Los beneficios derivados de la reutilizacion de la informacion clinica no constituyen una novedad... more Los beneficios derivados de la reutilizacion de la informacion clinica no constituyen una novedad, ya que de hecho han sido objeto de trabajos publicados en la literatura cientifica en muchas ocasiones (1,2).
Studies in health technology and informatics, 2020
People use language to express their thoughts and feelings, unveiling important aspects of their ... more People use language to express their thoughts and feelings, unveiling important aspects of their psychological traits and social interactions. Although there are several studies describing methodologies to create a collection of words in English related to depression and other conditions, in most of them the selection of words is not clinical or expert based. The objective of this study is twofold: firstly, to introduce a comprehensive collection of Spanish words commonly used by patients suffering from depression, which will be available as a free open source for research purposes (GitHub), and secondly, to study the usefulness of this collection of words in identifying social media posts that could be indicative of patients suffering from depression. The level of agreement among medical doctors to determine the best words that should be used to select tweets related to depression was low. This finding may be due to the complexity of depression and the extraordinary diversity in th...
Studies in health technology and informatics, 2016
Progress in healthcare and biomedical research involves taking advantage of the huge amount of cl... more Progress in healthcare and biomedical research involves taking advantage of the huge amount of clinical data and biological knowledge that already exists and is currently being generated. Bioinformatic methods and tools have become essential for data extraction, management, and integration. However, it is necessary to overcome two barriers: the deficit of integrative computational approaches that combine different types of data and sources, and the lack of active involvement of the potential users in the process of creating applications for the management of biomedical information.
Motivation Incorporating the temporal dimension into multimorbidity studies has shown to be cruci... more Motivation Incorporating the temporal dimension into multimorbidity studies has shown to be crucial for achieving a better understanding of the disease associations. Furthermore, due to the multifactorial nature of human disease, exploring disease associations from different perspectives can provide a holistic view to support the study of their aetiology. Results In this work, a temporal systems-medicine approach is proposed for identifying time-dependent multimorbidity patterns from patient disease trajectories, by integrating data from electronic health records with genetic and phenotypic information. Specifically, the disease trajectories are clustered using an unsupervised algorithm based on dynamic time warping and three disease similarity metrics: clinical, genetic and phenotypic. An evaluation method is also presented for quantitatively assessing, in the different disease spaces, both the cluster homogeneity and the respective similarities between the associated diseases with...
The advent of digital medical data has brought an exponential increase in information available f... more The advent of digital medical data has brought an exponential increase in information available for each patient, allowing for novel knowledge generation methods to emerge. Tapping into this data brings clinical research and clinical practice closer together, as data generated in ordinary clinical practice can be used towards rapid-learning healthcare systems, continuously improving and personalizing healthcare. In this context, the recent use of Data Science technologies for healthcare is providing mutual benefits to both patients and medical professionals, improving prevention and treatment for several kinds of diseases. However, the adoption and usage of Data Science solutions for healthcare still require social capacity, knowledge and higher acceptance. The goal of this chapter is to provide an overview of needs, opportunities, recommendations and challenges of using (Big) Data Science technologies in the healthcare sector. This contribution is based on a recent whitepaper (http://www.bdva.eu/sites/default/files/Big%20Data%20Technologies%20in%20Healthcare.pdf) provided by the Big Data Value Association (BDVA) (http://www.bdva.eu/), the private counterpart to the EC to implement the BDV PPP (Big Data Value PPP) programme, which focuses on the challenges and impact that (Big) Data Science may have on the entire healthcare chain.
Background In the last few years, the number of mobile apps for health professionals has increase... more Background In the last few years, the number of mobile apps for health professionals has increased exponentially. Nevertheless, there is a lack of knowledge about the professional use, training requirements, and quality perception of these apps among health care professionals such as nurses. Considering that the nursing profession is the largest segment of health care workforce in many countries such as Spain, the impact of the use of health apps by these professionals can be critical to the future of modern health care. Objective The main objective of this study was to determine if nurses were using health apps professionally and what types of apps they were using. The secondary objectives were (1) to find out if, among nurses, there is a need for training in the use of health apps and (2) to explore nurses’ perceptions of health professional apps, determining whether there is a need for a certification process for health apps and the type of institution or organization that should...
Background The number of Mobile Medical applications or “mobile medical apps” has been growing ex... more Background The number of Mobile Medical applications or “mobile medical apps” has been growing exponentially in the last few months and they are expected to grow even more in the next future. The use of health apps promises to be a means for improving patient care and making easier professional activity. However, some cases of malfunction or inaccurate diagnosis and treatment recommendations have been reported. Regulations are necessary tools to safeguard users (general public and professionals) and support the product development. In this work we present a preliminary analysis of the current recommendations related to medical apps, and based on the previous experience acquired, in the accreditation activities of health related content websites of the Medical Association of Barcelona during ten years, we put forward the development of a specific health apps certification program in Spain. Objective To determine the existence of practical recommendations for the design and use of medical and health apps and, by analyzing them, to establish the basis for setting up a health apps certification program. Methods Based on the combination of several keywords in Google, Bing and Yahoo!, the first 50 links, displayed in the page results of these search engines in the 20th February 2013, were reviewed in order to find recommendations and practical guidelines related to medical and health apps. The search strategy used was the following: ("mobile medical application" OR "health apps" OR "medical apps") AND (regulation OR guidance OR ((certification OR accreditation) program OR standards) OR "practical guide"). Results There are several institutions around the world promoting recommendations and practical guidelines for the design, implementation and use of medical and health apps, such as the Food and Drug Administration, Happtique, Devices 4 Limited or mHIMSS. Other institutions such as the European Commission, the National Library of Medicine or the National Health Service (UK) are promoting a repository website (something like an app store) where some apps are included after been submitted to some kind of screening process. The CE Mark for medical devices (European Commission) could be applied in some kinds of apps used in clinical environments. The main recommendations include standards related to accessibility, privacy and confidentiality, technical aspects, security and scientific accuracy. Conclusions The use of medical apps, above all those that are used in a clinical environment, should follow certain regulatory requirements and a clear protocol in the process of designing them to guarantee that, as much the health information as the clinical advice (diagnosis or treatment) they are providing, are accurate and avoid the potential risks to public health and patients. As a first step it seems critical to establish whether an app is a medical or not. Based on the analysis of international practical guidelines, the process model of the experienced quality program of health-related content websites, and the application of the specific features and use of medical apps, the most important standards and process of a certification program have been defined (target and general information, technical aspects, security, privacy and scientific content). []
This paper proposes a new methodology for assessing the efficiency of medical diagnostic systems ... more This paper proposes a new methodology for assessing the efficiency of medical diagnostic systems and clinical decision support systems by using the feedback/opinions of medical experts. The methodology behind this work is based on a comparison between the expert feedback that has helped solve different clinical cases and the expert system that has evaluated these same cases. Once the results are returned, an arbitration process is carried out in order to ensure the correctness of the results provided by both methods. Once this process has been completed, the results are analyzed using Precision, Recall, Accuracy, Specificity and Matthews Correlation Coefficient (MCC) (PRAS-M) metrics. When the methodology is applied, the results obtained from a real diagnostic system allow researchers to establish the accuracy of the system based on objective facts. The methodology returns enough information to analyze the system's behavior for each disease in the knowledge base or across the entire knowledge base. It also returns data on the efficiency of the different assessors involved in the evaluation process, analyzing their behavior in the diagnostic process. The proposed work facilitates the evaluation of medical diagnostic systems, having a reliable process based on objective facts. The methodology presented in this research makes it possible to identify the main characteristics that define a medical diagnostic system and their values, allowing for system improvement. A good example of the results provided by the application of the methodology is shown in this paper. A diagnosis system was evaluated by means of this methodology, yielding positive results (statistically significant) when comparing the system with the assessors that participated in the evaluation process of the system through metrics such as recall (+27.54%) and MCC (+32.19%). These results demonstrate the real applicability of the methodology used.
Objective To quantify the comparative risk of thrombosis with thrombocytopenia syndrome or thromb... more Objective To quantify the comparative risk of thrombosis with thrombocytopenia syndrome or thromboembolic events associated with use of adenovirus based covid-19 vaccines versus mRNA based covid-19 vaccines. Design International network cohort study. Setting Routinely collected health data from contributing datasets in France, Germany, the Netherlands, Spain, the UK, and the US. Participants Adults (age ≥18 years) registered at any contributing database and who received at least one dose of a covid-19 vaccine (ChAdOx1-S (Oxford-AstraZeneca), BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), or Ad26.COV2.S (Janssen/Johnson & Johnson)), from December 2020 to mid-2021. Main outcome measures Thrombosis with thrombocytopenia syndrome or venous or arterial thromboembolic events within the 28 days after covid-19 vaccination. Incidence rate ratios were estimated after propensity scores matching and were calibrated using negative control outcomes. Estimates specific to the database were poole...
Los beneficios derivados de la reutilizacion de la informacion clinica no constituyen una novedad... more Los beneficios derivados de la reutilizacion de la informacion clinica no constituyen una novedad, ya que de hecho han sido objeto de trabajos publicados en la literatura cientifica en muchas ocasiones (1,2).
Studies in health technology and informatics, 2020
People use language to express their thoughts and feelings, unveiling important aspects of their ... more People use language to express their thoughts and feelings, unveiling important aspects of their psychological traits and social interactions. Although there are several studies describing methodologies to create a collection of words in English related to depression and other conditions, in most of them the selection of words is not clinical or expert based. The objective of this study is twofold: firstly, to introduce a comprehensive collection of Spanish words commonly used by patients suffering from depression, which will be available as a free open source for research purposes (GitHub), and secondly, to study the usefulness of this collection of words in identifying social media posts that could be indicative of patients suffering from depression. The level of agreement among medical doctors to determine the best words that should be used to select tweets related to depression was low. This finding may be due to the complexity of depression and the extraordinary diversity in th...
Studies in health technology and informatics, 2016
Progress in healthcare and biomedical research involves taking advantage of the huge amount of cl... more Progress in healthcare and biomedical research involves taking advantage of the huge amount of clinical data and biological knowledge that already exists and is currently being generated. Bioinformatic methods and tools have become essential for data extraction, management, and integration. However, it is necessary to overcome two barriers: the deficit of integrative computational approaches that combine different types of data and sources, and the lack of active involvement of the potential users in the process of creating applications for the management of biomedical information.
Motivation Incorporating the temporal dimension into multimorbidity studies has shown to be cruci... more Motivation Incorporating the temporal dimension into multimorbidity studies has shown to be crucial for achieving a better understanding of the disease associations. Furthermore, due to the multifactorial nature of human disease, exploring disease associations from different perspectives can provide a holistic view to support the study of their aetiology. Results In this work, a temporal systems-medicine approach is proposed for identifying time-dependent multimorbidity patterns from patient disease trajectories, by integrating data from electronic health records with genetic and phenotypic information. Specifically, the disease trajectories are clustered using an unsupervised algorithm based on dynamic time warping and three disease similarity metrics: clinical, genetic and phenotypic. An evaluation method is also presented for quantitatively assessing, in the different disease spaces, both the cluster homogeneity and the respective similarities between the associated diseases with...
The advent of digital medical data has brought an exponential increase in information available f... more The advent of digital medical data has brought an exponential increase in information available for each patient, allowing for novel knowledge generation methods to emerge. Tapping into this data brings clinical research and clinical practice closer together, as data generated in ordinary clinical practice can be used towards rapid-learning healthcare systems, continuously improving and personalizing healthcare. In this context, the recent use of Data Science technologies for healthcare is providing mutual benefits to both patients and medical professionals, improving prevention and treatment for several kinds of diseases. However, the adoption and usage of Data Science solutions for healthcare still require social capacity, knowledge and higher acceptance. The goal of this chapter is to provide an overview of needs, opportunities, recommendations and challenges of using (Big) Data Science technologies in the healthcare sector. This contribution is based on a recent whitepaper (http://www.bdva.eu/sites/default/files/Big%20Data%20Technologies%20in%20Healthcare.pdf) provided by the Big Data Value Association (BDVA) (http://www.bdva.eu/), the private counterpart to the EC to implement the BDV PPP (Big Data Value PPP) programme, which focuses on the challenges and impact that (Big) Data Science may have on the entire healthcare chain.
Background In the last few years, the number of mobile apps for health professionals has increase... more Background In the last few years, the number of mobile apps for health professionals has increased exponentially. Nevertheless, there is a lack of knowledge about the professional use, training requirements, and quality perception of these apps among health care professionals such as nurses. Considering that the nursing profession is the largest segment of health care workforce in many countries such as Spain, the impact of the use of health apps by these professionals can be critical to the future of modern health care. Objective The main objective of this study was to determine if nurses were using health apps professionally and what types of apps they were using. The secondary objectives were (1) to find out if, among nurses, there is a need for training in the use of health apps and (2) to explore nurses’ perceptions of health professional apps, determining whether there is a need for a certification process for health apps and the type of institution or organization that should...
Background The number of Mobile Medical applications or “mobile medical apps” has been growing ex... more Background The number of Mobile Medical applications or “mobile medical apps” has been growing exponentially in the last few months and they are expected to grow even more in the next future. The use of health apps promises to be a means for improving patient care and making easier professional activity. However, some cases of malfunction or inaccurate diagnosis and treatment recommendations have been reported. Regulations are necessary tools to safeguard users (general public and professionals) and support the product development. In this work we present a preliminary analysis of the current recommendations related to medical apps, and based on the previous experience acquired, in the accreditation activities of health related content websites of the Medical Association of Barcelona during ten years, we put forward the development of a specific health apps certification program in Spain. Objective To determine the existence of practical recommendations for the design and use of medical and health apps and, by analyzing them, to establish the basis for setting up a health apps certification program. Methods Based on the combination of several keywords in Google, Bing and Yahoo!, the first 50 links, displayed in the page results of these search engines in the 20th February 2013, were reviewed in order to find recommendations and practical guidelines related to medical and health apps. The search strategy used was the following: ("mobile medical application" OR "health apps" OR "medical apps") AND (regulation OR guidance OR ((certification OR accreditation) program OR standards) OR "practical guide"). Results There are several institutions around the world promoting recommendations and practical guidelines for the design, implementation and use of medical and health apps, such as the Food and Drug Administration, Happtique, Devices 4 Limited or mHIMSS. Other institutions such as the European Commission, the National Library of Medicine or the National Health Service (UK) are promoting a repository website (something like an app store) where some apps are included after been submitted to some kind of screening process. The CE Mark for medical devices (European Commission) could be applied in some kinds of apps used in clinical environments. The main recommendations include standards related to accessibility, privacy and confidentiality, technical aspects, security and scientific accuracy. Conclusions The use of medical apps, above all those that are used in a clinical environment, should follow certain regulatory requirements and a clear protocol in the process of designing them to guarantee that, as much the health information as the clinical advice (diagnosis or treatment) they are providing, are accurate and avoid the potential risks to public health and patients. As a first step it seems critical to establish whether an app is a medical or not. Based on the analysis of international practical guidelines, the process model of the experienced quality program of health-related content websites, and the application of the specific features and use of medical apps, the most important standards and process of a certification program have been defined (target and general information, technical aspects, security, privacy and scientific content). []
This paper proposes a new methodology for assessing the efficiency of medical diagnostic systems ... more This paper proposes a new methodology for assessing the efficiency of medical diagnostic systems and clinical decision support systems by using the feedback/opinions of medical experts. The methodology behind this work is based on a comparison between the expert feedback that has helped solve different clinical cases and the expert system that has evaluated these same cases. Once the results are returned, an arbitration process is carried out in order to ensure the correctness of the results provided by both methods. Once this process has been completed, the results are analyzed using Precision, Recall, Accuracy, Specificity and Matthews Correlation Coefficient (MCC) (PRAS-M) metrics. When the methodology is applied, the results obtained from a real diagnostic system allow researchers to establish the accuracy of the system based on objective facts. The methodology returns enough information to analyze the system's behavior for each disease in the knowledge base or across the entire knowledge base. It also returns data on the efficiency of the different assessors involved in the evaluation process, analyzing their behavior in the diagnostic process. The proposed work facilitates the evaluation of medical diagnostic systems, having a reliable process based on objective facts. The methodology presented in this research makes it possible to identify the main characteristics that define a medical diagnostic system and their values, allowing for system improvement. A good example of the results provided by the application of the methodology is shown in this paper. A diagnosis system was evaluated by means of this methodology, yielding positive results (statistically significant) when comparing the system with the assessors that participated in the evaluation process of the system through metrics such as recall (+27.54%) and MCC (+32.19%). These results demonstrate the real applicability of the methodology used.
Objective To quantify the comparative risk of thrombosis with thrombocytopenia syndrome or thromb... more Objective To quantify the comparative risk of thrombosis with thrombocytopenia syndrome or thromboembolic events associated with use of adenovirus based covid-19 vaccines versus mRNA based covid-19 vaccines. Design International network cohort study. Setting Routinely collected health data from contributing datasets in France, Germany, the Netherlands, Spain, the UK, and the US. Participants Adults (age ≥18 years) registered at any contributing database and who received at least one dose of a covid-19 vaccine (ChAdOx1-S (Oxford-AstraZeneca), BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), or Ad26.COV2.S (Janssen/Johnson & Johnson)), from December 2020 to mid-2021. Main outcome measures Thrombosis with thrombocytopenia syndrome or venous or arterial thromboembolic events within the 28 days after covid-19 vaccination. Incidence rate ratios were estimated after propensity scores matching and were calibrated using negative control outcomes. Estimates specific to the database were poole...
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