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We studied how lagged linear regression can be used to detect the physiologic effects of drugs from data in the electronic health record (EHR). We systematically examined the effect of methodological variations ((i) time series construction, (ii) temporal parameterization, (iii) intra-subject normalization, (iv) differencing (lagged rates of change achieved by taking differences between consecutive measurements), (v) explanatory variables, and (vi) regression models) on performance of lagged linear methods in this context. We generated two gold standards (one knowledge-base derived, one expert-curated) for expected pairwise relationships between 7 drugs and 4 labs, and evaluated how the 64 unique combinations of methodological perturbations reproduce gold standards. Our 28 cohorts included patients in Columbia University Medical Center/NewYork-Presbyterian Hospital clinical database. The most accurate methods achieved AUROC of 0.794 for knowledge-base derived gold standard (95%CI [0.741, 0.847]) and 0.705 for expert-curated gold standard (95% CI [0.629, 0.781]). We observed a 0.633 mean AUROC (95%CI [0.610, 0.657], expert-curated gold standard) across all methods that re-parameterize time according to sequence and use either a joint autoregressive model with differencing or an independent lag model without differencing. The complement of this set of methods achieved a mean AUROC close to 0.5, indicating the importance of these choices. We conclude that time- series analysis of EHR data will likely rely on some of the beneficial pre-processing and modeling methodologies identified, and will certainly benefit from continued careful analysis of methodological perturbations. This study found that methodological variations, such as pre-processing and representations, significantly affect results, exposing the importance of evaluating these components when comparing machine-learning methods.
A new class of survival frailty models based on the Generalized Inverse-Gaussian (GIG) distributions is proposed. We show that the GIG frailty models are flexible and mathematically convenient like the popular gamma frailty model. Furthermore, our pr
The central aim in this paper is to address variable selection questions in nonlinear and nonparametric regression. Motivated by statistical genetics, where nonlinear interactions are of particular interest, we introduce a novel and interpretable way
The hematopoietic system has a highly regulated and complex structure in which cells are organized to successfully create and maintain new blood cells. Feedback regulation is crucial to tightly control this system, but the specific mechanisms by whic
Background: During the early stages of hospital admission, clinicians must use limited information to make diagnostic and treatment decisions as patient acuity evolves. However, it is common that the time series vital sign information from patients t
Estimating causal effects for survival outcomes in the high-dimensional setting is an extremely important topic for many biomedical applications as well as areas of social sciences. We propose a new orthogonal score method for treatment effect estima