4.4LGJul 15
A Temporal Machine Learning-Based Time-to-Event Model for Predicting ALS Progression and Healthcare UtilizationZongliang Yue, Qi Li, Terry Heiman-Patterson et al.
Amyotrophic lateral sclerosis (ALS) is a progressive and heterogeneous neurodegenerative disease in which predicting clinically meaningful milestones, such as assistive device use, remains challenging. We developed a time-to-event, digital-twin-inspired framework that integrates longitudinal ALS Functional Rating Scale-Revised (ALSFRS-R) trajectories with survival modeling to support individualized prediction of functional decline and assistive device utilization. We constructed a harmonized longitudinal dataset by integrating diagnosis records, ALSFRS-R assessments, activities of daily living, and demographic information, followed by preprocessing to ensure data quality, temporal alignment, and cohort consistency. Correlation-based clustering identified coherent functional domains spanning bulbar, upper limb, axial, lower limb, and respiratory systems. Generalized additive mixed models characterized nonlinear, domain-specific functional decline across all domains. In addition, a temporal machine learning model was developed to predict longitudinal functional decline and capture stage-dependent disease progression. Cox proportional hazards modeling further identified lower limb function, particularly walking and stair climbing, as the strongest predictors of earlier wheelchair access. Building on these results, we implemented a digital twin-inspired temporal machine learning-based time-to-event (TTE) model that generates individualized survival curves and dynamically predicts wheelchair-free survival. This framework provides a scalable, interpretable, and clinically actionable approach for linking ALS progression with personalized decision support, with applications in proactive care planning, clinical trial stratification, and precision medicine.
Integrating Social Determinants of Health into Knowledge Graphs: Evaluating Prediction Bias and Fairness in HealthcareTianqi Shang, Weiqing He, Tianlong Chen et al.
Social determinants of health (SDoH) play a crucial role in patient health outcomes, yet their integration into biomedical knowledge graphs remains underexplored. This study addresses this gap by constructing an SDoH-enriched knowledge graph using the MIMIC-III dataset and PrimeKG. We introduce a novel fairness formulation for graph embeddings, focusing on invariance with respect to sensitive SDoH information. Via employing a heterogeneous-GCN model for drug-disease link prediction, we detect biases related to various SDoH factors. To mitigate these biases, we propose a post-processing method that strategically reweights edges connected to SDoHs, balancing their influence on graph representations. This approach represents one of the first comprehensive investigations into fairness issues within biomedical knowledge graphs incorporating SDoH. Our work not only highlights the importance of considering SDoH in medical informatics but also provides a concrete method for reducing SDoH-related biases in link prediction tasks, paving the way for more equitable healthcare recommendations. Our code is available at \url{https://github.com/hwq0726/SDoH-KG}.
1.2QMDec 12, 2024
Predicting Emergency Department Visits for Patients with Type II DiabetesJavad M Alizadeh, Jay S Patel, Gabriel Tajeu et al.
Over 30 million Americans are affected by Type II diabetes (T2D), a treatable condition with significant health risks. This study aims to develop and validate predictive models using machine learning (ML) techniques to estimate emergency department (ED) visits among patients with T2D. Data for these patients was obtained from the HealthShare Exchange (HSX), focusing on demographic details, diagnoses, and vital signs. Our sample contained 34,151 patients diagnosed with T2D which resulted in 703,065 visits overall between 2017 and 2021. A workflow integrated EMR data with SDoH for ML predictions. A total of 87 out of 2,555 features were selected for model construction. Various machine learning algorithms, including CatBoost, Ensemble Learning, K-nearest Neighbors (KNN), Support Vector Classification (SVC), Random Forest, and Extreme Gradient Boosting (XGBoost), were employed with tenfold cross-validation to predict whether a patient is at risk of an ED visit. The ROC curves for Random Forest, XGBoost, Ensemble Learning, CatBoost, KNN, and SVC, were 0.82, 0.82, 0.82, 0.81, 0.72, 0.68, respectively. Ensemble Learning and Random Forest models demonstrated superior predictive performance in terms of discrimination, calibration, and clinical applicability. These models are reliable tools for predicting risk of ED visits among patients with T2D. They can estimate future ED demand and assist clinicians in identifying critical factors associated with ED utilization, enabling early interventions to reduce such visits. The top five important features were age, the difference between visitation gaps, visitation gaps, R10 or abdominal and pelvic pain, and the Index of Concentration at the Extremes (ICE) for income.
HCMay 15
Natural Language Processing in Health Professions Education: A Scoping ReviewJavad Mohammad Alizadeh, Pegah Saebi, Mukesh Kumar Patel et al.
Natural language processing (NLP) and artificial intelligence (AI) are rapidly transforming health professions education, yet no scoping review has systematically mapped their applications across the full spectrum of health education contexts, including public health. Following the Arksey and O'Malley framework and PRISMA-ScR guidelines, this review synthesized evidence from 64 studies published between 2015 and 2026, identified through searches of PubMed, ERIC, IEEE Xplore, and Google Scholar. Seven thematic domains were identified: automated assessment, large language models (LLMs) as student-facing learning support, virtual patients and clinical simulation, curriculum analysis and program evaluation, personalized and adaptive learning, public health and health promotion education, and educator and institutional integration. Findings reveal significant technical promise, particularly in automated assessment, clinical simulation, and curriculum analysis, alongside persistent challenges including hallucination and accuracy concerns, algorithmic bias, data privacy, digital divide, overreliance, and absence of standardized outcome measures. Only four studies explicitly addressed public health education, representing a major evidence gap. This review provides a foundation for evidence-informed integration of NLP and AI across health professions education and highlights public health education as a priority area for future research and investment.
3.8CRFeb 23, 2021
Usability and Security of Different Authentication Methods for an Electronic Health Records SystemSaptarshi Purkayastha, Shreya Goyal, Bolu Oluwalade et al.
We conducted a survey of 67 graduate students enrolled in the Privacy and Security in Healthcare course at Indiana University Purdue University Indianapolis. This was done to measure user preference and their understanding of usability and security of three different Electronic Health Records authentication methods: single authentication method (username and password), Single sign-on with Central Authentication Service (CAS) authentication method, and a bio-capsule facial authentication method. This research aims to explore the relationship between security and usability, and measure the effect of perceived security on usability in these three aforementioned authentication methods. We developed a formative-formative Partial Least Square Structural Equation Modeling (PLS-SEM) model to measure the relationship between the latent variables of Usability, and Security. The measurement model was developed using five observed variables (measures). - Efficiency and Effectiveness, Satisfaction, Preference, Concerns, and Confidence. The results obtained highlight the importance and impact of these measures on the latent variables and the relationship among the latent variables. From the PLS-SEM analysis, it was found that security has a positive impact on usability for Single sign-on and bio-capsule facial authentication methods. We conclude that the facial authentication method was the most secure and usable among the three authentication methods. Further, descriptive analysis was done to draw out the interesting findings from the survey regarding the observed variables.