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Managing research data is an important and challenging aspect of clinical studies, especially for multi-site collaboratives. To address this challenge, we designed, developed and deployed a multi-faceted, multi-level interactive data tracker (DaT3M) for multi-site clinical research data submission, curation, master inventorying, and sharing. Components of DaT3M include data overview, data portal, data status panel, data query engine, and data downloader. DaT3M managed clinical research data for the Center for SUDEP Research (CSR). The CSR instance of DaT3M includes 2,743 subjects from seven data contributing institutions, 7 data modalities and 10,678 data components: 3,398 Epilepsy Monitoring Unit reports, 3,440 electroencephalography recordings, 629 MRI imaging datasets, 177 bio-chemistry datasets, 722 DNA datasets, 2,289 follow-up forms, and 30 SUDEP forms. Preliminary, structured, one-on-one usability evaluations were performed with 7 researchers from four institutions. System Usability Score reached 85.3, showing that DaT3M has achieved high levels of user satisfaction based on our pilot evaluation.

ObjectiveTo analyze the association between peri-ictal brainstem posturing semiologies with postictal generalized electroencephalographic suppression (PGES) and breathing dysfunction in generalized convulsive seizures (GCS).MethodsIn this prospective, multicenter analysis of GCS, ictal brainstem semiology was classified as (1) decerebration (bilateral symmetric tonic arm extension), (2) decortication (bilateral symmetric tonic arm flexion only), (3) hemi-decerebration (unilateral tonic arm extension with contralateral flexion) and (4) absence of ictal tonic phase. Postictal posturing was also assessed. Respiration was monitored with thoracoabdominal belts, video, and pulse oximetry.ResultsTwo hundred ninety-five seizures (180 patients) were analyzed. Ictal decerebration was observed in 122 of 295 (41.4%), decortication in 47 of 295 (15.9%), and hemi-decerebration in 28 of 295 (9.5%) seizures. Tonic phase was absent in 98 of 295 (33.2%) seizures. Postictal posturing occurred in 18 of 295 (6.1%) seizures. PGES risk increased with ictal decerebration (odds ratio [OR] 14.79, 95% confidence interval [CI] 6.18–35.39,p< 0.001), decortication (OR 11.26, 95% CI 2.96–42.93,p< 0.001), or hemi-decerebration (OR 48.56, 95% CI 6.07–388.78,p< 0.001). Ictal decerebration was associated with longer PGES (p= 0.011). Postictal posturing was associated with postconvulsive central apnea (PCCA) (p= 0.004), longer hypoxemia (p< 0.001), and Spo2recovery (p= 0.035).ConclusionsIctal brainstem semiology is associated with increased PGES risk. Ictal decerebration is associated with longer PGES. Postictal posturing is associated with a 6-fold increased risk of PCCA, longer hypoxemia, and Spo2recovery. Peri-ictal brainstem posturing may be a surrogate biomarker for GCS severity identifiable without in-hospital monitoring.Classification of EvidenceThis study provides Class III evidence that peri-ictal brainstem posturing is associated with the GCS with more prolonged PGES and more severe breathing dysfunction.

With the growing acceptance and expansion of near-infrared spectroscopy as a potential tool in chemical research and industrial quality and process control, it has also become an academic challenge...

Applying machine learning to healthcare sheds light on evidence-based decision making and has shown promises to improve healthcare by combining clinical knowledge and biomedical data. However, medicine and data science are not synchronized. Oftentimes, researchers with a strong data science background do not understand the clinical challenges, while on the other hand, physicians do not know the capacity and limitation of state-of-the-art machine learning methods. The difficulty boils down to the lack of a common interface between two highly intelligent communities due to the privacy concerns and the disciplinary gap. The School of Biomedical Informatics (SBMI) at UTHealth is a pilot in connecting both worlds to promote interdisciplinary research. Recently, the Center for Secure Artificial Intelligence For hEalthcare (SAFE) at SBMI is organizing a series of machine learning healthcare hackathons for real-world clinical challenges. We hosted our first Hackathon themed centered around Sudden Unexpected Death in Epilepsy and finding ways to recognize the warning signs. This community effort demonstrated that interdisciplinary discussion and productive competition has significantly increased the accuracy of warning sign detection compared to the previous work, and ultimately showing a potential of this hackathon as a platform to connect the two communities of data science and medicine.

Background The Kentucky Cancer Registry (KCR) is a central cancer registry for the state of Kentucky that receives data about incident cancer cases from all healthcare facilities in the state within 6 months of diagnosis. Similar to all other U.S. and Canadian cancer registries, KCR uses a data dictionary provided by the North American Association of Central Cancer Registries (NAACCR) for standardized data entry. The NAACCR data dictionary is not an ontological system. Mapping between the NAACCR data dictionary and the National Cancer Institute (NCI) Thesaurus (NCIt) will facilitate the enrichment, dissemination and utilization of cancer registry data. We introduce a web-based system, called Interactive Mapping Interface (IMI), for creating mappings from data dictionaries to ontologies, in particular from NAACCR to NCIt. Method IMI has been designed as a general approach with three components: (1) ontology library; (2) mapping interface; and (3) recommendation engine. The ontology library provides a list of ontologies as targets for building mappings. The mapping interface consists of six modules: project management, mapping dashboard, access control, logs and comments, hierarchical visualization, and result review and export. The built-in recommendation engine automatically identifies a list of candidate concepts to facilitate the mapping process. Results We report the architecture design and interface features of IMI. To validate our approach, we implemented an IMI prototype and pilot-tested features using the IMI interface to map a sample set of NAACCR data elements to NCIt concepts. 47 out of 301 NAACCR data elements have been mapped to NCIt concepts. Five branches of hierarchical tree have been identified from these mapped concepts for visual inspection. Conclusions IMI provides an interactive, web-based interface for building mappings from data dictionaries to ontologies. Although our pilot-testing scope is limited, our results demonstrate feasibility using IMI for semantic enrichment of cancer registry data by mapping NAACCR data elements to NCIt concepts.

Background While electronic health records (EHR) bring various benefits to health care, EHR systems are often criticized as cumbersome to use, failing to fulfill the promise of improved health care delivery with little more than a means of meeting regulatory and billing requirements. EHR has also been recognized as one of the contributing factors for physician burnout. Objective Specialty-specific EHR systems have been suggested as an alternative approach that can potentially address challenges associated with general-purpose EHRs. We introduce the Epilepsy Tracking and optimized Management engine (EpiToMe), an exemplar bespoke EHR system for epilepsy care. EpiToMe uses an agile, physician-centered development strategy to optimize clinical workflow and patient care documentation. We present the design and implementation of EpiToMe and report the initial feedback on its utility for physician burnout. Methods Using collaborative, asynchronous data capturing interfaces anchored to a domain ontology, EpiToMe distributes reporting and documentation workload among technicians, clinical fellows, and attending physicians. Results of documentation are transmitted to the parent EHR to meet patient care requirements with a push of a button. An HL7 (version 2.3) messaging engine exchanges information between EpiToMe and the parent EHR to optimize clinical workflow tasks without redundant data entry. EpiToMe also provides live, interactive patient tracking interfaces to ease the burden of care management. Results Since February 2019, 15,417 electroencephalogram reports, 2635 Epilepsy Monitoring Unit daily reports, and 1369 Epilepsy Monitoring Unit phase reports have been completed in EpiToMe for 6593 unique patients. A 10-question survey was completed by 11 (among 16 invited) senior clinical attending physicians. Consensus was found that EpiToMe eased the burden of care documentation for patient management, a contributing factor to physician burnout. Conclusions EpiToMe offers an exemplar bespoke EHR system developed using a physician-centered design and latest advancements in information technology. The bespoke approach has the potential to ease the burden of care management in epilepsy. This approach is applicable to other clinical specialties.

BACKGROUND While electronic health records (EHR) bring various benefits to health care, EHR systems are often criticized as cumbersome to use, failing to fulfill the promise of improved health care delivery with little more than a means of meeting regulatory and billing requirements. EHR has also been recognized as one of the contributing factors for physician burnout. OBJECTIVE Specialty-specific EHR systems have been suggested as an alternative approach that can potentially address challenges associated with general-purpose EHRs. We introduce the Epilepsy Tracking and optimized Management engine (EpiToMe), an exemplar bespoke EHR system for epilepsy care. EpiToMe uses an agile, physician-centered development strategy to optimize clinical workflow and patient care documentation. We present the design and implementation of EpiToMe and report the initial feedback on its utility for physician burnout. METHODS Using collaborative, asynchronous data capturing interfaces anchored to a domain ontology, EpiToMe distributes reporting and documentation workload among technicians, clinical fellows, and attending physicians. Results of documentation are transmitted to the parent EHR to meet patient care requirements with a push of a button. An HL7 (version 2.3) messaging engine exchanges information between EpiToMe and the parent EHR to optimize clinical workflow tasks without redundant data entry. EpiToMe also provides live, interactive patient tracking interfaces to ease the burden of care management. RESULTS Since February 2019, 15,417 electroencephalogram reports, 2635 Epilepsy Monitoring Unit daily reports, and 1369 Epilepsy Monitoring Unit phase reports have been completed in EpiToMe for 6593 unique patients. A 10-question survey was completed by 11 (among 16 invited) senior clinical attending physicians. Consensus was found that EpiToMe eased the burden of care documentation for patient management, a contributing factor to physician burnout. CONCLUSIONS EpiToMe offers an exemplar bespoke EHR system developed using a physician-centered design and latest advancements in information technology. The bespoke approach has the potential to ease the burden of care management in epilepsy. This approach is applicable to other clinical specialties.

Non-lattice subgraphs are often indicative of structural anomalies in ontological systems. Visualization of SNOMED CT’s non-lattice subgraphs can help make sense of what has been asserted in the hierarchical (“is-a”) relation. More importantly, it can demonstrate what has not been asserted, or “is-not-a,” using Closed-World Assumption for such subgraphs. A feature-rich web-based interactive graph-visualization engine called WINS is introduced, for supporting non-lattice based analysis of ontological systems such as SNOMED CT. A faceted search interface is designed for querying conjunctively specified non-lattice subgraphs. To manage the large number of possible nonlattice subgraphs, MongoDB is used for storing and processing sets of concepts, relationships, and subgraphs, as well as for query optimization. WINS’ interactive visualization interface is implemented in the open source package D3.js. 14 versions of SNOMED CT (US editions from March 2012 to September 2018), with about 170,000 subgraphs in each version, were extracted and imported into WINS. Two types of non-lattice based ontology quality assurance (OQA) tasks were highlighted to demonstrate use cases of WINS in sense-making of such non-lattice subgraphs.

PURPOSE To audit and improve the completeness of the hierarchic (or is-a) relations of the National Cancer Institute (NCI) Thesaurus to support its role as a faceted system for querying cancer registry data. METHODS We performed quality auditing of the 19.01d version of the NCI Thesaurus. Our hybrid auditing method consisted of three main steps: computing nonlattice subgraphs, constructing lexical features for concepts in each subgraph, and performing subsumption reasoning with each subgraph to automatically suggest potentially missing is-a relations. RESULTS A total of 9,512 nonlattice subgraphs were obtained. Our method identified 925 potentially missing is-a relations in 441 nonlattice subgraphs; 72 of 176 reviewed samples were confirmed as valid missing is-a relations and have been incorporated in the newer versions of the NCI Thesaurus. CONCLUSION Autosuggested changes resulting from our auditing method can improve the structural organization of the NCI Thesaurus in supporting its new role for faceted query.

Approximately 60 million people worldwide suffer from epileptic seizures. A key challenge in machine learning ap proaches for epilepsy research is the lack of a data resource of analysis-ready (no additional preprocessing is needed when using the data for developing computational methods) seizure signal datasets with associated tools for seizure data management and visualization. We introduce SeizureBank, a web-based data management and visualization system for epileptic seizures. SeizureBank comes with a built-in seizure data preparation pipeline and web-based interfaces for querying, exporting and visualizing seizure-related signal data. In this pilot study, 224 seizures from 115 patients were extracted from over one terabyte of signal data and deposited in SeizureBank. To demonstrate the value of this approach, we develop a feature-based seizure identification approach and evaluate the performance on a variety of data sources. The results can serve as a cross-dataset evaluation benchmark for future seizure identification studies.

Background Sudden unexpected death in epilepsy (SUDEP) is second only to stroke in neurological events resulting in years of potential life lost. Postictal generalized electroencephalogram (EEG) suppression (PGES) is a period of suppressed brain activity often occurring after generalized tonic-clonic seizure, a most significant risk factor for SUDEP. Therefore, PGES has been considered as a potential biomarker for SUDEP risk. Automatic PGES detection tools can address the limitations of labor-intensive, and sometimes inconsistent, visual analysis. A successful approach to automatic PGES detection must overcome computational challenges involved in the detection of subtle amplitude changes in EEG recordings, which may contain physiological and acquisition artifacts. Objective This study aimed to present a random forest approach for automatic PGES detection using multichannel human EEG recordings acquired in epilepsy monitoring units. Methods We used a combination of temporal, frequency, wavelet, and interchannel correlation features derived from EEG signals to train a random forest classifier. We also constructed and applied confidence-based correction rules based on PGES state changes. Motivated by practical utility, we introduced a new, time distance–based evaluation method for assessing the performance of PGES detection algorithms. Results The time distance–based evaluation showed that our approach achieved a 5-second tolerance-based positive prediction rate of 0.95 for artifact-free signals. For signals with different artifact levels, our prediction rates varied from 0.68 to 0.81. Conclusions We introduced a feature-based, random forest approach for automatic PGES detection using multichannel EEG recordings. Our approach achieved increasingly better time distance–based performance with reduced signal artifact levels. Further study is needed for PGES detection algorithms to perform well irrespective of the levels of signal artifacts.

Objective: Quality assurance of large ontological systems such as SNOMED CT is an indispensable part of the terminology management lifecycle. We introduce a hybrid structural-lexical method for scalable and systematic discovery of missing hierarchical relations and concepts in SNOMED CT. Material and Methods: All non-lattice subgraphs (the structural part) in SNOMED CT are exhaustively extracted using a scalable MapReduce algorithm. Four lexical patterns (the lexical part) are identified among the extracted non-lattice subgraphs. Non-lattice subgraphs exhibiting such lexical patterns are often indicative of missing hierarchical relations or concepts. Each lexical pattern is associated with a potential specific type of error. Results: Applying the structural-lexical method to SNOMED CT (September 2015 US edition), we found 6801 non-lattice subgraphs that matched these lexical patterns, of which 2046 were amenable to visual inspection. We evaluated a random sample of 100 small subgraphs, of which 59 were reviewed in detail by domain experts. All the subgraphs reviewed contained errors confirmed by the experts. The most frequent type of error was missing is-a relations due to incomplete or inconsistent modeling of the concepts. Conclusions: Our hybrid structural-lexical method is innovative and proved effective not only in detecting errors in SNOMED CT, but also in suggesting remediation for these errors.

About 20% of individuals with attention deficit hyperactivity disorder (ADHD) are first diagnosed during adolescence. While preclinical experiments suggest that adolescent-onset exposure to ADHD medication is an important factor in the development of substance use disorder (SUD) phenotypes in adulthood, the long-term impact of ADHD medication initiated during adolescence has been largely unexplored in humans. Our analysis of 11,624 adolescent ADHD patients in the Truven database indicates that temporal medication features are the important factors on the health consequences related to SUD and ADHD medication initiation during adolescence.

Insomnia is prevalent in the general population and is often difficult to be identified reliably. The sleep spindle is a key electroencephalograph (EEG) signal that plays an important role in the preservation of sleep continuity. Previous studies on the relationship between spindle and insomnia mainly focus on the density distribution of spindle waves. In this article, we leverage the large amount of sleep data in the National Sleep Research Resource (NSRR) to develop two sequence models to take into consideration the temporal features of sleep spindles in the whole night sleep recording, and treat the interplay between insomnia and sleep spindle wave as a continuous process. The experimental results on two study cohorts of NSRR show that our method achieved the best performance among all the compared methods, indicating that it is the temporal feature of spindles, rather than stationary features (i.e., frequency, duration, amplitude) that are critical for identifying insomnia patients.

About 20% of individuals with attention deficit hyperactivity disorder are first diagnosed during adolescence. While preclinical experiments suggest that adolescent-onset exposure to attention deficit hyperactivity disorder medication is an important factor in the development of substance use disorder phenotypes in adulthood, the long-term impact of attention deficit hyperactivity disorder medication initiated during adolescence has been largely unexplored in humans. Our analysis of 11,624 adolescent enrollees with attention deficit hyperactivity disorder in the Truven database indicates that temporal medication features, rather than stationary features, are the most important factors on the health consequences related to substance use disorder and attention deficit hyperactivity disorder medication initiation during adolescence.

Objective: The gold standard for diagnosing sleep disorders is polysomnography, which generates extensive data about biophysical changes occurring during sleep. We developed the National Sleep Research Resource (NSRR), a comprehensive system for sharing sleep data. The NSRR embodies elements of a data commons aimed at accelerating research to address critical questions about the impact of sleep disorders on important health outcomes. Approach: We used a metadata-guided approach, with a set of common sleep-specific terms enforcing uniform semantic interpretation of data elements across three main components: (1) annotated datasets; (2) user interfaces for accessing data; and (3) computational tools for the analysis of polysomnography recordings. We incorporated the process for managing dataset-specific data use agreements, evidence of Institutional Review Board review, and the corresponding access control in the NSRR web portal. The metadata-guided approach facilitates structural and semantic interoperability, ultimately leading to enhanced data reusability and scientific rigor. Results: The authors curated and deposited retrospective data from 10 large, NIH-funded sleep cohort studies, including several from the Trans-Omics for Precision Medicine (TOPMed) program, into the NSRR. The NSRR currently contains data on 26,808 subjects and 31,166 signal files in European Data Format. Launched in April 2014, over 3000 registered users have downloaded over 130 terabytes of data. Conclusions: The NSRR offers a use case and an example for creating a full-fledged data commons. It provides a single point of access to analysis-ready physiological signals from polysomnography obtained from multiple sources, and a wide variety of clinical data to facilitate sleep research. The NIH Data Commons (or Commons) is an ambitious vision for a shared virtual space to allow digital objects to be stored and computed upon by the scientific community. The Commons would allow investigators to find, manage, share, use and reuse data, software, metadata and workflows. It imagines an ecosystem that makes digital objects Findable, Accessible, Interoperable and Reusable (FAIR). Four components are considered integral parts of the Commons: a computing resource for accessing and processing of digital objects; a "digital object compliance model" that describes the properties of digital objects that enable them to be FAIR; datasets that adhere to the digital object compliance model; and software and services to facilitate access to and use of data. This paper describes the contributions of NSRR along several aspects of the Commons vision: metadata for sleep research digital objects; a collection of annotated sleep data sets; and interfaces and tools for accessing and analyzing such data. More importantly, the NSRR provides the design of a functional architecture for implementing a Sleep Data Commons. The NSRR also reveals complexities and challenges involved in making clinical sleep data conform to the FAIR principles. Future directions: Shared resources offered by emerging resources such as cloud instances provide promising platforms for the Data Commons. However, simply expanding storage or adding compute power may not allow us to cope with the rapidly expanding volume and increasing complexity of biomedical data. Concurrent efforts must be spent to address digital object organization challenges. To make our approach future-proof, we need to continue advancing research in data representation and interfaces for human-data interaction. A possible next phase of NSRR is the creation of a universal self-descriptive sequential data format. The idea is to break large, unstructured, sequential data files into minimal, semantically meaningful, fragments. Such fragments can be indexed, assembled, retrieved, rendered, or repackaged on-the-fly, for multitudes of application scenarios. Data points in such a fragment will be locally embedded with relevant metadata labels, governed by terminology and ontology. Potential benefits of such an approach may include precise levels of data access, increased analysis readiness with on-the-fly data conversion, multi-level data discovery and support for effective web-based visualization of contents in large sequential files.

To help researchers better access clinical data, we developed a prototype query engine called DataSphere for exploring large-scale integrated clinical data repositories. DataSphere expedites data importing using a NoSQL data management system and dynamically renders its user interface for concept-based querying tasks. DataSphere provides an interactive query-building interface together with query translation and optimization strategies, which enable users to build and execute queries effectively and efficiently. We successfully loaded a dataset of one million patients for University of Kentucky (UK) Healthcare into DataSphere with more than 300 million clinical data records. We evaluated DataSphere by comparing it with an instance of i2b2 deployed at UK Healthcare, demonstrating that DataSphere provides enhanced user experience for both query building and execution.

BACKGROUND Pressure ulcers (PU) and deep tissue injuries (DTI), collectively known as pressure injuries are serious complications causing staggering costs and human suffering with over 200 reported risk factors from many domains. Primary pressure injury prevention seeks to prevent the first incidence, while secondary PU/DTI prevention aims to decrease chronic recurrence. Clinical practice guidelines (CPG) combine evidence-based practice and expert opinion to aid clinicians in the goal of achieving best practices for primary and secondary prevention. The correction of all risk factors can be both overwhelming and impractical to implement in clinical practice. There is a need to develop practical clinical tools to prioritize the multiple recommendations of CPG, but there is limited guidance on how to prioritize based on individual cases. Bioinformatics platforms enable data management to support clinical decision support and user-interface development for complex clinical challenges such as pressure injury prevention care planning. OBJECTIVE The central hypothesis of the study is that the individual’s risk factor profile can provide the basis for adaptive, personalized care planning for PU prevention based on CPG prioritization. The study objective is to develop the Spinal Cord Injury Pressure Ulcer and Deep Tissue Injury (SCIPUD+) Resource to support personalized care planning for primary and secondary PU/DTI prevention. METHODS The study is employing a retrospective electronic health record (EHR) chart review of over 75 factors known to be relevant for pressure injury risk in individuals with a spinal cord injury (SCI) and routinely recorded in the EHR. We also perform tissue health assessments of a selected sub-group. A systems approach is being used to develop and validate the SCIPUD+ Resource incorporating the many risk factor domains associated with PU/DTI primary and secondary prevention, ranging from the individual’s environment to local tissue health. Our multiscale approach will leverage the strength of bioinformatics applied to an established national EHR system. A comprehensive model is being used to relate the primary outcome of interest (PU/DTI development) with over 75 PU/DTI risk factors using a retrospective chart review of 5000 individuals selected from the study cohort of more than 36,000 persons with SCI. A Spinal Cord Injury Pressure Ulcer and Deep Tissue Injury Ontology (SCIPUDO) is being developed to enable robust text-mining for data extraction from free-form notes. RESULTS The results from this study are pending. CONCLUSIONS PU/DTI remains a highly significant source of morbidity for individuals with SCI. Personalized interactive care plans may decrease both initial PU formation and readmission rates for high-risk individuals. The project is using established EHR data to build a comprehensive, structured model of environmental, social and clinical pressure injury risk factors. The comprehensive SCIPUD+ health care tool will be used to relate the primary outcome of interest (pressure injury development) with covariates including environmental, social, clinical, personal and tissue health profiles as well as possible interactions among some of these covariates. The study will result in a validated tool for personalized implementation of CPG recommendations and has great potential to change the standard of care for PrI clinical practice by enabling clinicians to provide personalized application of CPG priorities tailored to the needs of each at-risk individual with SCI. REGISTERED REPORT IDENTIFIER RR1-10.2196/10871

Sudden Unexpected Death in Epilepsy (SUDEP) is the leading mode of epilepsy-related death and is most common in patients with intractable, frequent, and continuing seizures. Magnetic Resonance Imaging (MRI) and other neuroimaging techniques create an important data source for investigators to collaborate and share a larger cohort of potential SUDEP patient data. To address the challenges of sharing neuroimaging data across institutions with good semantic precision, we developed ImageSfERe, a web-based image sharing module for Epilepsy Research. Since various aspects of patient information need to be harmonized and integrated, a dedicated questionnaire consisting of 248 questions about patient background information is incorporated into ImageSfERe. Eight repositories of patient de-identified images in Digital Image and Communications in Medicine (DICOM) format, over 23 GB of data, have been successfully processed and made available via ImageSfERe. To enable interoperability, we also adapted epilepsy neuroimaging common data elements from the National Institute of Health (NIH).

Automatic identification of sleep stage is an important step in a sleep study. In this paper, we propose a hybrid automatic sleep stage scoring approach, named HyCLASSS, based on single channel electroencephalogram (EEG). HyCLASSS, for the first time, leverages both signal and stage transition features of human sleep for automatic identification of sleep stages. HyCLASSS consists of two parts: A random forest classifier and correction rules. Random forest classifier is trained using 30 EEG signal features, including temporal, frequency, and nonlinear features. The correction rules are constructed based on stage transition feature, importing the continuity property of sleep, and characteristic of sleep stage transition. Compared with the gold standard of manual scoring using Rechtschaffen and Kales criterion, the overall accuracy and kappa coefficient applied on 198 subjects has reached 85.95% and 0.8046 in our experiment, respectively. The performance of HyCLASS compared favorably to previous work, and it could be integrated with sleep evaluation or sleep diagnosis system in the future.

Ontology search interfaces can benefit from the latest information retrieval advances. This paper introduces a Conjunctive Ontology Browser and Explorer (COBE) for searching and exploring SNOMED CT concepts and visualizing SNOMED CT fragments. COBE combines navigational exploration (NE) with direct lookup (DL) as two complementary modes for finding specific SNOMED CT concepts. The NE mode allows a user to interactively and incrementally narrow down (hence conjunctive) the search space by adding word stems, one at a time. Such word stems serve as attribute constraints, or “attributes” in Formal Concept Analysis, which allows the user to navigate to specific SNOMED CT concept clusters. The DL mode represents the common search mechanism by using a collection of key words, as well as concept identifiers. With respect to the DL mode, evaluation against manually created reference standard showed that COBE attains an example-based precision of 0.958, recall of 0.917, and F1 measure of 0.875. With respect to the NE mode, COBE leverages 28,371 concepts in non-lattice fragments to construct the stem cloud. With merely 9.37% of the total SNOMED CT stem cloud, our navigational exploration mode covers 98.97% of the entire concept collection.

Parkinson’s Disease is a common chronic neurological motor system disorder that affects more than 10 million people worldwide with no known cure. With Deep Brain Stimulation (DBS) emerging as one of the main treatments for Parkinson’s Disease, the effective capture, retrieval, and analysis of data generated from DBS are important informatics challenges. To address these challenges, this paper presents the design and implementation of Neuro3D, a web-interfaced system for DBS data capture and management in the clinical setting. Neuro3D provides: (1) data capture interfaces with multiple data entry assistances and validations to improve both the data entry efficiency and the data quality; (2) intuitive data organization that mirrors the workflow of clinical operations; and (3) a novel data exploration as a basis for clinical decision support. Neuro3D accomplishes these utilizing an agile development strategy called Web-Interface-Driven Development (WIDD) to optimize the communication between software developers and domain experts. 36 distinct data forms consisting of 1109 discrete data elements are captured and managed in Neuro3D. Pilot deployment of Neuro3D in the Movement Disorders Center of the University Hospitals Neurological Institute in Cleveland captured clinical data for 236 patients, in a comprehensive and research-ready fashion beyond the scope of current EMR. Neuro3D fills an important void in terms of tools for capturing large-scale clinical neurology data to improve care and outcome for patients with Parkinson’s disease.