一种受自然语言处理启发的新方法(检测、初始特征描述和语义特征描述),用于调查医疗保健数据中的时空转移(漂移):定量研究。

IF 3.1 3区 医学 Q2 MEDICAL INFORMATICS
Bruno Paiva, Marcos André Gonçalves, Leonardo Chaves Dutra da Rocha, Milena Soriano Marcolino, Fernanda Cristina Barbosa Lana, Maira Viana Rego Souza-Silva, Jussara M Almeida, Polianna Delfino Pereira, Claudio Moisés Valiense de Andrade, Angélica Gomides Dos Reis Gomes, Maria Angélica Pires Ferreira, Frederico Bartolazzi, Manuela Furtado Sacioto, Ana Paula Boscato, Milton Henriques Guimarães-Júnior, Priscilla Pereira Dos Reis, Felício Roberto Costa, Alzira de Oliveira Jorge, Laryssa Reis Coelho, Marcelo Carneiro, Thaís Lorenna Souza Sales, Silvia Ferreira Araújo, Daniel Vitório Silveira, Karen Brasil Ruschel, Fernanda Caldeira Veloso Santos, Evelin Paola de Almeida Cenci, Luanna Silva Monteiro Menezes, Fernando Anschau, Maria Aparecida Camargos Bicalho, Euler Roberto Fernandes Manenti, Renan Goulart Finger, Daniela Ponce, Filipe Carrilho de Aguiar, Luiza Margoto Marques, Luís César de Castro, Giovanna Grünewald Vietta, Mariana Frizzo de Godoy, Mariana do Nascimento Vilaça, Vivian Costa Morais
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引用次数: 0

摘要

背景:正确分析和解释医疗保健数据可以通过加强服务和揭示新技术和新疗法的影响来显著改善患者的治疗效果。了解这些数据的时间变化所产生的重大影响至关重要。例如,COVID-19 疫苗接种最初降低了高危患者的平均年龄,后来又改变了死亡患者的特征。这凸显了了解这些变化对于评估影响患者预后的因素的重要性:本研究旨在提出检测、初始表征和语义表征(DIS)这一新方法,用于分析健康结果和变量随时间的变化,同时发现大量数据中结果的背景变化:DIS 方法包括 3 个步骤:检测、初始表征和语义表征。检测使用詹森-香农分歧等指标来识别重要的数据漂移。初始特征描述对数据分布的变化和预测特征的重要性进行全局分析。语义特征描述使用自然语言处理启发技术来理解这些变化的局部背景,帮助识别推动患者结果变化的因素。通过整合这 3 个步骤的结果,我们的结果可以识别出推动患者预后变化的具体因素(例如,医疗保健实践中的干预和修改)。我们将 DIS 应用于巴西 COVID-19 登记和重症监护医学信息市场第四版(MIMIC-IV)数据集:我们的方法使我们能够:(1)有效识别漂移,尤其是使用詹森-香农发散等指标;(2)揭示 COVID-19 和 MIMIC-IV 数据集中总死亡率下降的原因,以及不同疾病与这一特定结果之间共同发生的变化。COVID-19 大流行期间的疫苗接种以及 MIMIC-IV 中减少的先天性事件和癌症相关死亡等因素都得到了强调。该方法还准确地指出了患者人口统计学和疾病模式的变化,为研究期间不断变化的医疗状况提供了见解:我们开发了一种结合机器学习和自然语言处理技术的新方法,用于检测、描述和理解医疗数据的时间变化。这种理解可以增强预测算法,改善患者预后,优化医疗资源分配,最终提高应用于医疗数据的机器学习预测算法的有效性。除了本文所讨论的情况,我们的方法还可应用于其他各种情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A New Natural Language Processing-Inspired Methodology (Detection, Initial Characterization, and Semantic Characterization) to Investigate Temporal Shifts (Drifts) in Health Care Data: Quantitative Study.

Background: Proper analysis and interpretation of health care data can significantly improve patient outcomes by enhancing services and revealing the impacts of new technologies and treatments. Understanding the substantial impact of temporal shifts in these data is crucial. For example, COVID-19 vaccination initially lowered the mean age of at-risk patients and later changed the characteristics of those who died. This highlights the importance of understanding these shifts for assessing factors that affect patient outcomes.

Objective: This study aims to propose detection, initial characterization, and semantic characterization (DIS), a new methodology for analyzing changes in health outcomes and variables over time while discovering contextual changes for outcomes in large volumes of data.

Methods: The DIS methodology involves 3 steps: detection, initial characterization, and semantic characterization. Detection uses metrics such as Jensen-Shannon divergence to identify significant data drifts. Initial characterization offers a global analysis of changes in data distribution and predictive feature significance over time. Semantic characterization uses natural language processing-inspired techniques to understand the local context of these changes, helping identify factors driving changes in patient outcomes. By integrating the outcomes from these 3 steps, our results can identify specific factors (eg, interventions and modifications in health care practices) that drive changes in patient outcomes. DIS was applied to the Brazilian COVID-19 Registry and the Medical Information Mart for Intensive Care, version IV (MIMIC-IV) data sets.

Results: Our approach allowed us to (1) identify drifts effectively, especially using metrics such as the Jensen-Shannon divergence, and (2) uncover reasons for the decline in overall mortality in both the COVID-19 and MIMIC-IV data sets, as well as changes in the cooccurrence between different diseases and this particular outcome. Factors such as vaccination during the COVID-19 pandemic and reduced iatrogenic events and cancer-related deaths in MIMIC-IV were highlighted. The methodology also pinpointed shifts in patient demographics and disease patterns, providing insights into the evolving health care landscape during the study period.

Conclusions: We developed a novel methodology combining machine learning and natural language processing techniques to detect, characterize, and understand temporal shifts in health care data. This understanding can enhance predictive algorithms, improve patient outcomes, and optimize health care resource allocation, ultimately improving the effectiveness of machine learning predictive algorithms applied to health care data. Our methodology can be applied to a variety of scenarios beyond those discussed in this paper.

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来源期刊
JMIR Medical Informatics
JMIR Medical Informatics Medicine-Health Informatics
CiteScore
7.90
自引率
3.10%
发文量
173
审稿时长
12 weeks
期刊介绍: JMIR Medical Informatics (JMI, ISSN 2291-9694) is a top-rated, tier A journal which focuses on clinical informatics, big data in health and health care, decision support for health professionals, electronic health records, ehealth infrastructures and implementation. It has a focus on applied, translational research, with a broad readership including clinicians, CIOs, engineers, industry and health informatics professionals. Published by JMIR Publications, publisher of the Journal of Medical Internet Research (JMIR), the leading eHealth/mHealth journal (Impact Factor 2016: 5.175), JMIR Med Inform has a slightly different scope (emphasizing more on applications for clinicians and health professionals rather than consumers/citizens, which is the focus of JMIR), publishes even faster, and also allows papers which are more technical or more formative than what would be published in the Journal of Medical Internet Research.
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