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959 Publications visible to you, out of a total of 959
Implementation of a clinical trial recruitment support system based on fast healthcare interoperability resources (FHIR) in a cardiology department
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

Clinical Trial Recruitment Support Systems can booster patient inclusion of clinical trials by automatically analyzing eligibility criteria based on electronic health records. However, missing … interoperability has hindered introduction of those systems on a broader scale. Therefore, our aim was to develop a recruitment support system based on FHIR R4 and evaluate its usage and features in a cardiology department. Clinical conditions, anamnesis, examinations, allergies, medication, laboratory data and echocardiography results were imported as FHIR resources. Clinical trial information, eligibility criteria and recruitment status were recorded using the appropriate FHIR resources without extensions. Eligibility criteria linked by the logical operation “OR” were represented by using multiple FHIR Group resources for enrollment. The system was able to identify 52 of 55 patients included in four clinical trials. In conclusion, use of FHIR for defining eligibility criteria of clinical trials may facilitate interoperability and allow automatic screening for eligible patients at multiple sites of different healthcare providers in the future. Upcoming changes in FHIR should allow easier description of “OR”-linked eligibility criteria.

Authors: Clemens Scherer, Stephan Endres, Martin Orban, Stefan Kääb, Steffen Massberg, Alfred Winter, Matthias Löbe

Date Published: 1st May 2022

Publication Type: Journal article

Shift of radiotherapy use during the first wave of the COVID-19 pandemic? An analysis of German inpatient data
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

OBJECTIVE: To assess the change in inpatient radiotherapy related to COVID-19 lockdown measures during the first wave of the pandemic in 2020. METHODS: We included cases hospitalized between January 1 … and August 31, 2018-2020, with a primary ICD-10 diagnosis of C00-C13, C32 (head and neck cancer, HNC) and C53 (cervical cancer, CC). Data collection was conducted within the Medical Informatics Initiative. Outcomes were fractions and admissions. Controlling for decreasing hospital admissions during holidays, calendar weeks of 2018/2019 were aligned to Easter 2020. A lockdown period (LP; 16/03/2020-02/08/2020) and a return-to-normal period (RNP; 04/05/2020-02/08/2020) were defined. The study sample comprised a control (admission 2018/19) and study cohort (admission 2020). We computed weekly incidence and IR ratios from generalized linear mixed models. RESULTS: We included 9365 (CC: 2040, HNC: 7325) inpatient hospital admissions from 14 German university hospitals. For CC, fractions decreased by 19.97% in 2020 compared to 2018/19 in the LP. In the RNP the reduction was 28.57% (p < 0.001 for both periods). LP fractions for HNC increased by 10.38% (RNP: 9.27%; p < 0.001 for both periods). Admissions for CC decreased in both periods (LP: 10.2%, RNP: 22.14%), whereas for HNC, admissions increased (LP: 2.25%, RNP: 1.96%) in 2020. Within LP, for CC, radiotherapy admissions without brachytherapy were reduced by 23.92%, whereas surgery-related admissions increased by 20.48%. For HNC, admissions with radiotherapy increased by 13.84%, while surgery-related admissions decreased by 11.28% in the same period. CONCLUSION: Related to the COVID-19 lockdown in an inpatient setting, radiotherapy for HNC treatment became a more frequently applied modality, while admissions of CC cases decreased.

Authors: Daniel Medenwald, Thomas Brunner, Hans Christiansen, Ulrich Kisser, Sina Mansoorian, Dirk Vordermark, Hans-Ulrich Prokosch, Susanne A Seuchter, Lorenz A Kapsner, our MII research group

Date Published: 1st Apr 2022

Publication Type: Journal article

Multi-institutional breast cancer detection using a secure on-boarding service for Distributed Analytics
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

The constant upward movement of data-driven medicine as a valuable option to enhance daily clinical practice has brought new challenges for data analysts to get access to valuable but sensitive data … due to privacy considerations. One solution for most of these challenges are Distributed Analytics (DA) infrastructures, which are technologies fostering collaborations between healthcare institutions by establishing a privacy-preserving network for data sharing. However, in order to participate in such a network, a lot of technical and administrative prerequisites have to be made, which could pose bottlenecks and new obstacles for non-technical personnel during their deployment. We have identified three major problems in the current state-of-the-art. Namely, the missing compliance with FAIR data principles, the automation of processes, and the installation. In this work, we present a seamless on-boarding workflow based on a DA reference architecture for data sharing institutions to address these problems. The on-boarding service manages all technical configurations and necessities to reduce the deployment time. Our aim is to use well-established and conventional technologies to gain acceptance through enhanced ease of use. We evaluate our development with six institutions across Germany by conducting a DA study with open-source breast cancer data, which represents the second contribution of this work. We find that our on-boarding solution lowers technical barriers and efficiently deploys all necessary components and is, therefore, indeed an enabler for collaborative data sharing.

Authors: Sascha Welten, Lars Hempel, Masoud Abedi, Yongli Mou, Mehrshad Jaberansary, Laurenz Neumann, Sven Weber, Kais Tahar, Yeliz Ucer Yediel, Matthias Löbe, Stefan Decker, Oya Beyan, Toralf Kirsten

Date Published: 1st Apr 2022

Publication Type: Journal article

Applying the FAIR4Health Solution to Identify Multimorbidity Patterns and Their Association with Mortality through a Frequent Pattern Growth Association Algorithm
FAIR4Health

Abstract (Expand)

The current availability of electronic health records represents an excellent research opportunity on multimorbidity, one of the most relevant public health problems nowadays. However, it also poses a …t also poses a methodological challenge due to the current lack of tools to access, harmonize and reuse research datasets. In FAIR4Health, a European Horizon 2020 project, a workflow to implement the FAIR (findability, accessibility, interoperability and reusability) principles on health datasets was developed, as well as two tools aimed at facilitating the transformation of raw datasets into FAIR ones and the preservation of data privacy. As part of this project, we conducted a multicentric retrospective observational study to apply the aforementioned FAIR implementation workflow and tools to five European health datasets for research on multimorbidity. We applied a federated frequent pattern growth association algorithm to identify the most frequent combinations of chronic diseases and their association with mortality risk. We identified several multimorbidity patterns clinically plausible and consistent with the bibliography, some of which were strongly associated with mortality. Our results show the usefulness of the solution developed in FAIR4Health to overcome the difficulties in data management and highlight the importance of implementing a FAIR data policy to accelerate responsible health research.

Authors: Jonás Carmona-Pírez, Beatriz Poblador-Plou, Antonio Poncel-Falcó, Jessica Rochat, Celia Alvarez-Romero, Alicia Martínez-García, Carmen Angioletti, Marta Almada, Mert Gencturk, A. Anil Sinaci, Jara Eloisa Ternero-Vega, Christophe Gaudet-Blavignac, Christian Lovis, Rosa Liperoti, Elisio Costa, Carlos Luis Parra-Calderón, Aida Moreno-Juste, Antonio Gimeno-Miguel, Alexandra Prados-Torres

Date Published: 1st Feb 2022

Publication Type: Journal article

Reduction of platelet outdating and shortage by forecasting demand with statistical learning and deep neural networks: Modeling study
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

BACKGROUND: Platelets are a valuable and perishable blood product. Managing platelet inventory is a demanding task because of short shelf lives and high variation in daily platelet use patterns. … Predicting platelet demand is a promising step toward avoiding obsolescence and shortages and ensuring optimal care. OBJECTIVE: The aim of this study is to forecast platelet demand for a given hospital using both a statistical model and a deep neural network. In addition, we aim to calculate the possible reduction in waste and shortage of platelets using said predictions in a retrospective simulation of the platelet inventory. METHODS: Predictions of daily platelet demand were made by a least absolute shrinkage and selection operator (LASSO) model and a recurrent neural network (RNN) with long short-term memory (LSTM). Both models used the same set of 81 clinical features. Predictions were passed to a simulation of the blood inventory to calculate the possible reduction in waste and shortage as compared with historical data. RESULTS: From January 1, 2008, to December 31, 2018, the waste and shortage rates for platelets were 10.1% and 6.5%, respectively. In simulations of platelet inventory, waste could be lowered to 4.9% with the LASSO and 5% with the RNN, whereas shortages were 2.1% and 1.7% with the LASSO and RNN, respectively. Daily predictions of platelet demand for the next 2 days had mean absolute percent errors of 25.5% (95% CI 24.6%-26.6%) with the LASSO and 26.3% (95% CI 25.3%-27.4%) with the LSTM (P=.01). Predictions for the next 4 days had mean absolute percent errors of 18.1% (95% CI 17.6%-18.6%) with the LASSO and 19.2% (95% CI 18.6%-19.8%) with the LSTM (P<.001). CONCLUSIONS: Both models allow for predictions of platelet demand with similar and sufficient accuracy to significantly reduce waste and shortage in a retrospective simulation study. The possible improvements in platelet inventory management are roughly equivalent to US $250,000 per year.

Authors: Maximilian Schilling, Lennart Rickmann, Gabriele Hutschenreuter, Cord Spreckelsen

Date Published: 1st Feb 2022

Publication Type: Journal article

Attitudes and perception of artificial intelligence in healthcare: A cross-sectional survey among patients
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

Objective: The attitudes about the usage of artificial intelligence in healthcare are controversial. Unlike the perception of healthcare professionals, the attitudes of patients and their companions … have been of less interest so far. In this study, we aimed to investigate the perception of artificial intelligence in healthcare among this highly relevant group along with the influence of digital affinity and sociodemographic factors. Methods: We conducted a cross-sectional study using a paper-based questionnaire with patients and their companions at a German tertiary referral hospital from December 2019 to February 2020. The questionnaire consisted of three sections examining (a) the respondents’ technical affinity, (b) their perception of different aspects of artificial intelligence in healthcare and (c) sociodemographic characteristics. Results: From a total of 452 participants, more than 90% already read or heard about artificial intelligence, but only 24% reported good or expert knowledge. Asked on their general perception, 53.18% of the respondents rated the use of artificial intelligence in medicine as positive or very positive, but only 4.77% negative or very negative. The respondents denied concerns about artificial intelligence, but strongly agreed that artificial intelligence must be controlled by a physician. Older patients, women, persons with lower education and technical affinity were more cautious on the healthcare-related artificial intelligence usage. Conclusions: German patients and their companions are open towards the usage of artificial intelligence in healthcare. Although showing only a mediocre knowledge about artificial intelligence, a majority rated artificial intelligence in healthcare as positive. Particularly, patients insist that a physician supervises the artificial intelligence and keeps ultimate responsibility for diagnosis and therapy.

Authors: Sebastian J Fritsch, Andrea Blankenheim, Alina Wahl, Petra Hetfeld, Oliver Maassen, Saskia Deffge, Julian Kunze, Rolf Rossaint, Morris Riedel, Gernot Marx, Johannes Bickenbach

Date Published: 2022

Publication Type: Journal article

Towards harmonized data quality in the medical informatics initiative - current state and future directions
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

Health data from hospital information systems are valuable sources for medical research but have known issues in terms of data quality. In a nationwide data integration project in Germany, health care … data from all participating university hospitals are being pooled and refined in local centers. As there is currently no overarching agreement on how to deal with errors and implausibilities, meetings were held to discuss the current status and the need to develop consensual measures at the organizational and technical levels. This paper analyzes the discovered similarities and differences. The result shows that although data quality checks are carried out at all sites, there is a lack of both centrally coordinated data quality indicators and a formalization of plausibility rules as well as a repository for automatic querying of the rules, for example in ETL processes.

Authors: Matthias Löbe, Gaetan Kamdje-Wabo, Adriana Carina Sinza, Helmut Spengler, Marcus Strobel, Erik Tute

Date Published: 2022

Publication Type: Journal article

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