EHR-based machine learning modeling for preterm birth prediction: A systematic review (Preprint)

2021 ◽  
Author(s):  
Zahra Sharifiheris ◽  
Juho Laitala ◽  
Antti Airola ◽  
Amir M Rahmani ◽  
Miriam Bender

BACKGROUND Preterm birth (PTB) as a common pregnancy complication is responsible for 35% of the 3.1 million pregnancy-related deaths each year and significantly impacts around 15 million children annually across the world. Conventional approaches to predict PTB may neither be applicable for first-time mothers nor possess reliable predictive power. Recently, machine learning (ML) models have shown the potential as an appropriate complementary approach for PTB prediction. OBJECTIVE In this article we systematically reviewed the literature concerned with PTB prediction using ML modeling. METHODS This systematic review was conducted in accordance with the PRISMA statement. A comprehensive search was performed in seven bibliographic databases up until 15 May 2021. The quality of studies was assessed, and the descriptive information including socio-demographic characteristics, ML modeling processes, and model performance were extracted and reported. RESULTS A total of 732 papers were screened through title and abstract. Of these, 23 studies were screened by full text resulting in 13 papers that met the inclusion criteria. CONCLUSIONS We identified various ML models used for different EHR data resulting in a desirable performance for PTB prediction. However, evaluation metrics, software/package used, data size and type, and selected features, and importantly data management method often varied from study to study threatening the reliability and generalizability of the model. CLINICALTRIAL n.a.

2015 ◽  
Vol 26 (3) ◽  
pp. 415-425 ◽  
Author(s):  
Morten Schrøder ◽  
Kirsten A. Boisen ◽  
Jesper Reimers ◽  
Grete Teilmann ◽  
Jesper Brok

AbstractPurposeWe performed a systematic review and meta-analysis of observational studies assessing quality of life in adolescents and young adults born with CHD compared with age-matched controls.MethodsWe carried out a systematic search of the literature published in Medline, Embase, PsychINFO, and the Cochrane Library’s Database (1990–2013); two authors independently extracted data from the included studies. We used the Newcastle–Ottawa scale for quality assessment of studies. A random effects meta-analysis model was used. Heterogeneity was assessed using the I2-test.ResultsWe included 18 studies with 1786 patients. The studies were of acceptable-to-good quality. The meta-analysis of six studies on quality of life showed no significant difference – mean difference: −1.31; 95% confidence intervals: −6.51 to +3.89, I2=90.9% – between adolescents and young adults with CHD and controls. Similar results were found in 10 studies not eligible for the meta-analysis. In subdomains, it seems that patients had reduced physical quality of life; however, social functioning was comparable or better compared with controls.ConclusionFor the first time in a meta-analysis, we have shown that quality of life in adolescents and young adults with CHD is not reduced when compared with age-matched controls.


2020 ◽  
Vol 3 ◽  
pp. 36
Author(s):  
Marina Zaki ◽  
Marie Galligan ◽  
Lydia O'Sullivan ◽  
Declan Devane ◽  
Eilish McAuliffe

Trials can be defined as prospective human research studies to test the effectiveness and safety of interventions, such as medications, surgeries, medical devices and other interventions for the management of patient care. Statistics is an important and powerful tool in trials. Inappropriately designed trials and/or inappropriate statistical analysis produce unreliable results, with limited clinical use. The aim of this systematic literature review is to identify, describe and synthesise factors contributing to or influencing the statistical planning, design, conduct, analysis and reporting of trials. This protocol will describe the methodological approach taken for the following: conducting a systematic and comprehensive search for relevant articles, applying eligibility criteria for the inclusion of such articles, extracting data and information, appraising the quality of the articles, and thematically synthesizing the data to illuminate the key factors influencing statistical aspects of trials.


2019 ◽  
Author(s):  
Georgy Kopanitsa ◽  
Aleksei Dudchenko ◽  
Matthias Ganzinger

BACKGROUND It has been shown in previous decades, that Machine Learning (ML) has a huge variety of possible implementations in medicine and can be very helpful. Neretheless, cardiovascular diseases causes about third of of all global death. Does ML work in cardiology domain and what is current progress in that regard? OBJECTIVE The review aims at (1) identifying studies where machine-learning algorithms were applied in the cardiology domain; (2) providing an overview based on identified literature of the state of the art of the ML algorithm applying in cardiology. METHODS For organizing this review, we have employed PRISMA statement. PRISMA is a set of items for reporting in systematic reviews and meta-analyses, focused on the reporting of reviews evaluating randomized trials, but can also be used as a basis for reporting systematic review. For the review, we have adopted PRISMA statement and have identified the following items: review questions, information sources, search strategy, selection criteria. RESULTS In total 27 scientific articles or conference papers written in English and reporting about implementation of an ML-method or algorithm in cardiology domain were included in this review. We have examined four aspects: aims of ML-systems, methods, datasets and evaluation metrics. CONCLUSIONS We suppose, this systematic review will be helpful for researchers developing machine-learning system for a medical domain and in particular for cardiology.


2019 ◽  
Vol 35 (2) ◽  
pp. 196-204 ◽  
Author(s):  
Luis F Gomez ◽  
Carolina Soto-Salazar ◽  
José Guerrero ◽  
María Garcia ◽  
Diana C Parra

Abstract To conduct a systematic review examining the associations between neighborhood environments and self-rated health (SRH) and health-related quality of life (HR-QOL) in the urban context of Latin America. We conducted a structured search of quantitative studies in three bibliographic databases published in Spanish, English, Portuguese and French from January 1990 to December 2015. We restricted the search to studies conducted in Latin-American cities with one million and more inhabitants. Eleven studies were finally included in the analysis. Ten were cross-sectional studies and one was a cohort follow-up study. Two studies found positive associations between accessibility to parks and HR-QOL. One study found that high neighborhood social capital was positively associated with SRH. Neighborhood socioeconomic status was positively associated with both HR-QOL and SRH in two studies. A walkable neighborhood was positively associated with SRH in two studies. Three studies included attributes related with neighborhood security perception and road safety, with higher scores of HR-QOL, both in the physical and mental dimensions, while high levels of street noise were negatively associated. Narrowness and slope of streets were negatively associated with SRH. No association was found between the perception of neighborhood security and SRH. The results of this systematic review show that several studies conducted in Latin America have found significant associations between neighborhood environment and SRH and HRQOL. However, the relatively small number of studies and the heterogeneity among them require further studies to better understand this topic in the region.


2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Jamie Miles ◽  
Janette Turner ◽  
Richard Jacques ◽  
Julia Williams ◽  
Suzanne Mason

Abstract Background The primary objective of this review is to assess the accuracy of machine learning methods in their application of triaging the acuity of patients presenting in the Emergency Care System (ECS). The population are patients that have contacted the ambulance service or turned up at the Emergency Department. The index test is a machine-learning algorithm that aims to stratify the acuity of incoming patients at initial triage. This is in comparison to either an existing decision support tool, clinical opinion or in the absence of these, no comparator. The outcome of this review is the calibration, discrimination and classification statistics. Methods Only derivation studies (with or without internal validation) were included. MEDLINE, CINAHL, PubMed and the grey literature were searched on the 14th December 2019. Risk of bias was assessed using the PROBAST tool and data was extracted using the CHARMS checklist. Discrimination (C-statistic) was a commonly reported model performance measure and therefore these statistics were represented as a range within each machine learning method. The majority of studies had poorly reported outcomes and thus a narrative synthesis of results was performed. Results There was a total of 92 models (from 25 studies) included in the review. There were two main triage outcomes: hospitalisation (56 models), and critical care need (25 models). For hospitalisation, neural networks and tree-based methods both had a median C-statistic of 0.81 (IQR 0.80-0.84, 0.79-0.82). Logistic regression had a median C-statistic of 0.80 (0.74-0.83). For critical care need, neural networks had a median C-statistic of 0.89 (0.86-0.91), tree based 0.85 (0.84-0.88), and logistic regression 0.83 (0.79-0.84). Conclusions Machine-learning methods appear accurate in triaging undifferentiated patients entering the Emergency Care System. There was no clear benefit of using one technique over another; however, models derived by logistic regression were more transparent in reporting model performance. Future studies should adhere to reporting guidelines and use these at the protocol design stage. Registration and funding This systematic review is registered on the International prospective register of systematic reviews (PROSPERO) and can be accessed online at the following URL: https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42020168696 This study was funded by the NIHR as part of a Clinical Doctoral Research Fellowship.


2020 ◽  
pp. 030802262091040
Author(s):  
Ghodsiyeh Joveini ◽  
Armin Zareiyan ◽  
Laleh Lajevardi ◽  
Mitra Khalafbeigi ◽  
Afsoon Hassani Mehraban

Introduction Enhancing participation is the focus of occupational therapy. Comprehensive and accurate assessment ensures that clinicians can tailor an intervention to the client’s needs. This systematic review was completed to identify Persian adolescents’ participation measures and critically appraise them. It would be helpful in the selection of the most appropriate instrument to use in adolescent-related research and clinical practice. Method Ten bibliographic databases, four Iranian and six international, without year limits were searched up to June 2019. A systematic search was directed according to COSMIN guidelines for systematic reviews of patient-reported outcome measures and PRISMA guidelines (Systematic review registration: CRD42017073581). Results Seven measures were extracted from the articles. Reviewing the content and psychometric properties of the measures as well as the methodological quality of the studies indicated that the Modified Activity Questionnaire is the only measure with consistent and moderately reliable results. It measures adolescent participation in leisure activities but not all domains of participation. Conclusion There may be a growing need for adapting existing Persian measures or developing new ones based on specific age features related to puberty-stage alongside cultural, social and academic demands, which have a significant effect on adolescents’ participation in meaningful occupations. High methodological quality in designing such studies also has great importance.


2019 ◽  
Vol 33 (12) ◽  
pp. 1963-1977 ◽  
Author(s):  
Sally Davenport ◽  
Angela Dickinson ◽  
Catherine Minns Lowe

Objectives: Many patients do not meet recommended levels of therapy-based exercise. This review aims to explore how adult patients view being prescribed therapy-based exercise, the information/education they are given and receive and if/how they independently practise and adhere. Design: A qualitative systematic review conducted using an ethnographic approach and in accordance with the PRISMA statement. Sources: PubMed, CINAHL, SCOPUS and EMBASE databases (01 January 2000–31 December 2018). Methods: Qualitative studies with a focus on engagement/adherence with therapy-based exercise were included. Data extraction and quality appraisal were undertaken by two reviewers. Results were discussed and data synthesized. Results: A total of 20,294 titles were screened, with data extracted from 39 full texts and data from 18 papers used to construct three themes. ‘The Guidance received’ suggests that the type of delivery desired to support and sustain engagement was context-dependent and individually situated. ‘The Therapist as teacher’ advocates that patients see independent therapy-based exercise as a shared activity and value caring, kind and professional qualities in their therapist. ‘The Person as learner’ proposes that when having to engage with and practise therapy-based exercise because of ill-health, patients often see themselves as new learners who experience fear and uncertainty about what to do. Patients may have unacknowledged ambivalences about learning that impact on engagement and persistence. Conclusion: The quality of the interaction between therapists and patients appears integral to patients engaging with, and sustaining practice of, rehabilitation programmes. Programmes need to be individualized, and health care professionals need to take patients’ previous experiences and ambivalences in motivation and empowerment into account.


2021 ◽  
Vol 11 (5) ◽  
pp. 67
Author(s):  
Olufemi Timothy Adigun ◽  
Olugbenga Akinrinoye ◽  
Helen Ngozichukwuka Obilor

This paper presents global evidence derived from a systematic review of the literature on the issues of D/deaf pregnant women and antenatal care. A comprehensive search through four bibliographic databases identified a dataset of 10,375 academic papers, from which six papers met the inclusion criteria for in-depth analysis related to D/deaf pregnant women’s use of antenatal care/clinics. Findings from the analysis revealed four major concerns for D/deaf pregnant women who attended antenatal clinics for care. These concerns were communication difficulties, satisfaction with antenatal care services, attendance at antenatal clinics, and associated health outcomes. Based on the identified issues and concerns, it is recommended that pre- and in-service healthcare workers should be trained on how to communicate through sign language with their D/deaf patients. In addition, there is a need to rapidly expand the body of knowledge on the issues concerning antenatal care for D/deaf pregnant women vis-à-vis their relationship with healthcare workers in antenatal facilities.


Author(s):  
R Kamhawy ◽  
R Mcginn ◽  
H He ◽  
J Ho ◽  
M Sharma ◽  
...  

Background: Machine learning (ML) methods hold promise in allowing early detection of dementia. We performed a systematic review to assess the quality of published evidence for using ML methods applied to drawing tests of cognition, and to describe the accuracy of the methods. Methods: Embase, Medline, and Cochrane Central Library databases were searched for potential studies up to December 8, 2018 by four independent reviewers. Included articles satisfied the following criteria: 1) use of ML on 2) a drawing test in order to 3) assess cognition. The quality of evidence was then assessed using GRADE methodology. Results: The initial search yielded 4620 citations. Of these, 64 were eligible for full text review. 18 articles then met inclusion criteria. Median AUC across all models was 0.765, with certain ML algorithms performing better in terms of AUC or diagnostic accuracy. However, based on GRADE, the quality of evidence was deemed very low. Conclusions: ML has been applied by several groups to drawing tests of cognition. The quality of evidence is currently too low to make recommendations on their use. Future work must focus on improving reporting, and using standard algorithms and larger, more diverse datasets to improve comparability and generalizability.


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