Design of dimensional model for clinical data storage and analysis

Current research in the field of Life and Medical Sciences is generating chunk of data on daily basis. It has thus become a necessity to find solutions for efficient storage of this data, trying to correlate and extract knowledge from it. Clinical data generated in Hospitals, Clinics & Diagnostics centers is falling under a similar paradigm. Patient’s records in various hospitals are increasing at an exponential rate, thus adding to the problem of data management and storage. Major problem being faced corresponding to storage, is the varied dimensionality of the data, ranging from images to numerical form. Therefore there is a need for development of efficient data model which can handle this multi-dimensionality data issue and store the data with historical aspect. For the stated problem lying in façade of clinical informatics we propose a clinical dimensional model design which can be used for development of a clinical data mart. The model has been designed keeping in consideration temporal storage of patient's data with respect to all possible clinical parameters which can include both textual and image based data. Availability of said data for each patient can be then used for application of data mining techniques for finding the correlation of all the parameters at the level of individual and population

A Learning Health System for Radiation Oncology

The proposed research aims to address the challenges faced by clinical data science researchers in radiation oncology accessing, integrating, and analyzing heterogeneous data from various sources. The research presents a scalable intelligent infrastructure, called the Health Information Gateway and Exchange (HINGE), which captures and structures data from multiple sources into a knowledge base with semantically interlinked entities. This infrastructure enables researchers to mine novel associations and gather relevant knowledge for personalized clinical outcomes. The dissertation discusses the design framework and implementation of HINGE, which abstracts structured data from treatment planning systems, treatment management systems, and electronic health records. It utilizes disease-specific smart templates for capturing clinical information in a discrete manner. HINGE performs data extraction, aggregation, and quality and outcome assessment functions automatically, connecting seamlessly with local IT/medical infrastructure. Furthermore, the research presents a knowledge graph-based approach to map radiotherapy data to an ontology-based data repository using FAIR (Findable, Accessible, Interoperable, Reusable) concepts. This approach ensures that the data is easily discoverable and accessible for clinical decision support systems. The dissertation explores the ETL (Extract, Transform, Load) process, data model frameworks, ontologies, and provides a real-world clinical use case for this data mapping. To improve the efficiency of retrieving information from large clinical datasets, a search engine based on ontology-based keyword searching and synonym-based term matching tool was developed. The hierarchical nature of ontologies is leveraged to retrieve patient records based on parent and children classes. Additionally, patient similarity analysis is conducted using vector embedding models (Word2Vec, Doc2Vec, GloVe, and FastText) to identify similar patients based on text corpus creation methods. Results from the analysis using these models are presented. The implementation of a learning health system for predicting radiation pneumonitis following stereotactic body radiotherapy is also discussed. 3D convolutional neural networks (CNNs) are utilized with radiographic and dosimetric datasets to predict the likelihood of radiation pneumonitis. DenseNet-121 and ResNet-50 models are employed for this study, along with integrated gradient techniques to identify salient regions within the input 3D image dataset. The predictive performance of the 3D CNN models is evaluated based on clinical outcomes. Overall, the proposed Learning Health System provides a comprehensive solution for capturing, integrating, and analyzing heterogeneous data in a knowledge base. It offers researchers the ability to extract valuable insights and associations from diverse sources, ultimately leading to improved clinical outcomes. This work can serve as a model for implementing LHS in other medical specialties, advancing personalized and data-driven medicine

Business Analytics in the Context of Big Data: A Roadmap for Research

This paper builds on academic and industry discussions from the 2012 and 2013 pre-ICIS events: BI Congress III and the Special Interest Group on Decision Support Systems (SIGDSS) workshop, respectively. Recognizing the potential of “big data” to offer new insights for decision making and innovation, panelists at the two events discussed how organizations can use and manage big data for competitive advantage. In addition, expert panelists helped to identify research gaps. While emerging research in the academic community identifies some of the issues in acquiring, analyzing, and using big data, many of the new developments are occurring in the practitioner community. We bridge the gap between academic and practitioner research by presenting a big data analytics framework that depicts a process view of the components needed for big data analytics in organizations. Using practitioner interviews and literature from both academia and practice, we identify the current state of big data research guided by the framework and propose potential areas for future research to increase the relevance of academic research to practice

The Assessment of Technology Adoption Interventions and Outcome Achievement Related to the Use of a Clinical Research Data Warehouse

Introduction: While funding for research has declined since 2004, the need for rapid, innovative, and lifesaving clinical and translational research has never been greater due to the rise in chronic health conditions, which have resulted in lower life expectancy and higher rates of mortality and adverse outcomes. Finding effective diagnostic and treatment methods to address the complex challenges in individual and population health will require a team science approach, creating the need for multidisciplinary collaboration among practitioners and researchers. To address this need, the National Institutes of Health (NIH) created the Clinical and Translational Science Awards (CTSA) program. The CTSA program distributes funds to a national network of medical research institutions, known as “hubs,” that work together to improve the translational research process. With this funding, each hub is required to achieve specific goals to support clinical and translational research teams by providing a variety of services, including cutting edge use of informatics technologies. As a result, the majority of CTSA recipients have implemented and maintain data warehouses, which combine disparate data types from a range of clinical and administrative sources, include data from multiple institutions, and support a variety of workflows. These data warehouses provide comprehensive sets of data that extend beyond the contents of a single EHR system and provide more valuable information for translational research. Although significant research has been conducted related to this technology, gaps exist regarding research team adoption of data warehouses. As a result, more information is needed to understand how data warehouses are adopted and what outcomes are achieved when using them. Specifically, this study focuses on three gaps: research team awareness of data warehouses, the outcomes of data warehouse training for research teams, and how to measure objectively outcomes achieved after training. By assessing and measuring data warehouse use, this study aims to provide a greater understanding of data warehouse adoption and the outcomes achieved. With this understanding, the most effective and efficient development, implementation, and maintenance strategies can be used to increase the return on investment for these resource-intensive technologies. In addition, technologies can be better designed to ensure they are meeting the needs of clinical and translational science in the 21st century and beyond. Methods: During the study period, presentations were held to raise awareness of data warehouse technology. In addition, training sessions were provided that focused on the use of data warehouses for research projects. To assess the impact of the presentations and training sessions, pre- and post-assessments gauged knowledge and likelihood to use the technology. As objective measurements, the number of data warehouse access and training requests were obtained, and audit trails were reviewed to assess trainee activities within the data warehouse. Finally, trainees completed a 30-day post-training assessment to provide information about barriers and benefits of the technology. Results: Key study findings suggest that the awareness presentations and training were successful in increasing research team knowledge of data warehouses and likelihood to use this technology, but did not result in a subsequent increase in access or training requests within the study period. In addition, 24% of trainees completed the associated data warehouse activities to achieve their intended outcomes within 30 days of training. The time needed for adopting the technology, the ease of use of data warehouses, the types of support available, and the data available within the data warehouse may all be factors influencing this completion rate. Conclusion: The key finding of this study is that data warehouse awareness presentations and training sessions are insufficient to result in research team adoption of the technology within a three-month study period. Several important implications can be drawn from this finding. First, the timeline for technology adoption requires further investigation, although it is likely longer than 90 days. Future assessments of technology adoption should include an individual’s timeline for pursuing the use of that technology. Second, this study provided a definition for outcome achievement, which was completion o

Business Analytics in the Context of Big Data: A Roadmap for Research

This paper builds on academic and industry discussions from the 2012 and 2013 pre-ICIS events: BI Congress III and the Special Interest Group on Decision Support Systems (SIGDSS) workshop, respectively. Recognizing the potential of “big data” to offer new insights for decision making and innovation, panelists at the two events discussed how organizations can use and manage big data for competitive advantage. In addition, expert panelists helped to identify research gaps. While emerging research in the academic community identifies some of the issues in acquiring, analyzing, and using big data, many of the new developments are occurring in the practitioner community. We bridge the gap between academic and practitioner research by presenting a big data analytics framework that depicts a process view of the components needed for big data analytics in organizations. Using practitioner interviews and literature from both academia and practice, we identify the current state of big data research guided by the framework and propose potential areas for future research to increase the relevance of academic research to practice

Multivariate data-driven decision guidance for clinical scientists

Clinical decision-support is gaining widespread attention as medical institutions and governing bodies turn towards utilising better information management for effective and efficient healthcare delivery and quality assured outcomes. Amass of data across all stages, from disease diagnosis to palliative care, is further indication of the opportunities and challenges created for effective data management, analysis, prediction and optimization techniques as parts of knowledge management in clinical environments. A Data-driven Decision Guidance Management System (DD-DGMS) architecture can encompass solutions into a single closed-loop integrated platform to empower clinical scientists to seamlessly explore a multivariate data space in search of novel patterns and correlations to inform their research and practice. The paper describes the components of such an architecture, which includes a robust data warehouse as an infrastructure for comprehensive clinical knowledge management. The proposed DD-DGMS architecture incorporates the dynamic dimensional data model as its elemental core. Given the heterogeneous nature of clinical contexts and corresponding data, the dimensional data model presents itself as an adaptive model that facilitates knowledge discovery, distribution and application, which is essential for clinical decision support. The paper reports on a trial of the DD-DGMS system prototype conducted on diabetes screening data which further establishes the relevance of the proposed architecture to a clinical context.E

Developing HL7 CDA-Based Data Warehouse for the Use of Electronic Health Record Data for Secondary Purposes

Background The growing availability of clinical and administrative data collected in electronic health records (EHRs) have led researchers and policy makers to implement data warehouses to improve the reuse of EHR data for secondary purposes. This approach can take advantages from a unique source of information that collects data from providers across multiple organizations. Moreover, the development of a data warehouse benefits from the standards adopted to exchange data provided by heterogeneous systems. Objective This article aims to design and implement a conceptual framework that semiautomatically extracts information collected in Health Level 7 Clinical Document Architecture (CDA) documents stored in an EHR and transforms them to be loaded in a target data warehouse. Results The solution adopted in this article supports the integration of the EHR as an operational data store in a data warehouse infrastructure. Moreover, data structure of EHR clinical documents and the data warehouse modeling schemas are analyzed to define a semiautomatic framework that maps the primitives of the CDA with the concepts of the dimensional model. The case study successfully tests this approach. Conclusion The proposed solution guarantees data quality using structured documents already integrated in a large-scale infrastructure, with a timely updated information flow. It ensures data integrity and consistency and has the advantage to be based on a sample size that covers a broad target population. Moreover, the use of CDAs simplifies the definition of extract, transform, and load tools through the adoption of a conceptual framework that load the information stored in the CDA in the data warehouse

Systematizing FAIR research data management in biomedical research projects: a data life cycle approach

Biomedical researchers are facing data management challenges brought by a new generation of data driven by the advent of translational medicine research. These challenges are further complicated by the recent calls for data re-use and long-term stewardship spearheaded by the FAIR principles initiative. As a result, there is an increasingly wide-spread recognition that advancing biomedical science is becoming dependent on the application of data science to manage and utilize highly diverse and complex data in ways that give it context, meaning, and longevity beyond its initial purpose. However, current methods and practices in biomedical informatics remain to adopt a traditional linear view of the informatics process (collect, store and analyse); focusing primarily on the challenges in data integration and analysis, which are challenges only pertaining to a part of the overall life cycle of research data. The aim of this research is to facilitate the adoption and integration of data management practices into the research life cycle of biomedical projects, thus improving their capabilities into solving data management-related challenges that they face throughout the course of their research work. To achieve this aim, this thesis takes a data life cycle approach to define and develop a systematic methodology and framework towards the systematization of FAIR data management in biomedical research projects. The overarching contribution of this research is the provision of a data-state life cycle model for research data management in Biomedical Translational Research Projects. This model provides insight into the dynamics between 1) the purpose of a research-driven data use case, 2) the data requirements that renders data in a state fit for purpose, 3) the data management functions that prepare and act upon data and 4) the resulting state of data that is _t to serve the use case. This insight led to the development of a FAIR data management framework, which is another contribution of this thesis. This framework provides data managers the groundwork, including the data models, resources and capabilities, needed to build a FAIR data management environment to manage data during the operational stages of a biomedical research project. An exemplary implementation of this architecture (PlatformTM) was developed and validated by real-world research datasets produced by collaborative research programs funded by the Innovative Medicine Initiative (IMI) BioVacSafe 1 , eTRIKS 2 and FAIRplus 3.Open Acces