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  • 1
    Online Resource
    Online Resource
    Elsevier BV ; 2022
    In:  American Journal of Transplantation Vol. 22, No. 5 ( 2022-05), p. 1372-1381
    In: American Journal of Transplantation, Elsevier BV, Vol. 22, No. 5 ( 2022-05), p. 1372-1381
    Type of Medium: Online Resource
    ISSN: 1600-6135
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2045621-9
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  • 2
    Online Resource
    Online Resource
    Elsevier BV ; 2020
    In:  Journal of Biomedical Informatics Vol. 109 ( 2020-09), p. 103515-
    In: Journal of Biomedical Informatics, Elsevier BV, Vol. 109 ( 2020-09), p. 103515-
    Type of Medium: Online Resource
    ISSN: 1532-0464
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2057141-0
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  • 3
    Online Resource
    Online Resource
    Frontiers Media SA ; 2021
    In:  Transplant International Vol. 34, No. 7 ( 2021-07), p. 1239-1250
    In: Transplant International, Frontiers Media SA, Vol. 34, No. 7 ( 2021-07), p. 1239-1250
    Type of Medium: Online Resource
    ISSN: 0934-0874 , 1432-2277
    URL: Issue
    Language: English
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 1463183-0
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  • 4
    In: Journal of Biomedical Optics, SPIE-Intl Soc Optical Eng, Vol. 21, No. 12 ( 2016-12-21), p. 127006-
    Type of Medium: Online Resource
    ISSN: 1083-3668
    Language: English
    Publisher: SPIE-Intl Soc Optical Eng
    Publication Date: 2016
    detail.hit.zdb_id: 2001934-8
    SSG: 12
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  • 5
    Online Resource
    Online Resource
    Elsevier BV ; 2021
    In:  Journal of Biomedical Informatics Vol. 121 ( 2021-09), p. 103870-
    In: Journal of Biomedical Informatics, Elsevier BV, Vol. 121 ( 2021-09), p. 103870-
    Type of Medium: Online Resource
    ISSN: 1532-0464
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2057141-0
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  • 6
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2023
    In:  Journal of the American Medical Informatics Association Vol. 30, No. 6 ( 2023-05-19), p. 1022-1031
    In: Journal of the American Medical Informatics Association, Oxford University Press (OUP), Vol. 30, No. 6 ( 2023-05-19), p. 1022-1031
    Abstract: To develop a computable representation for medical evidence and to contribute a gold standard dataset of annotated randomized controlled trial (RCT) abstracts, along with a natural language processing (NLP) pipeline for transforming free-text RCT evidence in PubMed into the structured representation. Materials and methods Our representation, EvidenceMap, consists of 3 levels of abstraction: Medical Evidence Entity, Proposition and Map, to represent the hierarchical structure of medical evidence composition. Randomly selected RCT abstracts were annotated following EvidenceMap based on the consensus of 2 independent annotators to train an NLP pipeline. Via a user study, we measured how the EvidenceMap improved evidence comprehension and analyzed its representative capacity by comparing the evidence annotation with EvidenceMap representation and without following any specific guidelines. Results Two corpora including 229 disease-agnostic and 80 COVID-19 RCT abstracts were annotated, yielding 12 725 entities and 1602 propositions. EvidenceMap saves users 51.9% of the time compared to reading raw-text abstracts. Most evidence elements identified during the freeform annotation were successfully represented by EvidenceMap, and users gave the enrollment, study design, and study Results sections mean 5-scale Likert ratings of 4.85, 4.70, and 4.20, respectively. The end-to-end evaluations of the pipeline show that the evidence proposition formulation achieves F1 scores of 0.84 and 0.86 in the adjusted random index score. Conclusions EvidenceMap extends the participant, intervention, comparator, and outcome framework into 3 levels of abstraction for transforming free-text evidence from the clinical literature into a computable structure. It can be used as an interoperable format for better evidence retrieval and synthesis and an interpretable representation to efficiently comprehend RCT findings.
    Type of Medium: Online Resource
    ISSN: 1067-5027 , 1527-974X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2018371-9
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  • 7
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2019
    In:  Journal of the American Medical Informatics Association Vol. 26, No. 8-9 ( 2019-08-01), p. 730-736
    In: Journal of the American Medical Informatics Association, Oxford University Press (OUP), Vol. 26, No. 8-9 ( 2019-08-01), p. 730-736
    Abstract: We sought to assess the quality of race and ethnicity information in observational health databases, including electronic health records (EHRs), and to propose patient self-recording as an improvement strategy. Materials and Methods We assessed completeness of race and ethnicity information in large observational health databases in the United States (Healthcare Cost and Utilization Project and Optum Labs), and at a single healthcare system in New York City serving a racially and ethnically diverse population. We compared race and ethnicity data collected via administrative processes with data recorded directly by respondents via paper surveys (National Health and Nutrition Examination Survey and Hospital Consumer Assessment of Healthcare Providers and Systems). Respondent-recorded data were considered the gold standard for the collection of race and ethnicity information. Results Among the 160 million patients from the Healthcare Cost and Utilization Project and Optum Labs datasets, race or ethnicity was unknown for 25%. Among the 2.4 million patients in the single New York City healthcare system’s EHR, race or ethnicity was unknown for 57%. However, when patients directly recorded their race and ethnicity, 86% provided clinically meaningful information, and 66% of patients reported information that was discrepant with the EHR. Discussion Race and ethnicity data are critical to support precision medicine initiatives and to determine healthcare disparities; however, the quality of this information in observational databases is concerning. Patient self-recording through the use of patient-facing tools can substantially increase the quality of the information while engaging patients in their health. Conclusions Patient self-recording may improve the completeness of race and ethnicity information.
    Type of Medium: Online Resource
    ISSN: 1527-974X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2018371-9
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  • 8
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2021
    In:  Journal of the American Medical Informatics Association Vol. 28, No. 8 ( 2021-07-30), p. 1703-1711
    In: Journal of the American Medical Informatics Association, Oxford University Press (OUP), Vol. 28, No. 8 ( 2021-07-30), p. 1703-1711
    Abstract: We introduce Medical evidence Dependency (MD)–informed attention, a novel neuro-symbolic model for understanding free-text clinical trial publications with generalizability and interpretability. Materials and Methods We trained one head in the multi-head self-attention model to attend to the Medical evidence Ddependency (MD) and to pass linguistic and domain knowledge on to later layers (MD informed). This MD-informed attention model was integrated into BioBERT and tested on 2 public machine reading comprehension benchmarks for clinical trial publications: Evidence Inference 2.0 and PubMedQA. We also curated a small set of recently published articles reporting randomized controlled trials on COVID-19 (coronavirus disease 2019) following the Evidence Inference 2.0 guidelines to evaluate the model’s robustness to unseen data. Results The integration of MD-informed attention head improves BioBERT substantially in both benchmark tasks—as large as an increase of +30% in the F1 score—and achieves the new state-of-the-art performance on the Evidence Inference 2.0. It achieves 84% and 82% in overall accuracy and F1 score, respectively, on the unseen COVID-19 data. Conclusions MD-informed attention empowers neural reading comprehension models with interpretability and generalizability via reusable domain knowledge. Its compositionality can benefit any transformer-based architecture for machine reading comprehension of free-text medical evidence.
    Type of Medium: Online Resource
    ISSN: 1527-974X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2018371-9
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  • 9
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2015
    In:  Journal of the American Medical Informatics Association Vol. 22, No. 4 ( 2015-07-01), p. 872-880
    In: Journal of the American Medical Informatics Association, Oxford University Press (OUP), Vol. 22, No. 4 ( 2015-07-01), p. 872-880
    Abstract: Background As adoption of electronic health records continues to increase, there is an opportunity to incorporate clinical documentation as well as laboratory values and demographics into risk prediction modeling. Objective The authors develop a risk prediction model for chronic kidney disease (CKD) progression from stage III to stage IV that includes longitudinal data and features drawn from clinical documentation. Methods The study cohort consisted of 2908 primary-care clinic patients who had at least three visits prior to January 1, 2013 and developed CKD stage III during their documented history. Development and validation cohorts were randomly selected from this cohort and the study datasets included longitudinal inpatient and outpatient data from these populations. Time series analysis (Kalman filter) and survival analysis (Cox proportional hazards) were combined to produce a range of risk models. These models were evaluated using concordance, a discriminatory statistic. Results A risk model incorporating longitudinal data on clinical documentation and laboratory test results (concordance 0.849) predicts progression from state III CKD to stage IV CKD more accurately when compared to a similar model without laboratory test results (concordance 0.733, P & lt;.001), a model that only considers the most recent laboratory test results (concordance 0.819, P & lt; .031) and a model based on estimated glomerular filtration rate (concordance 0.779, P & lt; .001). Conclusions A risk prediction model that takes longitudinal laboratory test results and clinical documentation into consideration can predict CKD progression from stage III to stage IV more accurately than three models that do not take all of these variables into consideration.
    Type of Medium: Online Resource
    ISSN: 1527-974X , 1067-5027
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2015
    detail.hit.zdb_id: 2018371-9
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  • 10
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2021
    In:  Journal of the American Medical Informatics Association Vol. 28, No. 9 ( 2021-08-13), p. 1970-1976
    In: Journal of the American Medical Informatics Association, Oxford University Press (OUP), Vol. 28, No. 9 ( 2021-08-13), p. 1970-1976
    Abstract: Clinical notes present a wealth of information for applications in the clinical domain, but heterogeneity across clinical institutions and settings presents challenges for their processing. The clinical natural language processing field has made strides in overcoming domain heterogeneity, while pretrained deep learning models present opportunities to transfer knowledge from one task to another. Pretrained models have performed well when transferred to new tasks; however, it is not well understood if these models generalize across differences in institutions and settings within the clinical domain. We explore if institution or setting specific pretraining is necessary for pretrained models to perform well when transferred to new tasks. We find no significant performance difference between models pretrained across institutions and settings, indicating that clinically pretrained models transfer well across such boundaries. Given a clinically pretrained model, clinical natural language processing researchers may forgo the time-consuming pretraining step without a significant performance drop.
    Type of Medium: Online Resource
    ISSN: 1527-974X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2018371-9
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