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Hardenberg JHB. [Data-driven intensive care: a lack of comprehensive datasets]. Med Klin Intensivmed Notfmed 2024; 119:352-357. [PMID: 38668882 DOI: 10.1007/s00063-024-01141-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 03/26/2024] [Indexed: 05/28/2024]
Abstract
Intensive care units provide a data-rich environment with the potential to generate datasets in the realm of big data, which could be utilized to train powerful machine learning (ML) models. However, the currently available datasets are too small and exhibit too little diversity due to their limitation to individual hospitals. This lack of extensive and varied datasets is a primary reason for the limited generalizability and resulting low clinical utility of current ML models. Often, these models are based on data from single centers and suffer from poor external validity. There is an urgent need for the development of large-scale, multicentric, and multinational datasets. Ensuring data protection and minimizing re-identification risks pose central challenges in this process. The "Amsterdam University Medical Center database (AmsterdamUMCdb)" and the "Salzburg Intensive Care database (SICdb)" demonstrate that open access datasets are possible in Europe while complying with the data protection regulations of the General Data Protection Regulation (GDPR). Another challenge in building intensive care datasets is the absence of semantic definitions in the source data and the heterogeneity of data formats. Establishing binding industry standards for the semantic definition is crucial to ensure seamless semantic interoperability between datasets.
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Affiliation(s)
- Jan-Hendrik B Hardenberg
- Medizinische Klinik mit Schwerpunkt Nephrologie und internistische Intensivmedizin, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
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2
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Sadeghi S, Hempel L, Rodemund N, Kirsten T. Salzburg Intensive Care database (SICdb): a detailed exploration and comparative analysis with MIMIC-IV. Sci Rep 2024; 14:11438. [PMID: 38763952 PMCID: PMC11102905 DOI: 10.1038/s41598-024-61380-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/06/2024] [Indexed: 05/21/2024] Open
Abstract
The utilization of artificial intelligence (AI) in healthcare is on the rise, demanding increased accessibility to (public) medical data for benchmarking. The digitization of healthcare in recent years has facilitated medical data scientists' access to extensive hospital data, fostering AI-based research. A notable addition to this trend is the Salzburg Intensive Care database (SICdb), made publicly available in early 2023. Covering over 27 thousand intensive care admissions at the University Hospital Salzburg from 2013 to 2021, this dataset presents a valuable resource for AI-driven investigations. This article explores the SICdb and conducts a comparative analysis with the widely recognized Medical Information Mart for Intensive Care - version IV (MIMIC-IV) database. The comparison focuses on key aspects, emphasizing the availability and granularity of data provided by the SICdb, particularly vital signs and laboratory measurements. The analysis demonstrates that the SICdb offers more detailed information with higher data availability and temporal resolution for signal data, especially for vital signs, compared to the MIMIC-IV. This is advantageous for longitudinal studies of patients' health conditions in the intensive care unit. The SICdb provides a valuable resource for medical data scientists and researchers. The database offers comprehensive and diverse healthcare data in a European country, making it well suited for benchmarking and enhancing AI-based healthcare research. The importance of ongoing efforts to expand and make public datasets available for advancing AI applications in the healthcare domain is emphasized by the findings.
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Affiliation(s)
- Sina Sadeghi
- Department for Medical Data Science, Leipzig University Medical Center, Leipzig, Germany.
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany.
| | - Lars Hempel
- Department for Medical Data Science, Leipzig University Medical Center, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
- Faculty Applied Computer and Bio Sciences, Mittweida University of Applied Sciences, Mittweida, Germany
| | - Niklas Rodemund
- Department of Anaesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Toralf Kirsten
- Department for Medical Data Science, Leipzig University Medical Center, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
- Faculty Applied Computer and Bio Sciences, Mittweida University of Applied Sciences, Mittweida, Germany
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3
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Bittner B, Munoz FJ, Odonoghue J, Ordonez JM, Schmidt J, Schmitt K, Stassen K. Disease-Agnostic Electronic Adherence Aid for Subcutaneous at-Home and Self-Administration Devices-The Lowest Common Denominator Based on a Cross-Indication Survey. ACS Pharmacol Transl Sci 2024; 7:1310-1319. [PMID: 38751643 PMCID: PMC11091979 DOI: 10.1021/acsptsci.3c00377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 05/18/2024]
Abstract
The value of connected devices and health apps with features such as adherence trackers, dosing reminders, and remote communication tools for users and healthcare providers has been assessed to support home-based subcutaneous administration. A comprehensive survey was conducted with 605 participants, including users and caregivers, from eight countries. Medical conditions encompassed ankylosing spondylitis, asthma, cerebral palsy, cluster headaches, Crohn's disease, hemophilia, lupus, migraine, multiple sclerosis, Parkinson's disease, plaque psoriasis, psoriatic arthritis, rheumatoid arthritis, spasticity, spondyloarthritis, and ulcerative colitis. Utilizing a maximum difference scaling methodology, the survey gauged participant preferences regarding specific attributes and features of connected drug delivery devices. Irrespective of demographic factors like age, gender, nationality, or the specific medical condition, the device's ability to verify a successful injection stood out as universally valued. The second and third most valued attributes pertained to temperature-related indicators or warnings. These features do not necessitate the use of a connected device and can be integrated into existing autoinjector platforms. The survey findings support the development of a universal adherence tool for at-home subcutaneous dosing, independent of a specific medical condition. This tool may be gradually improved with disease-specific features. Once established as a platform, manufacturers can launch any subcutaneous medication and later integrate real-world evidence for enhanced educational, treatment, and diagnostic capabilities. This approach is crucial for advancing connected adherence tools in decentralized healthcare, aligning with user and healthcare system needs while translating scientific innovation into practical solutions.
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Affiliation(s)
- Beate Bittner
- Global
Product Strategy, Product Optimization, F. Hoffmann-La Roche Ltd., Basel 4070, Switzerland
| | - Francisco Javier Munoz
- Global
Product Strategy, Product Optimization, F. Hoffmann-La Roche Ltd., Basel 4070, Switzerland
| | | | - Jose Manuel Ordonez
- Product
Development Clinical Operations, F. Hoffmann-La
Roche Ltd., Madrid 28042, Spain
| | - Johannes Schmidt
- Global
Product Strategy, Product Optimization, F. Hoffmann-La Roche Ltd., Basel 4070, Switzerland
| | | | - Katja Stassen
- Product
Development Medical Affairs, F. Hoffmann-La
Roche Ltd., Basel 4070, Switzerland
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4
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Albiol-Perarnau M, Alarcón Belmonte I. [Blockchain in health: Transforming security and clinical data management]. Aten Primaria 2024; 56:102848. [PMID: 38228052 PMCID: PMC10803907 DOI: 10.1016/j.aprim.2023.102848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 01/18/2024] Open
Abstract
INTRODUCTION Technological advances continue to transform society, including the health sector. The decentralized and verifiable nature of blockchain technology presents great potential for addressing current challenges in healthcare data management. DISCUSSION This article reports on how the generalized adoption of blockchain faces important challenges and barriers that must be addressed, such as the lack of regulation, technical complexity, safeguarding privacy, and economic and technological costs. Collaboration between medical professionals, technologists and legislators is essential to establish a solid regulatory framework and adequate training. CONCLUSION Blockchain technology has the potential to revolutionize data management in the healthcare sector, improving the quality of medical care, empowering users, and promoting the secure sharing of data, but an important cultural change is needed, along with more evidence, to reveal its advantages in front of the existing technological alternative.
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Affiliation(s)
- Marc Albiol-Perarnau
- Grup de Salut Digital CAMFiC, Barcelona, España; Medicina Familiar y Comunitaria, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, Barcelona, España.
| | - Iris Alarcón Belmonte
- Grup de Salut Digital CAMFiC, Barcelona, España; Servei d'Atenció Primària Dreta i Muntanya, Gerència Territorial Barcelona ciutat, Institut Català de la Salut, Barcelona, España
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Muñoz-Lezcano S, de la Fuente C, Estella Á, Amaya-Villar R, Puppo-Moreno AM, Armengol-de la Hoz MÁ, Garnacho-Montero J. The open data revolution: Enhancing healthcare in intensive care units. Med Intensiva 2024:S2173-5727(24)00064-X. [PMID: 38582714 DOI: 10.1016/j.medine.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 04/08/2024]
Affiliation(s)
- Sergio Muñoz-Lezcano
- Universidad Internacional de La Rioja (UNIR), Avenida de La Paz, 137, 26006 Logroño, La Rioja, Spain
| | | | - Ángel Estella
- Intensive Care Unit Hospital of Jerez, Medicine Department University of Cádiz, INIBiCA, Spain
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Balagopalan A, Baldini I, Celi LA, Gichoya J, McCoy LG, Naumann T, Shalit U, van der Schaar M, Wagstaff KL. Machine learning for healthcare that matters: Reorienting from technical novelty to equitable impact. PLOS DIGITAL HEALTH 2024; 3:e0000474. [PMID: 38620047 PMCID: PMC11018283 DOI: 10.1371/journal.pdig.0000474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/18/2024] [Indexed: 04/17/2024]
Abstract
Despite significant technical advances in machine learning (ML) over the past several years, the tangible impact of this technology in healthcare has been limited. This is due not only to the particular complexities of healthcare, but also due to structural issues in the machine learning for healthcare (MLHC) community which broadly reward technical novelty over tangible, equitable impact. We structure our work as a healthcare-focused echo of the 2012 paper "Machine Learning that Matters", which highlighted such structural issues in the ML community at large, and offered a series of clearly defined "Impact Challenges" to which the field should orient itself. Drawing on the expertise of a diverse and international group of authors, we engage in a narrative review and examine issues in the research background environment, training processes, evaluation metrics, and deployment protocols which act to limit the real-world applicability of MLHC. Broadly, we seek to distinguish between machine learning ON healthcare data and machine learning FOR healthcare-the former of which sees healthcare as merely a source of interesting technical challenges, and the latter of which regards ML as a tool in service of meeting tangible clinical needs. We offer specific recommendations for a series of stakeholders in the field, from ML researchers and clinicians, to the institutions in which they work, and the governments which regulate their data access.
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Affiliation(s)
- Aparna Balagopalan
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology; Cambridge, Massachusetts, United States of America
| | - Ioana Baldini
- IBM Research; Yorktown Heights, New York, United States of America
| | - Leo Anthony Celi
- Laboratory for Computational Physiology, Massachusetts Institute of Technology; Cambridge, Massachusetts, United States of America
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center; Boston, Massachusetts, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health; Boston, Massachusetts, United States of America
| | - Judy Gichoya
- Department of Radiology and Imaging Sciences, School of Medicine, Emory University; Atlanta, Georgia, United States of America
| | - Liam G. McCoy
- Division of Neurology, Department of Medicine, University of Alberta; Edmonton, Alberta, Canada
| | - Tristan Naumann
- Microsoft Research; Redmond, Washington, United States of America
| | - Uri Shalit
- The Faculty of Data and Decision Sciences, Technion; Haifa, Israel
| | - Mihaela van der Schaar
- Department of Applied Mathematics and Theoretical Physics, University of Cambridge; Cambridge, United Kingdom
- The Alan Turing Institute; London, United Kingdom
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Bell LC, Shimron E. Sharing Data Is Essential for the Future of AI in Medical Imaging. Radiol Artif Intell 2024; 6:e230337. [PMID: 38231036 PMCID: PMC10831510 DOI: 10.1148/ryai.230337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 01/18/2024]
Abstract
If we want artificial intelligence to succeed in radiology, we must share data and learn how to share data.
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Affiliation(s)
- Laura C. Bell
- From the Clinical Imaging Group, Genentech, 1 DNA Way, South San
Francisco, CA 94080 (L.C.B.); and Department of Electrical and Computer
Engineering and Department of Biomedical Engineering, Technion-Israel Institute
of Technology, Haifa, Israel (E.S.)
| | - Efrat Shimron
- From the Clinical Imaging Group, Genentech, 1 DNA Way, South San
Francisco, CA 94080 (L.C.B.); and Department of Electrical and Computer
Engineering and Department of Biomedical Engineering, Technion-Israel Institute
of Technology, Haifa, Israel (E.S.)
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8
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Restrepo D, Quion J, Vásquez-Venegas C, Villanueva C, Anthony Celi L, Nakayama LF. A scoping review of the landscape of health-related open datasets in Latin America. PLOS DIGITAL HEALTH 2023; 2:e0000368. [PMID: 37878549 PMCID: PMC10599518 DOI: 10.1371/journal.pdig.0000368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/16/2023] [Indexed: 10/27/2023]
Abstract
Artificial intelligence (AI) algorithms have the potential to revolutionize healthcare, but their successful translation into clinical practice has been limited. One crucial factor is the data used to train these algorithms, which must be representative of the population. However, most healthcare databases are derived from high-income countries, leading to non-representative models and potentially exacerbating health inequities. This review focuses on the landscape of health-related open datasets in Latin America, aiming to identify existing datasets, examine data-sharing frameworks, techniques, platforms, and formats, and identify best practices in Latin America. The review found 61 datasets from 23 countries, with the DATASUS dataset from Brazil contributing to the majority of articles. The analysis revealed a dearth of datasets created by the authors themselves, indicating a reliance on existing open datasets. The findings underscore the importance of promoting open data in Latin America. We provide recommendations for enhancing data sharing in the region.
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Affiliation(s)
- David Restrepo
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Telematics Department, University of Cauca, Popayán, Cauca, Colombia
| | - Justin Quion
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Constanza Vásquez-Venegas
- Scientific Image Analysis Lab, Integrative Biology Program, Biomedical Sciences Institute (ICBM), Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Cleva Villanueva
- Instituto Politécnico Nacional, Escuela Superior de Medicina, Ciudad de Mexico, Mexico
| | - Leo Anthony Celi
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Luis Filipe Nakayama
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Department of Ophthalmology, São Paulo Federal University, São Paulo, São Paulo, Brazil
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