Profiling risk factors for chronic uveitis in juvenile idiopathic arthritis: a new model for EHR-based research.

BackgroundJuvenile idiopathic arthritis is the most common rheumatic disease in children. Chronic uveitis is a common and serious comorbid condition of juvenile idiopathic arthritis, with insidious presentation and potential to cause blindness. Knowledge of clinical associations will improve risk stratification. Based on clinical observation, we hypothesized that allergic conditions are associated with chronic uveitis in juvenile idiopathic arthritis patients.MethodsThis study is a retrospective cohort study using Stanford's clinical data warehouse containing data from Lucile Packard Children's Hospital from 2000-2011 to analyze patient characteristics associated with chronic uveitis in a large juvenile idiopathic arthritis cohort. Clinical notes in patients under 16 years of age were processed via a validated text analytics pipeline. Bivariate-associated variables were used in a multivariate logistic regression adjusted for age, gender, and race. Previously reported associations were evaluated to validate our methods. The main outcome measure was presence of terms indicating allergy or allergy medications use overrepresented in juvenile idiopathic arthritis patients with chronic uveitis. Residual text features were then used in unsupervised hierarchical clustering to compare clinical text similarity between patients with and without uveitis.ResultsPreviously reported associations with uveitis in juvenile idiopathic arthritis patients (earlier age at arthritis diagnosis, oligoarticular-onset disease, antinuclear antibody status, history of psoriasis) were reproduced in our study. Use of allergy medications and terms describing allergic conditions were independently associated with chronic uveitis. The association with allergy drugs when adjusted for known associations remained significant (OR 2.54, 95% CI 1.22-5.4).ConclusionsThis study shows the potential of using a validated text analytics pipeline on clinical data warehouses to examine practice-based evidence for evaluating hypotheses formed during patient care. Our study reproduces four known associations with uveitis development in juvenile idiopathic arthritis patients, and reports a new association between allergic conditions and chronic uveitis in juvenile idiopathic arthritis patients

An Advanced Conceptual Diagnostic Healthcare Framework for Diabetes and Cardiovascular Disorders

The data mining along with emerging computing techniques have astonishingly influenced the healthcare industry. Researchers have used different Data Mining and Internet of Things (IoT) for enrooting a programmed solution for diabetes and heart patients. However, still, more advanced and united solution is needed that can offer a therapeutic opinion to individual diabetic and cardio patients. Therefore, here, a smart data mining and IoT (SMDIoT) based advanced healthcare system for proficient diabetes and cardiovascular diseases have been proposed. The hybridization of data mining and IoT with other emerging computing techniques is supposed to give an effective and economical solution to diabetes and cardio patients. SMDIoT hybridized the ideas of data mining, Internet of Things, chatbots, contextual entity search (CES), bio-sensors, semantic analysis and granular computing (GC). The bio-sensors of the proposed system assist in getting the current and precise status of the concerned patients so that in case of an emergency, the needful medical assistance can be provided. The novelty lies in the hybrid framework and the adequate support of chatbots, granular computing, context entity search and semantic analysis. The practical implementation of this system is very challenging and costly. However, it appears to be more operative and economical solution for diabetes and cardio patients.Comment: 11 PAGE

MedTruth: A Semi-supervised Approach to Discovering Knowledge Condition Information from Multi-Source Medical Data

Knowledge Graph (KG) contains entities and the relations between entities. Due to its representation ability, KG has been successfully applied to support many medical/healthcare tasks. However, in the medical domain, knowledge holds under certain conditions. For example, symptom \emph{runny nose} highly indicates the existence of disease \emph{whooping cough} when the patient is a baby rather than the people at other ages. Such conditions for medical knowledge are crucial for decision-making in various medical applications, which is missing in existing medical KGs. In this paper, we aim to discovery medical knowledge conditions from texts to enrich KGs. Electronic Medical Records (EMRs) are systematized collection of clinical data and contain detailed information about patients, thus EMRs can be a good resource to discover medical knowledge conditions. Unfortunately, the amount of available EMRs is limited due to reasons such as regularization. Meanwhile, a large amount of medical question answering (QA) data is available, which can greatly help the studied task. However, the quality of medical QA data is quite diverse, which may degrade the quality of the discovered medical knowledge conditions. In the light of these challenges, we propose a new truth discovery method, MedTruth, for medical knowledge condition discovery, which incorporates prior source quality information into the source reliability estimation procedure, and also utilizes the knowledge triple information for trustworthy information computation. We conduct series of experiments on real-world medical datasets to demonstrate that the proposed method can discover meaningful and accurate conditions for medical knowledge by leveraging both EMR and QA data. Further, the proposed method is tested on synthetic datasets to validate its effectiveness under various scenarios.Comment: Accepted as CIKM2019 long pape