Cardea: An Open Automated Machine Learning Framework for Electronic Health Records

An estimated 180 papers focusing on deep learning and EHR were published between 2010 and 2018. Despite the common workflow structure appearing in these publications, no trusted and verified software framework exists, forcing researchers to arduously repeat previous work. In this paper, we propose Cardea, an extensible open-source automated machine learning framework encapsulating common prediction problems in the health domain and allows users to build predictive models with their own data. This system relies on two components: Fast Healthcare Interoperability Resources (FHIR) -- a standardized data structure for electronic health systems -- and several AUTOML frameworks for automated feature engineering, model selection, and tuning. We augment these components with an adaptive data assembler and comprehensive data- and model- auditing capabilities. We demonstrate our framework via 5 prediction tasks on MIMIC-III and Kaggle datasets, which highlight Cardea's human competitiveness, flexibility in problem definition, extensive feature generation capability, adaptable automatic data assembler, and its usability

SPINE20 A global advocacy group promoting evidence-based spine care of value

PURPOSE: The Global Burden of Diseases (GBD) Studies have estimated that low back pain is one of the costliest ailments worldwide. Subsequent to GBD publications, leadership of the four largest global spine societies agreed to form SPINE20. This article introduces the concept of SPINE20, the recommendations, and the future of this global advocacy group linked to G20 annual summits. METHODS: The founders of SPINE20 advocacy group coordinated with G20 Saudi Arabia to conduct the SPINE20 summit in 2020. The summit was intended to promote evidence-based recommendations to use the most reliable information from high-level research. Eight areas of importance to mitigate spine disorders were identified through a voting process of the participating societies. Twelve recommendations were discussed and vetted. RESULTS: The areas of immediate concern were "Aging spine," "Future of spine care," "Spinal cord injuries," "Children and adolescent spine," "Spine-related disability," "Spine Educational Standards," "Patient safety," and "Burden on economy." Twelve recommendations were created and endorsed by 31/33 spine societies and 2 journals globally during a vetted process through the SPINE20.org website and during the virtual inaugural meeting November 10-11, 2020 held from the G20 platform. CONCLUSIONS: This is the first time that international spine societies have joined to support actions to mitigate the burden of spine disorders across the globe. SPINE20 seeks to change awareness and treatment of spine pain by supporting local projects that implement value-based practices with healthcare policies that are culturally sensitive based on scientific evidence

SPINE20 A global advocacy group promoting evidence-based spine care of value

Purpose The Global Burden of Diseases (GBD) Studies have estimated that low back pain is one of the costliest ailments worldwide. Subsequent to GBD publications, leadership of the four largest global spine societies agreed to form SPINE20. This article introduces the concept of SPINE20, the recommendations, and the future of this global advocacy group linked to G20 annual summits. Methods The founders of SPINE20 advocacy group coordinated with G20 Saudi Arabia to conduct the SPINE20 summit in 2020. The summit was intended to promote evidence-based recommendations to use the most reliable information from high-level research. Eight areas of importance to mitigate spine disorders were identified through a voting process of the participating societies. Twelve recommendations were discussed and vetted. Results The areas of immediate concern were Aging spine, Future of spine care, Spinal cord injuries, Children and adolescent spine, Spine-related disability, Spine Educational Standards, Patient safety, and Burden on economy. Twelve recommendations were created and endorsed by 31/33 spine societies and 2 journals globally during a vetted process through the SPINE20.org website and during the virtual inaugural meeting November 10-11, 2020 held from the G20 platform. Conclusions This is the first time that international spine societies have joined to support actions to mitigate the burden of spine disorders across the globe. SPINE20 seeks to change awareness and treatment of spine pain by supporting local projects that implement value-based practices with healthcare policies that are culturally sensitive based on scientific evidence

Age density patterns in patients medical conditions: A clustering approach

<div><p>This paper presents a data analysis framework to uncover relationships between health conditions, age and sex for a large population of patients. We study a massive heterogeneous sample of 1.7 million patients in Brazil, containing 47 million of health records with detailed medical conditions for visits to medical facilities for a period of 17 months. The findings suggest that medical conditions can be grouped into clusters that share very distinctive densities in the ages of the patients. For each cluster, we further present the ICD-10 chapters within it. Finally, we relate the findings to comorbidity networks, uncovering the relation of the discovered clusters of age densities to comorbidity networks literature.</p></div

Age distribution for patients with Chickenpox (A) and Glaucoma (B).

<p>Age distribution for patients with Chickenpox (A) and Glaucoma (B).</p

Network representation of the ICD-10 grouped in their 22 category chapters.

<p>The weight of the links represent the number of co-occurrences in the patients records and the size of the nodes represent the frequency of each chapter.</p

Traumatic spinopelvic dissociation: A case series

Introduction: Spinopelvic dissociation was described first in 1969. It is an injury characterized by the separation of the lumbar spine, with parts of the sacrum, from the rest of the sacrum and pelvis with the appendicular skeleton through the sacral ala. Spinopelvic dissociation has an incidence of approximately 2.9% of all pelvic disruptions and corresponds with high-energy trauma. The objective of this study was to review and analyze a case series of spinopelvic dissociations that were treated in our institution from May 2016 to December 2020. Methods: This was a retrospective study reviewing medical records of a series of cases with spinopelvic dissociating. A total of nine patients were encountered. Demographic data including gender and age were analyzed with the mechanism of injury, fracture characteristics, and classifications in addition to neurological deficits. Fractures were classified by the AO Spine Sacral Classification System. Moreover, neurological deficits were classified using the Gibbon's classification score. Finally, the Majeed score was utilized for the assessment of the functional outcome after the injury. Results: A total of nine patients with spinopelvic dissociation were encountered, seven males and two females. Seven patients were due to motor vehicle accidents, one patient was due to a suicidal attempt, and one patient was due to seizure. Four patients suffered from neurological deficits. One patient needed an intensive care unit admission. Spinopelvic fixation was done for all patients. One patient had surgical wound infection with wound dehiscence, one had infected instruments with confirmed spine osteomyelitis, and one had a focal neurological deficit. Six patients went on to heal and showed complete neurological improvements. Conclusion: Spinopelvic dissociation injuries represent a variety of injuries that are commonly associated with high-energy trauma. The triangular fixation method has proven to be a stable construct in dealing with such injuries

Lines in gray represent cumulative distribution of <i>P</i>(<i>age</i>|<i>patients</i> ∈ <i>c</i>) and lines in red are the cluster averages for illustration.

<p>The clusters of ICD-10 codes given by the HAC are labeled from A to F. Cluster A of ICD-10 codes have more concentration towards infants and children. Cluster B of diseases having a density closer to a uniform but with a tendency to have relatively more concentration in teenage years and early adulthood. Cluster C has the narrowest concentration of age in the thirties. Cluster D groups codes that distribute uniformly in all ages. Cluster E groups codes for ages over 60. Cluster F groups ICD-10 codes in patients over 70.</p

Aggressive L3 vertebral hemangioma coexisting with adult thoracolumbar scoliosis: Case report

Vertebral hemangiomas are benign vascular tumors that are commonly asymptomatic. A low percentage might become aggressive; however, they are not known to be associated with scoliosis. We present a case of a third lumbar vertebral lesion coexisting with a moderate thoracolumbar scoliosis. The patient's initial presentation was back pain with bilateral lower limb radiculopathy and neurogenic claudication. Diagnosis was established using CT and MRI, which showed classical findings of an aggressive vertebral hemangioma. The patient underwent Partial hemangioma excision and scoliosis correction, with satisfactory outcome at 1 year follow up

Hierarchical clustering with a depth of six in the dendrogram tree, branches of depth higher than six are represented by the ICD-10 code that is most common in that branch.

<p>The frequency of each ICD-10 code is in parenthesis in percentage of the total population of patients. The alphabet letters assignments correspond to the clusters discussed in <a href="http://www.ploscompbiol.org/article/info:doi/10.1371/journal.pcbi.1006115#pcbi.1006115.g004" target="_blank">Fig 4</a>.</p