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Sarah Osmundson

Publications and source records attributed to Sarah Osmundson.

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Harmonization mitigates diffusion MRI scanner effects in infancy: insights from the HEALthy Brain and Childhood Development (HBCD) study

The HEALthy Brain and Childhood Development (HBCD) Study is an ongoing longitudinal initiative to understand population-level brain maturation; however, large-scale studies must overcome site-related variance and preserve biologically relevant signal. In addition to diffusion-weighted magnetic resonance imaging images, the HBCD dataset offers analysis-ready derivatives for scientists to conduct their analysis, including scalar diffusion tensor (DTI) metrics in a predetermined set of bundles. The purpose of this study is to characterize HBCD-specific site effects in diffusion MRI data, which have not been systematically reported. In this work, we investigate the sensitivity of HBCD bundle metrics to scanner model-related variance and address these variations with ComBat-GAM harmonization within the current HBCD data release 1.1 across six scanner models. Following ComBat-GAM, we observe zero statistically significant differences between the distributions from any scanner model following FDR correction and reduce Cohen's f effect sizes across all metrics. Our work underscores the importance of rigorous harmonization efforts in large-scale studies, and we encourage future investigations of HBCD data to control for these effects.

eess.IV

Learning Bundled Care Opportunities from Electronic Medical Records

Objectives: The fee-for-service approach to healthcare leads to the management of a patient's conditions in an independent manner, inducing various negative consequences. It is recognized that a bundled care approach to healthcare-one that manages a collection of health conditions together-may enable greater efficacy and cost savings. However, it is not always evident which sets of conditions should be managed in a bundled program. Study Design: Retrospective inference of clusters of health conditions from an electronic medical record (EMR) system. A survey of healthcare experts to ascertain the plausibility of the clusters for bundled care programs. Methods: We designed a data-driven framework to infer clusters of health conditions via their shared clinical workflows according to EMR utilization by healthcare employees. We evaluated the framework with approximately 16,500 inpatient stays from a large medical center. The plausibility of the clusters for bundled care was assessed through a survey of a panel of healthcare experts using an analysis of variance (ANOVA) under a 95% confidence interval. Results: The framework inferred four condition clusters: 1) fetal abnormalities, 2) late pregnancies, 3) prostate problems, and 4) chronic diseases (with congestive heart failure featuring prominently). Each cluster was deemed plausible by the experts for bundled care. Conclusions: The findings suggest that data from EMRs may provide a basis for discovering new directions in bundled care. Still, translating such findings into actual care management will require further refinement, implementation, and evaluation.

cs.CY