Using Clinical Narratives and Structured Data to Identify Distant Recurrences in Breast Cancer

Accurately identifying distant recurrences in breast cancer from the Electronic Health Records (EHR) is important for both clinical care and secondary analysis. Although multiple applications have been developed for computational phenotyping in breast cancer, distant recurrence identification still relies heavily on manual chart review. In this study, we aim to develop a model that identifies distant recurrences in breast cancer using clinical narratives and structured data from EHR. We apply MetaMap to extract features from clinical narratives and also retrieve structured clinical data from EHR. Using these features, we train a support vector machine model to identify distant recurrences in breast cancer patients. We train the model using 1,396 double-annotated subjects and validate the model using 599 double-annotated subjects. In addition, we validate the model on a set of 4,904 single-annotated subjects as a generalization test. We obtained a high area under curve (AUC) score of 0.92 (SD=0.01) in the cross-validation using the training dataset, then obtained AUC scores of 0.95 and 0.93 in the held-out test and generalization test using 599 and 4,904 samples respectively. Our model can accurately and efficiently identify distant recurrences in breast cancer by combining features extracted from unstructured clinical narratives and structured clinical data

Combining Multiple Algorithms in Classifier Ensembles using Generalized Mixture Functions

Classifier ensembles are pattern recognition structures composed of a set of classification algorithms (members), organized in a parallel way, and a combination method with the aim of increasing the classification accuracy of a classification system. In this study, we investigate the application of a generalized mixture (GM) functions as a new approach for providing an efficient combination procedure for these systems through the use of dynamic weights in the combination process. Therefore, we present three GM functions to be applied as a combination method. The main advantage of these functions is that they can define dynamic weights at the member outputs, making the combination process more efficient. In order to evaluate the feasibility of the proposed approach, an empirical analysis is conducted, applying classifier ensembles to 25 different classification data sets. In this analysis, we compare the use of the proposed approaches to ensembles using traditional combination methods as well as the state-of-the-art ensemble methods. Our findings indicated gains in terms of performance when comparing the proposed approaches to the traditional ones as well as comparable results with the state-of-the-art methods