ObjectiveTo assess the association of symptoms of depression and anxiety with sexual risk behavio... more ObjectiveTo assess the association of symptoms of depression and anxiety with sexual risk behaviour and history, among women and heterosexual men attending genitourinary medicine (GUM) clinics.MethodsAttitudes to and Understanding of Risk of Acquisition of HIV (AURAH) was a cross-sectional, self-administered questionnaire study recruited from 20 GUM clinics in England, 2013–2014. This analysis included women and heterosexual men. The prevalence of depression and anxiety symptoms was assessed. Modified Poisson regression was used to produce adjusted prevalence ratios (aPR) for the association of t demographic, socioeconomic and lifestyle factors with depression and anxiety, adjusted for gender, age, ethnicity, education level and study region. Among individuals reporting sex in the past 3 months, associations of depression and anxiety with sexual risk behaviour and history were assessed separately by gender, adjusted for age, ethnicity, study region, education and relationship status...
ImportanceInsomnia has been associated with altered inflammatory response as well as increased ri... more ImportanceInsomnia has been associated with altered inflammatory response as well as increased risk of infections and sepsis in observational studies. However, these studies are prone to bias, such as residual confounding. To further understand the potential causal association between insomnia and sepsis risk, a 2-sample Mendelian randomization (MR) approach should be explored.ObjectiveTo evaluate whether genetically predicted insomnia is associated with risk of sepsis.Design, Setting, and ParticipantsTwo-sample MR was performed to estimate the association between genetically predicted insomnia and sepsis risk. Data were obtained from a genome-wide association study identifying 555 independent genetic variants (R2 < 0.01) strongly associated with insomnia (P < 5 × 10−8). Sensitivity analyses were conducted to address bias due to pleiotropy and sample overlap, along with mediation analyses and sex-stratified analyses. The insomnia data set included 2.4 million individuals of Eu...
ObjectivesTo estimate temporal trends in incidence rate (IR) and case fatality during a 14-year p... more ObjectivesTo estimate temporal trends in incidence rate (IR) and case fatality during a 14-year period from 2008 to 2021, and to assess possible shifts in these trends during the COVID-19 pandemic.SettingAll Norwegian hospitals 2008–2021.Participants317 705 patients ≥18 year with a sepsis International Classification of Diseases 10th revision code retrieved from The Norwegian Patient Registry.Primary and secondary measuresAnnual age-standardised IRs with 95% CIs. Poisson regression was used to estimate changes in IRs across time, and logistic regression was used to estimate ORs for in-hospital death.ResultsAmong 12 619 803 adult hospitalisations, a total of 317 705 (2.5%) hospitalisations in 222 832 (70.0%) unique patients met the sepsis criteria. The overall age-standardised IR of a first sepsis admission was 246/100 000 (95% CI 245 to 247), whereas the age-standardised IR of all sepsis admissions was 352/100 000 (95% CI 351 to 354). In the period 2009–2019, the annual IR for a fir...
ObjectivesThere is a lack of data regarding the quality of peripheral intravenous catheter (PIVC)... more ObjectivesThere is a lack of data regarding the quality of peripheral intravenous catheter (PIVC)-related care from low-income and middle-income countries, even though the use of PIVCs may lead to local or severe systemic infections. Our main objective was to assess the feasibility and inter-rater agreement on the PIVC-mini Questionnaire (PIVC-miniQ) in a tertiary care hospital in Nepal.DesignWe performed an observational cross-sectional quantitative study using the PIVC-miniQ to collect information on PIVC quality.SettingSecondary care in a Nepalese hospital. All patients with PIVCs in selected wards were included in the study and PIVCs were assessed independently by two raters. Eight Nepalese nurses, one Nepalese student and three Norwegian students participated as raters.Primary and secondary outcome measuresThe intraclass correlation coefficient (ICC), positive, negative, absolute agreement, Scott’s pi and sum score were calculated using PIVC-miniQ. We also aimed to describe PIV...
Background Few studies have reported on mortality beyond one year after sepsis. We aim to describ... more Background Few studies have reported on mortality beyond one year after sepsis. We aim to describe trends in short- and long-term mortality among patients admitted with sepsis, and to identify clinical characteristics associated with mortality for improved monitoring, treatment and prognosis. Methods Patients ≥ 18 years admitted to all Norwegian hospitals (2008–2021) with a first sepsis episode were identified using Norwegian Patient Registry and International Classification of Diseases 10th Revision codes. Sepsis was classified as implicit (known infection site plus organ dysfunction), explicit (unknown infection site), or COVID-19 related sepsis. The outcome was all-cause mortality. We calculated age-standardized 30-day, 90-day, 1-, 5- and 10-year mortality for each admission year and estimated the annual percentage change with 95% confidence interval (CI). The association between clinical characteristics and all-cause mortality is reported as hazard ratios (HRs) from Cox regressi...
Annotations enrich text corpora and provide necessary labels for natural language processing stud... more Annotations enrich text corpora and provide necessary labels for natural language processing studies. To reason and infer underlying implicit knowledge captured by labels, an ontology is needed to provide a semantically annotated corpus with structured domain knowledge. Utilizing a corpus of adverse event documents annotated for sepsis-related signs and symptoms as a use case, this paper details how a terminology and corresponding ontology were developed. The Annotated Adverse Event NOte TErminology (AAENOTE) represents annotated documents and assists annotators in annotating text. In contrast, the complementary Catheter Infection Indications Ontology (CIIO) is intended for clinician use and captures domain knowledge needed to reason and infer implicit information from data. The approach taken makes ontology development understandable and accessible to domain experts without formal ontology training.
ImportanceSepsis is one of the leading causes of morbidity and mortality. The majority of sepsis ... more ImportanceSepsis is one of the leading causes of morbidity and mortality. The majority of sepsis cases is attributed to bacterial infections, but virus infections can also induce sepsis. Conflicting results in incidence rates and case fatality trends of sepsis is reported, and how the COVID-19 pandemic influenced these trends are unknown.ObjectiveTo estimate temporal trends in incidence rate and case fatality during a 14-year period from 2008 through 2021, and to assess possible shifts in these trends during the COVID-19 pandemic.DesignA nationwide longitudinal registry study using ICD-10 discharge codes to identify sepsis.SettingAll Norwegian hospitals from 2008 through 2021.ParticipantsAll sepsis cases included 317.705 patients and of these, 222.832 had a first sepsis episode.Main outcomes and measuresAnnual age-standardized incidence rates with 95% confidence intervals (CI). Poisson regression was used to estimate changes in incidence rates across time, and logistic regression wa...
Previous studies indicate sex differences in incidence and severity of bloodstream infections (BS... more Previous studies indicate sex differences in incidence and severity of bloodstream infections (BSI). We examined the effect of sex on risk of BSI, BSI mortality, and BSI caused by the most common infecting bacteria. Using causal mediation analyses, we assessed if this effect is mediated by health behaviours (smoking, alcohol consumption), education, cardiovascular risk factors (systolic blood pressure, non-HDL cholesterol, body mass index) and selected comorbidities. This prospective study included 64,040 participants (46.8% men) in the population-based HUNT2 Survey (1995–1997) linked with hospital records in incident BSI. During median follow-up of 15.2 years, 1840 (2.9%) participants (51.3% men) experienced a BSI and 396 (0.6%) died (56.6% men). Men had 41% higher risk of first-time BSI (95% confidence interval (CI), 28–54%) than women. Together, health behaviours, education, cardiovascular risk factors and comorbidities mediated 34% of the excess risk of BSI observed in men. The ...
ObjectivePrevious research suggest decreased immune function and increased risk of infections in ... more ObjectivePrevious research suggest decreased immune function and increased risk of infections in persons with insomnia. We examined the effect of insomnia symptoms on risk of bloodstream infections (BSI) and BSI-related mortality in a population-based prospective study.MethodsA total of 53,536 participants in the Norwegian HUNT2 study (1995–97) were linked to prospective data on clinically relevant BSIs until 2011. In Cox regression, we estimated hazard ratios (HRs) with 95% confidence interval (CI) for a first-time BSI and for BSI related mortality (BSI registered ≤30 days prior to death) associated with insomnia symptoms.ResultsCompared with participants who reported “no symptoms of insomnia”, participants reporting having “difficulty initiating sleep” often/almost every night had a HR for a first-time BSI of 1.14 (95% CI 0.96–1.34). Participants reporting “difficulties maintaining sleep” often/almost every night had a HR of 1.19 (95% CI 1.01–1.40), whereas those having a “feeling...
Background: Studies suggest increased risk for an outcome in people with joint exposures that sha... more Background: Studies suggest increased risk for an outcome in people with joint exposures that share common causal pathways. The objective of this study was to determine the risk of incident acute myocardial infarction (AMI) following exposure to both albuminuria and/or anxiety and depression symptoms.Methods: Participants who provided urine samples to the HUNT2 (1995–97) or HUNT3 (2007–2009) surveys were followed until the end of 2016. Albuminuria was measured by Albumin Creatine Ratio (ACR) and participants self-reported mood and anxiety symptoms on the Hospital Anxiety and Depression scale. We used Cox regression to estimate hazard ratios (HRs) for first incident AMI considering interaction between exposures and additive models to calculate the proportion of AMI that were attributable to the synergy of both exposures, adjusted for the Framingham variables.Results: 11 014 participants free of previous AMI were eligible for participation, with 1 234 incident AMIs occurred during a m...
2021 IEEE International Conference on Bioinformatics and Biomedicine (BIBM), 2021
In the clinical domain, patient states such as sepsis due to bloodstream infection (BSI) result i... more In the clinical domain, patient states such as sepsis due to bloodstream infection (BSI) result in observable symptoms and signs used to determine diagnosis and treatment, all of which often is documented in electronic health records. However, clinical text is brief and implicit, making it challenging to infer patient conditions by reasoning tasks and supervised machine learning. To study sepsis-related BSIs, we developed an ontology from an annotation guideline and annotated corpus that empirically captures BSIs from adverse event notes containing procedural deviations, guideline deviations, and unwanted incidents that can bring harm to patients. The resulting ontology represents (1) the physical patient state, clinical observations, and clinical documentation, and (2) background clinical knowledge for artificial intelligence, reasoning, and machine learning.
The association between pulmonary sequelae and markers of disease severity, as well as pro-fibrot... more The association between pulmonary sequelae and markers of disease severity, as well as pro-fibrotic mediators, were studied in 108 patients 3 months after hospital admission for COVID-19. The COPD assessment test (CAT-score), spirometry, diffusion capacity of the lungs (DLCO), and chest-CT were performed at 23 Norwegian hospitals included in the NOR-SOLIDARITY trial, an open-labelled, randomised clinical trial, investigating the efficacy of remdesivir and hydroxychloroquine (HCQ). Thirty-eight percent had a CAT-score ≥ 10. DLCO was below the lower limit of normal in 29.6%. Ground-glass opacities were present in 39.8% on chest-CT, parenchymal bands were found in 41.7%. At admission, low pO2/FiO2 ratio, ICU treatment, high viral load, and low antibody levels, were predictors of a poorer pulmonary outcome after 3 months. High levels of matrix metalloproteinase (MMP)-9 during hospitalisation and at 3 months were associated with persistent CT-findings. Except for a negative effect of rem...
ObjectivePrevious studies on thyroid function and risk of infection is conflicting and often stem... more ObjectivePrevious studies on thyroid function and risk of infection is conflicting and often stem from intensive care cohorts were nonthyroidal illness syndrome (NTIS) may be present. The objective of this study was to identify the risk of bloodstream infections (BSI) and BSI‐related mortality with thyroid‐stimulating hormone (TSH) levels within the reference range in a general population.DesignProspective follow‐up.ParticipantsThe HUNT2 (1995‐97) included 34,619 participants with information on TSH levels.MeasurementsHazard ratios (HRs) with 95% confidence interval (CI) confirmed BSIs and BSI‐related mortality until 2011.ResultsDuring a median follow‐up of 14.5 years, 1179 experienced at least one episode of BSI and 208 died within 30 days after a BSI. TSH levels within the reference range of 0.5–4.5 mU/L were not associated with the risk of first‐time BSI, with an HR of 0.97 (95% CI: 0.90–1.04) per mU/L. Stratified by baseline age < or ≥65 years, TSH was inversely associated wi...
Journal of the American Medical Informatics Association, 2021
Objective To determine the effects of using unstructured clinical text in machine learning (ML) f... more Objective To determine the effects of using unstructured clinical text in machine learning (ML) for prediction, early detection, and identification of sepsis. Materials and methods PubMed, Scopus, ACM DL, dblp, and IEEE Xplore databases were searched. Articles utilizing clinical text for ML or natural language processing (NLP) to detect, identify, recognize, diagnose, or predict the onset, development, progress, or prognosis of systemic inflammatory response syndrome, sepsis, severe sepsis, or septic shock were included. Sepsis definition, dataset, types of data, ML models, NLP techniques, and evaluation metrics were extracted. Results The clinical text used in models include narrative notes written by nurses, physicians, and specialists in varying situations. This is often combined with common structured data such as demographics, vital signs, laboratory data, and medications. Area under the receiver operating characteristic curve (AUC) comparison of ML methods showed that utilizin...
ObjectiveTo assess the association of symptoms of depression and anxiety with sexual risk behavio... more ObjectiveTo assess the association of symptoms of depression and anxiety with sexual risk behaviour and history, among women and heterosexual men attending genitourinary medicine (GUM) clinics.MethodsAttitudes to and Understanding of Risk of Acquisition of HIV (AURAH) was a cross-sectional, self-administered questionnaire study recruited from 20 GUM clinics in England, 2013–2014. This analysis included women and heterosexual men. The prevalence of depression and anxiety symptoms was assessed. Modified Poisson regression was used to produce adjusted prevalence ratios (aPR) for the association of t demographic, socioeconomic and lifestyle factors with depression and anxiety, adjusted for gender, age, ethnicity, education level and study region. Among individuals reporting sex in the past 3 months, associations of depression and anxiety with sexual risk behaviour and history were assessed separately by gender, adjusted for age, ethnicity, study region, education and relationship status...
ImportanceInsomnia has been associated with altered inflammatory response as well as increased ri... more ImportanceInsomnia has been associated with altered inflammatory response as well as increased risk of infections and sepsis in observational studies. However, these studies are prone to bias, such as residual confounding. To further understand the potential causal association between insomnia and sepsis risk, a 2-sample Mendelian randomization (MR) approach should be explored.ObjectiveTo evaluate whether genetically predicted insomnia is associated with risk of sepsis.Design, Setting, and ParticipantsTwo-sample MR was performed to estimate the association between genetically predicted insomnia and sepsis risk. Data were obtained from a genome-wide association study identifying 555 independent genetic variants (R2 < 0.01) strongly associated with insomnia (P < 5 × 10−8). Sensitivity analyses were conducted to address bias due to pleiotropy and sample overlap, along with mediation analyses and sex-stratified analyses. The insomnia data set included 2.4 million individuals of Eu...
ObjectivesTo estimate temporal trends in incidence rate (IR) and case fatality during a 14-year p... more ObjectivesTo estimate temporal trends in incidence rate (IR) and case fatality during a 14-year period from 2008 to 2021, and to assess possible shifts in these trends during the COVID-19 pandemic.SettingAll Norwegian hospitals 2008–2021.Participants317 705 patients ≥18 year with a sepsis International Classification of Diseases 10th revision code retrieved from The Norwegian Patient Registry.Primary and secondary measuresAnnual age-standardised IRs with 95% CIs. Poisson regression was used to estimate changes in IRs across time, and logistic regression was used to estimate ORs for in-hospital death.ResultsAmong 12 619 803 adult hospitalisations, a total of 317 705 (2.5%) hospitalisations in 222 832 (70.0%) unique patients met the sepsis criteria. The overall age-standardised IR of a first sepsis admission was 246/100 000 (95% CI 245 to 247), whereas the age-standardised IR of all sepsis admissions was 352/100 000 (95% CI 351 to 354). In the period 2009–2019, the annual IR for a fir...
ObjectivesThere is a lack of data regarding the quality of peripheral intravenous catheter (PIVC)... more ObjectivesThere is a lack of data regarding the quality of peripheral intravenous catheter (PIVC)-related care from low-income and middle-income countries, even though the use of PIVCs may lead to local or severe systemic infections. Our main objective was to assess the feasibility and inter-rater agreement on the PIVC-mini Questionnaire (PIVC-miniQ) in a tertiary care hospital in Nepal.DesignWe performed an observational cross-sectional quantitative study using the PIVC-miniQ to collect information on PIVC quality.SettingSecondary care in a Nepalese hospital. All patients with PIVCs in selected wards were included in the study and PIVCs were assessed independently by two raters. Eight Nepalese nurses, one Nepalese student and three Norwegian students participated as raters.Primary and secondary outcome measuresThe intraclass correlation coefficient (ICC), positive, negative, absolute agreement, Scott’s pi and sum score were calculated using PIVC-miniQ. We also aimed to describe PIV...
Background Few studies have reported on mortality beyond one year after sepsis. We aim to describ... more Background Few studies have reported on mortality beyond one year after sepsis. We aim to describe trends in short- and long-term mortality among patients admitted with sepsis, and to identify clinical characteristics associated with mortality for improved monitoring, treatment and prognosis. Methods Patients ≥ 18 years admitted to all Norwegian hospitals (2008–2021) with a first sepsis episode were identified using Norwegian Patient Registry and International Classification of Diseases 10th Revision codes. Sepsis was classified as implicit (known infection site plus organ dysfunction), explicit (unknown infection site), or COVID-19 related sepsis. The outcome was all-cause mortality. We calculated age-standardized 30-day, 90-day, 1-, 5- and 10-year mortality for each admission year and estimated the annual percentage change with 95% confidence interval (CI). The association between clinical characteristics and all-cause mortality is reported as hazard ratios (HRs) from Cox regressi...
Annotations enrich text corpora and provide necessary labels for natural language processing stud... more Annotations enrich text corpora and provide necessary labels for natural language processing studies. To reason and infer underlying implicit knowledge captured by labels, an ontology is needed to provide a semantically annotated corpus with structured domain knowledge. Utilizing a corpus of adverse event documents annotated for sepsis-related signs and symptoms as a use case, this paper details how a terminology and corresponding ontology were developed. The Annotated Adverse Event NOte TErminology (AAENOTE) represents annotated documents and assists annotators in annotating text. In contrast, the complementary Catheter Infection Indications Ontology (CIIO) is intended for clinician use and captures domain knowledge needed to reason and infer implicit information from data. The approach taken makes ontology development understandable and accessible to domain experts without formal ontology training.
ImportanceSepsis is one of the leading causes of morbidity and mortality. The majority of sepsis ... more ImportanceSepsis is one of the leading causes of morbidity and mortality. The majority of sepsis cases is attributed to bacterial infections, but virus infections can also induce sepsis. Conflicting results in incidence rates and case fatality trends of sepsis is reported, and how the COVID-19 pandemic influenced these trends are unknown.ObjectiveTo estimate temporal trends in incidence rate and case fatality during a 14-year period from 2008 through 2021, and to assess possible shifts in these trends during the COVID-19 pandemic.DesignA nationwide longitudinal registry study using ICD-10 discharge codes to identify sepsis.SettingAll Norwegian hospitals from 2008 through 2021.ParticipantsAll sepsis cases included 317.705 patients and of these, 222.832 had a first sepsis episode.Main outcomes and measuresAnnual age-standardized incidence rates with 95% confidence intervals (CI). Poisson regression was used to estimate changes in incidence rates across time, and logistic regression wa...
Previous studies indicate sex differences in incidence and severity of bloodstream infections (BS... more Previous studies indicate sex differences in incidence and severity of bloodstream infections (BSI). We examined the effect of sex on risk of BSI, BSI mortality, and BSI caused by the most common infecting bacteria. Using causal mediation analyses, we assessed if this effect is mediated by health behaviours (smoking, alcohol consumption), education, cardiovascular risk factors (systolic blood pressure, non-HDL cholesterol, body mass index) and selected comorbidities. This prospective study included 64,040 participants (46.8% men) in the population-based HUNT2 Survey (1995–1997) linked with hospital records in incident BSI. During median follow-up of 15.2 years, 1840 (2.9%) participants (51.3% men) experienced a BSI and 396 (0.6%) died (56.6% men). Men had 41% higher risk of first-time BSI (95% confidence interval (CI), 28–54%) than women. Together, health behaviours, education, cardiovascular risk factors and comorbidities mediated 34% of the excess risk of BSI observed in men. The ...
ObjectivePrevious research suggest decreased immune function and increased risk of infections in ... more ObjectivePrevious research suggest decreased immune function and increased risk of infections in persons with insomnia. We examined the effect of insomnia symptoms on risk of bloodstream infections (BSI) and BSI-related mortality in a population-based prospective study.MethodsA total of 53,536 participants in the Norwegian HUNT2 study (1995–97) were linked to prospective data on clinically relevant BSIs until 2011. In Cox regression, we estimated hazard ratios (HRs) with 95% confidence interval (CI) for a first-time BSI and for BSI related mortality (BSI registered ≤30 days prior to death) associated with insomnia symptoms.ResultsCompared with participants who reported “no symptoms of insomnia”, participants reporting having “difficulty initiating sleep” often/almost every night had a HR for a first-time BSI of 1.14 (95% CI 0.96–1.34). Participants reporting “difficulties maintaining sleep” often/almost every night had a HR of 1.19 (95% CI 1.01–1.40), whereas those having a “feeling...
Background: Studies suggest increased risk for an outcome in people with joint exposures that sha... more Background: Studies suggest increased risk for an outcome in people with joint exposures that share common causal pathways. The objective of this study was to determine the risk of incident acute myocardial infarction (AMI) following exposure to both albuminuria and/or anxiety and depression symptoms.Methods: Participants who provided urine samples to the HUNT2 (1995–97) or HUNT3 (2007–2009) surveys were followed until the end of 2016. Albuminuria was measured by Albumin Creatine Ratio (ACR) and participants self-reported mood and anxiety symptoms on the Hospital Anxiety and Depression scale. We used Cox regression to estimate hazard ratios (HRs) for first incident AMI considering interaction between exposures and additive models to calculate the proportion of AMI that were attributable to the synergy of both exposures, adjusted for the Framingham variables.Results: 11 014 participants free of previous AMI were eligible for participation, with 1 234 incident AMIs occurred during a m...
2021 IEEE International Conference on Bioinformatics and Biomedicine (BIBM), 2021
In the clinical domain, patient states such as sepsis due to bloodstream infection (BSI) result i... more In the clinical domain, patient states such as sepsis due to bloodstream infection (BSI) result in observable symptoms and signs used to determine diagnosis and treatment, all of which often is documented in electronic health records. However, clinical text is brief and implicit, making it challenging to infer patient conditions by reasoning tasks and supervised machine learning. To study sepsis-related BSIs, we developed an ontology from an annotation guideline and annotated corpus that empirically captures BSIs from adverse event notes containing procedural deviations, guideline deviations, and unwanted incidents that can bring harm to patients. The resulting ontology represents (1) the physical patient state, clinical observations, and clinical documentation, and (2) background clinical knowledge for artificial intelligence, reasoning, and machine learning.
The association between pulmonary sequelae and markers of disease severity, as well as pro-fibrot... more The association between pulmonary sequelae and markers of disease severity, as well as pro-fibrotic mediators, were studied in 108 patients 3 months after hospital admission for COVID-19. The COPD assessment test (CAT-score), spirometry, diffusion capacity of the lungs (DLCO), and chest-CT were performed at 23 Norwegian hospitals included in the NOR-SOLIDARITY trial, an open-labelled, randomised clinical trial, investigating the efficacy of remdesivir and hydroxychloroquine (HCQ). Thirty-eight percent had a CAT-score ≥ 10. DLCO was below the lower limit of normal in 29.6%. Ground-glass opacities were present in 39.8% on chest-CT, parenchymal bands were found in 41.7%. At admission, low pO2/FiO2 ratio, ICU treatment, high viral load, and low antibody levels, were predictors of a poorer pulmonary outcome after 3 months. High levels of matrix metalloproteinase (MMP)-9 during hospitalisation and at 3 months were associated with persistent CT-findings. Except for a negative effect of rem...
ObjectivePrevious studies on thyroid function and risk of infection is conflicting and often stem... more ObjectivePrevious studies on thyroid function and risk of infection is conflicting and often stem from intensive care cohorts were nonthyroidal illness syndrome (NTIS) may be present. The objective of this study was to identify the risk of bloodstream infections (BSI) and BSI‐related mortality with thyroid‐stimulating hormone (TSH) levels within the reference range in a general population.DesignProspective follow‐up.ParticipantsThe HUNT2 (1995‐97) included 34,619 participants with information on TSH levels.MeasurementsHazard ratios (HRs) with 95% confidence interval (CI) confirmed BSIs and BSI‐related mortality until 2011.ResultsDuring a median follow‐up of 14.5 years, 1179 experienced at least one episode of BSI and 208 died within 30 days after a BSI. TSH levels within the reference range of 0.5–4.5 mU/L were not associated with the risk of first‐time BSI, with an HR of 0.97 (95% CI: 0.90–1.04) per mU/L. Stratified by baseline age < or ≥65 years, TSH was inversely associated wi...
Journal of the American Medical Informatics Association, 2021
Objective To determine the effects of using unstructured clinical text in machine learning (ML) f... more Objective To determine the effects of using unstructured clinical text in machine learning (ML) for prediction, early detection, and identification of sepsis. Materials and methods PubMed, Scopus, ACM DL, dblp, and IEEE Xplore databases were searched. Articles utilizing clinical text for ML or natural language processing (NLP) to detect, identify, recognize, diagnose, or predict the onset, development, progress, or prognosis of systemic inflammatory response syndrome, sepsis, severe sepsis, or septic shock were included. Sepsis definition, dataset, types of data, ML models, NLP techniques, and evaluation metrics were extracted. Results The clinical text used in models include narrative notes written by nurses, physicians, and specialists in varying situations. This is often combined with common structured data such as demographics, vital signs, laboratory data, and medications. Area under the receiver operating characteristic curve (AUC) comparison of ML methods showed that utilizin...
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Papers by Lise Gustad