Subscribe to the gold package and get unlimited access to Shamra Academy
Register a new userA Scalable AI Approach for Clinical Trial Cohort Optimization
65
0
0.0
(
0
)
Added by
Xiong Liu
Publication date
2021
fields
Informatics Engineering
and research's language is
English
Ask ChatGPT about the research
No Arabic abstract
FDA has been promoting enrollment practices that could enhance the diversity of clinical trial populations, through broadening eligibility criteria. However, how to broaden eligibility remains a significant challenge. We propose an AI approach to Cohort Optimization (AICO) through transformer-based natural language processing of the eligibility criteria and evaluation of the criteria using real-world data. The method can extract common eligibility criteria variables from a large set of relevant trials and measure the generalizability of trial designs to real-world patients. It overcomes the scalability limits of existing manual methods and enables rapid simulation of eligibility criteria design for a disease of interest. A case study on breast cancer trial design demonstrates the utility of the method in improving trial generalizability.
rate research
Read More
Clinical decision support tools (DST) promise improved healthcare outcomes by offering data-driven insights. While effective in lab settings, almost all DSTs have failed in practice. Empirical research diagnosed poor contextual fit as the cause. This paper describes the design and field evaluation of a radically new form of DST. It automatically generates slides for clinicians decision meetings with subtly embedded machine prognostics. This design took inspiration from the notion of Unremarkable Computing, that by augmenting the users routines technology/AI can have significant importance for the users yet remain unobtrusive. Our field evaluation suggests clinicians are more likely to encounter and embrace such a DST. Drawing on their responses, we discuss the importance and intricacies of finding the right level of unremarkableness in DST design, and share lessons learned in prototyping critical AI systems as a situated experience.
Clinical trials predicate subject eligibility on a diversity of criteria ranging from patient demographics to food allergies. Trials post their requirements as semantically complex, unstructured free-text. Formalizing trial criteria to a computer-interpretable syntax would facilitate eligibility determination. In this paper, we investigate an information extraction (IE) approach for grounding criteria from trials in ClinicalTrials(dot)gov to a shared knowledge base. We frame the problem as a novel knowledge base population task, and implement a solution combining machine learning and context free grammar. To our knowledge, this work is the first criteria extraction system to apply attention-based conditional random field architecture for named entity recognition (NER), and word2vec embedding clustering for named entity linking (NEL). We release the resources and core components of our system on GitHub at https://github.com/facebookresearch/Clinical-Trial-Parser. Finally, we report our per module and end to end performances; we conclude that our system is competitive with Criteria2Query, which we view as the current state-of-the-art in criteria extraction.
Clinical trials provide essential guidance for practicing Evidence-Based Medicine, though often accompanying with unendurable costs and risks. To optimize the design of clinical trials, we introduce a novel Clinical Trial Result Prediction (CTRP) task. In the CTRP framework, a model takes a PICO-formatted clinical trial proposal with its background as input and predicts the result, i.e. how the Intervention group compares with the Comparison group in terms of the measured Outcome in the studied Population. While structured clinical evidence is prohibitively expensive for manual collection, we exploit large-scale unstructured sentences from medical literature that implicitly contain PICOs and results as evidence. Specifically, we pre-train a model to predict the disentangled results from such implicit evidence and fine-tune the model with limited data on the downstream datasets. Experiments on the benchmark Evidence Integration dataset show that the proposed model outperforms the baselines by large margins, e.g., with a 10.7% relative gain over BioBERT in macro-F1. Moreover, the performance improvement is also validated on another dataset composed of clinical trials related to COVID-19.
We propose a scalable computerized approach for large-scale inference of Liver Imaging Reporting and Data System (LI-RADS) final assessment categories in narrative ultrasound (US) reports. Although our model was trained on reports created using a LI-RADS template, it was also able to infer LI-RADS scoring for unstructured reports that were created before the LI-RADS guidelines were established. No human-labelled data was required in any step of this study; for training, LI-RADS scores were automatically extracted from those reports that contained structured LI-RADS scores, and it translated the derived knowledge to reasoning on unstructured radiology reports. By providing automated LI-RADS categorization, our approach may enable standardizing screening recommendations and treatment planning of patients at risk for hepatocellular carcinoma, and it may facilitate AI-based healthcare research with US images by offering large scale text mining and data gathering opportunities from standard hospital clinical data repositories.
The best evidence concerning comparative treatment effectiveness comes from clinical trials, the results of which are reported in unstructured articles. Medical experts must manually extract information from articles to inform decision-making, which is time-consuming and expensive. Here we consider the end-to-end task of both (a) extracting treatments and outcomes from full-text articles describing clinical trials (entity identification) and, (b) inferring the reported results for the former with respect to the latter (relation extraction). We introduce new data for this task, and evaluate models that have recently achieved state-of-the-art results on similar tasks in Natural Language Processing. We then propose a new method motivated by how trial results are typically presented that outperforms these purely data-driven baselines. Finally, we run a fielded evaluation of the model with a non-profit seeking to identify existing drugs that might be re-purposed for cancer, showing the potential utility of end-to-end evidence extraction systems.
suggested questions
Log in to be able to interact and post comments
comments
Fetching comments
Sign in to be able to follow your search criteria
