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1.
Front Psychol ; 13: 811517, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35478769

RESUMO

Background: Depression and anxiety create a large health burden and increase the risk of premature mortality. Mental health screening is vital, but more sophisticated screening and monitoring methods are needed. The Ellipsis Health App addresses this need by using semantic information from recorded speech to screen for depression and anxiety. Objectives: The primary aim of this study is to determine the feasibility of collecting weekly voice samples for mental health screening. Additionally, we aim to demonstrate portability and improved performance of Ellipsis' machine learning models for patients of various ages. Methods: Study participants were current patients at Desert Oasis Healthcare, mean age 63 years (SD = 10.3). Two non-randomized cohorts participated: one with a documented history of depression within 24 months prior to the study (Group Positive), and the other without depression (Group Negative). Participants recorded 5-min voice samples weekly for 6 weeks via the Ellipsis Health App. They also completed PHQ-8 and GAD-7 questionnaires to assess for depression and anxiety, respectively. Results: Protocol completion rate was 61% for both groups. Use beyond protocol was 27% for Group Positive and 9% for Group Negative. The Ellipsis Health App showed an AUC of 0.82 for the combined groups when compared to the PHQ-8 and GAD-7 with a threshold score of 10. Performance was high for senior participants as well as younger age ranges. Additionally, many participants spoke longer than the required 5 min. Conclusion: The Ellipsis Health App demonstrated feasibility in using voice recordings to screen for depression and anxiety among various age groups and the machine learning models using Transformer methodology maintain performance and improve over LSTM methodology when applied to the study population.

2.
Cancers (Basel) ; 14(4)2022 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-35205663

RESUMO

Adolescents and young adults (AYAs) diagnosed with cancer are an age-defined population, with studies reporting up to 45% of the population experiencing psychological distress. Although it is essential to screen and monitor for psychological distress throughout AYAs' cancer journeys, many cancer centers fail to effectively implement distress screening protocols largely due to busy clinical workflow and survey fatigue. Recent advances in mobile technology and speech science have enabled flexible and engaging methods to monitor psychological distress. However, patient-centered research focusing on these methods' feasibility and acceptability remains lacking. Therefore, in this project, we aim to evaluate the feasibility and acceptability of an artificial intelligence (AI)-enabled and speech-based mobile application to monitor psychological distress among AYAs diagnosed with cancer. We use a single-arm prospective cohort design with a stratified sampling strategy. We aim to recruit 60 AYAs diagnosed with cancer and to monitor their psychological distress using an AI-enabled speech-based distress monitoring tool over a 6 month period. The primary feasibility endpoint of this study is defined by the number of participants completing four out of six monthly distress assessments, and the acceptability endpoint is defined both quantitatively using the acceptability of intervention measure and qualitatively using semi-structured interviews.

3.
J Am Med Inform Assoc ; 28(8): 1765-1776, 2021 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-34051088

RESUMO

OBJECTIVE: To utilize, in an individual and institutional privacy-preserving manner, electronic health record (EHR) data from 202 hospitals by analyzing answers to COVID-19-related questions and posting these answers online. MATERIALS AND METHODS: We developed a distributed, federated network of 12 health systems that harmonized their EHRs and submitted aggregate answers to consortia questions posted at https://www.covid19questions.org. Our consortium developed processes and implemented distributed algorithms to produce answers to a variety of questions. We were able to generate counts, descriptive statistics, and build a multivariate, iterative regression model without centralizing individual-level data. RESULTS: Our public website contains answers to various clinical questions, a web form for users to ask questions in natural language, and a list of items that are currently pending responses. The results show, for example, that patients who were taking angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, within the year before admission, had lower unadjusted in-hospital mortality rates. We also showed that, when adjusted for, age, sex, and ethnicity were not significantly associated with mortality. We demonstrated that it is possible to answer questions about COVID-19 using EHR data from systems that have different policies and must follow various regulations, without moving data out of their health systems. DISCUSSION AND CONCLUSIONS: We present an alternative or a complement to centralized COVID-19 registries of EHR data. We can use multivariate distributed logistic regression on observations recorded in the process of care to generate results without transferring individual-level data outside the health systems.


Assuntos
Algoritmos , COVID-19 , Redes de Comunicação de Computadores , Confidencialidade , Registros Eletrônicos de Saúde , Armazenamento e Recuperação da Informação/métodos , Processamento de Linguagem Natural , Elementos de Dados Comuns , Feminino , Humanos , Modelos Logísticos , Masculino , Sistema de Registros
4.
medRxiv ; 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32995818

RESUMO

There is an urgent need to answer questions related to COVID-19's clinical course and associations with underlying conditions and health outcomes. Multi-center data are necessary to generate reliable answers, but centralizing data in a single repository is not always possible. Using a privacy-protecting strategy, we launched a public Questions & Answers web portal (https://covid19questions.org) with analyses of comorbidities, medications and laboratory tests using data from 202 hospitals (59,074 COVID-19 patients) in the USA and Germany. We find, for example, that 8.6% of hospitalizations in which the patient was not admitted to the ICU resulted in the patient returning to the hospital within seven days from discharge and that, when adjusted for age, mortality for hospitalized patients was not significantly different by gender or ethnicity.

5.
Stud Health Technol Inform ; 163: 670-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21335877

RESUMO

In this paper we summarize the progress of the Web3D scene graph model, and associated standards, specifically Extensible 3D (X3D) in the domain of medical simulation. Historically, the Web3D nodesets have focused on the representation and rendering of point, line or surface geometry. More recently, significant progress in X3D Volume rendering has been made available through the co-operative DICOM work item, n-Dimensional Presentation States. However, here we outline the need for a standard for simulation meshes and review several related approaches. As a result, we propose preliminary requirements for a simulation mesh standard and provide several use case scenarios of how Web3D and haptic technologies can aid the fulfillment of these requirements. We conclude with an X3D proposal to describe simulation meshes for soft (deformable) bodies.


Assuntos
Simulação por Computador , Internet , Modelos Anatômicos , Modelos Biológicos , Humanos
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