What Do Patients and Experts Want in a Smartphone-Based Application to Support Tuberculosis Treatment Completion?

A mobile application to support individuals receiving treatment for active tuberculosis (TB) by self-administration is being developed with TB experts and patients in active TB treatment using agile development methods to meet the needs of endusers.

Prognostics of surgical site infections using dynamic health data.

Surgical Site Infection (SSI) is a national priority in healthcare research. Much research attention has been attracted to develop better SSI risk prediction models. However, most of the existing SSI risk prediction models are built on static risk factors such as comorbidities and operative factors. In this paper, we investigate the use of the dynamic wound data for SSI risk prediction. There have been emerging mobile health (mHealth) tools that can closely monitor the patients and generate continuous measurements of many wound-related variables and other evolving clinical variables. Since existing prediction models of SSI have quite limited capacity to utilize the evolving clinical data, we develop the corresponding solution to equip these mHealth tools with decision-making capabilities for SSI prediction with a seamless assembly of several machine learning models to tackle the analytic challenges arising from the spatial-temporal data. The basic idea is to exploit the low-rank property of the spatial-temporal data via the bilinear formulation, and further enhance it with automatic missing data imputation by the matrix completion technique. We derive efficient optimization algorithms to implement these models and demonstrate the superior performances of our new predictive model on a real-world dataset of SSI, compared to a range of state-of-the-art methods.

Developing syndrome definitions based on consensus and current use.

OBJECTIVE: Standardized surveillance syndromes do not exist but would facilitate sharing data among surveillance systems and comparing the accuracy of existing systems. The objective of this study was to create reference syndrome definitions from a consensus of investigators who currently have or are building syndromic surveillance systems. DESIGN: Clinical condition-syndrome pairs were catalogued for 10 surveillance systems across the United States and the representatives of these systems were brought together for a workshop to discuss consensus syndrome definitions. RESULTS: Consensus syndrome definitions were generated for the four syndromes monitored by the majority of the 10 participating surveillance systems: Respiratory, gastrointestinal, constitutional, and influenza-like illness (ILI). An important element in coming to consensus quickly was the development of a sensitive and specific definition for respiratory and gastrointestinal syndromes. After the workshop, the definitions were refined and supplemented with keywords and regular expressions, the keywords were mapped to standard vocabularies, and a web ontology language (OWL) ontology was created. LIMITATIONS: The consensus definitions have not yet been validated through implementation. CONCLUSION: The consensus definitions provide an explicit description of the current state-of-the-art syndromes used in automated surveillance, which can subsequently be systematically evaluated against real data to improve the definitions. The method for creating consensus definitions could be applied to other domains that have diverse existing definitions.

Creating a note classification scheme for a multi-institutional electronic medical record.

How notes are categorized in an electronic medical record (EMR) influences how rapidly users can locate documents and enter new ones, whether algorithmic search for chart deficiencies is possible, and the ease of incorporating collections of existing notes. We balanced these competing needs when developing a note classification scheme for the Online Record of Clinical Activity (ORCA) electronic medical record at the University of Washington.