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Xiaoqian Jiang

Publications and source records attributed to Xiaoqian Jiang.

72 records · Page 4Linked to original sources

De-identification of Unstructured Clinical Texts from Sequence to Sequence Perspective

In this work, we propose a novel problem formulation for de-identification of unstructured clinical text. We formulate the de-identification problem as a sequence to sequence learning problem instead of a token classification problem. Our approach is inspired by the recent state-of -the-art performance of sequence to sequence learning models for named entity recognition. Early experimentation of our proposed approach achieved 98.91% recall rate on i2b2 dataset. This performance is comparable to current state-of-the-art models for unstructured clinical text de-identification.

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COVID-19 Smart Chatbot Prototype for Patient Monitoring

Many COVID-19 patients developed prolonged symptoms after the infection, including fatigue, delirium, and headache. The long-term health impact of these conditions is still not clear. It is necessary to develop a way to follow up with these patients for monitoring their health status to support timely intervention and treatment. In the lack of sufficient human resources to follow up with patients, we propose a novel smart chatbot solution backed with machine learning to collect information (i.e., generating digital diary) in a personalized manner. In this article, we describe the design framework and components of our prototype.

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An Empirical Study of UMLS Concept Extraction from Clinical Notes using Boolean Combination Ensembles

Our objective in this study is to investigate the behavior of Boolean operators on combining annotation output from multiple Natural Language Processing (NLP) systems across multiple corpora and to assess how filtering by aggregation of Unified Medical Language System (UMLS) Metathesaurus concepts affects system performance for Named Entity Recognition (NER) of UMLS concepts. We used three corpora annotated for UMLS concepts: 2010 i2b2 VA challenge set (31,161 annotations), Multi-source Integrated Platform for Answering Clinical Questions (MiPACQ) corpus (17,457 annotations including UMLS concept unique identifiers), and Fairview Health Services corpus (44,530 annotations). Our results showed that for UMLS concept matching, Boolean ensembling of the MiPACQ corpus trended towards higher performance over individual systems. Use of an approximate grid-search can help optimize the precision-recall tradeoff and can provide a set of heuristics for choosing an optimal set of ensembles.

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Real-time Prediction for Mechanical Ventilation in COVID-19 Patients using A Multi-task Gaussian Process Multi-objective Self-attention Network

We propose a robust in-time predictor for in-hospital COVID-19 patient's probability of requiring mechanical ventilation. A challenge in the risk prediction for COVID-19 patients lies in the great variability and irregular sampling of patient's vitals and labs observed in the clinical setting. Existing methods have strong limitations in handling time-dependent features' complex dynamics, either oversimplifying temporal data with summary statistics that lose information or over-engineering features that lead to less robust outcomes. We propose a novel in-time risk trajectory predictive model to handle the irregular sampling rate in the data, which follows the dynamics of risk of performing mechanical ventilation for individual patients. The model incorporates the Multi-task Gaussian Process using observed values to learn the posterior joint multi-variant conditional probability and infer the missing values on a unified time grid. The temporal imputed data is fed into a multi-objective self-attention network for the prediction task. A novel positional encoding layer is proposed and added to the network for producing in-time predictions. The positional layer outputs a risk score at each user-defined time point during the entire hospital stay of an inpatient. We frame the prediction task into a multi-objective learning framework, and the risk scores at all time points are optimized altogether, which adds robustness and consistency to the risk score trajectory prediction. Our experimental evaluation on a large database with nationwide in-hospital patients with COVID-19 also demonstrates that it improved the state-of-the-art performance in terms of AUC (Area Under the receiver operating characteristic Curve) and AUPRC (Area Under the Precision-Recall Curve) performance metrics, especially at early times after hospital admission.

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Privacy-Preserving Methods for Vertically Partitioned Incomplete Data

Distributed health data networks that use information from multiple sources have drawn substantial interest in recent years. However, missing data are prevalent in such networks and present significant analytical challenges. The current state-of-the-art methods for handling missing data require pooling data into a central repository before analysis, which may not be possible in a distributed health data network. In this paper, we propose a privacy-preserving distributed analysis framework for handling missing data when data are vertically partitioned. In this framework, each institution with a particular data source utilizes the local private data to calculate necessary intermediate aggregated statistics, which are then shared to build a global model for handling missing data. To evaluate our proposed methods, we conduct simulation studies that clearly demonstrate that the proposed privacy-preserving methods perform as well as the methods using the pooled data and outperform several naïve methods. We further illustrate the proposed methods through the analysis of a real dataset. The proposed framework for handling vertically partitioned incomplete data is substantially more privacy-preserving than methods that require pooling of the data, since no individual-level data are shared, which can lower hurdles for collaboration across multiple institutions and build stronger public trust.

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Deep Representation Learning of Patient Data from Electronic Health Records (EHR): A Systematic Review

Patient representation learning refers to learning a dense mathematical representation of a patient that encodes meaningful information from Electronic Health Records (EHRs). This is generally performed using advanced deep learning methods. This study presents a systematic review of this field and provides both qualitative and quantitative analyses from a methodological perspective. We identified studies developing patient representations from EHRs with deep learning methods from MEDLINE, EMBASE, Scopus, the Association for Computing Machinery (ACM) Digital Library, and Institute of Electrical and Electronics Engineers (IEEE) Xplore Digital Library. After screening 363 articles, 49 papers were included for a comprehensive data collection. We noticed a typical workflow starting with feeding raw data, applying deep learning models, and ending with clinical outcome predictions as evaluations of the learned representations. Specifically, learning representations from structured EHR data was dominant (37 out of 49 studies). Recurrent Neural Networks were widely applied as the deep learning architecture (LSTM: 13 studies, GRU: 11 studies). Disease prediction was the most common application and evaluation (31 studies). Benchmark datasets were mostly unavailable (28 studies) due to privacy concerns of EHR data, and code availability was assured in 20 studies. We show the importance and feasibility of learning comprehensive representations of patient EHR data through a systematic review. Advances in patient representation learning techniques will be essential for powering patient-level EHR analyses. Future work will still be devoted to leveraging the richness and potential of available EHR data. Knowledge distillation and advanced learning techniques will be exploited to assist the capability of learning patient representation further.

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Population stratification enables modeling effects of reopening policies on mortality and hospitalization rates

Objective: We study the influence of local reopening policies on the composition of the infectious population and their impact on future hospitalization and mortality rates. Materials and Methods: We collected datasets of daily reported hospitalization and cumulative morality of COVID 19 in Houston, Texas, from May 1, 2020 until June 29, 2020. These datasets are from multiple sources (USA FACTS, Southeast Texas Regional Advisory Council COVID 19 report, TMC daily news, and New York Times county level mortality reporting). Our model, risk stratified SIR HCD uses separate variables to model the dynamics of local contact (e.g., work from home) and high contact (e.g., work on site) subpopulations while sharing parameters to control their respective $R_0(t)$ over time. Results: We evaluated our models forecasting performance in Harris County, TX (the most populated county in the Greater Houston area) during the Phase I and Phase II reopening. Not only did our model outperform other competing models, it also supports counterfactual analysis to simulate the impact of future policies in a local setting, which is unique among existing approaches. Discussion: Local mortality and hospitalization are significantly impacted by quarantine and reopening policies. No existing model has directly accounted for the effect of these policies on local trends in infections, hospitalizations, and deaths in an explicit and explainable manner. Our work is an attempt to close this important technical gap to support decision making. Conclusion: Despite several limitations, we think it is a timely effort to rethink about how to best model the dynamics of pandemics under the influence of reopening policies.

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Secure and Differentially Private Bayesian Learning on Distributed Data

Data integration and sharing maximally enhance the potential for novel and meaningful discoveries. However, it is a non-trivial task as integrating data from multiple sources can put sensitive information of study participants at risk. To address the privacy concern, we present a distributed Bayesian learning approach via Preconditioned Stochastic Gradient Langevin Dynamics with RMSprop, which combines differential privacy and homomorphic encryption in a harmonious manner while protecting private information. We applied the proposed secure and privacy-preserving distributed Bayesian learning approach to logistic regression and survival analysis on distributed data, and demonstrated its feasibility in terms of prediction accuracy and time complexity, compared to the centralized approach.

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Privacy-Preserving Tensor Factorization for Collaborative Health Data Analysis

Tensor factorization has been demonstrated as an efficient approach for computational phenotyping, where massive electronic health records (EHRs) are converted to concise and meaningful clinical concepts. While distributing the tensor factorization tasks to local sites can avoid direct data sharing, it still requires the exchange of intermediary results which could reveal sensitive patient information. Therefore, the challenge is how to jointly decompose the tensor under rigorous and principled privacy constraints, while still support the model's interpretability. We propose DPFact, a privacy-preserving collaborative tensor factorization method for computational phenotyping using EHR. It embeds advanced privacy-preserving mechanisms with collaborative learning. Hospitals can keep their EHR database private but also collaboratively learn meaningful clinical concepts by sharing differentially private intermediary results. Moreover, DPFact solves the heterogeneous patient population using a structured sparsity term. In our framework, each hospital decomposes its local tensors, and sends the updated intermediary results with output perturbation every several iterations to a semi-trusted server which generates the phenotypes. The evaluation on both real-world and synthetic datasets demonstrated that under strict privacy constraints, our method is more accurate and communication-efficient than state-of-the-art baseline methods.

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Model-Protected Multi-Task Learning

Multi-task learning (MTL) refers to the paradigm of learning multiple related tasks together. In contrast, in single-task learning (STL) each individual task is learned independently. MTL often leads to better trained models because they can leverage the commonalities among related tasks. However, because MTL algorithms can ``leak" information from different models across different tasks, MTL poses a potential security risk. Specifically, an adversary may participate in the MTL process through one task and thereby acquire the model information for another task. The previously proposed privacy-preserving MTL methods protect data instances rather than models, and some of them may underperform in comparison with STL methods. In this paper, we propose a privacy-preserving MTL framework to prevent information from each model leaking to other models based on a perturbation of the covariance matrix of the model matrix. We study two popular MTL approaches for instantiation, namely, learning the low-rank and group-sparse patterns of the model matrix. Our algorithms can be guaranteed not to underperform compared with STL methods. We build our methods based upon tools for differential privacy, and privacy guarantees, utility bounds are provided, and heterogeneous privacy budgets are considered. The experiments demonstrate that our algorithms outperform the baseline methods constructed by existing privacy-preserving MTL methods on the proposed model-protection problem.

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Discriminative Sleep Patterns of Alzheimer's Disease via Tensor Factorization

Sleep change is commonly reported in Alzheimer's disease (AD) patients and their brain wave studies show decrease in dreaming and non-dreaming stages. Although sleep disturbance is generally considered as a consequence of AD, it might also be a risk factor of AD as new biological evidence shows. Leveraging National Sleep Research Resource (NSRR), we built a unique cohort of 83 cases and 331 controls with clinical variables and EEG signals. Supervised tensor factorization method was applied for this temporal dataset to extract discriminative sleep patterns. Among the 30 patterns extracted, we identified 5 significant patterns (4 patterns for AD likely and 1 pattern for normal ones) and their visual patterns provide interesting linkage to sleep with repeated wakefulness, insomnia, epileptic seizure, and etc. This study is preliminary but findings are interesting, which is a first step to provide quantifiable evidences to measure sleep as a risk factor of AD.

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From Brain Imaging to Graph Analysis: a study on ADNI's patient cohort

In this paper, we studied the association between the change of structural brain volumes to the potential development of Alzheimer's disease (AD). Using a simple abstraction technique, we converted regional cortical and subcortical volume differences over two time points for each study subject into a graph. We then obtained substructures of interest using a graph decomposition algorithm in order to extract pivotal nodes via multi-view feature selection. Intensive experiments using robust classification frameworks were conducted to evaluate the performance of using the brain substructures obtained under different thresholds. The results indicated that compact substructures acquired by examining the differences between patient groups were sufficient to discriminate between AD and healthy controls with an area under the receiver operating curve of 0.72.

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Combining Representation Learning with Tensor Factorization for Risk Factor Analysis - an application to Epilepsy and Alzheimer's disease

Existing studies consider Alzheimer's disease (AD) a comorbidity of epilepsy, but also recognize epilepsy to occur more frequently in patients with AD than those without. The goal of this paper is to understand the relationship between epilepsy and AD by studying causal relations among subgroups of epilepsy patients. We develop an approach combining representation learning with tensor factorization to provide an in-depth analysis of the risk factors among epilepsy patients for AD. An epilepsy-AD cohort of ~600,000 patients were extracted from Cerner Health Facts data (50M patients). Our experimental results not only suggested a causal relationship between epilepsy and later onset of AD ( p = 1.92e-51), but also identified five epilepsy subgroups with distinct phenotypic patterns leading to AD. While such findings are preliminary, the proposed method combining representation learning with tensor factorization seems to be an effective approach for risk factor analysis.

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Early Prediction of Acute Kidney Injury in Critical Care Setting Using Clinical Notes

Acute kidney injury (AKI) in critically ill patients is associated with significant morbidity and mortality. Development of novel methods to identify patients with AKI earlier will allow for testing of novel strategies to prevent or reduce the complications of AKI. We developed data-driven prediction models to estimate the risk of new AKI onset. We generated models from clinical notes within the first 24 hours following intensive care unit (ICU) admission extracted from Medical Information Mart for Intensive Care III (MIMIC-III). From the clinical notes, we generated clinically meaningful word and concept representations and embeddings, respectively. Five supervised learning classifiers and knowledge-guided deep learning architecture were used to construct prediction models. The best configuration yielded a competitive AUC of 0.779. Our work suggests that natural language processing of clinical notes can be applied to assist clinicians in identifying the risk of incident AKI onset in critically ill patients upon admission to the ICU.

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Efficient Determination of Equivalence for Encrypted Data

Secure computation of equivalence has fundamental application in many different areas, including healthcare. We study this problem in the context of matching an individual identity to link medical records across systems. We develop an efficient solution for equivalence based on existing work that can evaluate the greater than relation. We implement the approach and demonstrate its effectiveness on data, as well as demonstrate how it meets regulatory criteria for risk.

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Federated Tensor Factorization for Computational Phenotyping

Tensor factorization models offer an effective approach to convert massive electronic health records into meaningful clinical concepts (phenotypes) for data analysis. These models need a large amount of diverse samples to avoid population bias. An open challenge is how to derive phenotypes jointly across multiple hospitals, in which direct patient-level data sharing is not possible (e.g., due to institutional policies). In this paper, we developed a novel solution to enable federated tensor factorization for computational phenotyping without sharing patient-level data. We developed secure data harmonization and federated computation procedures based on alternating direction method of multipliers (ADMM). Using this method, the multiple hospitals iteratively update tensors and transfer secure summarized information to a central server, and the server aggregates the information to generate phenotypes. We demonstrated with real medical datasets that our method resembles the centralized training model (based on combined datasets) in terms of accuracy and phenotypes discovery while respecting privacy.

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SAFETY: Secure gwAs in Federated Environment Through a hYbrid solution with Intel SGX and Homomorphic Encryption

Recent studies demonstrate that effective healthcare can benefit from using the human genomic information. For instance, analysis of tumor genomes has revealed 140 genes whose mutations contribute to cancer. As a result, many institutions are using statistical analysis of genomic data, which are mostly based on genome-wide association studies (GWAS). GWAS analyze genome sequence variations in order to identify genetic risk factors for diseases. These studies often require pooling data from different sources together in order to unravel statistical patterns or relationships between genetic variants and diseases. In this case, the primary challenge is to fulfill one major objective: accessing multiple genomic data repositories for collaborative research in a privacy-preserving manner. Due to the sensitivity and privacy concerns regarding the genomic data, multi-jurisdictional laws and policies of cross-border genomic data sharing are enforced among different regions of the world. In this article, we present SAFETY, a hybrid framework, which can securely perform GWAS on federated genomic datasets using homomorphic encryption and recently introduced secure hardware component of Intel Software Guard Extensions (Intel SGX) to ensure high efficiency and privacy at the same time. Different experimental settings show the efficacy and applicability of such hybrid framework in secure conduction of GWAS. To the best of our knowledge, this hybrid use of homomorphic encryption along with Intel SGX is not proposed or experimented to this date. Our proposed framework, SAFETY is up to 4.82 times faster than the best existing secure computation technique.

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Predicting accurate probabilities with a ranking loss

In many real-world applications of machine learning classifiers, it is essential to predict the probability of an example belonging to a particular class. This paper proposes a simple technique for predicting probabilities based on optimizing a ranking loss, followed by isotonic regression. This semi-parametric technique offers both good ranking and regression performance, and models a richer set of probability distributions than statistical workhorses such as logistic regression. We provide experimental results that show the effectiveness of this technique on real-world applications of probability prediction.

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