Biology subjects

Murphy, S. N.

Publications and source records attributed to Murphy, S. N..

3 recordsLinked to original sources

bioRxiv2019

High-throughput Phenotyping with Temporal Sequences

ObjectiveHigh-throughput electronic phenotyping algorithms can accelerate translational research using data from electronic health record (EHR) systems. The temporal information buried in EHRs are often underutilized in developing computational phenotypic definitions. The objective of this study is to develop a high-throughput phenotyping method, leveraging temporal sequential patterns of discrete events from electronic health records. Materials and MethodsWe develop a representation mining algorithm to extract five classes of representations from EHR diagnosis and medication records: the aggregated vector of the records (AVR), the traditional immediate sequential patterns (SPM), the transitive sequential patterns (tSPM), as well as two hybrid classes of SPM+AVR and tSPM+AVR. A final small set of representations were selected from each class using the MSMR dimensionality reduction algorithm. Using EHR data on 10 phenotypes from Mass General Brigham Biobank, we trained regularized logistic regression algorithms, which we validated using labeled data. ResultsPhenotyping with temporal sequences resulted in a superior classification performance across all 10 phenotypes compared with the AVR representations that are conventionally used in electronic phenotyping. Although this study only utilizes the diagnosis and medication records, the high-throughput algorithms classification performance was superior or similar to the performance of previously published electronic phenotyping algorithms. We characterize and evaluate the top transitive sequences of diagnosis records paired with the records of risk factors, symptoms, complications, medications, or vaccinations. DiscussionThe proposed high-throughput phenotyping approach enables seamless discovery of sequential record combinations that may be difficult to assume from raw EHR data. A transitive sequence can offer a more accurate characterization of the phenotype, compared with its individual components. Additionally, the identified transitive sequences of a given phenotype reflect the actual lived experiences of the patients with that particular disease. ConclusionSequential data representations provide a precise mechanism for incorporating raw EHR records into downstream Machine Learning.

bioinformatics↗

bioRxiv2019

High-throughput Multimodal Automated Phenotyping (MAP) with Application to PheWAS

ObjectiveElectronic health records (EHR) linked with biorepositories are a powerful platform for translational studies. A major bottleneck exists in the ability to phenotype patients accurately and efficiently. The objective of this study was to develop an automated high-throughput phenotyping method integrating International Classification of Diseases (ICD) codes and narrative data extracted using natural language processing (NLP).\n\nMethodWe developed a mapping method for automatically identifying relevant ICD and NLP concepts for a specific phenotype leveraging the UMLS. Aggregated ICD and NLP counts along with healthcare utilization were jointly analyzed by fitting an ensemble of latent mixture models. The MAP algorithm yields a predicted probability of phenotype for each patient and a threshold for classifying subjects with phenotype yes/no. The algorithm was validated using labeled data for 16 phenotypes from a biorepository and further tested in an independent cohort PheWAS for two SNPs with known associations.\n\nResultsThe MAP algorithm achieved higher or similar AUC and F-scores compared to the ICD code across all 16 phenotypes. The features assembled via the automated approach had comparable accuracy to those assembled via manual curation (AUCMAP 0.943, AUCmanual 0.941). The PheWAS results suggest that the MAP approach detected previously validated associations with higher power when compared to the standard PheWAS method based on ICD codes.\n\nConclusionThe MAP approach increased the accuracy of phenotype definition while maintaining scalability, facilitating use in studies requiring large scale phenotyping, such as PheWAS.

bioinformatics↗

bioRxiv2019

A Clustering Approach for Detecting Implausible Observation Values in Electronic Health Records Data

BackgroundIdentifying implausible clinical observations (e.g., laboratory test and vital sign values) in Electronic Health Record (EHR) data using rule-based procedures is challenging. Anomaly/outlier detection methods can be applied as an alternative algorithmic approach to flagging such implausible values in EHRs.\n\nObjectiveThe primary objectives of this research were to develop and test an unsupervised clustering-based anomaly/outlier detection approach for detecting implausible observations in EHR data as an alternative algorithmic solution to the existing procedures.\n\nMethodsOur approach is built upon two underlying hypotheses that, (i) when there are large number of observations, implausible records should be sparse, and therefore (ii) if these data are clustered properly, clusters with sparse populations should represent implausible observations. To test these hypotheses, we applied an unsupervised clustering algorithm to EHR observation data on 50 laboratory tests. We tested different specifications of the clustering approach and computed confusion matrix indices against a set of silver-standard plausibility thresholds. We compared the results from the proposed approach with conventional anomaly detection (CAD) approachs, including standard deviation and Mahalanobis distance.\n\nResultsWe found that the clustering approach produced results with exceptional specificity and high sensitivity. Compared with the conventional anomaly detection approaches, our proposed clustering approach resulted in significantly smaller number of false positive cases.\n\nConclusionOur contributions include (i) a clustering approach for identifying implausible EHR observations, (ii) evidence that implausible observations are sparse in EHR laboratory test results, (iii) a parallel implementation of the clustering approach on i2b2 star schema, and (3) a set of silver-standard plausibility thresholds for 50 laboratory tests that can be used in other studies for validation. The proposed algorithmic solution can augment human decisions to improve data quality. Therefore, a workflow is needed to complement the algorithms job and initiate necessary actions that need to be taken in order to improve the quality of data.

bioinformatics↗