研究目的
To improve diagnostic classification by integrating electronic medical record (EMR) context signatures with medical imaging data, specifically for optic nerve diseases and diabetes.
研究成果
The integration of EMR context signatures with medical imaging data significantly improves diagnostic classification accuracy for optic nerve diseases, as evidenced by increased AUC values. For diabetes, EMR signatures alone are highly predictive, but imaging features do not add significant value. The PheDAS approach is scalable and effective for leveraging EMR data in medical image computing, aligning with known medical comorbidities and providing a foundation for clinical decision support systems.
研究不足
The study relies on ICD-9 codes from EMR, which may have inconsistencies in coding practices. Imaging data was acquired under varied settings and scanners, potentially introducing variability. The sample sizes for some disease groups are small, and the methods may not generalize to all medical conditions. Future work could incorporate other EMR data like procedure codes and lab results.
1:Experimental Design and Method Selection:
The study uses a phenome-disease association study (PheDAS) approach with a custom Python package (pyPheWAS) to create EMR signatures. Logistic regression with elastic net regularization is employed for classification, and ROC curves are used for evaluation.
2:Sample Selection and Data Sources:
Two studies are conducted: Study 1 uses data from Vanderbilt University Medical Center (VUMC) on optic nerve diseases (glaucoma, intrinsic optic nerve disease, thyroid eye disease, optic nerve edema) with controls from hearing loss patients; Study 2 uses data from the Baltimore Longitudinal Study of Aging (BLSA) on diabetes with age-matched controls. Datasets include EMR data (ICD-9 codes, demographics) and radiological imaging data (CT for Study 1, MRI for Study 2).
3:2). List of Experimental Equipment and Materials:
3. List of Experimental Equipment and Materials: CT and MRI scanners from various brands (e.g., Phillips, Marconi, GE), but specific models are not detailed. Software includes custom Python packages for data processing and analysis.
4:Experimental Procedures and Operational Workflow:
For each study, EMR data is processed to extract PheWAS codes, censored to one year before diagnosis, and age-matched. Imaging data is segmented using multi-atlas segmentation (for CT and MRI) to derive structural metrics. EMR signatures are combined with imaging features, and elastic net classifiers are trained and evaluated using bootstrapping for ROC analysis.
5:Data Analysis Methods:
Statistical analysis involves logistic regression with elastic net regularization, calculation of AUC from ROC curves, and false discovery rate correction for multiple testing.
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