Journal of Healthcare Informatics Research最新文献

The growth of COVID-19 cases in India is scaling high over the past weeks despite stringent lockdown policies. This study introduces a GPS-based tool, i.e., lockdown breaching index (LBI), which helps to determine the extent of breaching activities during the lockdown period. It is evaluated using the community mobility reports. This index ranges between 0 and 100, which implies the extent of following the lockdown policies. A score of 0 indicates that civilians strictly adhered to the guidelines while a score of 100 points to complete violation. Technique for Order Preference by Similarity to the Ideal Solution (TOPSIS) is modified to compute the LBI. We considered fifteen states of India, where the spread of coronavirus is relatively dominant. A significant breaching activity is observed during the first phase of lockdown, and the intensity increased in the third and fourth phases of lockdown. Overall breaching activities are dominant in Bihar with LBI of 75.28. At the same time, it is observed that the majority of the people in Delhi adhered to the lockdown policies strictly, as reflected with an LBI score of 47.05, which is the lowest. Though an average rise of 3% breaching activities during the second phase of lockdown (L2.0) with reference to the first phase of lockdown (L1.0) is noticed in all the states, a decreasing trend is noticed in Delhi and Tamil Nadu. Since the beginning of third phase of lockdown L3.0, a significant rise in breaching activities is observed in every state considered for the analysis. The average LBI rise of 16.9% and 27.6% relative to L1.0 is observed at the end of L3.0 and L4.0, respectively. A positive spearman rank correlation of 0.88 is noticed between LBI and the cumulative confirmed cases. This correlation serves as evidence and enlightens the fact that the breaching activities could be one of the possible reasons that contributed to the rise in COVID-19 cases throughout lockdown.

Multi-state model (MSM) is a useful tool to analyze longitudinal data for modeling disease progression at multiple time points. While the regularization approaches to variable selection have been widely used, extending them to MSM remains largely unexplored. In this paper, we have developed the L1-regularized multi-state model (L1MSTATE) framework that enables parameter estimation and variable selection simultaneously. The regularized optimization problem was solved by deriving a one-step coordinate descent algorithm with great computational efficiency. The L1MSTATE approach was evaluated using extensive simulation studies, and it showed that L1MSTATE outperformed existing regularized multi-state models in terms of the accurate identification of risk factors. It also outperformed the un-regularized multi-state models (MSTATE) in terms of identifying the important risk factors in situations with small sample sizes. The power of L1MSTATE in predicting the transition probabilities comparing with MSTATE was demonstrated using the Europe Blood and Marrow Transplantation (EBMT) dataset. The L1MSTATE was implemented in the open-access R package 'L1mstate'.

With the novel coronavirus (COVID-19) pandemic affecting the lives of the citizens of over 200 countries, there is a need for policy makers and clinicians to understand public sentiment and track the spread of the disease. One of the sources for gaining valuable insight into public sentiment is through social media. This study aims to extract this insight by producing a list of the most discussed topics regarding COVID-19 on Twitter every week and monitoring the evolution of topics from week to week. This research will propose two topic mining that can handle a large-scale dataset-rolling online non-negative matrix factorization (Rolling-ONMF) and sliding online non-negative matrix factorization (Sliding-ONMF)-and compare the insights produced by both techniques. Each algorithm produces 425 topics over the course of 17 weeks. However, topics that have not evolved from one week to the next beyond a certain evolution threshold are consolidated into a single topic. Since the topics produced by the Rolling-ONMF algorithm each week depend on the topics from the previous week, we find that the Sliding-ONMF algorithm produces more varied topics each week; however, the topics produced by the Rolling-ONMF algorithm contain keywords that appear more consistent with each other when reviewing the terms manually. We also observe that the Sliding-ONMF algorithm is able to capture events that have shorter time frames rather than ones that last throughout many months while the Rolling-ONMF algorithm detects more general themes due to a higher average evolution score which leads to more topic consolidation. We have also conducted a qualitative analysis and grouped the detected topics into themes. A number of important themes such as government policy, economic crisis, COVID-19-related updates, COVID-19-related events, prevention, vaccines and treatments, and COVID-19 testing are identified. These reflected the concerns related to the pandemic expressed in social media.

The purpose of this work is to describe the dynamics of the COVID-19 pandemics accounting for the mitigation measures, for the introduction or removal of the quarantine, and for the effect of vaccination when and if introduced. The methods used include the derivation of the Pandemic Equation describing the mitigation measures via the evolution of the growth time constant in the Pandemic Equation resulting in an asymmetric pandemic curve with a steeper rise than a decrease and mitigation measures. The Pandemic Equation predicts how the quarantine removal and business opening lead to a spike in the pandemic curve. The effective vaccination reduces the new daily infections predicted by the Pandemic Equation. The pandemic curves in many localities have similar time dependencies but shifted in time. The Pandemic Equation parameters extracted from the well advanced pandemic curves can be used for predicting the pandemic evolution in the localities, where the pandemics is still in the initial stages. Using the multiple pandemic locations for the parameter extraction allows for the uncertainty quantification in predicting the pandemic evolution using the introduced Pandemic Equation. Compared with other pandemic models our approach allows for easier parameter extraction amenable to using Artificial Intelligence models.

Remote monitoring of health can reduce frequent hospitalisations, diminishing the burden on the healthcare system and cost to the community. Patient monitoring helps identify symptoms associated with diseases or disease-driven disorders, which makes it an essential element of medical diagnoses, clinical interventions, and rehabilitation treatments for severe medical conditions. This monitoring can be expensive and time-consuming and provide an incomplete picture of the state of the patient. In the last decade, there has been a significant increase in the adoption of mobile and wearable devices, along with the introduction of smart textile solutions that offer the possibility of continuous monitoring. These alternatives fuel a technology shift in healthcare, one that involves the continuous tracking and monitoring of individuals. This scoping review examines how mobile, wearable, and textile sensing technology have been permeating healthcare by offering alternate solutions to challenging issues, such as personalised prescriptions or home-based secondary prevention. To do so, we have selected 222 healthcare literature articles published from 2007 to 2019 and reviewed them following the PRISMA process under the schema of a scoping review framework. Overall, our findings show a recent increase in research on mobile sensing technology to address patient monitoring, reflected by 128 articles published in journals and 19 articles in conference proceedings between 2014 and 2019, which represents 57.65% and 8.55% respectively of all included articles.

With the rapid development of computer software and hardware technologies, more and more healthcare data are becoming readily available from clinical institutions, patients, insurance companies, and pharmaceutical industries, among others. This access provides an unprecedented opportunity for data science technologies to derive data-driven insights and improve the quality of care delivery. Healthcare data, however, are usually fragmented and private making it difficult to generate robust results across populations. For example, different hospitals own the electronic health records (EHR) of different patient populations and these records are difficult to share across hospitals because of their sensitive nature. This creates a big barrier for developing effective analytical approaches that are generalizable, which need diverse, "big data." Federated learning, a mechanism of training a shared global model with a central server while keeping all the sensitive data in local institutions where the data belong, provides great promise to connect the fragmented healthcare data sources with privacy-preservation. The goal of this survey is to provide a review for federated learning technologies, particularly within the biomedical space. In particular, we summarize the general solutions to the statistical challenges, system challenges, and privacy issues in federated learning, and point out the implications and potentials in healthcare.

We collected over 50 million tweets referencing COVID-19 to understand the public's gendered discourses and concerns during the pandemic. We filtered the tweets based on English language and among three gender categories: men, women, and sexual and gender minorities. We used a mixed-method approach that included topic modelling, sentiment analysis, and text mining extraction procedures including words' mapping, proximity plots, top hashtags and mentions, and most retweeted posts. Our findings show stark differences among the different genders. In relation to women, we found a salient discussion on the risks of domestic violence due to the lockdown especially towards women and girls, while emphasizing financial challenges. The public discourses around SGM mostly revolved around blood donation concerns, which is a reminder of the discrimination against some of these communities during the early days of the HIV/AIDS epidemic. Finally, the discourses around men were focused on the high death rates and the sentiment analysis results showed more negative tweets than among the other genders. The study concludes that Twitter influencers can drive major online discussions which can be useful in addressing communication needs during pandemics.

This study was to understand the impacts of three key demographic variables, age, gender, and race, on the adverse outcome of all-cause hospitalization or all-cause mortality in patients with COVID-19, using a deep neural network (DNN) analysis. We created a cohort of Veterans who were tested positive for COVID-19, extracted data on age, gender, and race, and clinical characteristics from their electronic health records, and trained a DNN model for predicting the adverse outcome. Then, we analyzed the association of the demographic variables with the risks of the adverse outcome using the impact scores and interaction scores for explaining DNN models. The results showed that, on average, older age and African American race were associated with higher risks while female gender was associated with lower risks. However, individual-level impact scores of age showed that age was a more impactful risk factor in younger patients and in older patients with fewer comorbidities. The individual-level impact scores of gender and race variables had a wide span covering both positive and negative values. The interaction scores between the demographic variables showed that the interaction effects were minimal compared to the impact scores associated with them. In conclusion, the DNN model is able to capture the non-linear relationship between the risk factors and the adverse outcome, and the impact scores and interaction scores can help explain the complicated non-linear effects between the demographic variables and the risk of the outcome.

This paper reports on our efforts to collect daily COVID-19-related symptoms for a large public university population, as well as study relationship between reported symptoms and individual movements. We developed a set of tools to collect and integrate individual-level data. COVID-19-related symptoms are collected using a self-reporting tool initially implemented in Qualtrics survey system and consequently moved to .NET framework. Individual movement data are collected using off-the-shelf tracking apps available for iPhone and Android phones. Data integration and analysis are done in PostgreSQL, Python, and R. As of September 2020, we collected about 184,000 daily symptom responses for 20,000 individuals, as well as over 15,000 days of GPS movement data for 175 individuals. The analysis of the data indicates that headache is the most frequently reported symptom, present almost always when any other symptoms are reported as indicated by derived association rules. It is followed by cough, sore throat, and aches. The study participants traveled on average 223.61 km every week with a large standard deviation of 254.53 and visited on average 5.77 ± 4.75 locations each week for at least 10 min. However, there is no evidence that reported symptoms or prior COVID-19 contact affects movements (p > 0.3 in most models). The evidence suggests that although some individuals limit their movements during pandemics, the overall study population do not change their movements as suggested by guidelines.

Currently, there is an increasing global need for COVID-19 screening to help reduce the rate of infection and at-risk patient workload at hospitals. Smartphone-based screening for COVID-19 along with other respiratory illnesses offers excellent potential due to its rapid-rollout remote platform, user convenience, symptom tracking, comparatively low cost, and prompt result processing timeframe. In particular, speech-based analysis embedded in smartphone app technology can measure physiological effects relevant to COVID-19 screening that are not yet digitally available at scale in the healthcare field. Using a selection of the Sonde Health COVID-19 2020 dataset, this study examines the speech of COVID-19-negative participants exhibiting mild and moderate COVID-19-like symptoms as well as that of COVID-19-positive participants with mild to moderate symptoms. Our study investigates the classification potential of acoustic features (e.g., glottal, prosodic, spectral) from short-duration speech segments (e.g., held vowel, pataka phrase, nasal phrase) for automatic COVID-19 classification using machine learning. Experimental results indicate that certain feature-task combinations can produce COVID-19 classification accuracy of up to 80% as compared with using the all-acoustic feature baseline (68%). Further, with brute-forced n-best feature selection and speech task fusion, automatic COVID-19 classification accuracy of upwards of 82-86% was achieved, depending on whether the COVID-19-negative participant had mild or moderate COVID-19-like symptom severity.