302 research outputs found

    Medical data processing and analysis for remote health and activities monitoring

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    Recent developments in sensor technology, wearable computing, Internet of Things (IoT), and wireless communication have given rise to research in ubiquitous healthcare and remote monitoring of human\u2019s health and activities. Health monitoring systems involve processing and analysis of data retrieved from smartphones, smart watches, smart bracelets, as well as various sensors and wearable devices. Such systems enable continuous monitoring of patients psychological and health conditions by sensing and transmitting measurements such as heart rate, electrocardiogram, body temperature, respiratory rate, chest sounds, or blood pressure. Pervasive healthcare, as a relevant application domain in this context, aims at revolutionizing the delivery of medical services through a medical assistive environment and facilitates the independent living of patients. In this chapter, we discuss (1) data collection, fusion, ownership and privacy issues; (2) models, technologies and solutions for medical data processing and analysis; (3) big medical data analytics for remote health monitoring; (4) research challenges and opportunities in medical data analytics; (5) examples of case studies and practical solutions

    Informatic system for a global tissue–fluid biorepository with a graph theory–oriented graphical user interface

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    The Richard Floor Biorepository supports collaborative studies of extracellular vesicles (EVs) found in human fluids and tissue specimens. The current emphasis is on biomarkers for central nervous system neoplasms but its structure may serve as a template for collaborative EV translational studies in other fields. The informatic system provides specimen inventory tracking with bar codes assigned to specimens and containers and projects, is hosted on globalized cloud computing resources, and embeds a suite of shared documents, calendars, and video-conferencing features. Clinical data are recorded in relation to molecular EV attributes and may be tagged with terms drawn from a network of externally maintained ontologies thus offering expansion of the system as the field matures. We fashioned the graphical user interface (GUI) around a web-based data visualization package. This system is now in an early stage of deployment, mainly focused on specimen tracking and clinical, laboratory, and imaging data capture in support of studies to optimize detection and analysis of brain tumour–specific mutations. It currently includes 4,392 specimens drawn from 611 subjects, the majority with brain tumours. As EV science evolves, we plan biorepository changes which may reflect multi-institutional collaborations, proteomic interfaces, additional biofluids, changes in operating procedures and kits for specimen handling, novel procedures for detection of tumour-specific EVs, and for RNA extraction and changes in the taxonomy of EVs. We have used an ontology-driven data model and web-based architecture with a graph theory–driven GUI to accommodate and stimulate the semantic web of EV science

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

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    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

    PROTECTING UNPROTECTED DATA IN MHEALTH

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    Health-focused smartphone applications and internet of things (IoT) devices such as wearable fitness trackers (together, “mHealth”), offer a chance to monitor and manage health during the time spent away from a doctor. Unfortunately for consumers, much of personal health data generated by these devices and applications is critically unprotected by existing privacy laws in the United States. Due to the inadequacy of the current regulatory framework, there remain five crucial gaps of oversight and protection which plague many of these health-focused apps and devices: (A) Difference in Individuals’ Access Rights; (B) Difference in Re-Use of Data by Third Parties; (C) Difference in Security Standards Applicable to Data Holders and Users; (D) Differences in Understanding of Terminology About Privacy and Security Protections; and (E) Inadequate Collection, Use, and Disclosure Limitations. This Note explores these oversight gaps and analyzes whether proposed and emerging solutions can meet this fundamental regulatory need. These solutions range from sweeping industry-agnostic privacy legislation to proposals targeted to this specific problem in mHealth. Overall, this Note will weigh the costs and benefits of these options as they are currently understood

    Using machine learning for automated de-identification and clinical coding of free text data in electronic medical records

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    The widespread adoption of Electronic Medical Records (EMRs) in hospitals continues to increase the amount of patient data that are digitally stored. Although the primary use of the EMR is to support patient care by making all relevant information accessible, governments and health organisations are looking for ways to unleash the potential of these data for secondary purposes, including clinical research, disease surveillance and automation of healthcare processes and workflows. EMRs include large quantities of free text documents that contain valuable information. The greatest challenges in using the free text data in EMRs include the removal of personally identifiable information and the extraction of relevant information for specific tasks such as clinical coding. Machine learning-based automated approaches can potentially address these challenges. This thesis aims to explore and improve the performance of machine learning models for automated de-identification and clinical coding of free text data in EMRs, as captured in hospital discharge summaries, and facilitate the applications of these approaches in real-world use cases. It does so by 1) implementing an end-to-end de-identification framework using an ensemble of deep learning models; 2) developing a web-based system for de-identification of free text (DEFT) with an interactive learning loop; 3) proposing and implementing a hierarchical label-wise attention transformer model (HiLAT) for explainable International Classification of Diseases (ICD) coding; and 4) investigating the use of extreme multi-label long text transformer-based models for automated ICD coding. The key findings include: 1) An end-to-end framework using an ensemble of deep learning base-models achieved excellent performance on the de-identification task. 2) A new web-based de-identification software system (DEFT) can be readily and easily adopted by data custodians and researchers to perform de-identification of free text in EMRs. 3) A novel domain-specific transformer-based model (HiLAT) achieved state-of-the-art (SOTA) results for predicting ICD codes on a Medical Information Mart for Intensive Care (MIMIC-III) dataset comprising the discharge summaries (n=12,808) that are coded with at least one of the most 50 frequent diagnosis and procedure codes. In addition, the label-wise attention scores for the tokens in the discharge summary presented a potential explainability tool for checking the face validity of ICD code predictions. 4) An optimised transformer-based model, PLM-ICD, achieved the latest SOTA results for ICD coding on all the discharge summaries of the MIMIC-III dataset (n=59,652). The segmentation method, which split the long text consecutively into multiple small chunks, addressed the problem of applying transformer-based models to long text datasets. However, using transformer-based models on extremely large label sets needs further research. These findings demonstrate that the de-identification and clinical coding tasks can benefit from the application of machine learning approaches, present practical tools for implementing these approaches, and highlight priorities for further research
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