information: Supplementary data are available at Bioinformatics online.


Asunto(s)
Minería de Datos , Semántica , Unified Medical Language System , Humanos , Procesamiento de Lenguaje Natural , Redes Neurales de la Computación , PubMed , Estándares de Referencia , Programas Informáticos
8.
BMC Med Inform Decis Mak ; 17(Suppl 2): 68, 2017 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-28699564

RESUMEN

BACKGROUND: Automated methods for identifying clinically relevant new versus redundant information in electronic health record (EHR) clinical notes is useful for clinicians and researchers involved in patient care and clinical research, respectively. We evaluated methods to automatically identify clinically relevant new information in clinical notes, and compared the quantity of redundant information across specialties and clinical settings. METHODS: Statistical language models augmented with semantic similarity measures were evaluated as a means to detect and quantify clinically relevant new and redundant information over longitudinal clinical notes for a given patient. A corpus of 591 progress notes over 40 inpatient admissions was annotated for new information longitudinally by physicians to generate a reference standard. Note redundancy between various specialties was evaluated on 71,021 outpatient notes and 64,695 inpatient notes from 500 solid organ transplant patients (April 2015 through August 2015). RESULTS: Our best method achieved at best performance of 0.87 recall, 0.62 precision, and 0.72 F-measure. Addition of semantic similarity metrics compared to baseline improved recall but otherwise resulted in similar performance. While outpatient and inpatient notes had relatively similar levels of high redundancy (61% and 68%, respectively), redundancy differed by author specialty with mean redundancy of 75%, 66%, 57%, and 55% observed in pediatric, internal medicine, psychiatry and surgical notes, respectively. CONCLUSIONS: Automated techniques with statistical language models for detecting redundant versus clinically relevant new information in clinical notes do not improve with the addition of semantic similarity measures. While levels of redundancy seem relatively similar in the inpatient and ambulatory settings in the Fairview Health Services, clinical note redundancy appears to vary significantly with different medical specialties.


Asunto(s)
Registros Electrónicos de Salud , Informática Médica , Modelos Teóricos , Procesamiento de Lenguaje Natural , Humanos
9.
Neuroimage ; 104: 125-37, 2015 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-25315785

RESUMEN

Tests of generative semantic verbal fluency are widely used to study organization and representation of concepts in the human brain. Previous studies demonstrated that clustering and switching behavior during verbal fluency tasks is supported by multiple brain mechanisms associated with semantic memory and executive control. Previous work relied on manual assessments of semantic relatedness between words and grouping of words into semantic clusters. We investigated a computational linguistic approach to measuring the strength of semantic relatedness between words based on latent semantic analysis of word co-occurrences in a subset of a large online encyclopedia. We computed semantic clustering indices and compared them to brain network connectivity measures obtained with task-free fMRI in a sample consisting of healthy participants and those differentially affected by cognitive impairment. We found that semantic clustering indices were associated with brain network connectivity in distinct areas including fronto-temporal, fronto-parietal and fusiform gyrus regions. This study shows that computerized semantic indices complement traditional assessments of verbal fluency to provide a more complete account of the relationship between brain and verbal behavior involved organization and retrieval of lexical information from memory.


Asunto(s)
Lenguaje , Red Nerviosa/fisiología , Semántica , Anciano , Enfermedad de Alzheimer/patología , Cognición/fisiología , Simulación por Computador , Función Ejecutiva/fisiología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Memoria/fisiología , Persona de Mediana Edad , Pruebas Neuropsicológicas , Estimulación Luminosa , Conducta Verbal/fisiología
10.
Br J Clin Pharmacol ; 79(5): 820-30, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25403343

RESUMEN

AIMS: The aim was to develop a quantitative approach that characterizes the magnitude of and variability in phonemic generative fluency scores as measured by the Controlled Oral Word Association (COWA) test in healthy volunteers after administration of an oral and a novel intravenous (IV) formulation of topiramate (TPM). METHODS: Nonlinear mixed-effects modelling was used to describe the plasma TPM concentrations resulting from oral or IV administration. A pharmacokinetic-pharmacodynamic (PK-PD) model was developed sequentially to characterize the effect of TPM concentrations on COWA with different distributional assumptions. RESULTS: Topiramate was rapidly absorbed, with a median time to maximal concentration of 1 h and an oral bioavailability of ~100%. Baseline COWA score increased by an average of 12% after the third administration on drug-free sessions. An exponential model described the decline of COWA scores, which decreased by 14.5% for each 1 mg l(-1) increase in TPM concentration. The COWA scores were described equally well by both continuous normal and Poisson distributions. CONCLUSIONS: This analysis quantified the effect of TPM exposure on generative verbal fluency as measured by COWA. Repetitive administration of COWA resulted in a better performance, possibly due to a learning effect. The model predicts a 27% reduction in the COWA score at the average observed maximal plasma concentration after a 100 mg dose of TPM. The single-dose administration of relatively low TPM doses and narrow range of resultant concentrations in our study were limitations to investigating the PK-PD relationship at higher TPM exposures. Hence, the findings may not be readily generalized to the broader patient population.


Asunto(s)
Anticonvulsivantes/farmacología , Anticonvulsivantes/farmacocinética , Fructosa/análogos & derivados , Modelos Biológicos , Habla/efectos de los fármacos , Administración Oral , Adulto , Anticonvulsivantes/administración & dosificación , Estudios Cruzados , Método Doble Ciego , Femenino , Fructosa/administración & dosificación , Fructosa/farmacocinética , Fructosa/farmacología , Voluntarios Sanos , Humanos , Inyecciones Intravenosas , Masculino , Pruebas Neuropsicológicas , Topiramato
11.
J Biomed Inform ; 54: 1-9, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25661593

RESUMEN

BACKGROUND: Full syntactic parsing of clinical text as a part of clinical natural language processing (NLP) is critical for a wide range of applications. Several robust syntactic parsers are publicly available to produce linguistic representations for sentences. However, these existing parsers are mostly trained on general English text and may require adaptation for optimal performance on clinical text. Our objective was to adapt an existing general English parser for the clinical text of operative reports via lexicon augmentation, statistics adjusting, and grammar rules modification based on operative reports. METHOD: The Stanford unlexicalized probabilistic context-free grammar (PCFG) parser lexicon was expanded with SPECIALIST lexicon along with statistics collected from a limited set of operative notes tagged by two POS taggers (GENIA tagger and MedPost). The most frequently occurring verb entries of the SPECIALIST lexicon were adjusted based on manual review of verb usage in operative notes. Stanford parser grammar production rules were also modified based on linguistic features of operative reports. An analogous approach was then applied to the GENIA corpus to test the generalizability of this approach to biologic text. RESULTS: The new unlexicalized PCFG parser extended with the extra lexicon from SPECIALIST along with accurate statistics collected from an operative note corpus tagged with GENIA POS tagger improved the F-score by 2.26% from 87.64% to 89.90%. There was a progressive improvement with the addition of multiple approaches. Lexicon augmentation combined with statistics from the operative notes corpus provided the greatest improvement of parser performance. Application of this approach on the GENIA corpus increased the F-score by 3.81% with a simple new grammar and addition of the GENIA corpus lexicon. CONCLUSION: Using statistics collected from clinical text tagged with POS taggers along with proper modification of grammars and lexicons of an unlexicalized PCFG parser may improve parsing performance of existing parsers on specialized clinical text.


Asunto(s)
Registros Electrónicos de Salud , Informática Médica/métodos , Modelos Estadísticos , Procesamiento de Lenguaje Natural , Programas Informáticos , Curaduría de Datos , Humanos , Vocabulario Controlado
12.
J Biomed Inform ; 58 Suppl: S189-S196, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26210361

RESUMEN

OBJECTIVE: In recognition of potential barriers that may inhibit the widespread adoption of biomedical software, the 2014 i2b2 Challenge introduced a special track, Track 3 - Software Usability Assessment, in order to develop a better understanding of the adoption issues that might be associated with the state-of-the-art clinical NLP systems. This paper reports the ease of adoption assessment methods we developed for this track, and the results of evaluating five clinical NLP system submissions. MATERIALS AND METHODS: A team of human evaluators performed a series of scripted adoptability test tasks with each of the participating systems. The evaluation team consisted of four "expert evaluators" with training in computer science, and eight "end user evaluators" with mixed backgrounds in medicine, nursing, pharmacy, and health informatics. We assessed how easy it is to adopt the submitted systems along the following three dimensions: communication effectiveness (i.e., how effective a system is in communicating its designed objectives to intended audience), effort required to install, and effort required to use. We used a formal software usability testing tool, TURF, to record the evaluators' interactions with the systems and 'think-aloud' data revealing their thought processes when installing and using the systems and when resolving unexpected issues. RESULTS: Overall, the ease of adoption ratings that the five systems received are unsatisfactory. Installation of some of the systems proved to be rather difficult, and some systems failed to adequately communicate their designed objectives to intended adopters. Further, the average ratings provided by the end user evaluators on ease of use and ease of interpreting output are -0.35 and -0.53, respectively, indicating that this group of users generally deemed the systems extremely difficult to work with. While the ratings provided by the expert evaluators are higher, 0.6 and 0.45, respectively, these ratings are still low indicating that they also experienced considerable struggles. DISCUSSION: The results of the Track 3 evaluation show that the adoptability of the five participating clinical NLP systems has a great margin for improvement. Remedy strategies suggested by the evaluators included (1) more detailed and operation system specific use instructions; (2) provision of more pertinent onscreen feedback for easier diagnosis of problems; (3) including screen walk-throughs in use instructions so users know what to expect and what might have gone wrong; (4) avoiding jargon and acronyms in materials intended for end users; and (5) packaging prerequisites required within software distributions so that prospective adopters of the software do not have to obtain each of the third-party components on their own.


Asunto(s)
Actitud hacia los Computadores , Minería de Datos/estadística & datos numéricos , Registros Electrónicos de Salud/estadística & datos numéricos , Procesamiento de Lenguaje Natural , Reconocimiento de Normas Patrones Automatizadas/métodos , Programas Informáticos , Minería de Datos/métodos , Humanos , Persona de Mediana Edad , Interfaz Usuario-Computador
13.
Speech Commun ; 75: 14-26, 2015 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-26622073

RESUMEN

Cognitive tests of verbal fluency (VF) consist of verbalizing as many words as possible in one minute that either start with a specific letter of the alphabet or belong to a specific semantic category. These tests are widely used in neurological, psychiatric, mental health, and school settings and their validity for clinical applications has been extensively demonstrated. However, VF tests are currently administered and scored manually making them too cumbersome to use, particularly for longitudinal cognitive monitoring in large populations. The objective of the current study was to determine if automatic speech recognition (ASR) could be used for computerized administration and scoring of VF tests. We examined established techniques for constraining language modeling to a predefined vocabulary from a specific semantic category (e.g., animals). We also experimented with post-processing ASR output with confidence scoring, as well as with using speaker adaptation to improve automated VF scoring. Audio responses to a VF task were collected from 38 novice and experienced professional fighters (boxing and mixed martial arts) participating in a longitudinal study of effects of repetitive head trauma on brain function. Word error rate, correlation with manual word count and distance from manual word count were used to compare ASR-based approaches to scoring to each other and to the manually scored reference standard. Our study's results show that responses to the VF task contain a large number of extraneous utterances and noise that lead to relatively poor baseline ASR performance. However, we also found that speaker adaptation combined with confidence scoring significantly improves all three metrics and can enable use of ASR for reliable estimates of the traditional manual VF scores.

14.
J Biomed Inform ; 49: 134-47, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24448204

RESUMEN

In this study we report on potential drug-drug interactions between drugs occurring in patient clinical data. Results are based on relationships in SemMedDB, a database of structured knowledge extracted from all MEDLINE citations (titles and abstracts) using SemRep. The core of our methodology is to construct two potential drug-drug interaction schemas, based on relationships extracted from SemMedDB. In the first schema, Drug1 and Drug2 interact through Drug1's effect on some gene, which in turn affects Drug2. In the second, Drug1 affects Gene1, while Drug2 affects Gene2. Gene1 and Gene2, together, then have an effect on some biological function. After checking each drug pair from the medication lists of each of 22 patients, we found 19 known and 62 unknown drug-drug interactions using both schemas. For example, our results suggest that the interaction of Lisinopril, an ACE inhibitor commonly prescribed for hypertension, and the antidepressant sertraline can potentially increase the likelihood and possibly the severity of psoriasis. We also assessed the relationships extracted by SemRep from a linguistic perspective and found that the precision of SemRep was 0.58 for 300 randomly selected sentences from MEDLINE. Our study demonstrates that the use of structured knowledge in the form of relationships from the biomedical literature can support the discovery of potential drug-drug interactions occurring in patient clinical data. Moreover, SemMedDB provides a good knowledge resource for expanding the range of drugs, genes, and biological functions considered as elements in various drug-drug interaction pathways.


Asunto(s)
Interacciones Farmacológicas , Semántica , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/efectos adversos , Humanos , Lisinopril/administración & dosificación , Lisinopril/efectos adversos , Inhibidores Selectivos de la Recaptación de Serotonina/administración & dosificación , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Sertralina/administración & dosificación , Sertralina/efectos adversos
15.
Neurosci Inform ; 4(1)2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38433986

RESUMEN

Introduction: While linguistic retrogenesis has been extensively investigated in the neuroscientific and behavioral literature, there has been little work on retrogenesis using computerized approaches to language analysis. Methods: We bridge this gap by introducing a method based on comparing output of a pre-trained neural language model (NLM) with an artificially degraded version of itself to examine the transcripts of speech produced by seniors with and without dementia and healthy children during spontaneous language tasks. We compare a range of linguistic characteristics including language model perplexity, syntactic complexity, lexical frequency and part-of-speech use across these groups. Results: Our results indicate that healthy seniors and children older than 8 years share similar linguistic characteristics, as do dementia patients and children who are younger than 8 years. Discussion: Our study aligns with the growing evidence that language deterioration in dementia mirrors language acquisition in development using computational linguistic methods based on NLMs. This insight underscores the importance of further research to refine its application in guiding developmentally appropriate patient care, particularly in early stages.

16.
Pac Symp Biocomput ; 29: 24-38, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38160267

RESUMEN

We present a fully automated AI-based system for intensive monitoring of cognitive symptoms of neurotoxicity that frequently appear as a result of immunotherapy of hematologic malignancies. Early manifestations of these symptoms are evident in the patient's speech in the form of mild aphasia and confusion and can be detected and effectively treated prior to onset of more serious and potentially life-threatening impairment. We have developed the Automated Neural Nursing Assistant (ANNA) system designed to conduct a brief cognitive assessment several times per day over the telephone for 5-14 days following infusion of the immunotherapy medication. ANNA uses a conversational agent based on a large language model to elicit spontaneous speech in a semi-structured dialogue, followed by a series of brief language-based neurocognitive tests. In this paper we share ANNA's design and implementation, results of a pilot functional evaluation study, and discuss technical and logistic challenges facing the introduction of this type of technology in clinical practice. A large-scale clinical evaluation of ANNA will be conducted in an observational study of patients undergoing immunotherapy at the University of Minnesota Masonic Cancer Center starting in the Fall 2023.


Asunto(s)
Biología Computacional , Lenguaje , Humanos
17.
AMIA Jt Summits Transl Sci Proc ; 2024: 468-477, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38827079

RESUMEN

Consumer-grade heart rate (HR) sensors are widely used for tracking physical and mental health status. We explore the feasibility of using Polar H10 electrocardiogram (ECG) sensor to detect and predict cigarette smoking events in naturalistic settings with several machine learning approaches. We have collected and analyzed data for 28 participants observed over a two-week period. We found that using bidirectional long short-term memory (BiLSTM) with ECG-derived and GPS location input features yielded the highest mean accuracy of 69% for smoking event detection. For predicting smoking events, the highest accuracy of 67% was achieved using the fine-tuned LSTM approach. We also found a significant correlation between accuracy and the number of smoking events available from each participant. Our findings indicate that both detection and prediction of smoking events are feasible but require an individualized approach to training the models, particularly for prediction.

18.
J Biomed Inform ; 46(6): 1136-44, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24013076

RESUMEN

BACKGROUND: Time is a measurable and critical resource that affects the quality of services provided in clinical practice. There is limited insight into the effects of time restrictions on clinicians' cognitive processes with the electronic health record (EHR) in providing ambulatory care. OBJECTIVE: To understand the impact of time constraints on clinicians' synthesis of text-based EHR clinical notes. METHODS: We used an established clinician cognitive framework based on a think-aloud protocol. We studied interns' thought processes as they accomplished a set of four preformed ambulatory care clinical scenarios with and without time restrictions in a controlled setting. RESULTS: Interns most often synthesized details relevant to patients' problems and treatment, regardless of whether or not the time available for task performance was restricted. In contrast to previous findings, subsequent information commonly synthesized by clinicians related most commonly to the chronology of clinical events for the unrestricted time observations and to investigative procedures for the time-restricted sessions. There was no significant difference in the mean number of omission errors and incorrect deductions when interns synthesized the EHR clinical notes with and without time restrictions (3.5±0.5 vs. 2.3±0.5, p=0.14). CONCLUSION: Our results suggest that the incidence of errors during clinicians' synthesis of EHR clinical notes is not increased with modest time restrictions, possibly due to effective adjustments of information processing strategies learned from the usual time-constrained nature of patient visits. Further research is required to investigate the effects of similar or more extreme time variations on cognitive processes employed with different levels of expertise, specialty, and with different care settings.


Asunto(s)
Registros Electrónicos de Salud , Pautas de la Práctica en Medicina , Interfaz Usuario-Computador
19.
Pac Symp Biocomput ; 28: 43-54, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36540963

RESUMEN

Consumer-grade heart rate (HR) sensors including chest straps, wrist-worn watches and rings have become very popular in recent years for tracking individual physiological state, training for sports and even measuring stress levels and emotional changes. While the majority of these consumer sensors are not medical devices, they can still offer insights for consumers and researchers if used correctly taking into account their limitations. Multiple previous studies have been done using a large variety of consumer sensors including Polar® devices, Apple® watches, and Fitbit® wrist bands. The vast majority of prior studies have been done in laboratory settings where collecting data is relatively straightforward. However, using consumer sensors in naturalistic settings that present significant challenges, including noise artefacts and missing data, has not been as extensively investigated. Additionally, the majority of prior studies focused on wrist-worn optical HR sensors. Arm-worn sensors have not been extensively investigated either. In the present study, we validate HR measurements obtained with an arm-worn optical sensor (Polar OH1) against those obtained with a chest-strap electrical sensor (Polar H10) from 16 participants over a 2-week study period in naturalistic settings. We also investigated the impact of physical activity measured with 3-D accelerometers embedded in the H10 chest strap and OH1 armband sensors on the agreement between the two sensors. Overall, we find that the arm-worn optical Polar OH1 sensor provides a good estimate of HR (Pearson r = 0.90, p <0.01). Filtering the signal that corresponds to physical activity further improves the HR estimates but only slightly (Pearson r = 0.91, p <0.01). Based on these preliminary findings, we conclude that the arm-worn Polar OH1 sensor provides usable HR measurements in daily living conditions, with some caveats discussed in the paper.


Asunto(s)
Biología Computacional , Monitores de Ejercicio , Humanos , Frecuencia Cardíaca/fisiología , Estudios de Factibilidad , Ejercicio Físico/fisiología
20.
AMIA Jt Summits Transl Sci Proc ; 2023: 360-369, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37350929

RESUMEN

The evidence is growing that machine and deep learning methods can learn the subtle differences between the language produced by people with various forms of cognitive impairment such as dementia and cognitively healthy individuals. Valuable public data repositories such as TalkBank have made it possible for researchers in the computational community to join forces and learn from each other to make significant advances in this area. However, due to variability in approaches and data selection strategies used by various researchers, results obtained by different groups have been difficult to compare directly. In this paper, we present TRESTLE (Toolkit for Reproducible Execution of Speech Text and Language Experiments), an open source platform that focuses on two datasets from the TalkBank repository with dementia detection as an illustrative domain. Successfully deployed in the hackallenge (Hackathon/Challenge) of the International Workshop on Health Intelligence at AAAI 2022, TRESTLE provides a precise digital blueprint of the data pre-processing and selection strategies that can be reused via TRESTLE by other researchers seeking comparable results with their peers and current state-of-the-art (SOTA) approaches.

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