From Raw Data to FAIR Data: The FAIRification Workflow for Health Research

BackgroundFAIR (findability, accessibility, interoperability, and reusability) guidingprinciples seek the reuse of data and other digital research input, output, and objects(algorithms, tools, and workflows that led to that data) making themfindable, accessible,interoperable, and reusable. GO FAIR - a bottom-up, stakeholder driven and self-governedinitiative-defined a seven-step FAIRificationprocessfocusingondata,butalsoindicatingtherequired work for metadata. This FAIRification process aims at addressing the translation ofraw datasets into FAIR datasets in a general way, without considering specific requirementsand challenges that may arise when dealing with some particular types of data.This work was performed in the scope of FAIR4Healthproject. FAIR4Health has received funding from the European Union’s Horizon 2020 research and innovationprogramme under grant agreement number 824666

Challenges and opportunities beyond structured data in analysis of electronic health records

Electronic health records (EHR) contain a lot of valuable information about individual patients and the whole population. Besides structured data, unstructured data in EHRs can provide extra, valuable information but the analytics processes are complex, time-consuming, and often require excessive manual effort. Among unstructured data, clinical text and images are the two most popular and important sources of information. Advanced statistical algorithms in natural language processing, machine learning, deep learning, and radiomics have increasingly been used for analyzing clinical text and images. Although there exist many challenges that have not been fully addressed, which can hinder the use of unstructured data, there are clear opportunities for well-designed diagnosis and decision support tools that efficiently incorporate both structured and unstructured data for extracting useful information and provide better outcomes. However, access to clinical data is still very restricted due to data sensitivity and ethical issues. Data quality is also an important challenge in which methods for improving data completeness, conformity and plausibility are needed. Further, generalizing and explaining the result of machine learning models are important problems for healthcare, and these are open challenges. A possible solution to improve data quality and accessibility of unstructured data is developing machine learning methods that can generate clinically relevant synthetic data, and accelerating further research on privacy preserving techniques such as deidentification and pseudonymization of clinical text

Automated Transformation of Semi-Structured Text Elements

Interconnected systems, such as electronic health records (EHR), considerably improved the handling and processing of health information while keeping the costs at a controlled level. Since the EHR virtually stores all data in digitized form, personal medical documents are easily and swiftly available when needed. However, multiple formats and differences in the health documents managed by various health care providers severely reduce the efficiency of the data sharing process. This paper presents a rule-based transformation system that converts semi-structured (annotated) text into standardized formats, such as HL7 CDA. It identifies relevant information in the input document by analyzing its structure as well as its content and inserts the required elements into corresponding reusable CDA templates, where the templates are selected according to the CDA document type-specific requirements

Data Infrastructure for Medical Research

While we are witnessing rapid growth in data across the sciences and in many applications, this growth is particularly remarkable in the medical domain, be it because of higher resolution instruments and diagnostic tools (e.g. MRI), new sources of structured data like activity trackers, the wide-spread use of electronic health records and many others. The sheer volume of the data is not, however, the only challenge to be faced when using medical data for research. Other crucial challenges include data heterogeneity, data quality, data privacy and so on. In this article, we review solutions addressing these challenges by discussing the current state of the art in the areas of data integration, data cleaning, data privacy, scalable data access and processing in the context of medical data. The techniques and tools we present will give practitioners — computer scientists and medical researchers alike — a starting point to understand the challenges and solutions and ultimately to analyse medical data and gain better and quicker insights

CogStack - experiences of deploying integrated information retrieval and extraction services in a large National Health Service Foundation Trust hospital.

BACKGROUND: Traditional health information systems are generally devised to support clinical data collection at the point of care. However, as the significance of the modern information economy expands in scope and permeates the healthcare domain, there is an increasing urgency for healthcare organisations to offer information systems that address the expectations of clinicians, researchers and the business intelligence community alike. Amongst other emergent requirements, the principal unmet need might be defined as the 3R principle (right data, right place, right time) to address deficiencies in organisational data flow while retaining the strict information governance policies that apply within the UK National Health Service (NHS). Here, we describe our work on creating and deploying a low cost structured and unstructured information retrieval and extraction architecture within King's College Hospital, the management of governance concerns and the associated use cases and cost saving opportunities that such components present. RESULTS: To date, our CogStack architecture has processed over 300 million lines of clinical data, making it available for internal service improvement projects at King's College London. On generated data designed to simulate real world clinical text, our de-identification algorithm achieved up to 94% precision and up to 96% recall. CONCLUSION: We describe a toolkit which we feel is of huge value to the UK (and beyond) healthcare community. It is the only open source, easily deployable solution designed for the UK healthcare environment, in a landscape populated by expensive proprietary systems. Solutions such as these provide a crucial foundation for the genomic revolution in medicine

Guidelines and quality criteria for artificial intelligence-based prediction models in healthcare: a scoping review

While the opportunities of ML and AI in healthcare are promising, the growth of complex data-driven prediction models requires careful quality and applicability assessment before they are applied and disseminated in daily practice. This scoping review aimed to identify actionable guidance for those closely involved in AI-based prediction model (AIPM) development, evaluation and implementation including software engineers, data scientists, and healthcare professionals and to identify potential gaps in this guidance. We performed a scoping review of the relevant literature providing guidance or quality criteria regarding the development, evaluation, and implementation of AIPMs using a comprehensive multi-stage screening strategy. PubMed, Web of Science, and the ACM Digital Library were searched, and AI experts were consulted. Topics were extracted from the identified literature and summarized across the six phases at the core of this review: (1) data preparation, (2) AIPM development, (3) AIPM validation, (4) software development, (5) AIPM impact assessment, and (6) AIPM implementation into daily healthcare practice. From 2683 unique hits, 72 relevant guidance documents were identified. Substantial guidance was found for data preparation, AIPM development and AIPM validation (phases 1-3), while later phases clearly have received less attention (software development, impact assessment and implementation) in the scientific literature. The six phases of the AIPM development, evaluation and implementation cycle provide a framework for responsible introduction of AI-based prediction models in healthcare. Additional domain and technology specific research may be necessary and more practical experience with implementing AIPMs is needed to support further guidance.Public Health and primary carePrevention, Population and Disease management (PrePoD