IEEE International Conference on Healthcare Informatics. IEEE International Conference on Healthcare Informatics最新文献

Many studies have examined the impact of exercise and other physical activities in influencing the health outcomes of individuals. These physical activities entail an intricate sequence and series of physical anatomy, physiological movement, movement of the anatomy, etc. To better understand how these components interact with one another and their downstream impact on health outcomes, there needs to be an information model that conceptualizes all entities involved. In this study, we introduced our early development of an ontology model to computationally describe human physical activities and the various entities that compose each activity. We developed an open-sourced biomedical ontology called the Kinetic Human Movement Ontology that reused OBO Foundry terminologies and encoded in OWL2. We applied this ontology in modeling and linking a specific Tai Chi movement. The contribution of this work could enable modeling of information relating to human physical activity, like exercise, and lead towards information standardization of human movement for analysis. Future work will include expanding our ontology to include more expressive information and completely modeling entire sets of movement from human physical activity.

Social factors like family background, education level, financial status, and stress can impact public health outcomes, such as suicidal ideation. However, the analysis of social factors for suicide prevention has been limited by the lack of up-to-date suicide reporting data, variations in reporting practices, and small sample sizes. In this study, we analyzed 172,629 suicide incidents from 2014 to 2020 utilizing the National Violent Death Reporting System Restricted Access Database (NVDRS-RAD). Logistic regression models were developed to examine the relationships between demographics and suicide-related circumstances. Trends over time were assessed, and Latent Dirichlet Allocation (LDA) was used to identify common suicide-related social factors. Mental health, interpersonal relationships, mental health treatment and disclosure, and school/work-related stressors were identified as the main themes of suicide-related social factors. This study also identified systemic disparities across various population groups, particularly concerning Black individuals, young people aged under 24, healthcare practitioners, and those with limited education backgrounds, which shed light on potential directions for demographic-specific suicidal interventions.

Large Language Models (LLMs), enhanced with Clinical Practice Guidelines (CPGs), can significantly improve Clinical Decision Support (CDS). However, approaches for incorporating CPGs into LLMs are not well studied. In this study, we develop three distinct methods for incorporating CPGs into LLMs: Binary Decision Tree (BDT), Program-Aided Graph Construction (PAGC), and Chain-of-Thought-Few-Shot Prompting (CoT-FSP), and focus on CDS for COVID-19 outpatient treatment as the case study. Zero-Shot Prompting (ZSP) is our baseline method. To evaluate the effectiveness of the proposed methods, we create a set of synthetic patient descriptions and conduct both automatic and human evaluation of the responses generated by four LLMs: GPT-4, GPT-3.5 Turbo, LLaMA, and PaLM 2. All four LLMs exhibit improved performance when enhanced with CPGs compared to the baseline ZSP. BDT outperformed both CoT-FSP and PAGC in automatic evaluation. All of the proposed methods demonstrate high performance in human evaluation. LLMs enhanced with CPGs outperform plain LLMs with ZSP in providing accurate recommendations for COVID-19 outpatient treatment, highlighting the potential for broader applications beyond the case study.

Multivariate clinical time series data, such as those contained in Electronic Health Records (EHR), often exhibit high levels of irregularity, notably, many missing values and varying time intervals. Existing methods usually construct deep neural network architectures that combine recurrent neural networks and time decay mechanisms to model variable correlations, impute missing values, and capture the impact of varying time intervals. The complete data matrices thus obtained from the imputation task are used for downstream risk prediction tasks. This study aims to achieve more desirable imputation and prediction accuracy by performing both tasks simultaneously. We present a new multi-task deep neural network that incorporates the imputation task as an auxiliary task while performing risk prediction tasks. We validate the method on clinical time series imputation and in-hospital mortality prediction tasks using two publicly available EHR databases. The experimental results show that our method outperforms state-of-the-art imputation-prediction methods by significant margins. The results also empirically demonstrate that the incorporation of time decay mechanisms is a critical factor for superior imputation and prediction performance. The novel deep imputation-prediction network proposed in this study provides more accurate imputation and prediction results with EHR data. Future work should focus on developing more effective time decay mechanisms for simultaneously enhancing the imputation and prediction performance of multi-task learning models.

Predictive analytics using Electronic Health Records (EHRs) have become an active research area in recent years, especially with the development of deep learning techniques. A popular EHR data analysis paradigm in deep learning is patient representation learning, which aims to learn a condensed mathematical representation of individual patients. However, EHR data are often inherently irregular, i.e., data entries were captured at different times as well as with different contents due to the individualized needs of each patient. Most of the work focused on the provision of deep neural networks with attention mechanisms that generate complete patient representations that can be readily used for downstream prediction tasks. However, such approaches fail to take patient similarity into account, which is generally used in clinical reasoning scenarios. This study presents a new Contrastive Graph Similarity Network for similarity calculation among patients in large EHR datasets. Particularly, we apply graph-based similarity analysis that explicitly extracts the clinical characteristics of each patient and aggregates the information of similar patients to generate rich patient representations. Experimental results on real-world EHR databases demonstrate the effectiveness and superiority of our method for the task of vital signs imputation and ICU patient deterioration prediction.

Demand for genomic research data and genetic testing results from cancer patients has grown exponentially. When a patient is diagnosed with a hereditary cancer syndrome, standard practice is for providers to encourage patients to discuss their results with their relatives and encourage those relatives to have clinical genetic testing and possibly participate in genetic research. Genomic research data and genetic testing results are being shared and connected in ways never imagined. Genomic data sharing is critical for advancing precision health and increasing diversity in global genome databases. However, these advancements often come with undesirable consequences, which call for additional privacy safeguards and research practices to protect hereditary cancer patients and their families because relatives who may have genomic information in common with the patient causing privacy risks to ripple throughout a kinship network. We propose to address this gap using an interdisciplinary approach integrating bioethical principles (autonomy, non-maleficence, beneficence, respect for persons, and equity) with data science techniques to mitigate privacy risk challenges.

Data synthesis can address important data availability challenges in biomedical informatics. Quantitative evaluation of generative models may help understand their applications to synthesizing biomedical data. This poster paper examines state-of-the-art generative models used in medical imaging, such as StyleGAN and DDPM models, and evaluates their performance in learning data manifolds and in the visible features of generated samples. Results show that existing generative models have much to improve based on the studied measures.

Deep neural networks have been increasingly integrated in healthcare applications to enable accurate predicative analyses. Sharing trained deep models not only facilitates knowledge integration in collaborative research efforts but also enables equitable access to computational intelligence. However, recent studies have shown that an adversary may leverage a shared model to learn the participation of a target individual in the training set. In this work, we investigate privacy-protecting model sharing for survival studies. Specifically, we pose three research questions. (1) Do deep survival models leak membership information? (2) How effective is differential privacy in defending against membership inference in deep survival analyses? (3) Are there other effects of differential privacy on deep survival analyses? Our study assesses the membership leakage in emerging deep survival models and develops differentially private training procedures to provide rigorous privacy protection. The experimental results show that deep survival models leak membership information and our approach effectively reduces membership inference risks. The results also show that differential privacy introduces a limited performance loss, and may improve the model robustness in the presence of noisy data, compared to non-private models.

Fast and flexible communication options are limited for speech-impaired people. Hand gestures coupled with fast, generated speech can enable a more natural social dynamic for those individuals - particularly individuals without the fine motor skills to type on a keyboard or tablet reliably. We created a mobile phone application prototype that generates audible responses associated with trained hand movements and collects and organizes the accelerometer data for rapid training to allow tailored models for individuals who may not be able to perform standard movements such as sign language. Six participants performed 11 distinct gestures to produce the dataset. A mobile application was developed that integrated a bidirectional LSTM network architecture which was trained from this data. After evaluation using nested subject-wise cross-validation, our integrated bidirectional LSTM model demonstrates an overall recall of 91.8% in recognition of these pre-selected 11 hand gestures, with recall at 95.8% when two commonly confused gestures were not assessed. This prototype is a step in creating a mobile phone system capable of capturing new gestures and developing tailored gesture recognition models for individuals in speech-impaired populations. Further refinement of this prototype can enable fast and efficient communication with the goal of further improving social interaction for individuals unable to speak.

Electronic health records (EHR) have been widely used in building machine learning models for health outcomes prediction. However, many EHR-based models are inherently biased due to lack of risk factors on social determinants of health (SDoH), which are responsible for up to 40% preventive deaths. As SDoH information is often captured in clinical notes, recent efforts have been made to extract such information from notes with natural language processing and append it to other structured data. In this work, we benchmark 7 pre-trained transformer-based models, including BERT, ALBERT, BioBERT, BioClinicalBERT, RoBERTa, ELECTRA, and RoBERTa-MIMIC-Trial, for recognizing SDoH terms using a previously annotated corpus of MIMIC-III clinical notes. Our study shows that BioClinicalBERT model performs best on F-1 scores (0.911, 0.923) under both strict and relaxed criteria. This work shows the promise of using transformer-based models for recognizing SDoH information from clinical notes.