Liu, Hongfang

Background: A clinical decision support system (CDSS) for cervical cancer screening identifies patients due for routine cervical cancer screening. Yet, high-risk patients who require more frequent screening or earlier follow-up to address past abnormal results are not identified. We aimed to assess the effect of a complex CDSS, incorporating national guidelines for high-risk patient screening and abnormal result management, its implementation to identify patients overdue for testing, and the outcome of sending a targeted recommendation for follow-up. Materials and Methods: At three primary care clinics affiliated with an academic medical center, a reminder recommending an appointment for Papanicolaou (Pap) testing or Pap and human papillomavirus cotesting was sent to high-risk women aged 18 through 65 years (intervention group) identified by CDSS as overdue for testing. Historical control patients, who did not receive a reminder, were identified by CDSS 1 year before the date when reminders were sent to the intervention group. Test completion rates were compared between the intervention and control groups through a generalized estimating equation extension. Results: Across the three sites, the average completion rate of recommended follow-up testing was significantly higher in the intervention group at 23.7% (61/257) than the completion rate at 3.3% (17/516) in the control group ( p < 0.001). Conclusions: A CDSS with enhanced capabilities to identify high-risk women due for cervical cancer testing beyond routine screening intervals, with subsequent patient notification, has the potential to decrease cervical precancer and cancer by improving adherence to guideline-compliant follow-up and needed treatment.

AbstractThe recent movement towards open data in the biomedical domain has generated a large number of datasets that are publicly accessible. The Big Data to Knowledge data indexing project, biomedical and healthCAre Data Discovery Index Ecosystem (bioCADDIE), has gathered these datasets in a one-stop portal aiming at facilitating their reuse for accelerating scientific advances. However, as the number of biomedical datasets stored and indexed increases, it becomes more and more challenging to retrieve the relevant datasets according to researchers’ queries. In this article, we propose an information retrieval (IR) system to tackle this problem and implement it for the bioCADDIE Dataset Retrieval Challenge. The system leverages the unstructured texts of each dataset including the title and description for the dataset, and utilizes a state-of-the-art IR model, medical named entity extraction techniques, query expansion with deep learning-based word embeddings and a re-ranking strategy to enhance the retrieval performance. In empirical experiments, we compared the proposed system with 11 baseline systems using the bioCADDIE Dataset Retrieval Challenge datasets. The experimental results show that the proposed system outperforms other systems in terms of inference Average Precision and inference normalized Discounted Cumulative Gain, implying that the proposed system is a viable option for biomedical dataset retrieval.Database URL: https://github.com/yanshanwang/biocaddie2016mayodata