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A computerized algorithm to capture patient's past preeclampsia and eclampsia history from prenatal clinical notes

HEALTH INFORMATICS JOURNAL 2019年第4期25卷 1299-1313页

作者： Xie, Fagen Im, Theresa Getahun, Darios Kaiser Permanente Southern Calif Pasadena CA USA

Prenatal clinical notes in electronic medical records contain a wealth of information on pregnancy complications and outcomes. Extracting this critical information provides a unique opportunity for risk assessment to identify at-risk patients who may benefit from early monitoring and intervention. We developed and validated a rule-based computerized algorithm called PregHisEx to characterize past obstetrical history (preeclampsia/eclampsia) by mining prenatal clinical notes for women delivered in 2012 within a large healthcare maintenance organization. The algorithm successfully identified cases with past history of preeclampsia/eclampsia: 2984 definite and 479 probable cases at sentence level;2419 definite and 348 probable cases at note level;and 762 definite and 82 probable cases at pregnancy episode level. Validation conducted on a random sample of 200 notes using PregHisEx yielded 88.0percent sensitivity, 98.9percent specificity, 91.7percent positive predictive value, 98.3percent negative predictive value, and F-score of 0.90. The high-performing PregHisEx can be applied for other prenatal conditions.

关键词： computerized algorithm history natural language processing preeclampsia eclampsia pregnancy outcome prenatal care rule-based

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computerized algorithm for deducing the minimal cut sets used in substation reliability evaluation

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INTERNATIONAL TRANSACTIONS ON ELECTRICAL ENERGY SYSTEMS 2015年第4期25卷 573-588页

作者： Hajian-Hoseinabadi, Hamze Isfahan Univ Technol Dept Elect & Comp Engn Esfahan *** Iran

This paper presents a new technique for the determination of minimal cut sets in substation reliability evaluation. The proposed technique detects events including the malfunction of circuit breakers referred to as stuck-breaker conditions. These selections are important steps in substation reliability evaluation. The effectiveness of the proposed technique is examined by it being applied to breaker-and-a-half, ring bus and radial configurations. The proposed technique can be easily used in the expansion of computer programs in order to obtain the substation reliability indices. Copyright (c) 2014 John Wiley & Sons, Ltd.

关键词： computerized algorithm connection matrix minimal cut set substation reliability evaluation

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Reproducibility and prognostic ability of chronicity parameters in kidney biopsy - Comprehensive evaluation comparing microscopy and artificial intelligence in digital pathology

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HUMAN PATHOLOGY 2024年 146卷 75-85页

作者： Ganesh, Rajesh Nachiappa Graviss, Edward A. Nguyen, Duc El-Zaatari, Ziad Gaber, Lillian Barrios, Roberto Truong, Luan Farris, Alton B. Houston Methodist Hosp & Res Inst Dept Pathol & Genom Med Houston TX 77030 USA JC Walter Jr Transplant Ctr Dept Surg Houston TX USA Baylor Coll Med Dept Pediat Houston TX USA Emory Univ Hosp Dept Pathol & Lab Med Atlanta GA USA

Introduction: Semi-quantitative scoring of various parameters in renal biopsy is accepted as an important tool to assess disease activity and prognostication. There are concerns on the impact of interobserver variability in its prognostic utility, generating a need for computerized quantification. Methods: We studied 94 patients with renal biopsies, 45 with native diseases and 49 transplant patients with index biopsies for Polyomavirus nephropathy. Chronicity scores were evaluated using two methods. A standard definition diagram was agreed after international consultation and four renal pathologists scored each parameter in a double-blinded manner. Interstitial fibrosis (IF) score was assessed with five different computerized and AIbased algorithms on trichrome and PAS stains. Results: There was strong prognostic correlation with renal function and graft outcome at a median follow-up ranging from 24 to 42 months respectively, independent of moderate concordance for pathologists scores. IF scores with two of the computerized algorithms showed significant correlation with estimated glomerular filtration rate (eGFR) at biopsy but not at the end of follow-up. There was poor concordance for AI based platforms. Conclusion: Chronicity scores are robust prognostic tools despite interobserver reproducibility. AI-algorithms have absolute precision but are limited by significant variation when different hardware and software algorithms are used for quantification.

关键词： Histopathologic chronicity score computerized algorithm Artificial intelligence Interobserver variability Renal prognosis

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Identification of Preterm Labor Evaluation Visits and Extraction of Cervical Length Measures from Electronic Health Records Within a Large Integrated Health Care System: algorithm Development and Validation

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JMIR MEDICAL INFORMATICS 2022年第9期10卷 e37896页

作者： Xie, Fagen Khadka, Nehaa Fassett, Michael J. Chiu, Vicki Y. Avila, Chantal C. Shi, Jiaxiao Yeh, Meiyu Kawatkar, Aniket Mensah, Nana A. Sacks, David A. Getahun, Darios Kaiser Permanente Southern Calif Dept Res & Evaluat Pasadena CA USA Kaiser Permanente West Los Angeles Med Ctr Dept Obstet & Gynecol Los Angeles CA USA Kaiser Permanente Bernard J Tyson Sch Med Dept Clin Sci Pasadena CA USA Kaiser Permanente Bernard J Tyson Sch Med Dept Hlth Syst Sci Pasadena CA USA

Background: Preterm birth (PTB) represents a significant public health problem in the United States and throughout the world. Accurate identification of preterm labor (PTL) evaluation visits is the first step in conducting PTB-related research. Objective: We aimed to develop a validated computerized algorithm to identify PTL evaluation visits and extract cervical length (CL) measures from electronic health records (EHRs) within a large integrated health care system. Methods: We used data extracted from the EHRs at Kaiser Permanente Southern California between 2009 and 2020. First, we identified triage and hospital encounters with fetal fibronectin (fFN) tests, transvaginal ultrasound (TVUS) procedures, PTL medications, or PTL diagnosis codes within 24(0/7)-34(6/7) gestational weeks. Second, clinical notes associated with triage and hospital encounters within 24(0/7)-34(6/7) gestational weeks were extracted from EHRs. A computerized algorithm and an automated process were developed and refined by multiple iterations of chart review and adjudication to search the following PTL indicators: fFN tests, TVUS procedures, abdominal pain, uterine contractions, PTL medications, and descriptions of PTL evaluations. An additional process was constructed to extract the CLs from the corresponding clinical notes of these identified PTL evaluation visits. Results: A total of 441,673 live birth pregnancies were identified between 2009 and 2020. Of these, 103,139 pregnancies (23.35%) had documented PTL evaluation visits identified by the computerized algorithm. The trend of pregnancies with PTL evaluation visits slightly decreased from 24.41% (2009) to 17.42% (2020). Of the first 103,139 PTL visits, 19,439 (18.85%) and 44,423 (43.97%) had an fFN test and a TVUS, respectively. The percentage of first PTL visits with an fFN test decreased from 18.06% at 24(0/7) gestational weeks to 2.32% at 34(6/7) gestational weeks, and TVUS from 54.67% at 24(0/7) gestational weeks to 12.05% in 34(6/7

关键词： preterm labor preterm birth fetal fibronectin transvaginal ultrasound cervical length natural language processing computerized algorithm data extraction patient records clinical notes evaluation notes patient care patient notes electronic health records

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An automated algorithm using free-text clinical notes to improve identification of transgender people

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INFORMATICS FOR HEALTH & SOCIAL CARE 2021年第1期46卷 18-28页

作者： Xie, Fagen Getahun, Darios Quinn, Virginia P. Im, Theresa M. Contreras, Richard Silverberg, Michael J. Baird, Tisha C. Nash, Rebecca Cromwell, Lee Roblin, Douglas Hoffman, Trenton Goodman, Michael Kaiser Permanente Southern Calif Med Grp Dept Res & Evaluat Pasadena CA 91101 USA Kaiser Permanente Div Res Oakland CA USA Kaiser Permanente Los Angeles Med Ctr Dept Endocrinol Los Angeles CA USA Emory Univ Sch Publ Hlth Dept Epidemiol Atlanta GA USA Kaiser Permanente Georgia Ctr Clin & Outcomes Res Atlanta GA USA Georgia State Univ Sch Publ Hlth Atlanta GA 30303 USA

Accurate identification of transgender persons is a critical first step in conducting transgender health studies. To develop an automated algorithm for identifying transgender individuals from electronic medical records (EMR) using free-text clinical notes. The development and validation of the algorithm was based on data from an integrated healthcare system that served as a participating site in the multicenter Study of Transition Outcomes and Gender. The training and test datasets each contained a total of 300 individuals identified between 2006 and 2014. Both datasets underwent a full medical record review by experienced research abstractors. The validated algorithm was then implemented to identify transgender individuals in the EMR using all clinical notes of patients that received care between January 1, 2015 and June 30, 2018. Validation of the algorithm against the full chart review demonstrated a high degree of accuracy with 97% sensitivity, 95% specificity, 94% positive predictive value, and 97% negative predictive value. The algorithm classified 7,409 individuals (3.5%) as "Definitely transgender" and 679 individuals (0.3%) as "Probably transgender" out of 212,138 candidates with a total of 378,641 clinical notes. The computerized NLP algorithm can support essential efforts to improve the health of transgender people.

关键词： Transgender natural language processing computerized algorithm rule-based

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Identifying Symptoms Prior to Pancreatic Ductal Adenocarcinoma Diagnosis in Real-World Care Settings: Natural Language Processing Approach

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JMIR AI 2024年 3卷 e51240页

作者： Xie, Fagen Chang, Jenny Luong, Tiffany Wu, Bechien Lustigova, Eva Shrader, Eva Chen, Wansu Kaiser Permanente Southern Calif Dept Res & Evaluat 100 S Los Robles Ave Pasadena CA 91101 USA Pancreat Canc Act Network Manhattan Beach CA USA

Background: Pancreatic cancer is the third leading cause of cancer deaths in the United States. Pancreatic ductal adenocarcinoma (PDAC) is the most common form of pancreatic cancer, accounting for up to 90% of all cases. Patient-reported symptoms are often the triggers of cancer diagnosis and therefore, understanding the PDAC-associated symptoms and the timing of symptom Objective: This paper aims to develop a natural language processing (NLP) algorithm to capture symptoms associated with PDAC from clinical notes within a large integrated health care system. Methods: We used unstructured data within 2 years prior to PDAC diagnosis between 2010 and 2019 and among matched patients without PDAC to identify 17 PDAC-related symptoms. Related terms and phrases were first compiled from publicly available resources and then recursively reviewed and enriched with input from clinicians and chart review. A computerized NLP algorithm was iteratively developed and fine-trained via multiple rounds of chart review followed by adjudication. Finally, the developed algorithm was applied to the validation data set to assess performance and to the study implementation notes. Results: A total of 408,147 and 709,789 notes were retrieved from 2611 patients with PDAC and 10,085 matched patients without PDAC, respectively. In descending order, the symptom distribution of the study implementation notes ranged from 4.98% for abdominal or epigastric pain to 0.05% for upper extremity deep vein thrombosis in the PDAC group, and from 1.75% for back pain to 0.01% for pale stool in the non-PDAC group. Validation of the NLP algorithm against adjudicated chart review results of 1000 notes showed that precision ranged from 98.9% (jaundice) to 84% (upper extremity deep vein thrombosis), recall ranged from 98.1% (weight loss) to 82.8% (epigastric bloating), and F1-scores ranged from 0.97 (jaundice) to 0.86 (depression). Conclusions: The developed and validated NLP algorithm could be used for the early d

关键词： cancer pancreatic ductal adenocarcinoma symptom clinical note electronic health record natural language processing computerized algorithm pancreatic cancer cancer death abdominal pain pain validation detection pancreas

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Computer-Assisted Mapping in Electrophysiology: Are the Machines Taking Over?

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JACC. Clinical electrophysiology 2017年第7期3卷 700-702页

作者： Frank Bogun Mohammed Saeed Division of Cardiovascular Medicine University of Michigan Ann Arbor Michigan. Electronic address: fbogun@med.umich.edu. Division of Cardiovascular Medicine University of Michigan Ann Arbor Michigan.

Corresponding Author

关键词： computerized algorithm exit site machine learning ventricular tachycardia

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A Mixed-Methods Quick Strike Research Protocol to Learn About Children With Complex Health Conditions and Their Families

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INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2017年第1期16卷 1-1页

作者： Doucet, Shelley Nagel, Daniel A. Azar, Rima Montelpare, William J. Charlton, Pat Hyndman, Nicky Luke, Alison Stoddard, Roger Univ New Brunswick Dept Nursing & Hlth Sci 100 Tucker Pk Rd St John NB E2L 4L5 Canada Mt Allison Univ Dept Psychol Psychobiol Stress & Hlth Lab Sackville NB Canada Univ Prince Edward Isl Fac Sci Charlottetown PE Canada Univ Prince Edward Isl Fac Nursing Charlottetown PE Canada Univ Prince Edward Isl Dept Appl Human Sci Charlottetown PE Canada Horizon Hlth Prov Advisory Council St John NB Canada

Advances have been made to improve health care for children with complex health conditions (CCHCs);however, little is known of the needs of these children and their families in the Canadian context. In this article, we describe our Canadian Institutes of Health Research funded Quick Strike protocol, a mixed-methods multisite research project that explored CCHC and their families in two Canadian provinces. The aims were (a) to describe and define CCHC, (b) to understand the needs of CCHC and their families, (c) to identify gaps and barriers to services for this population, and (d) to adapt and test the application of a computerized algorithm to yield information on CCHC. The mixed-methods design was comprised of four components: three qualitative and one quantitative. We describe the components of this project and outline the methods and procedures of data collection and analysis for each component. One of the main sources of data was interviews from 121 stakeholders, which included CCHC and family members, as well as health, social, and education professionals. This Quick Strike project was designed to engage stakeholders and the public with integrated knowledge translation threaded as a core element throughout the research process. Multiple strategies were used to validate and disseminate early findings from the research. As we outline in this article, this research project provided the foundation for one innovative service model of care, NaviCare/SoinsNavi, and spawned a number of additional outcomes such as a secondary analysis of the data to describe interprofessional collaboration for CCHC.

关键词： mixed method qualitative methodology qualitative analysis quantitative analysis computerized algorithm protocol pediatrics

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Clinical validation of a new algorithm for computerized dosing of vitamin K antagonist therapy: a retrospective simulation study

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INTERNAL AND EMERGENCY MEDICINE 2013年第1期8卷 55-63页

作者： Basileo, Michela Micheluzzi, Carlo Minozzi, Marina Lazzaroni, Luigi Iorio, Alfonso Univ Perugia Dept Internal & Cardiovasc Med I-06100 Perugia Italy EDP Progetti Srl Bolzano Italy Univ Roma La Sapienza Dept Diag & Treatment Serv Thromboembol Disorders Rome Italy Roche Diagnost Italy SpA Milan Italy McMaster Univ Dept Clin Epidemiol & Biostat & Med Hamilton Hlth Sci Hamilton ON Canada

The number of patients on oral anticoagulant therapy has increased in recent years, and this trend is expected to continue. The increased workload for physicians has led to the development of computerized systems to make organizational workflow more efficient. These programs may include algorithms to propose a weekly dosage and timing for the following visit. Before introducing a new algorithm in clinical practice, its safety and efficacy must be validated. We undertook a retrospective simulation study to test a new algorithm for the TAOnet system. The main outcome was the percentage of concordant and discordant proposals between manual- and algorithm-based prescriptions. Pairs of computerized and physician prescriptions were assessed. They were categorized as 0.1-5, 5.1-10 and > 10% if the dose was different, and assigned as "algorithm better" or "manual better" dependent upon the subsequent international normalized ratio value. In 61.0% of cases, the manual and computerized weekly dosage assignments were identical;in 15.3% of cases, the difference was between 0.1 and 5%;in 14.7 of cases, it was between 5.1 and 10%;and in 9.0% of cases, it was > 10%. The algorithm did better in 43.9% of discordant pairs, generally due to less frequent under-dosing. In conclusion, the new algorithm proved to consistently overlap with the manual method. The algorithm is useful but must be tested in a multi-center, prospective, interventional study.

关键词： VKA therapy computerized algorithm Validation

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Mathematical Models for 3D Reconstruction using Surface Triangulation

Mathematical Models for 3D Reconstruction using Surface Tria...

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2nd International Conference on Energy and Environmental Protection (ICEEP 2013)

作者： Pan, Liyan Liu, Yanpei Beijing Jiaotong Univ Dept Math Beijing 100044 Peoples R China

ISBN: (纸本)9783037857441

3D reconstruction is one of the most important research areas in computer version, which has a very wide application. Triangulation of simple polygon has been quite a matural mathematical approach in this field. Based on the bijection between triangulation and graph without loop, the problem is converted into the study of graph without loop. Firstly, enumerative equations of graph without loop for given number of vertex degree and edges are provided, including orientable, nonorientable and total of all surfaces. These differential equations are all Riccati type. No feasible and convenient way has been in sight for extracting an explicit solution to resolve the functional equations up to now. Next, the corresponding calculative functions of graphs with two parameters are extracted directly and the number can be derived by simple recursive formulae. The established mathematical model could provide a theoretical foundation for computerized algorithms, which can be used for 3D reconstruction.

关键词： 3D reconstruction Surface triangulation Graph without loop computerized algorithm

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