Abstract:
BACKGROUND:Chronic diseases management outside expensive hospital settings has become a major target for governments, funders and healthcare service providers. It is well known that chronic diseases such as Type 2 Diabetes (T2D) do not occur in isolation, and has a shared aetiology common to many other diseases and disorders. Diabetes Australia reports that it is associated with a myriad of complications, which affect the feet, eyes, kidneys, and cardiovascular health. For instance, nerve damage in the lower limbs affects around 13% of Australians with diabetes, diabetic retinopathy occurs in over 15% of Australians with diabetes, and diabetes is now the leading cause of end-stage kidney disease. Our research focus is therefore to understand the comorbidity pattern, which in turn can enhance our understanding of the multifactorial risk factors of chronic diseases like Type 2 Diabetes. Our research approach is based on utilising valuable indicators present in pre-existing administrative healthcare data, which are routinely collected but often neglected in health research. One such administrative healthcare data is the hospital admission and discharge data that carries information about diagnoses, which are represented in the form of ICD-10 diagnosis codes. Analysis of diagnoses codes and their relationships helps us construct comorbidity networks which can provide insights that can be used to understand chronic disease progression pattern and comorbidity network at a population level. This understanding can subsequently enable healthcare providers to formulate appropriate preventive health policies targeted to address high-risk chronic conditions. METHODS AND FINDINGS:The research utilises network theory principles applied to administrative healthcare data. Given the high rate of prevalence, we selected Type 2 Diabetes as the exemplar chronic disease. We have developed a research framework to understand and represent the progression of Type 2 diabetes, utilising graph theory and social network analysis techniques. We propose the concept of a 'comorbidity network' that can effectively model chronic disease comorbidities and their transition patterns, thereby representing the chronic disease progression. We further take the attribution effect of the comorbidities into account while generating the network; that is, we not only look at the pattern of disease in chronic disease patients, but also compare the disease pattern with that of non-chronic patients, to understand which comorbidities have a higher influence on the chronic disease pathway. The research framework enables us to construct a baseline comorbidity network for each of the two cohorts. It then compares and merges these two networks into single comorbidity network to discover the comorbidities that are exclusive to diabetic patients. This framework was applied on administrative data drawn from the Australian healthcare context. The overall dataset contained approximately 1.4 million admission records from 0.75 million patients, from which we filtered and sampled the records of 2300 diabetics and 2300 non-diabetic patients. We found significant difference in the health trajectory of diabetic and non-diabetic cohorts. The diabetic cohort exhibited more comorbidity prevalence and denser network properties. For example, in the diabetic cohort, heart and liver-related disorders, cataract etc. were more prevalent. Over time, the prevalence of diseases in the health trajectory of diabetic cohorts were almost double of the prevalence in the non-diabetic cohort, indicating entirely different ways of disease progression. CONCLUSIONS:The paper presents a research framework based on network theory to understand chronic disease progression along with associated comorbidities that manifest over time. The analysis methods provide insights that can enable healthcare providers to develop targeted preventive health management programs to reduce hospital admissions and associated high costs. The baseline comorbidity network has the potential to be used as the basis to develop a chronic disease risk prediction model.
journal_name
Int J Med Informjournal_title
International journal of medical informaticsauthors
Khan A,Uddin S,Srinivasan Udoi
10.1016/j.ijmedinf.2018.04.001subject
Has Abstractpub_date
2018-07-01 00:00:00pages
1-9eissn
1386-5056issn
1872-8243pii
S1386-5056(18)30307-1journal_volume
115pub_type
杂志文章abstract::The SHARE(1) project (http://www.eu-share.org) was asked to identify the key developments needed to achieve wide adoption and deployment of HealthGrids throughout Europe. The project was asked to organise these as milestones on a road map, so that all technical advances, social actions, economic investments and ethica...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2008.10.003
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To obtain an overview of study designs and study methods used in research evaluating IT in health care, to present a list of quality criteria by which all kinds of reported evaluation studies on IT systems in health care can be assessed, and to assess the quality of reported evaluation studies on IT in health...
journal_title:International journal of medical informatics
pub_type: 杂志文章,评审
doi:10.1016/j.ijmedinf.2006.11.009
更新日期:2008-01-01 00:00:00
abstract::With the growing concern about health issues and the emergence of online communities based on user-generated content (UGC), more and more people are participating in online health communities (OHCs) to exchange opinions and health information. This paper aims to examine whether and how male and female users behave dif...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2017.12.019
更新日期:2018-03-01 00:00:00
abstract::It is becoming increasingly essential for individuals to be able uniquely to identify themselves and each other, even where they may never meet. Access to and use of privileges of membership, whether of a professional association, computer network or health insurance policy depends upon the 'members' being able to pro...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(00)00119-2
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Recent advances in artificial intelligence (AI) have shown great promise in detecting some diseases based on medical images. Most studies developed AI diagnostic systems only using eligible images. However, in real-world settings, ineligible images (including poor-quality and poor-location images) that can c...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2020.104363
更新日期:2021-03-01 00:00:00
abstract:BACKGROUND:Medical Information Technology may be understood as an interdisciplinary study of the conception, design, development, adoption and use of Information Technology (IT) innovations for healthcare provision, management and planning. Concerning the use of IT in reproductive health, the aim of the diverse range o...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2019.04.008
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:The "m" in mHealth is often thought of as the ability to receive health information and monitor behaviors on the go. Little is known about how people actually use mobile vs. traditional access methods and if access method affects engagement and health outcomes. METHODS:This study examines the 3-month outcom...
journal_title:International journal of medical informatics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijmedinf.2014.01.002
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:Efforts in the domain of mobile health, or mHealth, have been criticized for the unfettered proliferation of pilots and a lack of a rigorous evidence base to support these strategies. In this letter, we present the response of a group of researchers in the mHealth community to the recent calls for evidence is...
journal_title:International journal of medical informatics
pub_type: 信件
doi:10.1016/j.ijmedinf.2012.11.016
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVES:This paper has two objectives. First, it categorizes the Twitter handles tweeted flu related information based on the amount of replies and mentions within the Twitter network. The collected Twitter accounts are categorized as media, health related individuals, organizations, government, individuals with no ...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2016.04.009
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Electronic Consultation (e-consults) can provide improved access, enhance patient and provider satisfaction, and reduce beneficiary travel expenses. We explored how e-consults were implemented across three specialty areas, diabetes (Diab), gastroenterology (GI), and neurosurgery (Neuro), at two Veterans Affa...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2017.09.005
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:Heuristic evaluation (HE) is an inspection method that can be used for identifying usability problems of health information systems. There is insufficient evidence to what extent these problems are experienced by users in their working environment. The objective of this study was to investigate the agreement ...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2018.05.012
更新日期:2018-09-01 00:00:00
abstract:UNLABELLED:Given the increasing prevalence of multimorbidity in primary care (PC), interdisciplinary PC teams supported by appropriate clinical information systems (CIS) are needed in order to deal with the complexity of multimorbid patients' care. Our team has developed such a system, called the Da Vinci system. Howev...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2011.11.002
更新日期:2012-02-01 00:00:00
abstract::This paper reviews clinical decision support systems (CDSS) literature, with a focus on evaluation. The literature indicates a general consensus that clinical decision support systems are thought to have the potential to improve care. Evidence is more equivocal for guidelines and for systems to aid physicians with dia...
journal_title:International journal of medical informatics
pub_type: 杂志文章,评审
doi:10.1016/s1386-5056(01)00183-6
更新日期:2001-11-01 00:00:00
abstract::For Medinfo '98, as an exercise in technological forecasting and analysis, we volunteered to project the direction of healthcare informatics into the next century. This paper is an extended discussion of that presentation. We open with the observation that healthcare informatics is merely one of the many endeavors tha...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(98)00161-0
更新日期:1999-02-01 00:00:00
abstract:PURPOSE:Despite the proliferation of telemedicine technology, telemedicine service acceptance has been slow in actual healthcare settings. The purpose of this research is to develop a theoretical model for explaining the predictive factors influencing physicians' willingness to use telemedicine technology to provide he...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2014.05.005
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:There is a growing interest in using natural language processing (NLP) for healthcare-associated infections (HAIs) monitoring. A French project consortium, SYNODOS, developed a NLP solution for detecting medical events in electronic medical records for epidemiological purposes. The objective of this study was...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2018.06.002
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:To investigate the validity of using electronic medical records (EMR) database in a large health organization for identifying patients with clinical depression. METHOD:The Massachusetts General Hospital EMR system was used to generate a sample of primary care patients seen in the primary care clinic in 2007....
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2011.03.014
更新日期:2011-07-01 00:00:00
abstract:PURPOSE:One of the main challenges of eHealth is semantic interoperability of health systems. But, this will only be possible if the capture, representation and access of patient data is standardized. Clinical data models, such as OpenEHR Archetypes, define data structures that are agreed by experts to ensure the accur...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2012.02.007
更新日期:2012-08-01 00:00:00
abstract::Funding constraints, demands for improved efficiency, low staff to student ratios and improved computer software (D. Wright, The use of multimedia computers and software in nurse education, Health Inf. 1 (3) (1995) 101-107.) all combine to produce a situation where a dramatic increase in the use of CBE for tertiary nu...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(98)00057-4
更新日期:1998-06-01 00:00:00
abstract:INTRODUCTION:This article describes the evaluation of a prototype speech-input interface to an anaesthesia patient record, conducted in a full-scale anaesthesia simulator involving six doctor-nurse anaesthetist teams. OBJECTIVE:The aims of the experiment were, first, to assess the potential advantages and disadvantage...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2007.08.007
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Researches on Lifestyle medicine (LM) have emerged in recent years to garner wide attention. Prostate cancer (PCa) could be prevented and treated by positive lifestyles, but the association between lifestyles and PCa is always personalized. OBJECTIVES:In order to solve the heterogeneity and diversity of dif...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2020.104332
更新日期:2021-01-01 00:00:00
abstract::The present computer system is the first of its kind based on problem-oriented medical record (POMR) design developed and operated in a hospital in Hong Kong. It went live in May 1996 with two workstations installed in the medical record office (MRO). Doctors have no direct access to it. They dictate medical notes on ...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(99)00019-2
更新日期:1999-07-01 00:00:00
abstract::To assure sustainability of our health systems and improve quality, implementing integrated wellness, health and social care service models have been proposed. They will need the enabling power of Health ICT facilitated systems and applications. Such solutions support the efficient coordination of service provision ac...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2012.05.008
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:Electronic Medical Records (EMR) have the potential to improve the coordination of healthcare in this country, yet the field of psychiatry has lagged behind other medical disciplines in its adoption of EMR. METHODS:Psychiatrists at 18 of the top US hospitals completed an electronic survey detailing whether ...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2012.11.007
更新日期:2013-04-01 00:00:00
abstract:PURPOSE:The present study evaluated whether an intervention using a short message service (SMS) by personal cellular phone and Internet would reduce cardiovascular risk factors in post-menopausal women with abdominal obesity over 12 weeks. METHODS:This is a quasi-experimental design with pre and post tests. Participan...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2011.12.011
更新日期:2012-06-01 00:00:00
abstract::This paper presents a prototype of a computer-aided design (CAD) diagnostic system for mammography screening to automatically detect and classify microcalcifications (MCCs) in mammograms. It comprises four modules. The first module, called the Mammogram Preprocessing Module, inputs and digitizes mammograms into 8-bit ...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(00)00067-8
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:To develop a comprehensive instrument assessing quality of health-related web sites. METHODS:Phase I consisted of a literature review to identify constructs thought to indicate web site quality and to identify items. During content analysis, duplicate items were eliminated and items that were not clear, mean...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2005.07.034
更新日期:2006-01-01 00:00:00
abstract:UNLABELLED:Health care is moving toward a team effort, with patients as partners. This requires effective communication between physicians and patients, who have different understandings of health and illness. These understandings in turn guide their decisions about management of health and illness. With the introducti...
journal_title:International journal of medical informatics
pub_type: 临床试验,杂志文章
doi:10.1016/s1386-5056(98)00111-7
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:The authors have been conducting text mining analyses (extraction of useful information from text) of Medline records, using Abstracts as the main data source. For literature-based discovery, and other text mining applications as well, all records in a discipline need to be evaluated for determining prior ar...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2004.02.008
更新日期:2004-06-30 00:00:00
abstract::A model of expertise for monitoring antiepileptic drug treatment was implemented in a decision support system. We validated the advice of the system regarding treatment decisions at first follow-up with 265 paper cases based on patient records. The reference for comparison is based on the opinions of neurologists. We ...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(99)00052-0
更新日期:1999-11-01 00:00:00