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1.
Bioinformatics ; 37(8): 1140-1147, 2021 05 23.
Artículo en Inglés | MEDLINE | ID: mdl-33119053

RESUMEN

SUMMARY: The development of new drugs is costly, time consuming and often accompanied with safety issues. Drug repurposing can avoid the expensive and lengthy process of drug development by finding new uses for already approved drugs. In order to repurpose drugs effectively, it is useful to know which proteins are targeted by which drugs. Computational models that estimate the interaction strength of new drug-target pairs have the potential to expedite drug repurposing. Several models have been proposed for this task. However, these models represent the drugs as strings, which is not a natural way to represent molecules. We propose a new model called GraphDTA that represents drugs as graphs and uses graph neural networks to predict drug-target affinity. We show that graph neural networks not only predict drug-target affinity better than non-deep learning models, but also outperform competing deep learning methods. Our results confirm that deep learning models are appropriate for drug-target binding affinity prediction, and that representing drugs as graphs can lead to further improvements. AVAILABILITY OF IMPLEMENTATION: The proposed models are implemented in Python. Related data, pre-trained models and source code are publicly available at https://github.com/thinng/GraphDTA. All scripts and data needed to reproduce the post hoc statistical analysis are available from https://doi.org/10.5281/zenodo.3603523. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.


Asunto(s)
Redes Neurales de la Computación , Preparaciones Farmacéuticas , Reposicionamiento de Medicamentos , Proteínas , Programas Informáticos
2.
Health Care Manag Sci ; 24(4): 786-798, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34389924

RESUMEN

PURPOSE: Our objective is to identify the predictive factors and predict hospital length of stay (LOS) in dengue patients, for efficient utilization of hospital resources. METHODS: We collected 1360 medical patient records of confirmed dengue infection from 2012 to 2017 at Max group of hospitals in India. We applied two different data mining algorithms, logistic regression (LR) with elastic-net, and random forest to extract predictive factors and predict the LOS. We used an area under the curve (AUC), sensitivity, and specificity to evaluate the performance of the classifiers. RESULTS: The classifiers performed well, with logistic regression (LR) with elastic-net providing an AUC score of 0.75 and random forest providing a score of 0.72. Out of 1148 patients, 364 (32%) patients had prolonged length of stay (LOS) (> 5 days) and overall hospitalization mean was 4.03 ± 2.44 days (median ± IQR). The highest number of dengue cases belonged to the age group of 10-20 years (21.1%) with a male predominance. Moreover, the study showed that blood transfusion, emergency admission, assisted ventilation, low haemoglobin, high total leucocyte count (TLC), low or high haematocrit, and low lymphocytes have a significant correlation with prolonged LOS. CONCLUSION: Our findings demonstrated that the logistic regression with elastic-net was the best fit with an AUC of 0.75 and there is a significant association between LOS greater than five days and identified patient-specific variables. This method can identify the patients at highest risks and help focus time and resources.


Asunto(s)
Dengue , Hospitalización , Adolescente , Adulto , Niño , Dengue/epidemiología , Dengue/terapia , Femenino , Hospitales , Humanos , Tiempo de Internación , Modelos Logísticos , Masculino , Estudios Retrospectivos , Adulto Joven
3.
BMC Genomics ; 21(Suppl 4): 256, 2020 Jul 20.
Artículo en Inglés | MEDLINE | ID: mdl-32689932

RESUMEN

BACKGROUND: Technological advances in next-generation sequencing (NGS) and chromatographic assays [e.g., liquid chromatography mass spectrometry (LC-MS)] have made it possible to identify thousands of microbe and metabolite species, and to measure their relative abundance. In this paper, we propose a sparse neural encoder-decoder network to predict metabolite abundances from microbe abundances. RESULTS: Using paired data from a cohort of inflammatory bowel disease (IBD) patients, we show that our neural encoder-decoder model outperforms linear univariate and multivariate methods in terms of accuracy, sparsity, and stability. Importantly, we show that our neural encoder-decoder model is not simply a black box designed to maximize predictive accuracy. Rather, the network's hidden layer (i.e., the latent space, comprised only of sparsely weighted microbe counts) actually captures key microbe-metabolite relationships that are themselves clinically meaningful. Although this hidden layer is learned without any knowledge of the patient's diagnosis, we show that the learned latent features are structured in a way that predicts IBD and treatment status with high accuracy. CONCLUSIONS: By imposing a non-negative weights constraint, the network becomes a directed graph where each downstream node is interpretable as the additive combination of the upstream nodes. Here, the middle layer comprises distinct microbe-metabolite axes that relate key microbial biomarkers with metabolite biomarkers. By pre-processing the microbiome and metabolome data using compositional data analysis methods, we ensure that our proposed multi-omics workflow will generalize to any pair of -omics data. To the best of our knowledge, this work is the first application of neural encoder-decoders for the interpretable integration of multi-omics biological data.


Asunto(s)
Microbioma Gastrointestinal , Enfermedades Inflamatorias del Intestino/metabolismo , Enfermedades Inflamatorias del Intestino/microbiología , Metaboloma , Redes Neurales de la Computación , Humanos , Modelos Estadísticos
4.
Mol Biol Rep ; 46(6): 5919-5930, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31410687

RESUMEN

In the progression of cancer, cells acquire genetic mutations that cause uncontrolled growth. Over time, the primary tumour may undergo additional mutations that allow for the cancerous cells to spread throughout the body as metastases. Since metastatic development typically results in markedly worse patient outcomes, research into the identity and function of metastasis-associated biomarkers could eventually translate into clinical diagnostics or novel therapeutics. Although the general processes underpinning metastatic progression are understood, no clear cross-cancer biomarker profile has emerged. However, the literature suggests that some microRNAs (miRNAs) may play an important role in the metastatic progression of several cancer types. Using a subset of The Cancer Genome Atlas (TCGA) data, we performed an integrated analysis of mRNA and miRNA expression with paired metastatic and primary tumour samples to interrogate how the miRNA-mRNA regulatory axis influences metastatic progression. From this, we successfully built mRNA- and miRNA-specific classifiers that can discriminate pairs of metastatic and primary samples across 11 cancer types. In addition, we identified a number of miRNAs whose metastasis-associated dysregulation could predict mRNA metastasis-associated dysregulation. Among the most predictive miRNAs, we found several previously implicated in cancer progression, including miR-301b, miR-1296, and miR-423. Taken together, our results suggest that metastatic samples have a common cross-cancer signature when compared with their primary tumour pair, and that these miRNA biomarkers can be used to predict metastatic status as well as mRNA expression.


Asunto(s)
Regulación Neoplásica de la Expresión Génica/genética , Metástasis de la Neoplasia/genética , Neoplasias/genética , Biomarcadores de Tumor/genética , Bases de Datos Genéticas , Predicción/métodos , Perfilación de la Expresión Génica/métodos , Humanos , MicroARNs/genética , Análisis de Secuencia por Matrices de Oligonucleótidos/métodos , ARN Mensajero/genética
5.
J Med Internet Res ; 21(11): e16399, 2019 11 06.
Artículo en Inglés | MEDLINE | ID: mdl-31692450

RESUMEN

In this viewpoint we describe the architecture of, and design rationale for, a new software platform designed to support the conduct of digital phenotyping research studies. These studies seek to collect passive and active sensor signals from participants' smartphones for the purposes of modelling and predicting health outcomes, with a specific focus on mental health. We also highlight features of the current research landscape that recommend the coordinated development of such platforms, including the significant technical and resource costs of development, and we identify specific considerations relevant to the design of platforms for digital phenotyping. In addition, we describe trade-offs relating to data quality and completeness versus the experience for patients and public users who consent to their devices being used to collect data. We summarize distinctive features of the resulting platform, InSTIL (Intelligent Sensing to Inform and Learn), which includes universal (ie, cross-platform) support for both iOS and Android devices and privacy-preserving mechanisms which, by default, collect only anonymized participant data. We conclude with a discussion of recommendations for future work arising from learning during the development of the platform. The development of the InSTIL platform is a key step towards our research vision of a population-scale, international, digital phenotyping bank. With suitable adoption, the platform will aggregate signals from large numbers of participants and large numbers of research studies to support modelling and machine learning analyses focused on the prediction of mental illness onset and disease trajectories.


Asunto(s)
Inteligencia Artificial/normas , Teléfono Inteligente/normas , Humanos , Proyectos de Investigación
6.
Am J Med Genet B Neuropsychiatr Genet ; 180(7): 508-518, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31025483

RESUMEN

Although neuropsychiatric disorders have an established genetic background, their molecular foundations remain elusive. This has prompted many investigators to search for explanatory biomarkers that can predict clinical outcomes. One approach uses machine learning to classify patients based on blood mRNA expression. However, these endeavors typically fail to achieve the high level of performance, stability, and generalizability required for clinical translation. Moreover, these classifiers can lack interpretability because not all genes have relevance to researchers. For this study, we hypothesized that annotation-based classifiers can improve classification performance, stability, generalizability, and interpretability. To this end, we evaluated the models of four classification algorithms on six neuropsychiatric data sets using four annotation databases. Our results suggest that the Gene Ontology Biological Process database can transform gene expression into an annotation-based feature space that is accurate and stable. We also show how annotation features can improve the interpretability of classifiers: as annotations are used to assign biological importance to genes, the biological importance of annotation-based features are the features themselves. In evaluating the annotation features, we find that top ranked annotations tend contain top ranked genes, suggesting that the most predictive annotations are a superset of the most predictive genes. Based on this, and the fact that annotations are used routinely to assign biological importance to genetic data, we recommend transforming gene-level expression into annotation-level expression prior to the classification of neuropsychiatric conditions.


Asunto(s)
Trastornos Mentales/clasificación , Enfermedades del Sistema Nervioso/clasificación , Neuropsiquiatría/métodos , Algoritmos , Biología Computacional/métodos , Bases de Datos Genéticas , Ontología de Genes , Humanos
7.
Am J Med Genet B Neuropsychiatr Genet ; 180(6): 377-389, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-30520558

RESUMEN

Autism spectrum disorder (ASD) is a markedly heterogeneous condition with a varied phenotypic presentation. Its high concordance among siblings, as well as its clear association with specific genetic disorders, both point to a strong genetic etiology. However, the molecular basis of ASD is still poorly understood, although recent studies point to the existence of sex-specific ASD pathophysiologies and biomarkers. Despite this, little is known about how exactly sex influences the gene expression signatures of ASD probands. In an effort to identify sex-dependent biomarkers and characterize their function, we present an analysis of a single paired-end postmortem brain RNA-Seq data set and a meta-analysis of six blood-based microarray data sets. Here, we identify several genes with sex-dependent dysregulation, and many more with sex-independent dysregulation. Moreover, through pathway analysis, we find that these sex-independent biomarkers have substantially different biological roles than the sex-dependent biomarkers, and that some of these pathways are ubiquitously dysregulated in both postmortem brain and blood. We conclude by synthesizing the discovered biomarker profiles with the extant literature, by highlighting the advantage of studying sex-specific dysregulation directly, and by making a call for new transcriptomic data that comprise large female cohorts.


Asunto(s)
Trastorno del Espectro Autista/genética , Redes Reguladoras de Genes/genética , Caracteres Sexuales , Trastorno del Espectro Autista/fisiopatología , Trastorno Autístico/genética , Trastorno Autístico/fisiopatología , Biomarcadores , Encéfalo/metabolismo , Femenino , Perfilación de la Expresión Génica/métodos , Humanos , Masculino , Análisis de Secuencia de ARN/métodos , Hermanos , Transcriptoma/genética
8.
J Med Syst ; 42(5): 94, 2018 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-29644446

RESUMEN

Evidence-based medicine often involves the identification of patients with similar conditions, which are often captured in ICD (International Classification of Diseases (World Health Organization 2013)) code sequences. With no satisfying prior solutions for matching ICD-10 code sequences, this paper presents a method which effectively captures the clinical similarity among routine patients who have multiple comorbidities and complex care needs. Our method leverages the recent progress in representation learning of individual ICD-10 codes, and it explicitly uses the sequential order of codes for matching. Empirical evaluation on a state-wide cancer data collection shows that our proposed method achieves significantly higher matching performance compared with state-of-the-art methods ignoring the sequential order. Our method better identifies similar patients in a number of clinical outcomes including readmission and mortality outlook. Although this paper focuses on ICD-10 diagnosis code sequences, our method can be adapted to work with other codified sequence data.


Asunto(s)
Minería de Datos/métodos , Clasificación Internacional de Enfermedades/estadística & datos numéricos , Neoplasias/epidemiología , Neoplasias/fisiopatología , Factores de Edad , Anciano , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Sexuales
9.
J Biomed Inform ; 69: 218-229, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28410981

RESUMEN

Personalized predictive medicine necessitates the modeling of patient illness and care processes, which inherently have long-term temporal dependencies. Healthcare observations, stored in electronic medical records are episodic and irregular in time. We introduce DeepCare, an end-to-end deep dynamic neural network that reads medical records, stores previous illness history, infers current illness states and predicts future medical outcomes. At the data level, DeepCare represents care episodes as vectors and models patient health state trajectories by the memory of historical records. Built on Long Short-Term Memory (LSTM), DeepCare introduces methods to handle irregularly timed events by moderating the forgetting and consolidation of memory. DeepCare also explicitly models medical interventions that change the course of illness and shape future medical risk. Moving up to the health state level, historical and present health states are then aggregated through multiscale temporal pooling, before passing through a neural network that estimates future outcomes. We demonstrate the efficacy of DeepCare for disease progression modeling, intervention recommendation, and future risk prediction. On two important cohorts with heavy social and economic burden - diabetes and mental health - the results show improved prediction accuracy.


Asunto(s)
Atención a la Salud , Registros Electrónicos de Salud , Redes Neurales de la Computación , Progresión de la Enfermedad , Estado de Salud , Humanos
10.
J Biomed Inform ; 59: 149-68, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26689771

RESUMEN

Emerging Electronic Medical Records (EMRs) have reformed the modern healthcare. These records have great potential to be used for building clinical prediction models. However, a problem in using them is their high dimensionality. Since a lot of information may not be relevant for prediction, the underlying complexity of the prediction models may not be high. A popular way to deal with this problem is to employ feature selection. Lasso and l1-norm based feature selection methods have shown promising results. But, in presence of correlated features, these methods select features that change considerably with small changes in data. This prevents clinicians to obtain a stable feature set, which is crucial for clinical decision making. Grouping correlated variables together can improve the stability of feature selection, however, such grouping is usually not known and needs to be estimated for optimal performance. Addressing this problem, we propose a new model that can simultaneously learn the grouping of correlated features and perform stable feature selection. We formulate the model as a constrained optimization problem and provide an efficient solution with guaranteed convergence. Our experiments with both synthetic and real-world datasets show that the proposed model is significantly more stable than Lasso and many existing state-of-the-art shrinkage and classification methods. We further show that in terms of prediction performance, the proposed method consistently outperforms Lasso and other baselines. Our model can be used for selecting stable risk factors for a variety of healthcare problems, so it can assist clinicians toward accurate decision making.


Asunto(s)
Registros Electrónicos de Salud , Informática Médica/métodos , Modelos Estadísticos , Aprendizaje Automático Supervisado , Humanos
11.
BMC Pediatr ; 16(1): 167, 2016 10 19.
Artículo en Inglés | MEDLINE | ID: mdl-27760533

RESUMEN

BACKGROUND: Evidence for early intensive behavioural interventions (EIBI) by therapists as an effective treatment for children with an Autism Spectrum Disorder (ASD) is growing. High-intensity and sustained delivery of quality EIBI is expensive. The TOBY (Therapy Outcomes by You) Playpad is an App-based platform delivering EIBI to facilitate learning for young children with ASD, while enabling parents to become co-therapists. Intervention targets include increasing joint attention, imitation and communication of children with ASD. The primary aim of the study presented in this protocol is to determine the effectiveness of the TOBY App in reducing ASD symptoms when used as a complement to conventional EIBI. The secondary aim is to examine parental attributes as a result of TOBY App use. METHODS AND DESIGN: Children aged less than 4;3 years diagnosed with ASD and parents will be recruited into this single-blind, randomised controlled trial using a pragmatic approach. Eligible participants will be randomised to the treatment group 'TOBY therapy + therapy as usual' or, the control group 'therapy as usual' for six months. The treatment will be provided by the TOBY App and parent where a combination of learning environments such as on-iPad child only (solo), partner (with parent) and off-iPad - Natural Environment (with parent) Tasks will be implemented. Parents in the treatment group will participate in a TOBY training workshop. Treatment fidelity will be monitored via an App-based reporting system and parent diaries. The primary outcome measure is the Autism Treatment Evaluation Checklist. The secondary outcome measures involve diagnostics, functional and developmental assessments, including parent questionnaires at baseline (T0), three months (T1) and six months (T2). DISCUSSION: This trial will determine the effectiveness of the TOBY App as a therapeutic complement to other early interventions children with ASD receive. The trial will also determine the feasibility of a parent delivered early intervention using the iPad as an educational platform, and assess the impact of the TOBY App on parents' self-efficacy and empowerment in an effort to reduce children's ASD symptoms. The outcomes of this trial may have EIBI services implications for newly diagnosed children with ASD and parents. TRIAL REGISTRATION: ACTRN12614000738628 retrospectively registered on 1st of July, 2014. UTN: U1111-1158-6423.


Asunto(s)
Trastorno del Espectro Autista/terapia , Terapia Conductista/métodos , Computadoras de Mano , Intervención Educativa Precoz/métodos , Aplicaciones Móviles , Actitud Frente a la Salud , Preescolar , Protocolos Clínicos , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Padres/psicología , Proyectos de Investigación , Método Simple Ciego , Resultado del Tratamiento
12.
J Med Internet Res ; 18(12): e323, 2016 12 16.
Artículo en Inglés | MEDLINE | ID: mdl-27986644

RESUMEN

BACKGROUND: As more and more researchers are turning to big data for new opportunities of biomedical discoveries, machine learning models, as the backbone of big data analysis, are mentioned more often in biomedical journals. However, owing to the inherent complexity of machine learning methods, they are prone to misuse. Because of the flexibility in specifying machine learning models, the results are often insufficiently reported in research articles, hindering reliable assessment of model validity and consistent interpretation of model outputs. OBJECTIVE: To attain a set of guidelines on the use of machine learning predictive models within clinical settings to make sure the models are correctly applied and sufficiently reported so that true discoveries can be distinguished from random coincidence. METHODS: A multidisciplinary panel of machine learning experts, clinicians, and traditional statisticians were interviewed, using an iterative process in accordance with the Delphi method. RESULTS: The process produced a set of guidelines that consists of (1) a list of reporting items to be included in a research article and (2) a set of practical sequential steps for developing predictive models. CONCLUSIONS: A set of guidelines was generated to enable correct application of machine learning models and consistent reporting of model specifications and results in biomedical research. We believe that such guidelines will accelerate the adoption of big data analysis, particularly with machine learning methods, in the biomedical research community.


Asunto(s)
Investigación Biomédica/métodos , Interpretación Estadística de Datos , Aprendizaje Automático , Investigación Biomédica/normas , Humanos , Estudios Interdisciplinarios , Modelos Biológicos
14.
J Biomed Inform ; 53: 277-90, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25500636

RESUMEN

Modern healthcare is getting reshaped by growing Electronic Medical Records (EMR). Recently, these records have been shown of great value towards building clinical prediction models. In EMR data, patients' diseases and hospital interventions are captured through a set of diagnoses and procedures codes. These codes are usually represented in a tree form (e.g. ICD-10 tree) and the codes within a tree branch may be highly correlated. These codes can be used as features to build a prediction model and an appropriate feature selection can inform a clinician about important risk factors for a disease. Traditional feature selection methods (e.g. Information Gain, T-test, etc.) consider each variable independently and usually end up having a long feature list. Recently, Lasso and related l1-penalty based feature selection methods have become popular due to their joint feature selection property. However, Lasso is known to have problems of selecting one feature of many correlated features randomly. This hinders the clinicians to arrive at a stable feature set, which is crucial for clinical decision making process. In this paper, we solve this problem by using a recently proposed Tree-Lasso model. Since, the stability behavior of Tree-Lasso is not well understood, we study the stability behavior of Tree-Lasso and compare it with other feature selection methods. Using a synthetic and two real-world datasets (Cancer and Acute Myocardial Infarction), we show that Tree-Lasso based feature selection is significantly more stable than Lasso and comparable to other methods e.g. Information Gain, ReliefF and T-test. We further show that, using different types of classifiers such as logistic regression, naive Bayes, support vector machines, decision trees and Random Forest, the classification performance of Tree-Lasso is comparable to Lasso and better than other methods. Our result has implications in identifying stable risk factors for many healthcare problems and therefore can potentially assist clinical decision making for accurate medical prognosis.


Asunto(s)
Registros Electrónicos de Salud , Clasificación Internacional de Enfermedades , Informática Médica , Máquina de Vectores de Soporte , Algoritmos , Teorema de Bayes , Toma de Decisiones , Árboles de Decisión , Humanos , Modelos Logísticos , Probabilidad , Pronóstico , Análisis de Regresión , Reproducibilidad de los Resultados , Factores de Riesgo
15.
J Biomed Inform ; 54: 96-105, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25661261

RESUMEN

Electronic medical record (EMR) offers promises for novel analytics. However, manual feature engineering from EMR is labor intensive because EMR is complex - it contains temporal, mixed-type and multimodal data packed in irregular episodes. We present a computational framework to harness EMR with minimal human supervision via restricted Boltzmann machine (RBM). The framework derives a new representation of medical objects by embedding them in a low-dimensional vector space. This new representation facilitates algebraic and statistical manipulations such as projection onto 2D plane (thereby offering intuitive visualization), object grouping (hence enabling automated phenotyping), and risk stratification. To enhance model interpretability, we introduced two constraints into model parameters: (a) nonnegative coefficients, and (b) structural smoothness. These result in a novel model called eNRBM (EMR-driven nonnegative RBM). We demonstrate the capability of the eNRBM on a cohort of 7578 mental health patients under suicide risk assessment. The derived representation not only shows clinically meaningful feature grouping but also facilitates short-term risk stratification. The F-scores, 0.21 for moderate-risk and 0.36 for high-risk, are significantly higher than those obtained by clinicians and competitive with the results obtained by support vector machines.


Asunto(s)
Registros Electrónicos de Salud , Informática Médica/métodos , Modelos Estadísticos , Medición de Riesgo/métodos , Femenino , Humanos , Masculino , Cadenas de Markov , Trastornos Mentales/epidemiología , Neoplasias/epidemiología , Neoplasias/terapia , Redes Neurales de la Computación , Suicidio/estadística & datos numéricos , Máquina de Vectores de Soporte
16.
BMC Bioinformatics ; 15: 425, 2014 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-25547173

RESUMEN

BACKGROUND: Feature engineering is a time consuming component of predictive modeling. We propose a versatile platform to automatically extract features for risk prediction, based on a pre-defined and extensible entity schema. The extraction is independent of disease type or risk prediction task. We contrast auto-extracted features to baselines generated from the Elixhauser comorbidities. RESULTS: Hospital medical records was transformed to event sequences, to which filters were applied to extract feature sets capturing diversity in temporal scales and data types. The features were evaluated on a readmission prediction task, comparing with baseline feature sets generated from the Elixhauser comorbidities. The prediction model was through logistic regression with elastic net regularization. Predictions horizons of 1, 2, 3, 6, 12 months were considered for four diverse diseases: diabetes, COPD, mental disorders and pneumonia, with derivation and validation cohorts defined on non-overlapping data-collection periods. For unplanned readmissions, auto-extracted feature set using socio-demographic information and medical records, outperformed baselines derived from the socio-demographic information and Elixhauser comorbidities, over 20 settings (5 prediction horizons over 4 diseases). In particular over 30-day prediction, the AUCs are: COPD-baseline: 0.60 (95% CI: 0.57, 0.63), auto-extracted: 0.67 (0.64, 0.70); diabetes-baseline: 0.60 (0.58, 0.63), auto-extracted: 0.67 (0.64, 0.69); mental disorders-baseline: 0.57 (0.54, 0.60), auto-extracted: 0.69 (0.64,0.70); pneumonia-baseline: 0.61 (0.59, 0.63), auto-extracted: 0.70 (0.67, 0.72). CONCLUSIONS: The advantages of auto-extracted standard features from complex medical records, in a disease and task agnostic manner were demonstrated. Auto-extracted features have good predictive power over multiple time horizons. Such feature sets have potential to form the foundation of complex automated analytic tasks.


Asunto(s)
Diabetes Mellitus/etiología , Trastornos Mentales/etiología , Neumonía/etiología , Enfermedad Pulmonar Obstructiva Crónica/etiología , Medición de Riesgo , Programas Informáticos , Anciano , Área Bajo la Curva , Comorbilidad , Bases de Datos Factuales , Femenino , Hospitales , Humanos , Modelos Logísticos , Masculino , Modelos Teóricos
17.
BMC Psychiatry ; 14: 76, 2014 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-24628849

RESUMEN

BACKGROUND: To date, our ability to accurately identify patients at high risk from suicidal behaviour, and thus to target interventions, has been fairly limited. This study examined a large pool of factors that are potentially associated with suicide risk from the comprehensive electronic medical record (EMR) and to derive a predictive model for 1-6 month risk. METHODS: 7,399 patients undergoing suicide risk assessment were followed up for 180 days. The dataset was divided into a derivation and validation cohorts of 4,911 and 2,488 respectively. Clinicians used an 18-point checklist of known risk factors to divide patients into low, medium, or high risk. Their predictive ability was compared with a risk stratification model derived from the EMR data. The model was based on the continuation-ratio ordinal regression method coupled with lasso (which stands for least absolute shrinkage and selection operator). RESULTS: In the year prior to suicide assessment, 66.8% of patients attended the emergency department (ED) and 41.8% had at least one hospital admission. Administrative and demographic data, along with information on prior self-harm episodes, as well as mental and physical health diagnoses were predictive of high-risk suicidal behaviour. Clinicians using the 18-point checklist were relatively poor in predicting patients at high-risk in 3 months (AUC 0.58, 95% CIs: 0.50 - 0.66). The model derived EMR was superior (AUC 0.79, 95% CIs: 0.72 - 0.84). At specificity of 0.72 (95% CIs: 0.70-0.73) the EMR model had sensitivity of 0.70 (95% CIs: 0.56-0.83). CONCLUSION: Predictive models applied to data from the EMR could improve risk stratification of patients presenting with potential suicidal behaviour. The predictive factors include known risks for suicide, but also other information relating to general health and health service utilisation.


Asunto(s)
Registros Electrónicos de Salud/estadística & datos numéricos , Prevención del Suicidio , Suicidio/estadística & datos numéricos , Adolescente , Adulto , Anciano , Australia/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Masculino , Anamnesis/estadística & datos numéricos , Persona de Mediana Edad , Modelos Estadísticos , Pronóstico , Estudios Retrospectivos , Medición de Riesgo/estadística & datos numéricos , Factores de Riesgo , Ideación Suicida , Suicidio/psicología , Adulto Joven
18.
Aust Health Rev ; 38(4): 377-82, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25001433

RESUMEN

OBJECTIVE: Readmission rates are high following acute myocardial infarction (AMI), but risk stratification has proved difficult because known risk factors are only weakly predictive. In the present study, we applied hospital data to identify the risk of unplanned admission following AMI hospitalisations. METHODS: The study included 1660 consecutive AMI admissions. Predictive models were derived from 1107 randomly selected records and tested on the remaining 553 records. The electronic medical record (EMR) model was compared with a seven-factor predictive score known as the HOSPITAL score and a model derived from Elixhauser comorbidities. All models were evaluated for the ability to identify patients at high risk of 30-day ischaemic heart disease readmission and those at risk of all-cause readmission within 12 months following the initial AMI hospitalisation. RESULTS: The EMR model has higher discrimination than other models in predicting ischaemic heart disease readmissions (area under the curve (AUC) 0.78; 95% confidence interval (CI) 0.71-0.85 for 30-day readmission). The positive predictive value was significantly higher with the EMR model, which identifies cohorts that were up to threefold more likely to be readmitted. Factors associated with readmission included emergency department attendances, cardiac diagnoses and procedures, renal impairment and electrolyte disturbances. The EMR model also performed better than other models (AUC 0.72; 95% CI 0.66-0.78), and with greater positive predictive value, in identifying 12-month risk of all-cause readmission. CONCLUSIONS: Routine hospital data can help identify patients at high risk of readmission following AMI. This could lead to decreased readmission rates by identifying patients suitable for targeted clinical interventions.


Asunto(s)
Infarto del Miocardio , Readmisión del Paciente/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Bases de Datos Factuales , Registros Electrónicos de Salud , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Centros de Atención Terciaria , Victoria , Adulto Joven
19.
Trials ; 25(1): 466, 2024 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-38982443

RESUMEN

BACKGROUND: More than 50% of people who die by suicide have not been in contact with formal mental health services. The rate of people who fly 'under the radar' of mental health services is higher among men than women, indicating a need to improve engagement strategies targeted towards men who experience suicidal thoughts and/or behaviours. In Australia, a range of mental health support services exist, designed specifically for men, yet, a substantial proportion of men do not use these services. The aim of this study is to evaluate whether a brief online video-based messaging intervention is an effective approach for encouraging men with suicidal thoughts and/or behaviours to engage with existing support services. METHODS: Informed by a literature review, surveys, and consultation with men with a lived experience of suicidal thoughts and/or behaviours, we designed five video-based messages that will be used in this five-arm randomised controlled trial. A total of 380 (76 per arm) men aged 18 years or older with suicidal thoughts who are not currently accessing formal mental health services will be recruited online and randomly assigned to watch one of the five web-based video messages. After viewing the video, men will be presented with information about four existing Australian support services, along with links to these services. The primary outcome will be help-seeking, operationalised as a click on any one of the four support service links, immediately after viewing the video. Secondary outcomes include immediate self-reported help-seeking intentions in addition to self-reported use of the support services during a 1-week follow-up period. We will also use the Discrete Choice Experiment methodology to determine what aspects of support services (e.g. low cost, short appointment wait times) are most valued by this group of men. DISCUSSION: This study is the first to evaluate the effectiveness of a brief web-based video messaging intervention for promoting engagement with existing support services among men with suicidal thoughts who are not currently receiving formal help. If found to be effective, this would represent a scalable, cost-effective approach to promote help-seeking for this at-risk population. Limitations and strengths of this study design are discussed.


Asunto(s)
Ideación Suicida , Prevención del Suicidio , Humanos , Masculino , Intervención basada en la Internet , Grabación en Video , Ensayos Clínicos Controlados Aleatorios como Asunto , Suicidio/psicología , Internet , Resultado del Tratamiento , Factores de Tiempo , Salud Mental , Servicios de Salud Mental , Aceptación de la Atención de Salud , Factores Sexuales , Australia
20.
IEEE J Biomed Health Inform ; 27(10): 5042-5053, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37498761

RESUMEN

Fidgety movements occur in infants between the age of 9 to 20 weeks post-term, and their absence are a strong indicator that an infant has cerebral palsy. Prechtl's General Movement Assessment method evaluates whether an infant has fidgety movements, but requires a trained expert to conduct it. Timely evaluation facilitates early interventions, and thus computer-based methods have been developed to aid domain experts. However, current solutions rely on complex models or high-dimensional representations of the data, which hinder their interpretability and generalization ability. To address that we propose [Formula: see text], a method that detects fidgety movements and uses them towards an assessment of the quality of an infant's general movements. [Formula: see text] is true to the domain expert process, more accurate, and highly interpretable due to its fine-grained scoring system. The main idea behind [Formula: see text] is to specify signal properties of fidgety movements that are measurable and quantifiable. In particular, we measure the movement direction variability of joints of interest, for movements of small amplitude in short video segments. [Formula: see text] also comprises a strategy to reduce those measurements to a single score that quantifies the quality of an infant's general movements; the strategy is a direct translation of the qualitative procedure domain experts use to assess infants. This brings [Formula: see text] closer to the process a domain expert applies to decide whether an infant produced enough fidgety movements. We evaluated [Formula: see text] on the largest clinical dataset reported, where it showed to be interpretable and more accurate than many methods published to date.

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