Randomized pilot study and qualitative evaluation of a clinical decision support system for brain tumour diagnosis based on SV 1H MRS: Evaluation as an additional information procedure for novice radiologists
The results of a randomized pilot study and qualitative evaluation of the clinical decision support system Curiam BT are reported. We evaluated the system's feasibility and potential value as a radiological information procedure complementary to magnetic resonance (MR) imaging to assist novice radiologists in diagnosing brain tumours using MR spectroscopy (1.5 and 3.0T). Fifty-five cases were analysed at three hospitals according to four non-exclusive diagnostic questions. Our results show that Curiam BT improved the diagnostic accuracy in all the four questions. Additionally, we discuss the findings of the users' feedback about the system, and the further work to optimize it for real envir…
On the Implementation of HealthAgents: Agent-Based Brain Tumour Diagnosis
This paper introduces HealthAgents, an EC-funded research project to improve the classification of brain tumours through multi-agent decision support over a secure and distributed network of local databases or Data Marts. HealthAgents will not only develop new pattern recognition methods for distributed classification and analysis of in vivo MRS and ex vivo/in vitro HRMAS and DNA data, but also define a method to assess the quality and usability of a new candidate local database containing a set of new cases, based on a compatibility score. Using its Multi-Agent architecture, HealthAgents intends to apply cutting-edge agent technology to the Biomedical field and develop the HealthAgents net…
Temporal variability analysis reveals biases in electronic health records due to hospital process reengineering interventions over seven years
[EN] Objective To evaluate the effects of Process-Reengineering interventions on the Electronic Health Records (EHR) of a hospital over 7 years. Materials and methods Temporal Variability Assessment (TVA) based on probabilistic data quality assessment was applied to the historic monthly-batched admission data of Hospital La Fe Valencia, Spain from 2010 to 2016. Routine healthcare data with a complete EHR was expanded by processed variables such as the Charlson Comorbidity Index. Results Four Process-Reengineering interventions were detected by quantifiable effects on the EHR: (1) the hospital relocation in 2011 involved progressive reduction of admissions during the next four months, (2) th…
Subgrouping factors influencing migraine intensity in women: A semi-automatic methodology based on machine learning and information geometry
[EN] Background Migraine is a heterogeneous condition with multiple clinical manifestations. Machine learning algorithms permit the identification of population groups, providing analytical advantages over other modeling techniques. Objective The aim of this study was to analyze critical features that permit the differentiation of subgroups of patients with migraine according to the intensity and frequency of attacks by using machine learning algorithms. Methods Sixty-seven women with migraine participated. Clinical features of migraine, related disability (Migraine Disability Assessment Scale), anxiety/depressive levels (Hospital Anxiety and Depression Scale), anxiety state/trait levels (S…
EHRtemporalVariability: delineating temporal dataset shifts in electronic health records
AbstractBackgroundTemporal variability in healthcare 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 dataset shifts can present as trends, abrupt or seasonal changes in the statistical distributions of data over time, being particularly complex to address in multi-modal 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 historical data from EHRs, there is a need for spec…
Robust association between vascular habitats and patient prognosis in glioblastoma: An international multicenter study
Background Glioblastoma (GBM) is the most aggressive primary brain tumor, characterized by a heterogeneous and abnormal vascularity. Subtypes of vascular habitats within the tumor and edema can be distinguished: high angiogenic tumor (HAT), low angiogenic tumor (LAT), infiltrated peripheral edema (IPE), and vasogenic peripheral edema (VPE). Purpose To validate the association between hemodynamic markers from vascular habitats and overall survival (OS) in glioblastoma patients, considering the intercenter variability of acquisition protocols. Study Type Multicenter retrospective study. Population In all, 184 glioblastoma patients from seven European centers participating in the NCT03439332 c…
Data-driven discovery of changes in clinical code usage over time: a case-study on changes in cardiovascular disease recording in two English electronic health records databases (2001–2015)
[EN] Objectives To demonstrate how data-driven variability methods can be used to identify changes in disease recording in two English electronic health records databases between 2001 and 2015. Design Repeated cross-sectional analysis that applied data-driven temporal variability methods to assess month-by-month changes in routinely collected medical data. A measure of difference between months was calculated based on joint distributions of age, gender, socioeconomic status and recorded cardiovascular diseases. Distances between months were used to identify temporal trends in data recording. Setting 400 English primary care practices from the Clinical Practice Research Datalink (CPRD GOLD) …