Yola Jones

Muhammet Alkan, Hester Huijsdens, Yola Jones et al.

The pivotal shift from traditional paper-based records to sophisticated Electronic Health Records (EHR), enabled systematic collection and analysis of patient data through descriptive statistics, providing insight into patterns and trends across patient populations. This evolution continued toward predictive analytics, allowing healthcare providers to anticipate patient outcomes and potential complications before they occur. This progression from basic digital record-keeping to sophisticated predictive modelling and digital twins reflects healthcare's broader evolution toward more integrated, patient-centred approaches that combine data-driven insights with personalized care delivery. This chapter explores the evolution and significance of healthcare information systems, beginning with an examination of the implementation of EHR in the UK and the USA. It provides a comprehensive overview of the International Classification of Diseases (ICD) system, tracing its development from ICD-9 to ICD-10. Central to this discussion is the MIMIC-III database, a landmark achievement in healthcare data sharing and arguably the most comprehensive critical care database freely available to researchers worldwide. MIMIC-III has democratized access to high-quality healthcare data, enabling unprecedented opportunities for research and analysis. The chapter examines its structure, clinical outcome analysis capabilities, and practical applications through case studies, with a particular focus on mortality and length of stay metrics, vital signs extraction, and ICD coding. Through detailed entity-relationship diagrams and practical examples, the text illustrates MIMIC's complex data structure and demonstrates how different querying approaches can lead to subtly different results, emphasizing the critical importance of understanding the database's architecture for accurate data extraction.

Yola Jones, Fani Deligianni, Jeff Dalton

Cardiovascular disease is a large worldwide healthcare issue; symptoms often present suddenly with minimal warning. The electrocardiogram (ECG) is a fast, simple and reliable method of evaluating the health of the heart, by measuring electrical activity recorded through electrodes placed on the skin. ECGs often need to be analyzed by a cardiologist, taking time which could be spent on improving patient care and outcomes. Because of this, automatic ECG classification systems using machine learning have been proposed, which can learn complex interactions between ECG features and use this to detect abnormalities. However, algorithms built for this purpose often fail to generalize well to unseen data, reporting initially impressive results which drop dramatically when applied to new environments. Additionally, machine learning algorithms suffer a "black-box" issue, in which it is difficult to determine how a decision has been made. This is vital for applications in healthcare, as clinicians need to be able to verify the process of evaluation in order to trust the algorithm. This paper proposes a method for visualizing model decisions across each class in the MIT-BIH arrhythmia dataset, using adapted saliency maps averaged across complete classes to determine what patterns are being learned. We do this by building two algorithms based on state-of-the-art models. This paper highlights how these maps can be used to find problems in the model which could be affecting generalizability and model performance. Comparing saliency maps across complete classes gives an overall impression of confounding variables or other biases in the model, unlike what would be highlighted when comparing saliency maps on an ECG-by-ECG basis.