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Gonzalez R, Saha A, Campbell CJ, Nejat P, Lokker C, Norgan AP. Seeing the random forest through the decision trees. Supporting learning health systems from histopathology with machine learning models: Challenges and opportunities. J Pathol Inform 2024; 15:100347. [PMID: 38162950 PMCID: PMC10755052 DOI: 10.1016/j.jpi.2023.100347] [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: 08/21/2023] [Revised: 10/06/2023] [Accepted: 11/01/2023] [Indexed: 01/03/2024] Open
Abstract
This paper discusses some overlooked challenges faced when working with machine learning models for histopathology and presents a novel opportunity to support "Learning Health Systems" with them. Initially, the authors elaborate on these challenges after separating them according to their mitigation strategies: those that need innovative approaches, time, or future technological capabilities and those that require a conceptual reappraisal from a critical perspective. Then, a novel opportunity to support "Learning Health Systems" by integrating hidden information extracted by ML models from digitalized histopathology slides with other healthcare big data is presented.
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Affiliation(s)
- Ricardo Gonzalez
- DeGroote School of Business, McMaster University, Hamilton, Ontario, Canada
- Division of Computational Pathology and Artificial Intelligence, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Ashirbani Saha
- Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Escarpment Cancer Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Clinton J.V. Campbell
- William Osler Health System, Brampton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Peyman Nejat
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, United States
| | - Cynthia Lokker
- Health Information Research Unit, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Andrew P. Norgan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
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Lin JS, Webber EM, Bean SI, Martin AM, Davies MC. Rapid evidence review: Policy actions for the integration of public health and health care in the United States. Front Public Health 2023; 11:1098431. [PMID: 37064661 PMCID: PMC10090415 DOI: 10.3389/fpubh.2023.1098431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/02/2023] [Indexed: 03/31/2023] Open
Abstract
ObjectiveTo identify policy actions that may improve the interface of public health and health care in the United States.MethodsA rapid review of publicly-available documents informing the integration of public health and health care, and case examples reporting objective measures of success, with abstraction of policy actions, related considerations, and outcomes.ResultsAcross 109 documents, there were a number of recurrent themes related to policy actions and considerations to facilitate integration during peace time and during public health emergencies. The themes could be grouped into the need for adequate and dedicated funding; mandates and shared governance for integration; joint leadership that has the authority/ability to mobilize shared assets; adequately staffed and skilled workforces in both sectors with mutual awareness of shared functions; shared health information systems with modernized data and IT capabilities for both data collection and dissemination of information; engagement with multiple stakeholders in the community to be maximally inclusive; and robust communication strategies and training across partners and with the public.ConclusionWhile the evidence does not support a hierarchy of policies on strengthening the interface of public health and health care, recurrent policy themes can inform where to focus efforts.
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Sarmiento-Suárez R, Padron-Monedero A, Bogaert P, Abboud L, Van Oyen H, Tolonen H, Tijhuis M, Seeling S, Haneef R, Zaletel M, Palmieri L, Gallay A, Lapão LV, Nogueira P, Ziese T, Vukovic J, Beja A, Saso M, Noguer-Zambrano I. The InfAct proposal for a sustainable European health information infrastructure on population health: the Distributed Infrastructure on Population Health (DIPoH). Arch Public Health 2022; 80:139. [PMID: 35581661 PMCID: PMC9113621 DOI: 10.1186/s13690-022-00844-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 03/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background In Europe, data on population health is fragmented, difficult to access, project-based and prone to health information inequalities in terms of availability, accessibility and especially in quality between and within countries. This situation is further exacerbated and exposed by the recent COVID-19 pandemic. The Joint Action on Health Information (InfAct) that builds on previous works of the BRIDGE Health project, carried out collaborative action to set up a sustainable infrastructure for health information in the European Union (EU). The aim of this paper is to present InfAct’s proposal for a sustainable research infrastructure, the Distributed Infrastructure on Population Health (DIPoH), which includes the setup of a Health Information Portal on population health to be maintained beyond InfAct’s time span. Methods The strategy for the proposal was based on three components: scientific initiatives and proposals to improve Health Information Systems (HIS), exploration of technical acceptability and feasibility, and finally obtaining high-level political support.. The technical exploration (Technical Dialogues—TD) was assumed by technical experts proposed by the countries, and political guidance was provided by the Assembly of Members (AoM), which gathered representatives from Ministries of Health and Science of EU/EEA countries. The results from the AoM and the TD were integrated in the sustainability plan compiling all the major outputs of InfAct. Results The InfAct sustainability plan was organized in three main sections: a proposal of a new research infrastructure on population health (the DIPoH), new health information tools and innovative proposals for HIS, and a comprehensive capacity building programme. These activities were carried out in InfAct and are being further developed in the Population Health Information Research Infrastructure (PHIRI). PHIRI is a practical rollout of DIPoH facilitating and generating the best available evidence for research on health and wellbeing of populations as impacted by COVID-19. Conclusions The sustainability plan received wide support from Member States and was recognized to have an added value at EU level. Nevertheless, there were several aspects which still need to be considered for the near future such as: (i) a commitment of stable financial and political support by Member States (MSs), (ii) the availability of resources at regional, national and European level to deal with innovations, and (iii) a more direct involvement from EU and international institutions such as the European Centre for Disease Prevention and Control (ECDC), the World Health Organization (WHO) and the Organisation for Economic Cooperation and Development OECD for providing support and sustainable contributions.
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Affiliation(s)
- Rodrigo Sarmiento-Suárez
- National School of Public Health. Instituto de Salud Carlos III, Avenida Monforte de Lemos 5, 28029, Madrid, Spain. .,Medicine School, University of Applied and Environmental Sciences, Calle 222 #55-37, Bogota, Colombia.
| | - Alicia Padron-Monedero
- National School of Public Health. Instituto de Salud Carlos III, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
| | - Petronille Bogaert
- Scientific Institute of Public Health, SciensanoRue Juliette, Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Linda Abboud
- Scientific Institute of Public Health, SciensanoRue Juliette, Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Herman Van Oyen
- Scientific Institute of Public Health, SciensanoRue Juliette, Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Mannerheimintie 166, 00271, Helsinki, Finland
| | - Mariken Tijhuis
- National Institute for Public Health and the Environment RIVM, 3720 BA, Bilthoven, Netherlands
| | - Stefanie Seeling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, Germany
| | - Romana Haneef
- Santé Publique France, 12 Rue du Val d'Osne, Allée Vacassy, 94410, Saint-Maurice, France
| | - Metka Zaletel
- National Institute of Public Health, Trubarjeva 2, 1000, Ljubljana, Slovenia
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità (ISS), Via Giano della Bella, 34, 00161, Rome, Italy
| | - Anne Gallay
- Santé Publique France, 12 Rue du Val d'Osne, Allée Vacassy, 94410, Saint-Maurice, France
| | - Luís Velez Lapão
- Instituto de Higiene E Medicina Tropical, Universidade NOVA de Lisboa, R. da Junqueira 100, 1349-008, Lisboa, Portugal
| | - Paulo Nogueira
- Instituto de Medicina Preventiva E Saúde Pública, Faculdade de Medicina da Universidade de Lisboa, 1649-028, Lisboa, Portugal
| | - Thomas Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, Germany
| | - Jakov Vukovic
- Croatian Institute of Public Health, Rockefeller str 7, 10000, Zagreb, Croatia
| | - André Beja
- Instituto de Higiene E Medicina Tropical, Universidade NOVA de Lisboa, R. da Junqueira 100, 1349-008, Lisboa, Portugal
| | - Miriam Saso
- Scientific Institute of Public Health, SciensanoRue Juliette, Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Isabel Noguer-Zambrano
- National School of Public Health. Instituto de Salud Carlos III, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
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