Adverse Drug Event Detection, Causality Inference, Patient Communication and Translational Research

Adverse drug events (ADEs) are injuries resulting from a medical intervention related to a drug. ADEs are responsible for nearly 20% of all the adverse events that occur in hospitalized patients. ADEs have been shown to increase the cost of health care and the length of stays in hospital. Therefore, detecting and preventing ADEs for pharmacovigilance is an important task that can improve the quality of health care and reduce the cost in a hospital setting. In this dissertation, we focus on the development of ADEtector, a system that identifies ADEs and medication information from electronic medical records and the FDA Adverse Event Reporting System reports. The ADEtector system employs novel natural language processing approaches for ADE detection and provides a user interface to display ADE information. The ADEtector employs machine learning techniques to automatically processes the narrative text and identify the adverse event (AE) and medication entities that appear in that narrative text. The system will analyze the entities recognized to infer the causal relation that exists between AEs and medications by automating the elements of Naranjo score using knowledge and rule based approaches. The Naranjo Adverse Drug Reaction Probability Scale is a validated tool for finding the causality of a drug induced adverse event or ADE. The scale calculates the likelihood of an adverse event related to drugs based on a list of weighted questions. The ADEtector also presents the user with evidence for ADEs by extracting figures that contain ADE related information from biomedical literature. A brief summary is generated for each of the figures that are extracted to help users better comprehend the figure. This will further enhance the user experience in understanding the ADE information better. The ADEtector also helps patients better understand the narrative text by recognizing complex medical jargon and abbreviations that appear in the text and providing definitions and explanations for them from external knowledge resources. This system could help clinicians and researchers in discovering novel ADEs and drug relations and also hypothesize new research questions within the ADE domain

Mining the Medical and Patent Literature to Support Healthcare and Pharmacovigilance

Recent advancements in healthcare practices and the increasing use of information technology in the medical domain has lead to the rapid generation of free-text data in forms of scientific articles, e-health records, patents, and document inventories. This has urged the development of sophisticated information retrieval and information extraction technologies. A fundamental requirement for the automatic processing of biomedical text is the identification of information carrying units such as the concepts or named entities. In this context, this work focuses on the identification of medical disorders (such as diseases and adverse effects) which denote an important category of concepts in the medical text. Two methodologies were investigated in this regard and they are dictionary-based and machine learning-based approaches. Futhermore, the capabilities of the concept recognition techniques were systematically exploited to build a semantic search platform for the retrieval of e-health records and patents. The system facilitates conventional text search as well as semantic and ontological searches. Performance of the adapted retrieval platform for e-health records and patents was evaluated within open assessment challenges (i.e. TRECMED and TRECCHEM respectively) wherein the system was best rated in comparison to several other competing information retrieval platforms. Finally, from the medico-pharma perspective, a strategy for the identification of adverse drug events from medical case reports was developed. Qualitative evaluation as well as an expert validation of the developed system's performance showed robust results. In conclusion, this thesis presents approaches for efficient information retrieval and information extraction from various biomedical literature sources in the support of healthcare and pharmacovigilance. The applied strategies have potential to enhance the literature-searches performed by biomedical, healthcare, and patent professionals. The applied strategies have potential to enhance the literature-searches performed by biomedical, healthcare, and patent professionals. This can promote the literature-based knowledge discovery, improve the safety and effectiveness of medical practices, and drive the research and development in medical and healthcare arena

Medical Informatics

Information technology has been revolutionizing the everyday life of the common man, while medical science has been making rapid strides in understanding disease mechanisms, developing diagnostic techniques and effecting successful treatment regimen, even for those cases which would have been classified as a poor prognosis a decade earlier. The confluence of information technology and biomedicine has brought into its ambit additional dimensions of computerized databases for patient conditions, revolutionizing the way health care and patient information is recorded, processed, interpreted and utilized for improving the quality of life. This book consists of seven chapters dealing with the three primary issues of medical information acquisition from a patient's and health care professional's perspective, translational approaches from a researcher's point of view, and finally the application potential as required by the clinicians/physician. The book covers modern issues in Information Technology, Bioinformatics Methods and Clinical Applications. The chapters describe the basic process of acquisition of information in a health system, recent technological developments in biomedicine and the realistic evaluation of medical informatics

A Novel and Domain-Specific Document Clustering and Topic Aggregation Toolset for a News Organisation

Large collections of documents are becoming increasingly common in the news gathering industry. A review of the literature shows there is a growing interest in datadriven journalism and specifically that the journalism profession needs better tools to understand and develop actionable knowledge from large document sets. On a daily basis, journalists are tasked with searching a diverse range of document sets including news gathering services, emails, freedom of information requests, court records, government reports, press releases and many other types of generally unstructured documents. Document clustering techniques can help address problems of understanding the ever expanding quantities of documents available to journalists by finding patterns within documents. These patterns can be used to develop useful and actionable knowledge which can contribute to journalism. News articles in particular are fertile ground for document clustering principles. Term weighting schemes assign importance to terms within a document and are central to the study of document clustering methods. This study contributes a review of the dominant and most commonly used term frequency weighting functions put forward in research, establishes the merits and limitations of each approach, and proposes modifications to develop a news-centric document clustering and topic aggregation approach. Experimentation was conducted on a large unstructured collection of newspaper articles from the Irish Times to establish if the newly proposed news-centric term weighting and document similarity approach improves document clustering accuracy and topic aggregation capabilities for news articles when compared to the traditional term weighting approach. Whilst the experimentation shows that that the developed approach is promising when compared to the manual document clustering effort undertaken by the three journalist expert users, it also highlights the challenges of natural language processing and document clustering methods in general. The results may suggest that a blended approach of complimenting automated methods with human-level supervision and guidance may yield the best results

A Biased Topic Modeling Approach for Case Control Study from Health Related Social Media Postings

abstract: Online social networks are the hubs of social activity in cyberspace, and using them to exchange knowledge, experiences, and opinions is common. In this work, an advanced topic modeling framework is designed to analyse complex longitudinal health information from social media with minimal human annotation, and Adverse Drug Events and Reaction (ADR) information is extracted and automatically processed by using a biased topic modeling method. This framework improves and extends existing topic modelling algorithms that incorporate background knowledge. Using this approach, background knowledge such as ADR terms and other biomedical knowledge can be incorporated during the text mining process, with scores which indicate the presence of ADR being generated. A case control study has been performed on a data set of twitter timelines of women that announced their pregnancy, the goals of the study is to compare the ADR risk of medication usage from each medication category during the pregnancy. In addition, to evaluate the prediction power of this approach, another important aspect of personalized medicine was addressed: the prediction of medication usage through the identification of risk groups. During the prediction process, the health information from Twitter timeline, such as diseases, symptoms, treatments, effects, and etc., is summarized by the topic modelling processes and the summarization results is used for prediction. Dimension reduction and topic similarity measurement are integrated into this framework for timeline classification and prediction. This work could be applied to provide guidelines for FDA drug risk categories. Currently, this process is done based on laboratory results and reported cases. Finally, a multi-dimensional text data warehouse (MTD) to manage the output from the topic modelling is proposed. Some attempts have been also made to incorporate topic structure (ontology) and the MTD hierarchy. Results demonstrate that proposed methods show promise and this system represents a low-cost approach for drug safety early warning.Dissertation/ThesisDoctoral Dissertation Computer Science 201

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe