Biomedical subjects

Gregory F Cooper

Publications and source records attributed to Gregory F Cooper.

8 recordsLinked to original sources

PubMed2005

A prediction rule to identify low-risk patients with heart failure.

OBJECTIVES: To derive a prediction rule using data available in the emergency department (ED) to identify a group of patients hospitalized for the treatment of heart failure who are at low risk of death and serious complications. METHODS: The authors analyzed data for all 33,533 patients with a primary hospital discharge diagnosis of heart failure in 1999 who were admitted from EDs in Pennsylvania. Candidate predictors were demographic and medical history variables and the most abnormal examination or diagnostic test values measured in the ED (vital signs only) or on the first day of hospitalization. The authors constructed classification trees to identify a subgroup of patients with an observed rate of death or serious medical complications before discharge < 2%; the tree that identified the subgroup with the lowest rate of this outcome and an inpatient mortality rate < 1% was chosen. RESULTS: Within the entire cohort, 4.5% of patients died and 6.8% survived to hospital discharge after experiencing a serious medical complication. The prediction rule used 21 prognostic factors to classify 17.2% of patients as low risk; 19 (0.3%) died and 59 (1.0%) survived to hospital discharge after experiencing a serious medical complication. CONCLUSIONS: This clinical prediction rule identified a group of patients hospitalized from the ED for the treatment of heart failure who were at low risk of adverse inpatient outcomes. Model performance needs to be examined in a cohort of patients with an ED diagnosis of heart failure and treated as outpatients or hospitalized.

Aged↗

PubMed2004

Accelerating U.S. EHR adoption: how to get there from here. recommendations based on the 2004 ACMI retreat.

Despite growing support for the adoption of electronic health records (EHR) to improve U.S. healthcare delivery, EHR adoption in the United States is slow to date due to a fundamental failure of the healthcare information technology marketplace. Reasons for the slow adoption of healthcare information technology include a misalignment of incentives, limited purchasing power among providers, variability in the viability of EHR products and companies, and limited demonstrated value of EHRs in practice. At the 2004 American College of Medical Informatics (ACMI) Retreat, attendees discussed the current state of EHR adoption in this country and identified steps that could be taken to stimulate adoption. In this paper, based upon the ACMI retreat, and building upon the experiences of the authors developing EHR in academic and commercial settings we identify a set of recommendations to stimulate adoption of EHR, including financial incentives, promotion of EHR standards, enabling policy, and educational, marketing, and supporting activities for both the provider community and healthcare consumers.

Diffusion of Innovation↗

PubMed2004

An evaluation of a system that recommends microarray experiments to perform to discover gene-regulation pathways.

The main topic of this paper is modeling the expected value of experimentation (EVE) for discovering causal pathways in gene expression data. By experimentation we mean both interventions (e.g., a gene knockout experiment) and observations (e.g., passively observing the expression level of a "wild-type" gene). We introduce a system called GEEVE (causal discovery in Gene Expression data using Expected Value of Experimentation), which implements expected value of experimentation in discovering causal pathways using gene expression data. GEEVE provides the following assistance, which is intended to help biologists in their quest to discover gene-regulation pathways: Recommending which experiments to perform (with a focus on "knockout" experiments) using an expected value of experimentation method. Recommending the number of measurements (observational and experimental) to include in the experimental design, again using an EVE method. Providing a Bayesian analysis that combines prior knowledge with the results of recent microarray experimental results to derive posterior probabilities of gene regulation relationships. In recommending which experiments to perform (and how many times to repeat them) the EVE approach considers the biologist's preferences for which genes to focus the discovery process. Also, since exact EVE calculations are exponential in time, GEEVE incorporates approximation methods. GEEVE is able to combine data from knockout experiments with data from wild-type experiments to suggest additional experiments to perform and then to analyze the results of those microarray experimental results. It models the possibility that unmeasured (latent) variables may be responsible for some of the statistical associations among the expression levels of the genes under study. To evaluate the GEEVE system, we used a gene expression simulator to generate data from specified models of gene regulation. The results show that the GEEVE system gives better results than two recently published approaches (1) in learning the generating models of gene regulation and (2) in recommending experiments to perform.

Animals↗

PubMed2004

Causal discovery using a Bayesian local causal discovery algorithm.

This study focused on the development and application of an efficient algorithm to induce causal relationships from observational data. The algorithm, called BLCD, is based on a causal Bayesian network framework. BLCD initially uses heuristic greedy search to derive the Markov Blanket (MB) of a node that serves as the "locality" for the identification of pair-wise causal relationships. BLCD takes as input a dataset and outputs potential causes of the form variable X causally influences variable Y. Identification of the causal factors of diseases and outcomes, can help formulate better management, prevention and control strategies for the improvement of health care. In this study we focused on investigating factors that may contribute causally to infant mortality in the United States. We used the U.S. Linked Birth/Infant Death dataset for 1991 with more than four million records and about 200 variables for each record. Our sample consisted of 41,155 re-cords randomly selected from the whole dataset. Each record had maternal, paternal and child factors and the outcome at the end of the first year--whether the infant survived or not. Using the infant birth and death dataset as input, BLCD out-put six purported causal relationships. Three out of the six relationships seem plausible. Even though we have not yet discovered a clinically novel causal link, we plan to look for novel causal pathways using the full sample.

Algorithms↗

PubMed2003

Creating a text classifier to detect radiology reports describing mediastinal findings associated with inhalational anthrax and other disorders.

OBJECTIVE: The aim of this study was to create a classifier for automatic detection of chest radiograph reports consistent with the mediastinal findings of inhalational anthrax. DESIGN: The authors used the Identify Patient Sets (IPS) system to create a key word classifier for detecting reports describing mediastinal findings consistent with anthrax and compared their performances on a test set of 79,032 chest radiograph reports. MEASUREMENTS: Area under the ROC curve was the main outcome measure of the IPS classifier. Sensitivity and specificity of an initial IPS model were calculated based on an existing key word search and were compared against a Boolean version of the IPS classifier. RESULTS: The IPS classifier received an area under the ROC curve of 0.677 (90% CI = 0.628 to 0.772) with a specificity of 0.99 and maximum sensitivity of 0.35. The initial IPS model attained a specificity of 1.0 and a sensitivity of 0.04. CONCLUSION: The IPS system is a useful tool for helping domain experts create a statistical key word classifier for textual reports that is a potentially useful component in surveillance of radiographic findings suspicious for anthrax.

Anthrax↗

PubMed2003

Detecting adverse drug events in discharge summaries using variations on the simple Bayes model.

Detection and prevention of adverse events and, in particular, adverse drug events (ADEs), is an important problem in health care today. We describe the implementation and evaluation of four variations on the simple Bayes model for identifying ADE-related discharge summaries. Our results show that these probabilistic techniques achieve an ROC curve area of up to 0.77 in correctly determining which patient cases should be assigned an ADE-related ICD-9-CM code. These results suggest a potential for these techniques to contribute to the development of an automated system that helps identify ADEs, as a step toward further understanding and preventing them.

Abstracting and Indexing↗

PubMed2003

A computer-based microarray experiment design-system for gene-regulation pathway discovery.

This paper reports the methods and evaluation of a computer-based system that recommends microarray experimental design for biologists - causal discovery in Gene Expression data using Expected Value of Experimentation (GEEVE). The GEEVE system uses causal Bayesian networks and generates a decision tree for recommendations. To evaluate the GEEVE system, we first built an expression simulation model based on a gene regulation model assessed by an expert biologist. Using the simulation model, we conducted a controlled study that involved 10 biologists, some of whom used GEEVE and some of whom did not. The results show that biologists who used GEEVE reached correct causal assessments about gene regulation more often than did those biologists who did not use GEEVE.

Area Under Curve↗

PubMed2002

Discovery of gene-regulation pathways using local causal search.

This paper reports the methods and results of a computer-based algorithm that takes as input the expression levels of a set of genes as given by DNA microarray data, and then searches for causal pathways that represent how the genes regulate each other. The algorithm uses local heuristic search and a Bayesian scoring metric. We applied the algorithm to induce causal networks from a mixture of observational and experimental gene-expression data on genes involved in galactose metabolism in the yeast Saccharomyces cerevisiae. The observational data consisted of gene-expression levels obtained from unmanipulated inverted exclamation mark degrees wild-type inverted exclamation mark +/- cells. The experimental data were produced by deleting ( inverted exclamation mark degrees knocking out inverted exclamation mark +/-) genes and measuring the expression levels of other genes. We used this data to evaluate several variations of the local search method. In each evaluation, causal relationships were predicted for all 36 pairwise combinations of nine key galactose-related genes. These predictions were then compared to the known causal relationships among these genes.

Algorithms↗