EHRtemporalVariability: delineating temporal data-set shifts in electronic health records

[EN] Background: Temporal variability in health-care processes or protocols is intrinsic to medicine. Such variability can potentially introduce dataset shifts, a data quality issue when reusing electronic health records (EHRs) for secondary purposes. Temporal data-set shifts can present as trends, as well as abrupt or seasonal changes in the statistical distributions of data over time. The latter are particularly complicated to address in multimodal and highly coded data. These changes, if not delineated, can harm population and data-driven research, such as machine learning. Given that biomedical research repositories are increasingly being populated with large sets of historical data from EHRs, there is a need for specific software methods to help delineate temporal data-set shifts to ensure reliable data reuse. Results: EHRtemporalVariability is an open-source R package and Shiny app designed to explore and identify temporal data-set shifts. EHRtemporalVariability estimates the statistical distributions of coded and numerical data over time; projects their temporal evolution through non-parametric information geometric temporal plots; and enables the exploration of changes in variables through data temporal heat maps. We demonstrate the capability of EHRtemporalVariability to delineate data-set shifts in three impact case studies, one of which is available for reproducibility. Conclusions: EHRtemporalVariability enables the exploration and identification of data-set shifts, contributing to the broad examination and repurposing of large, longitudinal data sets. Our goal is to help ensure reliable data reuse for a wide range of biomedical data users. EHRtemporalVariability is designed for technical users who are programmatically utilizing the R package, as well as users who are not familiar with programming via the Shiny user interface.This work was supported by Universitat Politecnica de Valencia grant PAID-00-17, Generalitat Valenciana grant BEST/2018, and projects H2020-SC1-2016-CNECT No. 727560 and H2020-SC1-BHC-2018-2020 No. 825750Sáez Silvestre, C.; Gutiérrez-Sacristán, A.; Kohane, I.; Garcia-Gomez, JM.; Avillach, P. (2020). EHRtemporalVariability: delineating temporal data-set shifts in electronic health records. GigaScience. 9(8):1-7. https://doi.org/10.1093/gigascience/giaa079S1798Gewin, V. (2016). Data sharing: An open mind on open data. Nature, 529(7584), 117-119. doi:10.1038/nj7584-117aKatzan, I. L., & Rudick, R. A. (2012). Time to Integrate Clinical and Research Informatics. Science Translational Medicine, 4(162). doi:10.1126/scitranslmed.3004583Zhu, L., & Zheng, W. J. (2018). 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Biases in electronic health record data due to processes within the healthcare system: retrospective observational study. BMJ, k1479. doi:10.1136/bmj.k1479Sáez, C., & García-Gómez, J. M. (2018). Kinematics of Big Biomedical Data to characterize temporal variability and seasonality of data repositories: Functional Data Analysis of data temporal evolution over non-parametric statistical manifolds. International Journal of Medical Informatics, 119, 109-124. doi:10.1016/j.ijmedinf.2018.09.015Leek, J. T., Scharpf, R. B., Bravo, H. C., Simcha, D., Langmead, B., Johnson, W. E., … Irizarry, R. A. (2010). Tackling the widespread and critical impact of batch effects in high-throughput data. Nature Reviews Genetics, 11(10), 733-739. doi:10.1038/nrg2825Goh, W. W. B., Wang, W., & Wong, L. (2017). Why Batch Effects Matter in Omics Data, and How to Avoid Them. 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PsyGeNET : a knowledge platform on psychiatric disorders and their genes

Altres ajuts: Innovative Medicines Initiative Joint Undertaking (no. 115372, EMIF and no. 115191, Open PHACTS), resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and EFPIA companies' in kind contribution.Summary: PsyGeNET (Psychiatric disorders and Genes association NETwork) is a knowledge platform for the exploratory analysis of psychiatric diseases and their associated genes. PsyGeNET is composed of a database and a web interface supporting data search, visualization, filtering and sharing. PsyGeNET integrates information from DisGeNET and data extracted from the literature by text mining, which has been curated by domain experts. It currently contains 2642 associations between 1271 genes and 37 psychiatric disease concepts. In its first release, PsyGeNET is focused on three psychiatric disorders: major depression, alcohol and cocaine use disorders. PsyGeNET represents a comprehensive, open access resource for the analysis of the molecular mechanisms underpinning psychiatric disorders and their comorbidities

Multi-PheWAS intersection approach to identify sex differences across comorbidities in 59 140 pediatric patients with autism spectrum disorder

[EN] Objective: To identify differences related to sex and define autism spectrum disorder (ASD) comorbidities female-enriched through a comprehensive multi-PheWAS intersection approach on big, real-world data. Although sex difference is a consistent and recognized feature of ASD, additional clinical correlates could help to identify potential disease subgroups, based on sex and age. Materials and Methods: We performed a systematic comorbidity analysis on 1860 groups of comorbidities exploring all spectrum of known disease, in 59 140 individuals (11 440 females) with ASD from 4 age groups. We explored ASD sex differences in 2 independent real-world datasets, across all potential comorbidities by comparing (1) females with ASD vs males with ASD and (2) females with ASD vs females without ASD. Results: We identified 27 different comorbidities that appeared significantly more frequently in females with ASD. The comorbidities were mostly neurological (eg, epilepsy, odds ratio [OR]>1.8, 3-18 years of age), congenital (eg, chromosomal anomalies, OR>2, 3-18 years of age), and mental disorders (eg, intellectual disability, OR>1.7, 6-18 years of age). Novel comorbidities included endocrine metabolic diseases (eg, failure to thrive, OR=2.5, ages 0-2), digestive disorders (gastroesophageal reflux disease: OR=1.7, 6-11 years of age; and constipation: OR>1.6, 3-11 years of age), and sense organs (strabismus: OR>1.8, 3-18 years of age). Discussion: A multi-PheWAS intersection approach on real-world data as presented in this study uniquely contributes to the growing body of research regarding sex-based comorbidity analysis in ASD population. Conclusions: Our findings provide insights into female-enriched ASD comorbidities that are potentially important in diagnosis, as well as the identification of distinct comorbidity patterns influencing anticipatory treatment or referrals.This work has been supported by the National Institutes of Health BD2K grant U54HG007963. JMZ received grants from Stichting de Drie Lichten and Stichting Sophia Kinderziekenhuis Fonds for a research internship at Harvard Medical School.Gutiérrez-Sacristán, A.; Sáez Silvestre, C.; De Niz, C.; Jalali, N.; Desain, TN.; Kumar, R.; Zachariasse, JM.... (2021). Multi-PheWAS intersection approach to identify sex differences across comorbidities in 59 140 pediatric patients with autism spectrum disorder. Journal of the American Medical Informatics Association. 29(2):230-238. https://doi.org/10.1093/jamia/ocab14423023829

Del castigo a la humanización. Adolescentes en Centros de Justicia Juvenil: percepciones y reflexiones

El presente trabajo pretende aproximar la perspectiva de los Adolescentes en Conflicto con la Ley (en adelante ACL) sobre su proceso reeducativo y de paulatina recuperación de la libertad. ¿Existe algún contexto para el aprendizaje más complejo que el de una institución que limita las libertades? Este trabajo proyecta que los contextos basados en metodologías de acompañamiento humano, vinculación afectiva y socioeducativa, constituyen verdaderos espacios de transformación y de empoderamiento de los ACL. Eleva la importancia del principio de resocialización en la recuperación de hábitos prosociales de los delincuentes juveniles. Este artículo reproduce los resultados de una investigación longitudinal en la que participaron 157 ACL ingresados entre los años 2008 a 2012 en distintos centros públicos de Justicia Penal juvenil. El principio de resocialización del ACL nace al albor de estrategias para la transformación y aprendizaje desde contextos inclusivos. Por tanto, los recursos personales y ambientales, se fusionan en un proceso de intercambio que incide en la reflexión del individuo. Las vivencias de los ACL convergen con las prácticas educativas recibidas. La técnica etnográfica del relato de vida nos traslada al imaginario analítico de los ACL

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

psygenet2r: a R/Bioconductor package for the analysis of psychiatric disease genes

MOTIVATION: Psychiatric disorders have a great impact on morbidity and mortality. Genotype-phenotype resources for psychiatric diseases are key to enable the translation of research findings to a better care of patients. PsyGeNET is a knowledge resource on psychiatric diseases and their genes, developed by text mining and curated by domain experts. RESULTS: We present psygenet2r, an R package that contains a variety of functions for leveraging PsyGeNET database and facilitating its analysis and interpretation. The package offers different types of queries to the database along with variety of analysis and visualization tools, including the study of the anatomical structures in which the genes are expressed and gaining insight of gene's molecular function. Psygenet2r is especially suited for network medicine analysis of psychiatric disorders. AVAILABILITY AND IMPLEMENTATION: The package is implemented in R and is available under MIT license from Bioconductor (http://bioconductor.org/packages/release/bioc/html/psygenet2r.html).This work was supported by ISCIII-FEDER [PI13/00082, CP10/00524, CPII16/00026], MICINN [MTM2015-68140-R], IMI-JU under grants agreements no. 115191 (Open PHACTS), no. 115372 (EMIF), no. 115735 (iPiE), resources of which are composed of financial contribution from the EU-FP7 [FP7/2007–2013] and EFPIA companies in kind contribution, and the EU H2020 Programme 2014–2020 under grant agreements no. 634143 (MedBioinformatics) and no. 676559 (Elixir-Excelerate). The Research Programme on Biomedical Informatics (GRIB) is a member of ELIXIR-ES and the Spanish National Bioinformatics Institute (INB), PRB2-ISCIII and is supported by grant PT13/0001/0023, of the PE I + D+i 2013-2016, funded by ISCIII and FEDER. A.G.S. acknowledges financial support from the Spanish Ministry of Economy and Competitiveness, through the ‘María de Maeztu’ Programme for Units of Excellence in R&D [MDM-2014-0370]

psygenet2r: a R/Bioconductor package for the analysis of psychiatric disease genes

Motivation: Psychiatric disorders have a great impact on morbidity and mortality. Genotype-phenotype resources for psychiatric diseases are key to enable the translation of research findings to a better care of patients. PsyGeNET is a knowledge resource on psychiatric diseases and their genes, developed by text mining and curated by domain experts. Results: We present psygenet2r, an R package that contains a variety of functions for leveraging PsyGeNET database and facilitating its analysis and interpretation. The package offers different types of queries to the database along with variety of analysis and visualization tools, including the study of the anatomical structures in which the genes are expressed and gaining insight of gene's molecular function. Psygenet2r is especially suited for network medicine analysis of psychiatric disorders. Availability: The package is implemented in R and is available under MIT license from Bioconductor ( http://bioconductor.org/packages/release/bioc/html/psygenet2r.html ). Supplementary information: Supplementary data are available at Bioinformatics online

psygenet2r: a R/Bioconductor package for the analysis of psychiatric disease genes

MOTIVATION: Psychiatric disorders have a great impact on morbidity and mortality. Genotype-phenotype resources for psychiatric diseases are key to enable the translation of research findings to a better care of patients. PsyGeNET is a knowledge resource on psychiatric diseases and their genes, developed by text mining and curated by domain experts. RESULTS: We present psygenet2r, an R package that contains a variety of functions for leveraging PsyGeNET database and facilitating its analysis and interpretation. The package offers different types of queries to the database along with variety of analysis and visualization tools, including the study of the anatomical structures in which the genes are expressed and gaining insight of gene's molecular function. Psygenet2r is especially suited for network medicine analysis of psychiatric disorders. AVAILABILITY AND IMPLEMENTATION: The package is implemented in R and is available under MIT license from Bioconductor (http://bioconductor.org/packages/release/bioc/html/psygenet2r.html).This work was supported by ISCIII-FEDER [PI13/00082, CP10/00524, CPII16/00026], MICINN [MTM2015-68140-R], IMI-JU under grants agreements no. 115191 (Open PHACTS), no. 115372 (EMIF), no. 115735 (iPiE), resources of which are composed of financial contribution from the EU-FP7 [FP7/2007–2013] and EFPIA companies in kind contribution, and the EU H2020 Programme 2014–2020 under grant agreements no. 634143 (MedBioinformatics) and no. 676559 (Elixir-Excelerate). The Research Programme on Biomedical Informatics (GRIB) is a member of ELIXIR-ES and the Spanish National Bioinformatics Institute (INB), PRB2-ISCIII and is supported by grant PT13/0001/0023, of the PE I + D+i 2013-2016, funded by ISCIII and FEDER. A.G.S. acknowledges financial support from the Spanish Ministry of Economy and Competitiveness, through the ‘María de Maeztu’ Programme for Units of Excellence in R&D [MDM-2014-0370]

Identifying temporal patterns in patient disease trajectories using dynamic time warping: A population-based study

Time is a crucial parameter in the assessment of comorbidities in population-based studies, as it permits to identify more complex disease patterns apart from the pairwise disease associations. So far, it has been, either, completely ignored or only, taken into account by assessing the temporal directionality of identified comorbidity pairs. In this work, a novel time-analysis framework is presented for large-scale comorbidity studies. The disease-history vectors of patients of a regional Spanish health dataset are represented as time sequences of ordered disease diagnoses. Statistically significant pairwise disease associations are identified and their temporal directionality is assessed. Subsequently, an unsupervised clustering algorithm, based on Dynamic Time Warping, is applied on the common disease trajectories in order to group them according to the temporal patterns that they share. The proposed methodology for the temporal assessment of such trajectories could serve as the preliminary basis of a disease prediction system.We received support from ISCIII-FEDER (PI13/00082, CP10/00524, CPII16/00026), IMI-JU under grants agreements no. 115372 (EMIF), resources composed of financial contribution from the EU-FP7 (FP7/2007-2013) and EFPIA companies in kind contribution, and the EU H2020 Programme 2014-2020 under grant agreements no. 634143 (MedBioinformatics) and no. 676559 (Elixir-Excelerate). The Research Programme on Biomedical Informatics (GRIB) is a member of the Spanish National Bioinformatics Institute (INB), PRB2-ISCIII and is supported by grant PT13/0001/0023, of the PE I + D + i 2013-2016, funded by ISCIII and FEDER. Funding has been also received by the Marie-Curie UPFellowship Program