William L. Romine

Ankita Agarwal, Krishnaprasad Thirunarayan, William L. Romine et al.

Heart failure occurs when the heart is not able to pump blood and oxygen to support other organs in the body as it should. Treatments include medications and sometimes hospitalization. Patients with heart failure can have both cardiovascular as well as non-cardiovascular comorbidities. Clinical notes of patients with heart failure can be analyzed to gain insight into the topics discussed in these notes and the major comorbidities in these patients. In this regard, we apply machine learning techniques, such as topic modeling, to identify the major themes found in the clinical notes specific to the procedures performed on 1,200 patients admitted for heart failure at the University of Illinois Hospital and Health Sciences System (UI Health). Topic modeling revealed five hidden themes in these clinical notes, including one related to heart disease comorbidities.

Ankita Agarwal, Tanvi Banerjee, William Romine et al.

Artificial intelligence based predictive models trained on the clinical notes can be demographically biased. This could lead to adverse healthcare disparities in predicting outcomes like length of stay of the patients. Thus, it is necessary to mitigate the demographic biases within these models. We proposed an implicit in-processing debiasing method to combat disparate treatment which occurs when the machine learning model predict different outcomes for individuals based on the sensitive attributes like gender, ethnicity, race, and likewise. For this purpose, we used clinical notes of heart failure patients and used diagnostic codes, procedure reports and physiological vitals of the patients. We used Clinical BERT to obtain feature embeddings within the diagnostic codes and procedure reports, and LSTM autoencoders to obtain feature embeddings within the physiological vitals. Then, we trained two separate deep learning contrastive learning frameworks, one for gender and the other for ethnicity to obtain debiased representations within those demographic traits. We called this debiasing framework Debias-CLR. We leveraged clinical phenotypes of the patients identified in the diagnostic codes and procedure reports in the previous study to measure fairness statistically. We found that Debias-CLR was able to reduce the Single-Category Word Embedding Association Test (SC-WEAT) effect size score when debiasing for gender and ethnicity. We further found that to obtain fair representations in the embedding space using Debias-CLR, the accuracy of the predictive models on downstream tasks like predicting length of stay of the patients did not get reduced as compared to using the un-debiased counterparts for training the predictive models. Hence, we conclude that our proposed approach, Debias-CLR is fair and representative in mitigating demographic biases and can reduce health disparities.

Vaishnavi Visweswaraiah, Tanvi Banerjee, William Romine

Suicide prediction is the key for prevention, but real data with sufficient positive samples is rare and causes extreme class imbalance. We utilized machine learning (ML) to build the model and deep learning (DL) techniques, like Generative Adversarial Networks (GAN), to generate synthetic data samples to enhance the dataset. The initial dataset contained 656 samples, with only four positive cases, prompting the need for data augmentation. A variety of machine learning models, ranging from interpretable data models to black box algorithmic models, were used. On real test data, Logistic Regression (LR) achieved a weighted precision of 0.99, a weighted recall of 0.85, and a weighted F1 score of 0.91; Random Forest (RF) showed 0.98, 0.99, and 0.99, respectively; and Support Vector Machine (SVM) achieved 0.99, 0.76, and 0.86. LR and SVM correctly identified one suicide attempt case (sensitivity:1.0) and misclassified LR(20) and SVM (31) non-attempts as attempts (specificity: 0.85 & 0.76, respectively). RF identified 0 suicide attempt cases (sensitivity: 0.0) with 0 false positives (specificity: 1.0). These results highlight the models' effectiveness, with GAN playing a key role in generating synthetic data to support suicide prevention modeling efforts.

Ankita Agarwal, Tanvi Banerjee, William L. Romine et al.

Heart failure is a syndrome which occurs when the heart is not able to pump blood and oxygen to support other organs in the body. Identifying the underlying themes in the diagnostic codes and procedure reports of patients admitted for heart failure could reveal the clinical phenotypes associated with heart failure and to group patients based on their similar characteristics which could also help in predicting patient outcomes like length of stay. These clinical phenotypes usually have a probabilistic latent structure and hence, as there has been no previous work on identifying phenotypes in clinical notes of heart failure patients using a probabilistic framework and to predict length of stay of these patients using data-driven artificial intelligence-based methods, we apply natural language processing technique, topic modeling, to identify the themes present in diagnostic codes and in procedure reports of 1,200 patients admitted for heart failure at the University of Illinois Hospital and Health Sciences System (UI Health). Topic modeling identified twelve themes each in diagnostic codes and procedure reports which revealed information about different phenotypes related to various perspectives about heart failure, to study patients' profiles and to discover new relationships among medical concepts. Each theme had a set of keywords and each clinical note was labeled with two themes - one corresponding to its diagnostic code and the other corresponding to its procedure reports along with their percentage contribution. We used these themes and their percentage contribution to predict length of stay. We found that the themes discovered in diagnostic codes and procedure reports using topic modeling together were able to predict length of stay of the patients with an accuracy of 61.1% and an Area under the Receiver Operating Characteristic Curve (ROC AUC) value of 0.828.

Swati Padhee, Anurag Illendula, Megan Sadler et al.

Dementia is a group of irreversible, chronic, and progressive neurodegenerative disorders resulting in impaired memory, communication, and thought processes. In recent years, clinical research advances in brain aging have focused on the earliest clinically detectable stage of incipient dementia, commonly known as mild cognitive impairment (MCI). Currently, these disorders are diagnosed using a manual analysis of neuropsychological examinations. We measure the feasibility of using the linguistic characteristics of verbal utterances elicited during neuropsychological exams of elderly subjects to distinguish between elderly control groups, people with MCI, people diagnosed with possible Alzheimer's disease (AD), and probable AD. We investigated the performance of both theory-driven psycholinguistic features and data-driven contextual language embeddings in identifying different clinically diagnosed groups. Our experiments show that a combination of contextual and psycholinguistic features extracted by a Support Vector Machine improved distinguishing the verbal utterances of elderly controls, people with MCI, possible AD, and probable AD. This is the first work to identify four clinical diagnosis groups of dementia in a highly imbalanced dataset. Our work shows that machine learning algorithms built on contextual and psycholinguistic features can learn the linguistic biomarkers from verbal utterances and assist clinical diagnosis of different stages and types of dementia, even with limited data.

Ankita Agarwal, Preetham Salehundam, Swati Padhee et al.

The recent global outbreak of the coronavirus disease (COVID-19) has spread to all corners of the globe. The international travel ban, panic buying, and the need for self-quarantine are among the many other social challenges brought about in this new era. Twitter platforms have been used in various public health studies to identify public opinion about an event at the local and global scale. To understand the public concerns and responses to the pandemic, a system that can leverage machine learning techniques to filter out irrelevant tweets and identify the important topics of discussion on social media platforms like Twitter is needed. In this study, we constructed a system to identify the relevant tweets related to the COVID-19 pandemic throughout January 1st, 2020 to April 30th, 2020, and explored topic modeling to identify the most discussed topics and themes during this period in our data set. Additionally, we analyzed the temporal changes in the topics with respect to the events that occurred during this pandemic. We found out that eight topics were sufficient to identify the themes in our corpus. These topics depicted a temporal trend. The dominant topics vary over time and align with the events related to the COVID-19 pandemic.

Amir Hossein Yazdavar, Mohammad Saeid Mahdavinejad, Goonmeet Bajaj et al.

With ubiquity of social media platforms, millions of people are sharing their online persona by expressing their thoughts, moods, emotions, feelings, and even their daily struggles with mental health issues voluntarily and publicly on social media. Unlike the most existing efforts which study depression by analyzing textual content, we examine and exploit multimodal big data to discern depressive behavior using a wide variety of features including individual-level demographics. By developing a multimodal framework and employing statistical techniques for fusing heterogeneous sets of features obtained by processing visual, textual and user interaction data, we significantly enhance the current state-of-the-art approaches for identifying depressed individuals on Twitter (improving the average F1-Score by 5 percent) as well as facilitate demographic inference from social media for broader applications. Besides providing insights into the relationship between demographics and mental health, our research assists in the design of a new breed of demographic-aware health interventions.

William Romine, Tanvi Banerjee, Garrett Goodman

We use self-report and electrodermal activity (EDA) wearable sensor data from 77 nights of sleep on six participants to test the efficacy of EDA data for sleep monitoring. We used factor analysis to find latent factors in the EDA data, and causal model search to find the most probable graphical model accounting for self-reported sleep efficiency (SE), sleep quality (SQ), and the latent EDA factors. Structural equation modeling was used to confirm fit of the extracted graph. Based on the generated graph, logistic regression and naive Bayes models were used to test the efficacy of the EDA data in predicting SE and SQ. Six EDA features extracted from the total signal over a night's sleep could be explained by two latent factors, EDA Magnitude and EDA Storms. EDA Magnitude performed as a strong predictor for SE to aid detection of substantial changes in time asleep. The performance of EDA Magnitured and SE in classifying SQ showed promise for wearable sleep monitoring applications. However, our data suggest that obtaining a more accurate sensor-based measure of SE will be necessary before smaller changes in SQ can be detected from EDA sensor data alone.