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1.
BMC Med Inform Decis Mak ; 24(1): 54, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38365677

RESUMO

BACKGROUND: Electronic health records (EHRs) contain valuable information for clinical research; however, the sensitive nature of healthcare data presents security and confidentiality challenges. De-identification is therefore essential to protect personal data in EHRs and comply with government regulations. Named entity recognition (NER) methods have been proposed to remove personal identifiers, with deep learning-based models achieving better performance. However, manual annotation of training data is time-consuming and expensive. The aim of this study was to develop an automatic de-identification pipeline for all kinds of clinical documents based on a distant supervised method to significantly reduce the cost of manual annotations and to facilitate the transfer of the de-identification pipeline to other clinical centers. METHODS: We proposed an automated annotation process for French clinical de-identification, exploiting data from the eHOP clinical data warehouse (CDW) of the CHU de Rennes and national knowledge bases, as well as other features. In addition, this paper proposes an assisted data annotation solution using the Prodigy annotation tool. This approach aims to reduce the cost required to create a reference corpus for the evaluation of state-of-the-art NER models. Finally, we evaluated and compared the effectiveness of different NER methods. RESULTS: A French de-identification dataset was developed in this work, based on EHRs provided by the eHOP CDW at Rennes University Hospital, France. The dataset was rich in terms of personal information, and the distribution of entities was quite similar in the training and test datasets. We evaluated a Bi-LSTM + CRF sequence labeling architecture, combined with Flair + FastText word embeddings, on a test set of manually annotated clinical reports. The model outperformed the other tested models with a significant F1 score of 96,96%, demonstrating the effectiveness of our automatic approach for deidentifying sensitive information. CONCLUSIONS: This study provides an automatic de-identification pipeline for clinical notes, which can facilitate the reuse of EHRs for secondary purposes such as clinical research. Our study highlights the importance of using advanced NLP techniques for effective de-identification, as well as the need for innovative solutions such as distant supervision to overcome the challenge of limited annotated data in the medical domain.


Assuntos
Aprendizado Profundo , Humanos , Anonimização de Dados , Registros Eletrônicos de Saúde , Análise Custo-Benefício , Confidencialidade , Processamento de Linguagem Natural
2.
BMC Med Inform Decis Mak ; 21(1): 274, 2021 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-34600518

RESUMO

BACKGROUND: Artificial intelligence (AI) has the potential to transform our healthcare systems significantly. New AI technologies based on machine learning approaches should play a key role in clinical decision-making in the future. However, their implementation in health care settings remains limited, mostly due to a lack of robust validation procedures. There is a need to develop reliable assessment frameworks for the clinical validation of AI. We present here an approach for assessing AI for predicting treatment response in triple-negative breast cancer (TNBC), using real-world data and molecular -omics data from clinical data warehouses and biobanks. METHODS: The European "ITFoC (Information Technology for the Future Of Cancer)" consortium designed a framework for the clinical validation of AI technologies for predicting treatment response in oncology. RESULTS: This framework is based on seven key steps specifying: (1) the intended use of AI, (2) the target population, (3) the timing of AI evaluation, (4) the datasets used for evaluation, (5) the procedures used for ensuring data safety (including data quality, privacy and security), (6) the metrics used for measuring performance, and (7) the procedures used to ensure that the AI is explainable. This framework forms the basis of a validation platform that we are building for the "ITFoC Challenge". This community-wide competition will make it possible to assess and compare AI algorithms for predicting the response to TNBC treatments with external real-world datasets. CONCLUSIONS: The predictive performance and safety of AI technologies must be assessed in a robust, unbiased and transparent manner before their implementation in healthcare settings. We believe that the consideration of the ITFoC consortium will contribute to the safe transfer and implementation of AI in clinical settings, in the context of precision oncology and personalized care.


Assuntos
Inteligência Artificial , Neoplasias , Algoritmos , Humanos , Aprendizado de Máquina , Medicina de Precisão
3.
Eur J Clin Pharmacol ; 74(4): 525-534, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29255993

RESUMO

AIM: Our aim was to describe prevalence, nature, and level of severity of potential statin drug-drug interactions in a university hospital. METHODS: In a cross-sectional study, statin drug-drug interactions were screened from medical record of 10,506 in-patients treated stored in the clinical data warehouse "eHOP." We screened drug-drug interactions using Theriaque and Micromedex drug databases. RESULTS: A total of 22.5% of patients were exposed to at least one statin drug-drug interaction. Given their lipophilicity and CYP3A4 metabolic pathway, atorvastatin and simvastatin presented a higher prevalence of drug-drug interactions while fluvastatin presented the lowest prevalence. Up to 1% of the patients was exposed to a contraindicated drug-drug interaction, the most frequent drug-drug interaction involving influx-transporter (i.e., OATP1B1) interactions between simvastatin or rosuvastatin with cyclosporin. The second most frequent contraindicated drug-drug interaction involved CYP3A4 interaction between atorvastatin or simvastatin with either posaconazole or erythromycin. Furthermore, our analysis showed some discrepancies between Theriaque and Micromedex in the prevalence and the nature of drug-drug interactions. CONCLUSIONS: Different drug-drug interaction profiles were observed between statins with a higher prevalence of CYP3A4-based interactions for lipophilic statins. Analyzing the three most frequent DDIs, the more significant DDIs (level 1: contraindication) were reported for transporter-based DDI involving OATP1B1 influx transporter. These points are of concern to improve prescriptions of statins.


Assuntos
Mineração de Dados , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Registros Eletrônicos de Saúde , Hospitais Universitários , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Estudos Transversais , Citocromo P-450 CYP3A/metabolismo , Data Warehousing , Interações Medicamentosas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/metabolismo , França/epidemiologia , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacocinética , Transportador 1 de Ânion Orgânico Específico do Fígado/metabolismo , Prevalência , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença
4.
BMC Med Inform Decis Mak ; 18(1): 9, 2018 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-29368609

RESUMO

BACKGROUND: Medical coding is used for a variety of activities, from observational studies to hospital billing. However, comorbidities tend to be under-reported by medical coders. The aim of this study was to develop an algorithm to detect comorbidities in electronic health records (EHR) by using a clinical data warehouse (CDW) and a knowledge database. METHODS: We enriched the Theriaque pharmaceutical database with the French national Comorbidities List to identify drugs associated with at least one major comorbid condition and diagnoses associated with a drug indication. Then, we compared the drug indications in the Theriaque database with the ICD-10 billing codes in EHR to detect potentially missing comorbidities based on drug prescriptions. Finally, we improved comorbidity detection by matching drug prescriptions and laboratory test results. We tested the obtained algorithm by using two retrospective datasets extracted from the Rennes University Hospital (RUH) CDW. The first dataset included all adult patients hospitalized in the ear, nose, throat (ENT) surgical ward between October and December 2014 (ENT dataset). The second included all adult patients hospitalized at RUH between January and February 2015 (general dataset). We reviewed medical records to find written evidence of the suggested comorbidities in current or past stays. RESULTS: Among the 22,132 Common Units of Dispensation (CUD) codes present in the Theriaque database, 19,970 drugs (90.2%) were associated with one or several ICD-10 diagnoses, based on their indication, and 11,162 (50.4%) with at least one of the 4878 comorbidities from the comorbidity list. Among the 122 patients of the ENT dataset, 75.4% had at least one drug prescription without corresponding ICD-10 code. The comorbidity diagnoses suggested by the algorithm were confirmed in 44.6% of the cases. Among the 4312 patients of the general dataset, 68.4% had at least one drug prescription without corresponding ICD-10 code. The comorbidity diagnoses suggested by the algorithm were confirmed in 20.3% of reviewed cases. CONCLUSIONS: This simple algorithm based on combining accessible and immediately reusable data from knowledge databases, drug prescriptions and laboratory test results can detect comorbidities.


Assuntos
Algoritmos , Comorbidade , Data Warehousing , Bases de Dados de Produtos Farmacêuticos , Registros Eletrônicos de Saúde , Codificação Clínica , Técnicas de Laboratório Clínico , Prescrições de Medicamentos , Humanos
5.
BMC Med Inform Decis Mak ; 18(1): 86, 2018 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-30340483

RESUMO

BACKGROUND: Pharmacovigilance consists in monitoring and preventing the occurrence of adverse drug reactions (ADR). This activity requires the collection and analysis of data from the patient record or any other sources to find clues of a causality link between the drug and the ADR. This can be time-consuming because often patient data are heterogeneous and scattered in several files. To facilitate this task, we developed a timeline prototype to gather and classify patient data according to their chronology. Here, we evaluated its usability and quantified its contribution to routine pharmacovigilance using real ADR cases. METHODS: The timeline prototype was assessed using the biomedical data warehouse eHOP (from entrepôt de données biomédicales de l'HOPital) of the Rennes University Hospital Centre. First, the prototype usability was tested by six experts of the Regional Pharmacovigilance Centre of Rennes. Their experience was assessed with the MORAE software and a System and Usability Scale (SUS) questionnaire. Then, to quantify the timeline contribution to pharmacovigilance routine practice, three of them were asked to investigate possible ADR cases with the "Usual method" (analysis of electronic health record data with the DxCare software) or the "Timeline method". The time to complete the task and the data quality in their reports (using the vigiGrade Completeness score) were recorded and compared between methods. RESULTS: All participants completed their tasks. The usability could be considered almost excellent with an average SUS score of 82.5/100. The time to complete the assessment was comparable between methods (P = 0.38) as well as the average vigiGrade Completeness of the data collected with the two methods (P = 0.49). CONCLUSIONS: The results showed a good general level of usability for the timeline prototype. Conversely, no difference in terms of the time spent on each ADR case and data quality was found compared with the usual method. However, this absence of difference between the timeline and the usual tools that have been in use for several years suggests a potential use in pharmacovigilance especially because the testers asked to continue using the timeline after the evaluation.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Farmacovigilância , Confiabilidade dos Dados , Data Warehousing , Registros Eletrônicos de Saúde , Humanos , Software , Inquéritos e Questionários
6.
BMC Med Inform Decis Mak ; 17(1): 139, 2017 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-28946908

RESUMO

BACKGROUND: Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and durability of such projects. METHODS: A systematic review was conducted using the PubMed database to identify worldwide current primary care data collection projects. The gray literature was also searched via official project websites and their contact person was emailed to obtain information on the project managers. Data were retrieved from the included studies using a standardized form, screening four aspects: projects features, technological infrastructure, GPs' roles, data collection network organization. RESULTS: The literature search allowed identifying 36 routine data collection networks, mostly in English-speaking countries: CPRD and THIN in the United Kingdom, the Veterans Health Administration project in the United States, EMRALD and CPCSSN in Canada. These projects had in common the use of technical facilities that range from extraction tools to comprehensive computing platforms. Moreover, GPs initiated the extraction process and benefited from incentives for their participation. Finally, analysis of the literature data highlighted that governmental services, academic institutions, including departments of general practice, and software companies, are pivotal for the promotion and durability of primary care data collection projects. CONCLUSION: Solid technical facilities and strong academic and governmental support are required for promoting and supporting long-term and wide-range primary care data collection projects.


Assuntos
Coleta de Dados , Registros Eletrônicos de Saúde , Atenção Primária à Saúde , Humanos
7.
J Biomed Inform ; 53: 162-73, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25463966

RESUMO

OBJECTIVES: To describe the IMI EHR4CR project which is designing and developing, and aims to demonstrate, a scalable, widely acceptable and efficient approach to interoperability between EHR systems and clinical research systems. METHODS: The IMI EHR4CR project is combining and extending several previously isolated state-of-the-art technical components through a new approach to develop a platform for reusing EHR data to support medical research. This will be achieved through multiple but unified initiatives across different major disease areas (e.g. cardiovascular, cancer) and clinical research use cases (protocol feasibility, patient identification and recruitment, clinical trial execution and serious adverse event reporting), with various local and national stakeholders across several countries and therefore under various legal frameworks. RESULTS: An initial instance of the platform has been built, providing communication, security and terminology services to the eleven participating hospitals and ten pharmaceutical companies located in seven European countries. Proof-of-concept demonstrators have been built and evaluated for the protocol feasibility and patient recruitment scenarios. The specifications of the clinical trial execution and the adverse event reporting scenarios have been documented and reviewed. CONCLUSIONS: Through a combination of a consortium that brings collectively many years of experience from previous relevant EU projects and of the global conduct of clinical trials, of an approach to ethics that engages many important stakeholders across Europe to ensure acceptability, of a robust iterative design methodology for the platform services that is anchored on requirements of an underlying Service Oriented Architecture that has been designed to be scalable and adaptable, EHR4CR could be well placed to deliver a sound, useful and well accepted pan-European solution for the reuse of hospital EHR data to support clinical research studies.


Assuntos
Pesquisa Biomédica/organização & administração , Redes de Comunicação de Computadores , Sistemas Computacionais , Registros Eletrônicos de Saúde , Fluxo de Trabalho , Algoritmos , Doenças Cardiovasculares/fisiopatologia , Ensaios Clínicos como Assunto , Desenho de Equipamento , Europa (Continente) , Hospitais , Humanos , Armazenamento e Recuperação da Informação , Informática Médica , Neoplasias/fisiopatologia
8.
Therapie ; 2015 Oct 16.
Artigo em Francês | MEDLINE | ID: mdl-26475750

RESUMO

AIM: To evaluate the performance of the collection of cases of anaphylactic shock during anesthesia in the Regional Pharmacovigilance Center of Rennes and the contribution of a query in the biomedical data warehouse of the French University Hospital of Rennes in 2009. METHODS: Different sources were evaluated: the French pharmacovigilance database (including spontaneous reports and reports from a query in the database of the programme de médicalisation des systèmes d'information [PMSI]), records of patients seen in allergo-anesthesia (source considered as comprehensive as possible) and a query in the data warehouse. RESULTS: Analysis of allergo-anesthesia records detected all cases identified by other methods, as well as two other cases (nine cases in total). The query in the data warehouse enabled detection of seven cases out of the nine. CONCLUSION: Querying full-text reports and structured data extracted from the hospital information system improves the detection of anaphylaxis during anesthesia and facilitates access to data.

9.
Stud Health Technol Inform ; 316: 813-817, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176916

RESUMO

The application of machine learning algorithms in clinical decision support systems (CDSS) holds great promise for advancing patient care, yet practical implementation faces significant evaluation challenges. Through a scoping review, we investigate the common definitions of ground truth to collect clinically relevant reference values, as well as the typical metrics and combinations employed for assessing trueness. Our analysis reveals that ground truth definition is mostly not in accordance with the standard ISO expectation and that used combination of metrics does not usually cover all aspects of CDSS trueness, particularly neglecting the negative class perspective.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Aprendizado de Máquina , Humanos , Algoritmos
10.
Stud Health Technol Inform ; 316: 1584-1588, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176511

RESUMO

This study assesses the effectiveness of the Observational Medical Outcomes Partnership common data model (OMOP CDM) in standardising Continuous Renal Replacement Therapy (CRRT) data from intensive care units (ICU) of two French university hospitals. Our objective was to extract and standardise data from various sources, enabling the development of predictive models for CRRT weaning that are agnostic to the data's origin. Data for 1,696 ICU stays from the two data sources were extracted, transformed, and loaded into the OMOP format after semantic alignment of 46 CRRT standard concepts. Although the OMOP CDM demonstrated potential in harmonising CRRT data, we encountered challenges related to data variability and the lack of standard concepts. Despite these challenges, our study supports the promise of the OMOP CDM for ICU data standardization, suggesting that further refinement and adaptation could significantly improve clinical decision making and patient outcomes in critical care settings.


Assuntos
Unidades de Terapia Intensiva , Humanos , França , Unidades de Terapia Intensiva/normas , Terapia de Substituição Renal Contínua , Confiabilidade dos Dados , Cuidados Críticos/normas , Terapia de Substituição Renal/normas
11.
Stud Health Technol Inform ; 316: 611-615, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176816

RESUMO

Secure extraction of Personally Identifiable Information (PII) from Electronic Health Records (EHRs) presents significant privacy and security challenges. This study explores the application of Federated Learning (FL) to overcome these challenges within the context of French EHRs. By utilizing a multilingual BERT model in an FL simulation involving 20 hospitals, each represented by a unique medical department or pole, we compared the performance of two setups: individual models, where each hospital uses only its own training and validation data without engaging in the FL process, and federated models, where multiple hospitals collaborate to train a global FL model. Our findings demonstrate that FL models not only preserve data confidentiality but also outperform the individual models. In fact, the Global FL model achieved an F1 score of 75,7%, slightly comparable to that of the Centralized approach at 78,5%. This research underscores the potential of FL in extracting PIIs from EHRs, encouraging its broader adoption in health data analysis.


Assuntos
Segurança Computacional , Confidencialidade , Registros Eletrônicos de Saúde , Aprendizado de Máquina , França , Humanos , Registros de Saúde Pessoal
12.
Stud Health Technol Inform ; 316: 1577-1581, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176509

RESUMO

Hospital laboratory results are a significant data source in Clinical Data Ware-houses (CDW). To ensure comparability across healthcare organizations and for use in research studies, the results need to be interoperable. The LOINC (Logical Observation Identifiers, Names, and Codes) terminology provides a unique identifier for local codes for lab tests, enabling interoperability. However, in real-world, events occur over time and can disrupt the distribution of lab result values. For example, new equipment may be added to the analysis pipeline, a machine may be replaced, formulas may evolve due to new scientific knowledge, and legacy terminologies may be adopted. This article proposes a pipeline for creating an automated dashboard to monitor these events and data quality. We used automatic change point detection methods such as PELT for event detection in lab results. For a given LOINC code, we create a dashboard that summarizes the number of local codes mapped, and the number of patients (by sex, age, and hospital service) associated with the code. Finally, the dashboard enables the visualization of time events that disrupt the signal distribution. The biologists were able to explain to us the changes for several biological assays.


Assuntos
Data Warehousing , Humanos , Logical Observation Identifiers Names and Codes , Sistemas de Informação em Laboratório Clínico , Registros Eletrônicos de Saúde , Interface Usuário-Computador
13.
Stud Health Technol Inform ; 316: 1605-1606, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176517

RESUMO

This paper presents the development of a visualization dashboard for quality indicators in intensive care units (ICUs), using the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). The dashboard enables the user to visualize quality indicator data using histograms, pie charts and tables. Our project uses the OMOP CDM, ensuring a seamless implementation of our dashboard across various hospitals. Future directions for our research include expanding the dashboard to incorporate additional quality indicators and evaluating clinicians' feedback on its effectiveness.


Assuntos
Unidades de Terapia Intensiva , Indicadores de Qualidade em Assistência à Saúde , Unidades de Terapia Intensiva/normas , Cuidados Críticos/normas , Humanos , Interface Usuário-Computador , Avaliação de Resultados em Cuidados de Saúde , Benchmarking
14.
Stud Health Technol Inform ; 316: 1679-1683, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176533

RESUMO

The Ouest Data Hub (ODH) a project lead by GCS HUGO which is a cooperation group of University Hospitals in the French Grand Ouest region represents a groundbreaking initiative in this territory, advancing health data sharing and reuse to support research driven by real-world health data. Central to its structure are the Clinical Data Warehouses (CDWs) and Clinical Data Centers (CDCs), essential for analytics and as the linchpin of the ODH's status as an interregional Learning Health System. Aimed at fostering innovation and research, the ODH's collaborative and multi-institutional model effectively utilizes both local and shared resources. Yet, the path is not without challenges, especially in data quality and interoperability, where ongoing harmonization and standard adherence are critical. In 2023, this facilitated access to extensive health data from over 9.3 million patient records, demonstrating the ODH's capacity for both monocentric and multicentric research across various clinical fields, in close collaboration with physicians. The integration of healthcare professionals is crucial, ensuring data's clinical relevance and guiding accurate interpretations. Future expansions of the ODH to new hospitals and data types promise to enhance its model further, already inspiring similar frameworks across France. This scalable model for health data ecosystems showcases the ODH's potential as a foundation for national and supranational data sharing efforts.


Assuntos
Disseminação de Informação , França , Humanos , Registros Eletrônicos de Saúde , Data Warehousing , Pesquisa Biomédica
15.
Stud Health Technol Inform ; 316: 1739-1743, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176549

RESUMO

Continuous unfractionated heparin is widely used in intensive care, yet its complex pharmacokinetic properties complicate the determination of appropriate doses. To address this challenge, we developed machine learning models to predict over- and under-dosing, based on anti-Xa results, using a monocentric retrospective dataset. The random forest model achieved a mean AUROC of 0.80 [0.77-0.83], while the XGB model reached a mean AUROC of 0.80 [0.76-0.83]. Feature importance was employed to enhance the interpretability of the model, a critical factor for clinician acceptance. After prospective validation, machine learning models such as those developed in this study could be implemented within a computerized physician order entry (CPOE) as a clinical decision support system (CDSS).


Assuntos
Anticoagulantes , Sistemas de Apoio a Decisões Clínicas , Heparina , Unidades de Terapia Intensiva , Aprendizado de Máquina , Heparina/uso terapêutico , Humanos , Anticoagulantes/uso terapêutico , Sistemas de Registro de Ordens Médicas , Estudos Retrospectivos
16.
Stud Health Technol Inform ; 316: 221-225, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176713

RESUMO

This paper introduces a novel approach aimed at enhancing the accessibility of clinical data warehouses (CDWs) for external users, particularly researchers and biomedical companies interested in developing and testing their solutions. The primary focus is on proposing a clinical data catalogue designed to elucidate the contents of CDWs, facilitating biomedical project launch and completion. The catalogue is designed to address three fundamental inquiries that external users may have regarding CDWs: "What data is available, how much data is present, and how was it generated?" Additionally, the paper showcases a prototype of the catalogue through a visualization example, utilizing data from the CDW of Rennes University Hospital.


Assuntos
Data Warehousing , Registros Eletrônicos de Saúde , Humanos
17.
Eur Heart J Open ; 4(1): oead133, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38196848

RESUMO

Aims: Patients presenting symptoms of heart failure with preserved ejection fraction (HFpEF) are not a homogenous population. Different phenotypes can differ in prognosis and optimal management strategies. We sought to identify phenotypes of HFpEF by using the medical information database from a large university hospital centre using machine learning. Methods and results: We explored the use of clinical variables from electronic health records in addition to echocardiography to identify different phenotypes of patients with HFpEF. The proposed methodology identifies four phenotypic clusters based on both clinical and echocardiographic characteristics, which have differing prognoses (death and cardiovascular hospitalization). Conclusion: This work demonstrated that artificial intelligence-derived phenotypes could be used as a tool for physicians to assess risk and to target therapies that may improve outcomes.

18.
Stud Health Technol Inform ; 316: 1373-1377, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176636

RESUMO

The ONCO-FAIR project's initial experimentation aims to enhance data interoperability in oncology chemotherapy treatments, adhering to the FAIR principles. This study focuses on integrating the HL7 FHIR standard to address interoperability challenges within chemotherapy data exchange. Collaborating with healthcare institutions in Rennes, the research team assessed the limitations of current standards such as PN13, mCODE, and OSIRIS, leading to the customization of twelve FHIR resources complemented by two chemotherapy-specific extensions. The methodological approach follows the Integrating the Healthcare Enterprise (IHE) framework, organizing the process into four key stages to ensure the effectiveness and relevance of health data reuse for research. This framework facilitated the identification of chemotherapy-specific needs, the evaluation of existing standards, and data modeling through a FHIR implementation guide. The article underscores the importance of upstream interoperability for aligning chemotherapy software with clinical data warehouse infrastructure, showcasing the proposed solution's capability to overcome interoperability barriers and promote data reuse in line with FAIR principles. Furthermore, it discusses future directions, including extending this approach to other oncology data categories and enhancing downstream interoperability with health data sharing platforms.


Assuntos
Interoperabilidade da Informação em Saúde , Humanos , Interoperabilidade da Informação em Saúde/normas , Antineoplásicos/uso terapêutico , Oncologia/normas , Nível Sete de Saúde/normas , Registros Eletrônicos de Saúde , Neoplasias/tratamento farmacológico , Data Warehousing
19.
Stud Health Technol Inform ; 316: 1979-1983, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176881

RESUMO

Electronic health data concerning implantable medical devices (IMD) opens opportunities for dynamic real-world monitoring to assess associated risks related to implanted materials. Due to population ageing and expanding demands, total hip, knee, and shoulder arthroplasties are increasing. Automating the collection and analysis of orthopedic device features could benefit physicians and public health policies enabling early issue detection, IMD monitoring and patient safety assessment. A machine learning tool using natural language processing (NLP) was developed for the automated extraction of operation information from medical reports in orthopedics. A corpus of 959 orthopaedic operative reports from 5 centres was manually annotated using the Prodigy software® with a strong inter-annotator agreement of 0.80. Data to extract concerned key clinical and procedure information (n= 9) selected by a multidisciplinary group based on the French health authority checklist. Performances parameters of the NLP model estimated an overall strong precision and recall of respectively 97.0 and 96.0 with a F1-score 96.3. Systematic monitoring of orthopedic devices could be ensured by an automated tool, leveraging clinical data warehouses. Traceability of medical devices with implantation modalities will allow detection of implant factors leading to complications. The evidence from real-world data could provide concrete and dynamic insights to surgeons and infectious disease specialists concerning implant follow-up, guiding therapeutic decision-making, and informing public health policymakers. The tool will be applied on clinical data warehouses to automate information extraction and presentation, providing feedback on mandatory information completion and contents of operative reports to support improvements, and thereafter implant research projects.


Assuntos
Registros Eletrônicos de Saúde , Aprendizado de Máquina , Processamento de Linguagem Natural , França , Humanos , Procedimentos Ortopédicos
20.
Stud Health Technol Inform ; 316: 1465-1466, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39176480

RESUMO

Key Research Areas (KRAs) were identified to establish a semantic interoperability framework for intensive medicine data in Europe. These include assessing common data model value, ensuring smooth data interoperability, supporting data standardization for efficient dataset use, and defining anonymization requirements to balance data protection and innovation.


Assuntos
Registros Eletrônicos de Saúde , Europa (Continente) , Humanos , Interoperabilidade da Informação em Saúde , Cuidados Críticos , Segurança Computacional , Semântica
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