Calcium channel blockers as drug repurposing candidates for gestational diabetes: Mining large scale genomic and electronic health records data to repurpose medications

Large Scale ◽

Patient Data ◽

Health Records ◽

Privacy Concerns ◽

Ubiquitous Technology ◽

Emergency Situations ◽

User Centric ◽

Electronic Health Records (EHRs) are becoming the ubiquitous technology for managing patients' records in many countries. They allow for easier transfer and analysis of patient data on a large scale. However, privacy concerns linked to this technology are emerging. Namely, patients rarely fully understand how EHRs are managed. Additionally, the records are not necessarily stored within the organization where the patient is receiving her healthcare. This service may be delegated to a remote provider, and it is not always clear which health-provisioning entities have access to this data. Therefore, in this chapter the authors propose an alternative where users can keep and manage their records in their existing eHealth systems. The approach is user-centric and enables the patients to have better control over their data while still allowing for special measures to be taken in case of emergency situations with the goal of providing the required care to the patient.

Prediction of gestational diabetes based on nationwide electronic health records

Nature Medicine ◽

10.1038/s41591-019-0724-8 ◽

2020 ◽

Vol 26 (1) ◽

pp. 71-76 ◽

Cited By ~ 22

Author(s):

Nitzan Shalom Artzi ◽

Smadar Shilo ◽

Eran Hadar ◽

Hagai Rossman ◽

Shiri Barbash-Hazan ◽

...

Keyword(s):

Gestational Diabetes ◽

Health Records ◽

Five analytic challenges in working with electronic health records data to support clinical trials with some solutions

Clinical Trials ◽

10.1177/1740774520931211 ◽

2020 ◽

Vol 17 (4) ◽

pp. 370-376

Author(s):

Benjamin A Goldstein

Keyword(s):

Clinical Trials ◽

Large Scale ◽

Point Of Care ◽

Cross Sectional ◽

Health Records ◽

Data Resource ◽

Electronic Health ◽

Data Elements ◽

Data Efficiency

Electronic health records data are becoming a key data resource in clinical research. Owing to issues of data efficiency, electronic health records data are being used for clinical trials. This includes both large-scale pragmatic trails and smaller—more focused—point-of-care trials. While electronic health records data open up a number of scientific opportunities, they also present a number of analytic challenges. This article discusses five particular challenges related to organizing electronic health records data for analytic purposes. These are as follows: (1) data are not organized for research purposes, (2) data are both densely and irregularly observed, (3) we don’t have all data elements we may want or need, (4) data are both cross-sectional and longitudinal, and (5) data may be informatively observed. While laying out these challenges, the article notes how many of these challenges can be addressed by careful and thoughtful study design as well as by integration of clinicians and informaticians into the analytic team.

An Explainable Artificial Intelligence Approach for Predicting Cardiovascular Outcomes using Electronic Health Records

10.1101/2021.07.21.21260474 ◽

2021 ◽

Author(s):

Sergiusz Wesolowski ◽

Gordon Howard Lemmon ◽

Edgar J Hernandez ◽

Alex Ryan Henrie ◽

Thomas A Miller ◽

...

Keyword(s):

Artificial Intelligence ◽

Large Scale ◽

Cardiovascular Health ◽

Cardiovascular Outcomes ◽

Health Records ◽

University Of Utah ◽

Explainable Artificial Intelligence ◽

Electronic Health ◽

Discovery Method

Understanding the conditionally-dependent clinical variables that drive cardiovascular health outcomes is a major challenge for precision medicine. Here, we deploy a recently developed massively scalable comorbidity discovery method called Poisson Binomial based Comorbidity discovery (PBC), to analyze Electronic Health Records (EHRs) from the University of Utah and Primary Children's Hospital (over 1.6 million patients and 77 million visits) for comorbid diagnoses, procedures, and medications. Using explainable Artificial Intelligence (AI) methodologies, we then tease apart the intertwined, conditionally-dependent impacts of comorbid conditions and demography upon cardiovascular health, focusing on the key areas of heart transplant, sinoatrial node dysfunction and various forms of congenital heart disease. The resulting multimorbidity networks make possible wide-ranging explorations of the comorbid and demographic landscapes surrounding these cardiovascular outcomes, and can be distributed as web-based tools for further community-based outcomes research. The ability to transform enormous collections of EHRs into compact, portable tools devoid of Protected Health Information solves many of the legal, technological, and data-scientific challenges associated with large-scale EHR analyzes.

Privacy-Friendly Management of Electronic Health Records in the eHealth Context

Healthcare Ethics and Training ◽

10.4018/978-1-5225-2237-9.ch023 ◽

2017 ◽

pp. 528-542

Author(s):

Milica Milutinovic ◽

Bart De Decker

Keyword(s):

Large Scale ◽

Patient Data ◽

Health Records ◽

Privacy Concerns ◽

Ubiquitous Technology ◽

Emergency Situations ◽

User Centric ◽

Electronic Health Records (EHRs) are becoming the ubiquitous technology for managing patients' records in many countries. They allow for easier transfer and analysis of patient data on a large scale. However, privacy concerns linked to this technology are emerging. Namely, patients rarely fully understand how EHRs are managed. Additionally, the records are not necessarily stored within the organization where the patient is receiving her healthcare. This service may be delegated to a remote provider, and it is not always clear which health-provisioning entities have access to this data. Therefore, in this chapter the authors propose an alternative where users can keep and manage their records in their existing eHealth systems. The approach is user-centric and enables the patients to have better control over their data while still allowing for special measures to be taken in case of emergency situations with the goal of providing the required care to the patient.

Beta-blocker and calcium-channel blocker therapy in patients with cardiovascular pathologies during post-COVID period

Лечащий врач ◽

10.51793/os.2021.24.12.007 ◽

2021 ◽

Author(s):

А.Г. Арутюнов ◽

Г.П. Арутюнов ◽

Е.И. Тарловская ◽

Т.И. Батлук ◽

Р.А. Башкинов ◽

...

Keyword(s):

Calcium Channel ◽

Beta Blocker ◽

Calcium Channel Blockers ◽

Large Scale ◽

Channel Blockers ◽

Blocker Therapy ◽

Cardiovascular Patients ◽

Coronavirus Infection ◽

Novel Coronavirus ◽

The Impact

С начала 2020 г. в мире распространилась инфекция, вызванная вирусом SARS-CoV-2, что в дальнейшем привело к пандемии COVID-19. Долгое время вопросы ведения пациентов с новой коронавирусной инфекцией в остром периоде рассматривались как первоочередные. По мере накопления клинического опыта и данных о возбудителе новой коронавирусной инфекции стало очевидно, что проблема последствий перенесенного COVID-19 и ведения пациентов на постгоспитальном этапе является такой же важной. В силу прямой и опосредованной кардиотоксичности вируса SARS-CoV-2 особую группу риска на всех этапах составляют пациенты с сердечно-сосудистыми заболеваниями. Поэтому одной из важных задач мирового медицинского сообщества стала разработка способов улучшения качества и прогноза жизни пациентов с сердечно-сосудистыми заболеваниями в постковидном периоде. В статье сделан обзор наиболее крупных исследований, включая данные регистра «Анализ динамики коморбидных заболеваний пациентов, перенесших инфицирование SARS-CoV-2 (AКТИВ SARS-CoV-2)», по вопросу медикаментозной терапии пациентов с сердечно-сосудистыми заболеваниями с акцентом на бета-адреноблокаторы и блокаторы кальциевых каналов. В представленных работах терапия бета-адреноблокаторами продемонстрировала благоприятное влияние на тяжесть течения новой коронавирусной инфекции у пациентов с сердечно-сосудистыми заболеваниями, снижение смертности на госпитальном и в отдаленном постгоспитальном периодах. Данные по применению блокаторов кальциевых каналов изучены в меньшей степени, но можно отметить, что данная группа препаратов является одной из самых часто назначаемых в терапии пациентов с сохранением стойких жалоб на повышение артериального давления на постгоспитальном этапе. Требуется дальнейшее изучение влияния отдельных классов антигипертензивных препаратов на прогноз пациентов с сердечно-сосудистыми заболеваниями и COVID-19. Early in 2020, the infection caused by SARS-CoV-2 emerged and caused the COVID-19 pandemic. For a long time, management of patients with the acute novel coronavirus infection was of primary importance. With accumulation of clinical information and data on the causative agents of novel coronavirus infection it became obvious that the COVID-19 consequences and post-hospital follow-up of patients are important as well. Due to the direct and mediated cardiac toxicity of SARS-CoV-2 virus, cardiovascular patients are at high risk at any stage of the disease. Therefore, one of the priorities for healthcare professionals is development of the ways to improve the quality and prognosis of life for cardiovascular patients in the post-COVID period. The article discusses large-scale studies including the data from the International Register «Analysis of Chronic Non-infectious Diseases Dynamics After COVID-19 Infection in Adult Patients» (AСTIV-SARS-CoV-2), as regards drug therapy of cardiovascular patients with a focus on beta-blockers and calcium-channel blockers. In mentioned publications, beta-blocker therapy demonstrated favourable impact on the novel coronavirus infection severity in cardiovascular patients, reduction in mortality rates during the hospital and post-hospital periods. Data on the use of calcium-channel blockers have been studied to a lesser extent; however, calcium-channel blockers are thought to be one of the most commonly prescribed groups in the therapy of patients with persistent complaints of high blood pressure at the post-hospital period. A study of the impact of some categories of antihypertensives on the outcome for cardiovascular patients with COVID-19 is warranted.

Large-Scale Identification of Aortic Stenosis and its Severity Using Natural Language Processing on Electronic Health Records

Cardiovascular Digital Health Journal ◽

10.1016/j.cvdhj.2021.03.003 ◽

2021 ◽

Author(s):

Matthew D. Solomon ◽

Grace Tabada ◽

Amanda Allen ◽

Sue Hee Sung ◽

Alan S. Go

Keyword(s):

Natural Language Processing ◽

Aortic Stenosis ◽

Natural Language ◽

Language Processing ◽

Large Scale ◽

Health Records ◽

Med-BERT: pretrained contextualized embeddings on large-scale structured electronic health records for disease prediction

npj Digital Medicine ◽

10.1038/s41746-021-00455-y ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Laila Rasmy ◽

Yang Xiang ◽

Ziqian Xie ◽

Cui Tao ◽

Degui Zhi

Keyword(s):

Deep Learning ◽

Large Scale ◽

Training Data ◽

Fine Tuning ◽

Disease Prediction ◽

Operating Characteristics ◽

Health Records ◽

Clinical Databases ◽

AbstractDeep learning (DL)-based predictive models from electronic health records (EHRs) deliver impressive performance in many clinical tasks. Large training cohorts, however, are often required by these models to achieve high accuracy, hindering the adoption of DL-based models in scenarios with limited training data. Recently, bidirectional encoder representations from transformers (BERT) and related models have achieved tremendous successes in the natural language processing domain. The pretraining of BERT on a very large training corpus generates contextualized embeddings that can boost the performance of models trained on smaller datasets. Inspired by BERT, we propose Med-BERT, which adapts the BERT framework originally developed for the text domain to the structured EHR domain. Med-BERT is a contextualized embedding model pretrained on a structured EHR dataset of 28,490,650 patients. Fine-tuning experiments showed that Med-BERT substantially improves the prediction accuracy, boosting the area under the receiver operating characteristics curve (AUC) by 1.21–6.14% in two disease prediction tasks from two clinical databases. In particular, pretrained Med-BERT obtains promising performances on tasks with small fine-tuning training sets and can boost the AUC by more than 20% or obtain an AUC as high as a model trained on a training set ten times larger, compared with deep learning models without Med-BERT. We believe that Med-BERT will benefit disease prediction studies with small local training datasets, reduce data collection expenses, and accelerate the pace of artificial intelligence aided healthcare.

The Emerging Landscape of Epidemiological Research Based on Biobanks Linked to Electronic Health Records: Existing Resources, Analytic Challenges and Potential Opportunities

10.20944/preprints201809.0388.v1 ◽

2018 ◽

Cited By ~ 3

Author(s):

Lauren Beesley ◽

Maxwell Salvatore ◽

Lars Fritsche ◽

Anita Pandit ◽

Arvind Rao ◽

...

Keyword(s):

Large Scale ◽

Sampling Strategy ◽

Data Access ◽

Open Problems ◽

Health Records ◽

Data Resource ◽

Electronic Health ◽

Rich Data ◽

Scientific Questions

Biobanks linked to electronic health records provide a rich data resource for health-related research. With the establishment of large-scale infrastructure, the availability and utility of data from biobanks has dramatically increased over time. As more researchers become interested in using biobank data to explore a diverse spectrum of scientific questions, resources guiding the data access, design, and analysis of biobank-based studies will be crucial.  The first aim of this review is to characterize the types of biobanks that are discussed in the recent literature and provide detailed descriptions of specific biobanks including their location, size, data access, data linkages and more. The development and accessibility of large-scale biorepositories provide the opportunity to accelerate agnostic searches, new discoveries, and hypothesis-generating studies of disease-treatment, disease-exposure and disease-gene associations. Rather than spending time and money designing and implementing a single study with pre-defined objectives, researchers can use biobanks’ existing data-rich resources to answer scientific questions as quickly as they can analyze them. While the data are becoming increasingly available, additional thought is needed to address issues related to the design of such studies and analysis of these data. In the second aim of this review, we discuss statistical issues related to biobank research in general including study design, sampling strategy, phenotype identification, and missing data. These issues are illustrated using data from the Michigan Genomics Initiative, UK Biobank, and Genes for Good. We summarize the current body of statistical literature aimed at addressing some of these challenges and discuss some of the standing open problems in this area. This work serves to complement and extend recent reviews about biobank-based research and aims to provide a resource catalog with statistical and practical guidance to researchers pursuing biobank-based research.