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Lopez Pineda, A.

Publications and source records attributed to Lopez Pineda, A..

2 recordsLinked to original sources

Deep learning facilitates rapid cohort identification using human and veterinary clinical narratives

ObjectiveCurrently, dedicated tagging staff spend considerable effort assigning clinical codes to patient summaries for public health purposes, and machine-learning automated tagging is bottlenecked by availability of electronic medical records. Veterinary medical records, a largely untapped data source that could benefit both human and non-human patients, could fill the gap. Materials and MethodsIn this retrospective study, we trained long short-term memory (LSTM) recurrent neural networks (RNNs) on 52,722 human and 89,591 veterinary records. We established relevant baselines by training Decision Trees (DT) and Random Forests (RF) on the same data. We finally investigated the effect of merging data across clinical settings and probed model portability. ResultsWe show that the LSTM-RNNs accurately classify veterinary/human text narratives into top-level categories with an average weighted macro F1, score of 0.735/0.675 respectively. The evaluation metric for the LSTM was 7 and 8% higher than that of the DT and RF models respectively. We generally did not find evidence of model portability albeit moderate performance increases in select categories. DiscussionWe see a strong positive correlation between number of training samples and classification performance, which is promising for future efforts. The use of LSTM-RNN models represents a scalable structure that could prove useful in cohort selection, which could in turn better address emerging public health concerns. ConclusionDigitization of human and veterinary health information will continue to be a reality. Our approach is a step forward for these two domains to learn from, and inform, one another.

epidemiology

Therapeutic importance of timely immunophenotyping of breast cancer in a resource-constrained setting: a retrospective hospital-based cohort study

BackgroundOrganizations that issue guidance on breast cancer recommend the use of immunohistochemistry (IHC) for providing appropriate and precise care. However, little focus has been directed to the identification of maximum allowable turnaround times for IHC, which is necessary given the diversity of hospital settings in the world. Much less effort has been committed to the development of digital tools that allow hospital administrators to monitor service utilization histories of their patients.\n\nMethodsIn this retrospective cohort study, we reviewed electronic and paper medical records of all suspected breast cancer patients treated at one secondary-care hospital of the Mexican Institute of Social Security (IMSS), located in western Mexico. We then followed three years of medical history of those patients with IHC testing.\n\nResultsIn 2014, there were 402 breast cancer patients, of which 30 were tested for some IHC biomarker (ER, PR, HER2). The subtyping allowed doctors to adjust (56.7 %) or confirm (43.3 %) the initial therapeutic regimen. The average turnaround time was 56 days. Opportune IHC testing was found to be beneficial when it was available before or during the first rounds of chemotherapy.\n\nConclusionsThe use of data mining tools applied to health record data revealed that there is an association between timely immunohistochemistry and improved outcomes in breast cancer patients. Based on this finding, inclusion of turnaround time in clinical guidelines is recommended. As much of the health data in the country becomes digitized, our visualization tools allow a digital dashboard of the hospital service utilization histories.

epidemiology