Pittsburgh Center for Artificial Intelligence Innovation in Medical Imaging

We propose to create a medical imaging artificial intelligence (AI) center (name: Pittsburgh Center for Artificial Intelligence Innovation in Medical Imaging). AI is the new revolutionary technique for medical research and is reshaping tomorrow’s clinical practice in medical imaging (radiology and pathology). Our long-term vision is to build a center for innovative AI in clinical translational medical imaging by combining computational expertise and clinical resources across Pitt, UPMC, and CMU. The Center concept is a formalization of a group of researchers and clinicians that are united by the common theme: “building advanced and trustworthy imaging AI for clinical applications.” Our short-term plan is to assemble dedicated members from the School of Medicine, the School of Engineering, and the School of Computing and Information. We seek a Scaling grant from the Momentum Funds to foster collaborative activities of the Center between these three Pitt schools to provide the essential components of a competitive P41 (Biomedical Technology Resource Centers) center grant in 2 years. The National Institute of Biomedical Imaging and Bioengineering (NIBIB) P41 mechanism aligns with the overall vision of this initiative to develop specific AI imaging tools and to support the dissemination and commercialization pathways that are essential to bringing AI imaging tools to clinical practice. These projects will include key components: 1) Clinical need-driven medical imaging AI development and evaluation of tools, models, systems, and informatics, 2) Core imaging AI theory, methodology, and algorithm investigation, and 3) Linking imaging phenotypes to the biological (genomics and proteomics) underpinnings. To date, we have already 35 members for the Center. The Pitt Momentum Funds will provide critical scaling support to promote communication between the three Pitt schools to develop a competitive P41 grant application and a sustainable framework to ensure the clinical impact of these AI imaging tools

Navegabilidad y búsqueda en fuentes de información en salud

Teaching material for the healthcare professional (doctors, nurses, physical therapists...) who need to undertake searches and bibliographic reviews of evidence and recommendations; with the aim of complementing the best external clinical evidence available with their daily clinical practice. The success of evidence-based medicine lies in making available to health professionals studies that treat clinical problems using results from scientific research. There are new tools based on the Internet and other computer systems that have been developed to help us find and filter scientific evidence. At the same time, the misuse or lack of a search methodology and adequate interpretation of these studies can lead to their incorrect application in clinical practice, making the results unsatisfactory. For this reason, it is key that any health professional have a series of notions about how to pose their doubts and hypotheses, know effective search strategies, interrogate the main sources of evidence as well as know how to properly interpret the results and apply them. As a result of these needs to approach an adequate approach to evidence-based medicine, we have decided to organize the following teaching material as follows: ● Module 1: Presentation of the theoretical foundations related to evidence-based medicine: definition, background, practical application, positive and negative aspects. ● Module 2: Process of applying evidence-based medicine: formulating a precise clinical question, locating the evidence / tests available in the literature, critically evaluating this evidence, applying the evaluation's conclusions to practice, and Analysis of the performance of the MBE application. ● Module 3: Search for evidence and decision-making: definition of the Hayness pyramid, types of information sources for evidence and criteria for its consultation, sources of information for decision-making in health policies. ●Module 4: Sources of clinical information for evidence: presentation of search strategies in documentary databases. Presentation of different types of abstract databases, clinical practice guides, synopsis, systematic reviews

Navegabilidad y búsqueda en fuentes de información en salud

Teaching material for the healthcare professional (doctors, nurses, physical therapists...) who need to undertake searches and bibliographic reviews of evidence and recommendations; with the aim of complementing the best external clinical evidence available with their daily clinical practice. The success of evidence-based medicine lies in making available to health professionals studies that treat clinical problems using results from scientific research. There are new tools based on the Internet and other computer systems that have been developed to help us find and filter scientific evidence. At the same time, the misuse or lack of a search methodology and adequate interpretation of these studies can lead to their incorrect application in clinical practice, making the results unsatisfactory. For this reason, it is key that any health professional have a series of notions about how to pose their doubts and hypotheses, know effective search strategies, interrogate the main sources of evidence as well as know how to properly interpret the results and apply them. As a result of these needs to approach an adequate approach to evidence-based medicine, we have decided to organize the following teaching material as follows: ● Module 1: Presentation of the theoretical foundations related to evidence-based medicine: definition, background, practical application, positive and negative aspects. ● Module 2: Process of applying evidence-based medicine: formulating a precise clinical question, locating the evidence / tests available in the literature, critically evaluating this evidence, applying the evaluation's conclusions to practice, and Analysis of the performance of the MBE application. ● Module 3: Search for evidence and decision-making: definition of the Hayness pyramid, types of information sources for evidence and criteria for its consultation, sources of information for decision-making in health policies. ●Module 4: Sources of clinical information for evidence: presentation of search strategies in documentary databases. Presentation of different types of abstract databases, clinical practice guides, synopsis, systematic reviews

CDS, UX, and System Redesign - Promising Techniques and Tools to Bridge the Evidence Gap

INTRODUCTION: In this special issue of eGEMs, we explore the struggles related to bringing evidence into day-to-day practice, what I define as the evidence gap. We are all aware of high quality evidence in the form of guidelines, randomized clinical trials for treatments and diagnostic tests, and clinical prediction rules, which are all readily available online. We also know that electronic health records (EHRs) are now ubiquitous in health care and in most practices across the country. How we marry this high quality evidence and the practice of medicine through effective decision support is a major challenge. ABOUT THE ISSUE: All of the articles in this issue explore, in some fashion, CDS systems and how we can best bring providers and their work environment to the evidence. We are at the very early stages of the science of usability. Much more research and funding is needed in this area if we hope to improve the dissemination and implementation of evidence in practice. While the featured examples, techniques, and tools in the special issue are a promising start to improving usability and CDS, many of the papers highlight current gaps in knowledge and a great need for generalizable approaches. The great promise is for learning approaches to generate new evidence and to integrate this evidence in reliable, patient-centered ways at scale using new technology. Closing the evidence gap is a real possibility, but only if the community works together to innovate and invest in research on the best ways to disseminate, communicate, and implement evidence in practice

Clinical Value of Multiomics-Based Biomarker Signatures in Inflammatory Bowel Diseases:Challenges and Opportunities

Inflammatory bowel diseases (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), are complex and heterogeneous diseases characterized by a multifactorial etiology, therefore demanding a multimodal approach to disentangle the main pathophysiological components driving disease onset and progression. Adoption of a systems biology approach is increasingly advocated with the advent of multi-omics profiling technologies, aiming to improve disease classification, to identify disease biomarkers and to accelerate drug discovery for patients with IBD. However, clinical translation of multi-omics-derived biomarker signatures is lagging behind, since there are several obstacles that need to be addressed in order to realize clinically useful signatures. Multi-omics integration and IBD-specific identification of molecular networks, standardization and clearly defined outcomes, strategies to tackle cohort heterogeneity, and external validation of multi-omics-based signatures are critical aspects. While striving for personalized medicine in IBD, careful consideration of these aspects is however needed to adequately match biomarker targets (e.g. the gut microbiome, immunity or oxidative stress) with their corresponding utilities (e.g. early disease detection, endoscopic and clinical outcome). Theory-driven disease classifications and predictions are still governing clinical practice, while this could be improved by adopting an unbiased, data-driven approach relying on molecular data structures integrated with patient and disease characteristics. In the foreseeable future, the main challenge will lie in the complexity and impracticality of implementing multi-omics-based signatures into clinical practice. Still, this could be achieved by developing easy-to-use, robust and cost-effective tools incorporating omics-derived predictive signatures and through the design and execution of prospective, longitudinal, biomarker-stratified clinical trials

Virtual patient simulation: what do students make of it? A focus group study

<p>Abstract</p> <p>Background</p> <p>The learners' perspectives on Virtual Patient Simulation systems (VPS) are quintessential to their successful development and implementation. Focus group interviews were conducted in order to explore the opinions of medical students on the educational use of a VPS, the Web-based Simulation of Patients application (Web-SP).</p> <p>Methods</p> <p>Two focus group interviews-each with 8 undergraduate students who had used Web-SP cases for learning and/or assessment as part of their Internal Medicine curriculum in 2007-were performed at the Faculty of Medicine of Universidad el Bosque (Bogota), in January 2008. The interviews were conducted in Spanish, transcribed by the main researcher and translated into English. The resulting transcripts were independently coded by two authors, who also performed the content analysis. Each coder analyzed the data separately, arriving to categories and themes, whose final form was reached after a consensus discussion.</p> <p>Results</p> <p>Eighteen categories were identified and clustered into five main themes: learning, teaching, assessment, authenticity and implementation. In agreement with the literature, clinical reasoning development is envisaged by students to be the main scope of VPS use; transferable skills, retention enhancement and the importance of making mistakes are other categories circumscribed to this theme. VPS should enjoy a broad use across clinical specialties and support learning of topics not seen during clinical rotations; they are thought to have a regulatory effect at individual level, helping the students to plan their learning. The participants believe that assessment with VPS should be relevant for their future clinical practice; it is deemed to be qualitatively different from regular exams and to increase student motivation. The VPS design and content, the localization of the socio-cultural context, the realism of the cases, as well as the presence and quality of feedback are intrinsic features contributing to VPS authenticity.</p> <p>Conclusions</p> <p>Five main themes were found to be associated with successful VPS use in medical curriculum: Learning, Teaching, Assessment, Authenticity and Implementation. Medical students perceive Virtual Patients as important learning and assessment tools, fostering clinical reasoning, in preparation for the future clinical practice as young doctors. However, a number of issues regarding VPS design, authenticity and implementation need to be fulfilled, in order to reach the potential educational goals of such applications.</p

Development of an evidence-based medicine mobile application for the use in medical education

BACKGROUND: Evidence-based medicine (EBM) is a methodology that is being incorporated into more medical school curricula. Boston University School of Medicine was one of early adopters of Evidence Based Medicine in the United States. A growing concern in the medical community was that the complexities of applying EBM might be lost when students enter into their clinical rotations, thus there is a need for development of a tool to help reinforce the EBM principles. METHODS: The research team in collaboration with the designers of the Finding Information Framework, a custom-made EBM finding information tool, worked to develop a mobile application to help reinforce the framework for medical students. The app was designed with both Apple and PC operating systems in mind. Key features that were identified from current literature to provide the most user-friendly mobile application. Thus, the research team specifically utilized iOS and Android platforms as both platforms have a centralized app store, possess the highest volume of medical apps available, and are most widely used in the United States by medical students. RESULTS: The Finding Information Framework was a custom-made tool developed to guide new users of EBM, and help them to apply the principles in practice. The mobile application served an added convenience by allowing easy access and fast utilization of the EBM tools. The app was designed on an Android platform first due to its open-source OS and ease in app development to new programmers. Initially, the user-friendly web-based tool, App Inventor (AI), powered by Massachusetts Institute of Technology was evaluated to program the pilot Android app. Using both the AI Component Designer and the Block Editor, several problems were encountered in AI, such as the simplicity of the program and the lack of freedom in design. This moved the project to create the app natively and with a collaborative effort with the BU's Global App Initiative club. Initially, a wireframe was built using Balsamiq. Subsequently, the Android app was built using Android SDK and the iOS app was built in XCode with Objective C; both platforms had design sections prepared in Sketch, Adobe Photoshop and Illustrator. The last and final step was to obtain Boston University branding privileges for the app. CONCLUSION: The research team identified necessary features based on research to build a user-friendly, professional mobile application of an information mastery framework that can be used off-line. The app is called FIF as it is the title of the information mastery tool designed by BUSM EBM-VIG. With a clear mobile interface, it will be beneficial to the learning and training of medical students in EBM

Nanoinformatics: developing new computing applications for nanomedicine

Nanoinformatics has recently emerged to address the need of computing applications at the nano level. In this regard, the authors have participated in various initiatives to identify its concepts, foundations and challenges. While nanomaterials open up the possibility for developing new devices in many industrial and scientific areas, they also offer breakthrough perspectives for the prevention, diagnosis and treatment of diseases. In this paper, we analyze the different aspects of nanoinformatics and suggest five research topics to help catalyze new research and development in the area, particularly focused on nanomedicine. We also encompass the use of informatics to further the biological and clinical applications of basic research in nanoscience and nanotechnology, and the related concept of an extended ?nanotype? to coalesce information related to nanoparticles. We suggest how nanoinformatics could accelerate developments in nanomedicine, similarly to what happened with the Human Genome and other -omics projects, on issues like exchanging modeling and simulation methods and tools, linking toxicity information to clinical and personal databases or developing new approaches for scientific ontologies, among many others

Micro-meso-macro practice tensions in using patient-reported outcome and experience measures in hospital palliative care

This article applies a micro-meso-macro analytical framework to understand clinicians’ experiences and perspectives of using patient-reported outcome and experience measures (PROMs and PREMs) in routine hospital-based palliative care. We structure our discussion through qualitative analysis of a design and implementation project for using an electronic tablet-based tool among hospital-based palliative clinicians to assess patients’ and their family caregivers’ quality of life concerns and experiences of care. Our analysis identified three categories of practice tensions shaping clinicians’ use of PROMs and PREMs in routine care: tensions surrounding implementation, tensions in standardization and quantification, and tensions that arose from scope of practice concerns. Our findings highlight that clinicians necessarily work within the confluence of multiple system priorities, that navigating these priorities can result in irreducible practice tensions, and that awareness of these tensions is a critical consideration when integrating PROMs and PREMs into routine practice