Search Results (14)

Background: Genetic data play a crucial role in diagnosing and treating various diseases, reflecting a growing imperative to integrate these data into clinical care. However, significant barriers such as the structure of electronic health records (EHRs), insurance costs for genetic testing, and the interpretability of genetic results impede this integration. Methods: This paper explores solutions to these challenges by combining recent technological advances with informatics and data science, focusing on the diagnostic potential of artificial intelligence (AI) in cancer research. AI has historically been applied in medical research with limited success, but recent developments have led to the emergence of large language models (LLMs). These transformer-based generative AI models, trained on vast datasets, offer significant potential for genetic and genomic analyses. However, their effectiveness is constrained by their training on predominantly human-written text rather than comprehensive, structured genetic datasets. Results: This study reevaluates the capabilities of LLMs, specifically GPT models, in performing supervised prediction tasks using structured gene expression data. By comparing GPT models with traditional machine learning approaches, we assess their effectiveness in predicting cancer subtypes, demonstrating the potential of AI models to analyze real-world genetic data for generating real-world evidence. Full article

Amid global health challenges, resilient health systems require continuous innovation and progress. Stakeholders highlight the critical role of digital technologies in accelerating this progress. However, the digital health field faces significant challenges, including the sensitivity of health data, the absence of evidence-based standards, data governance issues, and a lack of evidence on the impact of digital health strategies. Overcoming these challenges is crucial to unlocking the full potential of digital health innovations in enhancing healthcare delivery and outcomes. Prioritizing security and privacy is essential in developing digital health solutions that are transparent, accessible, and effective. Non-fungible tokens (NFTs) have gained widespread attention, including in healthcare, offering innovative solutions and addressing challenges through blockchain technology. This paper addresses the gap in systematic-level studies on NFT applications in healthcare, aiming to comprehensively analyze use cases and associated research challenges. The search included primary studies published between 2014 and November 2023, searching in a balanced set of databases compiling articles from different fields. A review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and strictly focusing on research articles related to NFT applications in the healthcare sector. The electronic search retrieved 1902 articles, ultimately resulting in 15 articles for data extraction. These articles span applications of NFTs in medical devices, pathology exams, diagnosis, pharmaceuticals, and other healthcare domains, highlighting their potential to eliminate centralized trust sources in health informatics. The review emphasizes the adaptability and versatility of NFT-based solutions, indicating their broader applicability across various healthcare stages and expansion into diverse industries. Given their role in addressing challenges associated with enhancing data integrity, availability, non-repudiation, and authentication, NFTs remain a promising avenue for future research within digital health solutions. Full article

Background: Over the past few years, clinical studies have utilized machine learning in telehealth and smart care for disease management, self-management, and managing health issues like pulmonary diseases, heart failure, diabetes screening, and intraoperative risks. However, a systematic review of machine learning’s use in evidence-based telehealth and smart care is lacking, as evidence-based practice aims to eliminate biases and subjective opinions. Methods: The author conducted a mixed methods review to explore machine learning applications in evidence-based telehealth and smart care. A systematic search of the literature was performed during 16 June 2023–27 June 2023 in Google Scholar, PubMed, and the clinical registry platform ClinicalTrials.gov. The author included articles in the review if they were implemented by evidence-based health informatics and concerned with telehealth and smart care technologies. Results: The author identifies 18 key studies (17 clinical trials) from 175 citations found in internet databases and categorizes them using problem-specific groupings, medical/health domains, machine learning models, algorithms, and techniques. Conclusions: Machine learning combined with the application of evidence-based practices in healthcare can enhance telehealth and smart care strategies by improving quality of personalized care, early detection of health-related problems, patient quality of life, patient-physician communication, resource efficiency and cost-effectiveness. However, this requires interdisciplinary expertise and collaboration among stakeholders, including clinicians, informaticians, and policymakers. Therefore, further research using clinicall studies, systematic reviews, analyses, and meta-analyses is required to fully exploit the potential of machine learning in this area. Full article

Recent years have witnessed booming data on drugs and their associated adverse drug reactions (ADRs). It was reported that these ADRs have resulted in a high hospitalisation rate worldwide. Therefore, a tremendous amount of research has been carried out to predict ADRs in the early phases of drug development, with the goal of reducing possible future risks. The pre-clinical and clinical phases of drug research can be time-consuming and cost-ineffective, so academics are looking forward to more extensive data mining and machine learning methods to be applied in this field of study. In this paper, we try to construct a drug-to-drug network based on non-clinical data sources. The network presents underlying relationships between drug pairs according to their common ADRs. Then, multiple node-level and graph-level network features are extracted from this network, e.g., weighted degree centrality, weighted PageRanks, etc. After concatenating the network features to the original drug features, they were fed into seven machine learning models, e.g., logistic regression, random forest, support vector machine, etc., and were compared to the baseline, where there were no network-based features considered. These experiments indicate that all the tested machine-learning methods would benefit from adding these network features. Among all these models, logistic regression (LR) had the highest mean AUROC score (82.1%) across all ADRs tested. Weighted degree centrality and weighted PageRanks were identified to be the most critical network features in the LR classifier. These pieces of evidence strongly indicate that the network approach can be vital in future ADR prediction, and this network-based approach could also be applied to other health informatics datasets. Full article

Canada’s healthcare system, like others worldwide, is immersed in a process of evolution, attempting to adapt conventional frameworks of health technology assessment (HTA) and funding models to a new landscape of precision medicine in oncology. In particular, the need for real-world evidence in Canada is not matched by the necessary infrastructure and technologies required to integrate genomic and clinical data. Since healthcare systems in many developed nations face similar challenges, we adopted a solutions-based approach and conducted a search of worldwide programs in personalized medicine, with an emphasis on precision oncology. This search strategy included review articles published between 1 January 2016 and 1 March 2021 and hand-searches of their reference lists for relevant publications back to 1 December 2005. Thirty-nine initiatives across 37 countries in Europe, Australasia, Africa, and the Americas had the potential to lead to real-world data (RWD) on the clinical utility of oncology biomarkers. We highlight four initiatives with helpful lessons for Canada: Genomic Medicine France 2025, UNICANCER, the German Medical Informatics Initiative, and CANCER-ID. Among the 35 other programs evaluated, the main themes included the need for collaboration and systems to support data harmonization across multiple jurisdictions. In order to generate RWD in precision oncology that will prove acceptable to HTA bodies, Canada must take a national approach to biomarker strategy and unite all stakeholders at the highest level to overcome jurisdictional and technological barriers. Full article

The community’s mother and child health (MCH) and nutrition problems can be overcome through evidence-based health policy. Posyandu is an implementation of community empowerment in health promotion strategies. The iPosyandu application (app) is one of the health informatics tools, in which data quality should be considered before any Posyandu health interventions are made. This study aims to describe and assess differences in data quality based on the dimensions (completeness, accuracy, and consistency) of the secondary data collected from the app in Purwakarta Regency in 2019–2021. Obstacles and suggestions for improving its implementation were explored. This research applies a mixed-method explanatory approach. Data completeness was identified as the number of reported visits of children under five per year. Data accuracy was analyzed using WHO Z-score anthropometry and implausible Z-score values. Data consistency was measured using Cronbach’s alpha coefficient, followed by qualitative research with focus group discussions, in-depth interviews, and field observation notes. The quantitative study results found that some of the data were of good quality. The qualitative research identified the obstacles experienced using the iPosyandu app, one of them being that there were no regulations governing the use of iPosyandu to bridge the needs of the government, and provided suggestions from the field to improve its implementation. Full article

Background: The application of machine learning (ML) tools (MLTs) to support clinical trials outputs in evidence-based health informatics can be an effective, useful, feasible, and acceptable way to advance medical research and provide precision medicine. Methods: In this study, the author used the rapid review approach and snowballing methods. The review was conducted in the following databases: PubMed, Scopus, COCHRANE LIBRARY, clinicaltrials.gov, Semantic Scholar, and the first six pages of Google Scholar from the 10 July–15 August 2022 period. Results: Here, 49 articles met the required criteria and were included in this review. Accordingly, 32 MLTs and platforms were identified in this study that applied the automatic extraction of knowledge from clinical trial outputs. Specifically, the initial use of automated tools resulted in modest to satisfactory time savings compared with the manual management. In addition, the evaluation of performance, functionality, usability, user interface, and system requirements also yielded positive results. Moreover, the evaluation of some tools in terms of acceptance, feasibility, precision, accuracy, efficiency, efficacy, and reliability was also positive. Conclusions: In summary, design based on the application of clinical trial results in ML is a promising approach to apply more reliable solutions. Future studies are needed to propose common standards for the assessment of MLTs and to clinically validate the performance in specific healthcare and technical domains. Full article

Background: The application of Context Aware Computing (CAC) can be an effective, useful, feasible, and acceptable way to advance medical research and provide health services. Methods: This review was conducted in accordance with the principles of the development of a mixed methods review and existing knowledge in the field via the Synthesis Framework for the Assessment of Health Information Technology to evaluate CAC implemented by Evidence-Based Health Informatics (EBHI). A systematic search of the literature was performed during 18 November 2021–22 January 2022 in Cochrane Library, IEEE Xplore, PUBMED, Scopus and in the clinical registry platform Clinicaltrials.gov. The author included the articles in the review if they were implemented by EBHI and concerned with CAC technologies. Results: 29 articles met the inclusion criteria and refer to 26 trials published between 2011 and 2022. The author noticed improvements in healthcare provision using EBHI in the findings of CAC application. She also confirmed that CAC systems are a valuable and reliable method in health care provision. Conclusions: The use of CAC systems in healthcare is a promising new area of research and development. The author presented that the evaluation of CAC systems in EBHI presents positive effects on the state of health and the management of long-term diseases. These implications are presented in this article in a detailed, clear, and reliable manner. Full article

Data-driven modeling, action, and strategies have become popular, and the education community has witnessed increased interest in data-driven decision-making (DDDM). DDDM values and prioritizes decisions supported by high-quality, verifiable data that has been effectively processed and analyzed. The objective of our study is to describe the design, development, and implementation of a data-driven, evidence-based model of academic development in the context of CUNY Graduate School of Public Health and Health Policy (CUNY SPH) utilizing SMAART (Sustainability Multisector Accessible Affordable Reimbursable Tailored) model. The alignment of academic and student affairs within CUNY SPH brought with it several challenges. Defining roles and responsibilities across different student and academic affair units with a goal of collaborative leadership model and lack of meaningfulness were key challenges. It was important to listen to the experiences and recommendations of various individuals performing various functions in different capacities. A unified framework of key data indicators was needed to create a transparent and equitable model. An innovative interactive SMAART SPH dashboard designed, developed, and implemented to guide data-driven, evidence-based decision-making. Institutions can use a large amount of data from various sources to improve students’ learning experience, enhance research initiatives, support effective community outreach, and develop campus infrastructure to bring in sustainability. Full article

Predicting potential cancer treatment side effects at time of prescription could decrease potential health risks and achieve better patient satisfaction. This paper presents a new approach, founded on evidence-based medical knowledge, using as much information and proof as possible to help a computer program to predict bladder cancer treatment side effects and support the oncologist’s decision. This will help in deciding treatment options for patients with bladder malignancies. Bladder cancer knowledge is complex and requires simplification before any attempt to represent it in a formal or computerized manner. In this work we rely on the capabilities of OWL ontologies to seamlessly capture and conceptualize the required knowledge about this type of cancer and the underlying patient treatment process. Our ontology allows case-based reasoning to effectively predict treatment side effects for a given set of contextual information related to a specific medical case. The ontology is enriched with proofs and evidence collected from online biomedical research databases using “web crawlers”. We have exclusively designed the crawler algorithm to search for the required knowledge based on a set of specified keywords. Results from the study presented 80.3% of real reported bladder cancer treatment side-effects prediction and were close to really occurring adverse events recorded within the collected test samples when applying the approach. Evidence-based medicine combined with semantic knowledge-based models is prominent in generating predictions related to possible health concerns. The integration of a diversity of knowledge and evidence into one single integrated knowledge-base could dramatically enhance the process of predicting treatment risks and side effects applied to bladder cancer oncotherapy. Full article

Drug repurposing, the practice of utilizing existing drugs for novel clinical indications, has tremendous potential for improving human health outcomes and increasing therapeutic development efficiency. The goal of multi-disease multitarget drug repurposing, also known as shotgun drug repurposing, is to develop platforms that assess the therapeutic potential of each existing drug for every clinical indication. Our Computational Analysis of Novel Drug Opportunities (CANDO) platform for shotgun multitarget repurposing implements several pipelines for the large-scale modeling and simulation of interactions between comprehensive libraries of drugs/compounds and protein structures. In these pipelines, each drug is described by an interaction signature that is compared to all other signatures that are subsequently sorted and ranked based on similarity. Pipelines within the platform are benchmarked based on their ability to recover known drugs for all indications in our library, and predictions are generated based on the hypothesis that (novel) drugs with similar signatures may be repurposed for the same indication(s). The drug-protein interactions used to create the drug-proteome signatures may be determined by any screening or docking method, but the primary approach used thus far has been BANDOCK, our in-house bioanalytical or similarity docking protocol. In this study, we calculated drug-proteome interaction signatures using the publicly available molecular docking method Autodock Vina and created hybrid decision tree pipelines that combined our original bio- and chem-informatic approach with the goal of assessing and benchmarking their drug repurposing capabilities and performance. The hybrid decision tree pipeline outperformed the two docking-based pipelines from which it was synthesized, yielding an average indication accuracy of 13.3% at the top10 cutoff (the most stringent), relative to 10.9% and 7.1% for its constituent pipelines, and a random control accuracy of 2.2%. We demonstrate that docking-based virtual screening pipelines have unique performance characteristics and that the CANDO shotgun repurposing paradigm is not dependent on a specific docking method. Our results also provide further evidence that multiple CANDO pipelines can be synthesized to enhance drug repurposing predictive capability relative to their constituent pipelines. Overall, this study indicates that pipelines consisting of varied docking-based signature generation methods can capture unique and useful signals for accurate comparison of drug-proteome interaction signatures, leading to improvements in the benchmarking and predictive performance of the CANDO shotgun drug repurposing platform. Full article

This paper provides a summary of progress on implementation research conducted to deliver evidence-based informatics infrastructure and guidance resources to advance integrated care in Ireland. (1) Background: The International Classification for Nursing Practice (ICNP^©) R&D centre has progressed with its agenda to advance informatics theory and optimise the nursing contribution within eHealth Ireland. The centre has evolved as a formal multi-disciplinary research centre in Dublin City University expanding its research activity to become the Centre for eIntegrated Care (CeIC). The mission of the CeIC is to advance eIntegrated care in order to improve health and wellbeing of citizens; (2) Methods: In this paper, CeIC offers insights into the specific approaches adopted to realise this vision using Innovation 2.0 and Open Science as an emerging paradigm and rigorous methodology to drive transformational change; (3) Conclusions; we provide here a summary of our activity and discuss our experiences to date. We present detail on our progress through three core viewpoints namely (1) the individual and stakeholder engagement; (2) the development of technology infrastructure and (3) the political process considering the academic role in advancing informatics research. Our conclusions suggest that one needs to intrinsically link all three perspectives and provide focused interactions in order to bring about sustainable change for progression of eHealth. Full article

Background: The application of Health Information Technologies (HITs) can be an effective way to advance medical research and health services provision. The two-fold objective of this work is to: (i) identify and review state-of-the-art HITs that facilitate the aims of evidence-based medicine and (ii) propose a methodology for HIT assessment. Methods: The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Furthermore, we consolidated existing knowledge in the field and proposed a Synthesis Framework for the Assessment of Health Information Technology (SF/HIT) in order to evaluate the joint use of Randomized Controlled Trials (RCTs) along with HITs in the field of evidence-based medicine. Results: 55 articles met the inclusion criteria and refer to 51 (RCTs) published between 2008 and 2016. Significant improvements in healthcare through the use of HITs were observed in the findings of 31 out of 51 trials—60.8%. We also confirmed that RCTs are valuable tools for assessing the effectiveness, acceptability, safety, privacy, appropriateness, satisfaction, performance, usefulness and adherence. Conclusions: To improve health service delivery, RCTs apply and exhibit formalization by providing measurable outputs. Towards this direction, we propose the SF/HIT as a framework which may help researchers to carry out appropriate evaluations and extend their studies. Full article

Computer Interactive Reminiscence and Conversation Aid (CIRCA)is an interactive conversation support for people living with dementia. CIRCA facilitates one-to-one conversations and caregiving relationships in formal care environments. Originally developed as a standalone device, a new web-based version of CIRCA has been created to increase availability. The potential of CIRCA to support group activities and conversation between people living with dementia and a facilitator has not previously been explored. The two objectives of this study are (i) to validate the new web-based version of CIRCA against the original standalone device, and (ii) to explore the efficacy of CIRCA in supporting group activity for people with dementia in a formal care setting. This mixed-methods study comprises two parts: (i) an eight-session group activity using the CIRCA stand-alone device, and (ii) an eight-session group activity using the web-based CIRCA. One hundred and eighty people with dementia will be recruited: 90 for part (i) and 90 for part (ii). Measures of cognition and quality of life will be taken at the baseline, post-CIRCA intervention, and three months later, plus video recordings of the group sessions. Both parts of the study will be completed by June 2018. The study will provide evidence on two issues: (i) a validation of the new web-based version of CIRCA, and (ii) the suitability of CIRCA to support group activities in formal care settings for people living with dementia. This protocol is an extended version of the short paper presented at the AAATE 2017 conference and published in Studies in Health Technology & Informatics. Full article