Method for Designing Semantic Annotation of Sepsis Signs in Clinical Text

Annotated clinical text corpora are essential for machine learning studies that model and predict care processes and disease progression. However, few studies describe the necessary experimental design of the annotation guideline and annotation phases. This makes replication, reuse, and adoption challenging. Using clinical questions about sepsis, we designed a semantic annotation guideline to capture sepsis signs from clinical text. The clinical questions aid guideline design, application, and evaluation. Our method incrementally evaluates each change in the guideline by testing the resulting annotated corpus using clinical questions. Additionally, our method uses inter-annotator agreement to judge the annotator compliance and quality of the guideline. We show that the method, combined with controlled design increments, is simple and allows the development and measurable improvement of a purpose-built semantic annotation guideline. We believe that our approach is useful for incremental design of semantic annotation guidelines in general

Terminology and ontology development for semantic annotation : A use case on sepsis and adverse events

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The effects of shift work on the immune system : A narrative review

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Intensive care nurses’ experiences with organ donors at non-donor hospitals

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Predicting in-hospital death from derived EHR trajectory features

Medical histories of patients can provide insight into the immediate future of a patient. While most studies propose to predict survival from vital signs and hospital tests within one episode of care, we carry out selective feature engineering from longitudinal historical medical records in this study to develop a dataset with derived features. We then train multiple machine learning models for the binary prediction whether an episode of care will culminate in death among patients suspected of bloodstream infections. The machine learning classifier performance is evaluated and compared and the feature importance impacting the model output is explored. The findings indicated that the logistic regression model achieved the best performance for predicting death in the next hospital episode with an accuracy of 98% and an almost perfect area under the receiver operating characteristic curve. Exploring the feature importance reveals that time to and severity of the last episode and previous history of sepsis episodes were the most critical features

Cardiac function associated with previous, current and repeated depression and anxiety symptoms in a healthy population: the HUNT study.

Objective: Symptoms of anxiety and depression often co-exist with cardiovascular disease (CVD), yet little is known about the association with left ventricular (LV) subclinical dysfunction. We aimed to study the cross-sectional associations of previous, current and repeated depression or anxiety symptoms, with sensitive indices of LV systolic and diastolic function, based on tissue Doppler (TD) and speckle tracking (ST) imaging methods. Methods: A random selection of 1296 individuals free from known CVD, hypertension and diabetes were examined with echocardiography at baseline of the third Nord-Trøndelag Health Study, (HUNT3, 2006–2008). The primary outcomes were LV diastolic function (e′) and LV systolic function (longitudinal global strain). The primary exposures were self-report on the Hospital Anxiety and Depression Scale (HADS). Associations between outcomes and baseline exposures were available for 1034 (80%), and with previous and repeated exposures for 700 participants who also participated in HUNT2 (1995–1997). Results: Previous and repeated depression symptoms, but not current depression, were linearly associated with a reduction in e′. The average sum of two repeated HADS-D scores 10 years apart had the strongest effect on e′ (−8.3%; 95% CI −13.9% to −2.7%) per 5 units. We observed a sex difference between depression symptoms and longitudinal global strain (p for interaction 0.019), where women had a marginal negative effect. Anxiety symptoms, neither previous, current nor repeated were associated with subclinical LV dysfunction. Conclusions: In a healthy sample, confirmed free of CVD, past and repeated depression symptoms were associated with subclinical LV dysfunction. Thus, depression symptoms might represent a modifiable risk factor for future CVD.This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0

The bidirectional association between depressive symptoms, assessed by the HADS, and albuminuria-A longitudinal population-based cohort study with repeated measures from the HUNT2 and HUNT3 Study

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Direct and indirect effects of socioeconomic status on sepsis risk and mortality : a mediation analysis of the HUNT Study

Author's accepted version (postprint).This is an Accepted Manuscript of an article published by BMJ in Journal of Epidemiology and Community Health on 9/2/2023.Available online: doi.org/10.1136/jech-2022-219825acceptedVersio

Insomnia symptoms and risk of bloodstream infections : prospective data from the prospective population-based Nord-Trøndelag Health Study (HUNT), Norway

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