Identity and Granularity of Events in Text

In this paper we describe a method to detect event descrip- tions in different news articles and to model the semantics of events and their components using RDF representations. We compare these descriptions to solve a cross-document event coreference task. Our com- ponent approach to event semantics defines identity and granularity of events at different levels. It performs close to state-of-the-art approaches on the cross-document event coreference task, while outperforming other works when assuming similar quality of event detection. We demonstrate how granularity and identity are interconnected and we discuss how se- mantic anomaly could be used to define differences between coreference, subevent and topical relations.Comment: Invited keynote speech by Piek Vossen at Cicling 201

Depression in general practice:underrecognition? Overtreatment? Adequate care!

Dit proefschrift geeft een optimistisch beeld van de huidige zorg voor depressieve patiënten in de huisartsenpraktijk i.v.m. eerdere literatuur en mediaberichten. We concluderen dat, de zorg voor depressieve patiënten in de eerste lijn in het algemeen adequaat is, d.w.z. in overeenstemming met aanbevelingen uit geldende richtlijnen.Ruim twee-derde van de depressieve patiënten werd door de huisarts herkend. Patiënten die psychische problemen met de huisarts bespraken, met meer depressieve symptomen en met tevens een angststoornis werden beter herkend. Het atypische symptoom toegenomen eetlust leidde tot slechtere herkenning.58% van de depressieve patiënten werd verwezen voor psychologische of psychiatrische zorg. Huisartsen hielden de aanbevelingen voor verwijzing uit de richtlijn hierbij in het oog, patiënten met voorkeur voor psychotherapie, met chronische depressie of suïcidale neigingen werden vaker verwezen.Ook behandeling met antidepressiva schrijven huisartsen volgens de richtlijn voor. Slechts bij 5,4% van de antidepressiva-gebruikers was sprake van overbehandeling. Bovendien was meer dan de helft van deze overbehandelde patiënten met een goede reden gestart, maar te lang doorbehandeld.Uit een literatuur-review concludeerden wij dat aanbevelingen voor antidepressiva-gebruik gebaseerd zijn op voldoende bewijs v.w.b. acute behandeling en preventie van terugval gedurende enkele maanden, maar niet voor langdurige onderhoudsbehandeling.Aanbevelingen voor onderhoudsbehandeling worden ook minder goed gevolgd. Het zijn niet, zoals de richtlijn voorschrijft, patiënten met een chronische of recidiverende depressie die onderhoudsbehandeling krijgen. Wel lijken het patiënten met een slechtere prognose: patiënten met tevens een angststoornis of dysthyme stoornis (langdurige ‘milde’ depressie), patiënten die naast antidepressiva ook kalmerende middelen gebruikten en met recente psychiatrische contacten.Overall this thesis gives an optimistic picture of current care for depressed patients in primary care compared to previous literature and media reports. We conclude that, in general, the care for depressed patients in primary care is in most cases adequate, i.e. in accordance with ruling guideline recommendations.The general practitioner recognized over two-thirds of depressed patients. Patients discussing psychological problems with the general practitioner, those with more depressive symptoms and with a concurrent anxiety disorder were better recognized. The atypical symptom increased appetite led to worse recognition.58% of depressed patients were referred for psychological or psychiatric care. General practitioners took guideline recommendations into account in referring; patients with preference for psychotherapy, chronic depression or suicidal tendency were referred more often.Treatment with antidepressants was also prescribed according to guideline recommendations. In only 5.4% of antidepressant users it could be called overtreatment. Furthermore, over half of these overtreated patients started with a good reason, but were treated too long according to guideline recommendations.From review of the literature we conclude that guideline recommendations for antidepressant treatment are thoroughly evidence-based for acute treatment and relapse prevention during several months, but not for maintenance treatment.Recommendations for maintenance treatment are also less often followed. Maintenance users are not, as the guideline prescribes, patients with chronic or recurrent depression. It does however seem that maintenance antidepressant users are those with a worse prognosis such as patients with comorbid dysthymia or anxiety and patients also receiving sedatives or patients with recent psychiatric contacts

Heart failure biomarkers: The importance of cardiac specificity

In this thesis, three different approaches to study biomarkers (bioinformatics, animal models and clinical cohorts) were combined to improve our knowledge on HF biomarker biology, clinical utility, and HF biomarkers as treatment targets. The results of our unique and elaborate approach shed new light on the biomarker field as a whole. We showed that many novel HF biomarkers lack cardiac specificity and are produced by non-cardiac organs and tissues. Relating the levels of these markers to processes of pathological processes in the heart seems therewith impossible. Nevertheless, non-specific markers might still have clinical value, for example as markers of peripheral effects of HF or as pharmacological treatment targets. Finally, this thesis showed that for future biomarker studies it is indispensable to investigate tissue origin of markers in order to improve their specificity and therewith their clinical utility

MedRoBERTa.nl: A Language Model for Dutch Electronic Health Records

This paper presents MedRoBERTa.nl as the first Transformer-based language model for Dutch medical language. We show that using 13GB of text data from Dutch hospital notes, pre-training from scratch results in a better domain-specific language model than further pre-training RobBERT. When extending pre-training on RobBERT, we use a domain-specific vocabulary and re-train the embedding look-up layer. We show that MedRoBERTa.nl, the model that was trained from scratch, outperforms general language models for Dutch on a medical odd-one-out similarity task. MedRoBERTa.nl already reaches higher performance than general language models for Dutch on this task after only 10k pre-training steps. When fine-tuned, MedRobERTa.nl outperforms general language models for Dutch in a task classifying sentences from Dutch hospital notes that contain information about patients' mobility levels

Scientific Network of Experts: Interviewer Effects and Interviewer Training

Although the collection of survey data is undergoing a notable shift toward online and mixed-mode data collection methods (Baker et al., 2010; Groves, 2011), interviewers are still heavily involved in the majority of survey data collections that serve as a basis for important economic, educational, and public policy decisions. Research supports the notion that interviewer characteristics and task-specific skill levels significantly influence the resulting data quality (see, e.g. Ackermann-Piek, 2018; Billiet & Loosveldt, 1988; Dahlhamer, Cynamon, Gentleman, Piani, & Weiler, 2010; Durand, 2005; Fowler Jr., 1991; Hox & de Leeuw, 2002; Jäckle, Lynn, Sinibaldi, & Tipping, 2013; Sakshaug, Tutz, & Kreuter, 2013; Schnell & Trappman, 2006; Vannette & Krosnick, 2018; West & Blom, 2017; West, Kreuter, & Jaenichen, 2013). Thus, it is not surprising, that the international survey research community has sought opportunities to facilitate intensive exchanges between survey researchers on topics related to interviewer training procedures, fieldwork processes, and interviewer effects at international workshops and conferences (e.g. Workshop on Explaining interviewer effects in interviewer-mediated surveys, Germany: Mannheim, April 2013; Interviewer workshop, USA Nebraska: Lincoln, February 2019; Conferences of the European Survey Research Association, every other year at changing locations). However, such occurrences tend to be sporadic, one-off events, not designed to promote a continuous, ongoing dialogue of interviewer-related issues in the field. Furthermore, while most of the interviewer literature reports findings on interviewer effects and interviewer training, there is a lack of overarching recommendations and standards for reduction of interviewer effects and the implementation of appropriate interviewer training methods in interviewer-administered surveys. For example, international recommendations for interviewer training are typically quite broad and do not include a high level of detail suitable for prescriptive and standardized implementation in the field (Alcser, Clemens, Holland, Guyer, & Hu, 2016; Daikeler, Silber, Bosnjak, Zabal, & Martin, 2017; Fowler Jr. & Mangione, 1990; Lessler, Eyerman, & Wang, 2008). In the following proposal, we describe our vision to set up a multi-year scientific exchange and cooperation among a core group of international methods experts on topics related to interviewer involvement in the implementation of scientific surveys. We aim to start with three-year pilot phase to build up an infrastructure for regular knowledge exchanges and sharing of materials. Within this pilot phase, annual or biannual meetings will be organized to discuss best practices, exchange ideas, and identify research gaps on pressing topics pertinent to interviewer surveys. As the major outcome of this scientific network, we plan the production of research-based standards and recommendations reports to be published on various interviewer-related topics

Evaluation of the SUNHEART Cardiology Outreach Programme

Introduction: The demand for advanced cardiac care and specialised interventions is on the increase and this results in bottlenecks and increased waiting times for patients who require advanced cardiac care. By decentralising cardiac care, and using a hub-and-spoke model, the SUNHEART Outreach Programme of cardiovascular care aims to improve access to advanced cardiac care in the Western Cape. Tygerberg Hospital is the central hub, with the fi rst spoke being Paarl Hospital. Objective: To determine the value of the SUNHEART Outreach Programme to the public health care system. Methods: An audit of patients accessing the OutreachProgramme was performed for the period May 2013 - May 2014 and consequently compared to a historical cohort of patients accessing the health care system during the preceding 6 months, from October 2012 -April 2013. Access to advanced cardiac care was measured in time to initial evaluation, time to defi nitive diagnosis or intervention and patient compliance with appointments. The value to the health care system was also assessed by performing a cost analysis of transport of patients and health care workers, as well as compliance with appointments. We documented the spectrum of disease requiring advanced cardiac care toguide future interventions. Results: Data of 185 patients were included in the audit. Sixty four patients were referred to tertiary care from October 2012 - April 2013 and 121 patients were referred to the outreach facility from May 2013 - May 2014. There was a signifi cant reduction in waiting times with the median days to appointment of the historical cohort being 85 days compared to 18 days in the Outreach Programme cohort (p<0.01). Patient compliance with appointments was signifi cantly superior in the Outreach Programme cohort (90% vs. 56%: p<0.01). Valvular (36.5%) and ischaemic heart disease (35.5%) were the major pathologies requiring access to cardiac care services. Transport costs per patient treated was signifi cantly reduced in the outreach programme cohort (R118,09 vs. R308,77). Conclusion: Decentralisation of services in the form of an Outreach Programme, with a central hub, improves access to advanced cardiac care by decreasing waiting time, improving compliance with appointments and decreasing travel costs