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Social determinants of health in the era of artificial intelligence with electronic health records: A systematic review

arXiv.org Artificial Intelligence

There is growing evidence showing the significant role of social determinant of health (SDOH) on a wide variety of health outcomes. In the era of artificial intelligence (AI), electronic health records (EHRs) have been widely used to conduct observational studies. However, how to make the best of SDOH information from EHRs is yet to be studied. In this paper, we systematically reviewed recently published papers and provided a methodology review of AI methods using the SDOH information in EHR data. A total of 1250 articles were retrieved from the literature between 2010 and 2020, and 74 papers were included in this review after abstract and full-text screening. We summarized these papers in terms of general characteristics (including publication years, venues, countries etc.), SDOH types, disease areas, study outcomes, AI methods to extract SDOH from EHRs and AI methods using SDOH for healthcare outcomes. Finally, we conclude this paper with discussion on the current trends, challenges, and future directions on using SDOH from EHRs.


Learning the progression and clinical subtypes of Alzheimer's disease from longitudinal clinical data

arXiv.org Machine Learning

Alzheimer's disease (AD) is a degenerative brain disease impairing a person's ability to perform day to day activities. The clinical manifestations of Alzheimer's disease are characterized by heterogeneity in age, disease span, progression rate, impairment of memory and cognitive abilities. Due to these variabilities, personalized care and treatment planning, as well as patient counseling about their individual progression is limited. Recent developments in machine learning to detect hidden patterns in complex, multi-dimensional datasets provides significant opportunities to address this critical need. In this work, we use unsupervised and supervised machine learning approaches for subtype identification and prediction. We apply machine learning methods to the extensive clinical observations available at the Alzheimer's Disease Neuroimaging Initiative (ADNI) data set to identify patient subtypes and to predict disease progression. Our analysis depicts the progression space for the Alzheimer's disease into low, moderate and high disease progression zones. The proposed work will enable early detection and characterization of distinct disease subtypes based on clinical heterogeneity. We anticipate that our models will enable patient counseling, clinical trial design, and ultimately individualized clinical care.


Applications of Artificial Intelligence to aid detection of dementia: a narrative review on current capabilities and future directions

arXiv.org Artificial Intelligence

With populations ageing, the number of people with dementia worldwide is expected to triple to 152 million by 2050. Seventy percent of cases are due to Alzheimer's disease (AD) pathology and there is a 10-20 year 'pre-clinical' period before significant cognitive decline occurs. We urgently need, cost effective, objective methods to detect AD, and other dementias, at an early stage. Risk factor modification could prevent 40% of cases and drug trials would have greater chances of success if participants are recruited at an earlier stage. Currently, detection of dementia is largely by pen and paper cognitive tests but these are time consuming and insensitive to pre-clinical phases. Specialist brain scans and body fluid biomarkers can detect the earliest stages of dementia but are too invasive or expensive for widespread use. With the advancement of technology, Artificial Intelligence (AI) shows promising results in assisting with detection of early-stage dementia. Existing AI-aided methods and potential future research directions are reviewed and discussed.


Healthy Cognitive Aging: A Hybrid Random Vector Functional-Link Model for the Analysis of Alzheimer’s Disease

AAAI Conferences

Alzheimer's disease (AD) is a genetically complex neurodegenerative disease, which leads to irreversible brain damage, severe cognitive problems and ultimately death. A number of clinical trials and study initiatives have been set up to investigate AD pathology, leading to large amounts of high dimensional heterogeneous data (biomarkers) for analysis. This paper focuses on combining clinical features from different modalities, including medical imaging, cerebrospinal fluid (CSF), etc., to diagnose AD and predict potential progression. Due to privacy and legal issues involved with clinical research, the study cohort (number of patients) is relatively small, compared to thousands of available biomarkers (predictors). We propose a hybrid pathological analysis model, which integrates manifold learning and Random Vector functional-link network (RVFL) so as to achieve better ability to extract discriminant information with limited training materials. Furthermore, we model (current and future) cognitive healthiness as a regression problem about age. By comparing the difference between predicted age and actual age, we manage to show statistical differences between different pathological stages. Verification tests are conducted based on the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. Extensive comparison is made against different machine learning algorithms, i.e. Support Vector Machine (SVM), Random Forest (RF), Decision Tree and Multilayer Perceptron (MLP). Experimental results show that our proposed algorithm achieves better results than the comparison targets, which indicates promising robustness for practical clinical implementation.


Using Sensor Technology to Monitor Disruptive Behavior of Persons With Dementia

AAAI Conferences

An anticipated increase in the number of people withdementia will lead to an escalation in health and socialcare spending unless it is altered by a major breakthroughin treatment or prevention. Behavioral symptomsassociated with dementia (BSD) are some of themost difficult problems faced by caregivers. Severalmeasurement issues have hampered the progress oftimely intervention for BSD. Sensor technology mayoffer a solution to the early detection of BSD that willguide the development of tailored interventions. Similarly,a clinical conceptualization of BSD and its measurementissues can facilitate the engineering of sensornetworks and algorithms for activity recognition. Multidisciplinarycollaboration and the consideration of ethicalissues will improve the adoption of these technologiesin healthcare research.