arXiv subjects

Gyorgy Simon

Publications and source records attributed to Gyorgy Simon.

5 recordsLinked to original sources

arXiv2024

End-Stage Liver Disease Comorbidities in Patients Awaiting Transplantation: Identification and Impact on Liver Transplant Survival

End-Stage Liver Disease (ESLD), a complex condition, has high rates of co-occurring comorbidities affecting multiple organ systems. There is no clear evidence-based practice (EBP) guidelines addressing the progression of comorbidities in ESLD patients awaiting liver transplantation (LT) and their impact on survival, both pre- and post-transplant. This study aimed to identify and quantify the trajectory of the most common and deteriorating comorbidities in ESLD patients awaiting LT and to analyze their effect on patient outcomes. An initial exploratory phase to identify frequent comorbidities in ESLD patients. Relevant EBP-driven data for diagnosing and measuring the progression of these conditions were collected and organized into five research matrices. In the quantitative phase, a retrospective analysis was conducted using longitudinal de-identified data from electronic health records (EHR) for patients who underwent LT between 2011-2021. Data included demographics, labs, procedures, and medications. Descriptive statistics and survival analysis assessed the association of comorbidities with post-transplant survival. The five most frequent comorbidities identified were Diabetes Mellitus (DM), Chronic Kidney Disease (CKD), Malnutrition, Portal Hypertension (PH), and Ascites. Of the 722 patients analyzed, 68.2% were male, mean age of 54.81 (SD = 11.24), and 19.8% died post-LT. Survival analysis showed a gradual decline over time, with the most significant drop at five years post-LT. Significant predictors of post-LT survival were age at transplant (p=0.01), waitlist time (p=0.004), DM at listing (p=0.02), low albumin (p=0.03), and CKD stage 5 development after listing (p=0.04). This study highlights the variability in diagnosing and measuring comorbidities in ESLD patients and provides insights into their progression and impact on post-LT survival.

q-bio.QM↗

arXiv2022

Incorporating Causal Effects into Deep Learning Predictions on EHR Data

Electronic Health Records (EHR) data analysis plays a crucial role in healthcare system quality. Because of its highly complex underlying causality and limited observable nature, causal inference on EHR is quite challenging. Deep Learning (DL) achieved great success among the advanced machine learning methodologies. Nevertheless, it is still obstructed by the inappropriately assumed causal conditions. This work proposed a novel method to quantify clinically well-defined causal effects as a generalized estimation vector that is simply utilizable for causal models. We incorporated it into DL models to achieve better predictive performance and result interpretation. Furthermore, we also proved the existence of causal information blink spots that regular DL models cannot reach.

cs.LG↗

arXiv2022

Predicting Cancer Treatments Induced Cardiotoxicity of Breast Cancer Patients

Cardiotoxicity induced by the breast cancer treatments (i.e., chemotherapy, targeted therapy and radiation therapy) is a significant problem for breast cancer patients. The cardiotoxicity risk for breast cancer patients receiving different treatments remains unclear. We developed and evaluated risk predictive models for cardiotoxicity in breast cancer patients using EHR data. The AUC scores to predict the CHF, CAD, CM and MI are 0.846, 0.857, 0.858 and 0.804 respectively. After adjusting for baseline differences in cardiovascular health, patients who received chemotherapy or targeted therapy appeared to have higher risk of cardiotoxicity than patients who received radiation therapy. Due to differences in baseline cardiac health across the different breast cancer treatment groups, caution is recommended in interpreting the cardiotoxic effect of these treatments.

stat.AP↗

arXiv2017

Mining Electronic Health Records: A Survey

The continuously increasing cost of the US healthcare system has received significant attention. Central to the ideas aimed at curbing this trend is the use of technology, in the form of the mandate to implement electronic health records (EHRs). EHRs consist of patient information such as demographics, medications, laboratory test results, diagnosis codes and procedures. Mining EHRs could lead to improvement in patient health management as EHRs contain detailed information related to disease prognosis for large patient populations. In this manuscript, we provide a structured and comprehensive overview of data mining techniques for modeling EHR data. We first provide a detailed understanding of the major application areas to which EHR mining has been applied and then discuss the nature of EHR data and its accompanying challenges. Next, we describe major approaches used for EHR mining, the metrics associated with EHRs, and the various study designs. With this foundation, we then provide a systematic and methodological organization of existing data mining techniques used to model EHRs and discuss ideas for future research. We conclude this survey with a comprehensive summary of clinical data mining applications of EHR data, as illustrated in the online supplement.

cs.IR↗

arXiv2016

Causal Inference in Observational Data

Our aging population increasingly suffers from multiple chronic diseases simultaneously, necessitating the comprehensive treatment of these conditions. Finding the optimal set of drugs for a combinatorial set of diseases is a combinatorial pattern exploration problem. Association rule mining is a popular tool for such problems, but the requirement of health care for finding causal, rather than associative, patterns renders association rule mining unsuitable. To address this issue, we propose a novel framework based on the Rubin-Neyman causal model for extracting causal rules from observational data, correcting for a number of common biases. Specifically, given a set of interventions and a set of items that define subpopulations (e.g., diseases), we wish to find all subpopulations in which effective intervention combinations exist and in each such subpopulation, we wish to find all intervention combinations such that dropping any intervention from this combination will reduce the efficacy of the treatment. A key aspect of our framework is the concept of closed intervention sets which extend the concept of quantifying the effect of a single intervention to a set of concurrent interventions. We also evaluated our causal rule mining framework on the Electronic Health Records (EHR) data of a large cohort of patients from Mayo Clinic and showed that the patterns we extracted are sufficiently rich to explain the controversial findings in the medical literature regarding the effect of a class of cholesterol drugs on Type-II Diabetes Mellitus (T2DM).

cs.AI↗