Identification of Naloxone in Emergency Medical Services Data Substantially Improves by Processing Unstructured Patient Care Narratives.

Objectives: Structured data fields, including medication fields involving naloxone, are routinely used to identify opioid overdoses in emergency medical services (EMS) data; between January 2021 and March 2024, there were approximately 1.2 million instances of naloxone administration. in the United States.

The ENACT network is acting on housing instability and the unhoused using the open health natural language processing toolkit.

Housing is an environmental social determinant of health that is linked to mortality and clinical outcomes. We developed a lexicon of housing-related concepts and rule-based natural language processing methods for identifying these housing-related concepts within clinical text. We piloted our methods on several test cohorts: a synthetic cohort generated by ChatGPT for initial infrastructure testing, a cohort with substance use disorders (SUD), and a cohort diagnosed with problems related to housing and economic circumstances (HEC).

A Case Demonstration of the Open Health Natural Language Processing Toolkit From the National COVID-19 Cohort Collaborative and the Researching COVID to Enhance Recovery Programs for a Natural Language Processing System for COVID-19 or Postacute Sequelae of SARS CoV-2 Infection: Algorithm Development and Validation.

Background: A wealth of clinically relevant information is only obtainable within unstructured clinical narratives, leading to great interest in clinical natural language processing (NLP). While a multitude of approaches to NLP exist, current algorithm development approaches have limitations that can slow the development process. These limitations are exacerbated when the task is emergent, as is the case currently for NLP extraction of signs and symptoms of COVID-19 and postacute sequelae of SARS-CoV-2 infection (PASC).

Impact of the Communities That HEAL Intervention on Buprenorphine-Waivered Practitioners and Buprenorphine Prescribing: A Prespecified Secondary Analysis of the HCS Randomized Clinical Trial.

Importance: Buprenorphine significantly reduces opioid-related overdose mortality. From 2002 to 2022, the Drug Addiction Treatment Act of 2000 (DATA 2000) required qualified practitioners to receive a waiver from the Drug Enforcement Agency to prescribe buprenorphine for treatment of opioid use disorder. During this period, waiver uptake among practitioners was modest; subsequent changes need to be examined.

geoPIPE: Geospatial Pipeline for Enhancing Open Data for Substance Use Disorders Research.

We present our open-source pipeline for quickly enhancing open data sets with research-focused expansions and show its effectiveness on a cornerstone open data set released by the Cook County government in Illinois. The City of Chicago and Cook County were both early adopters of open data portals and have made a wide variety of data available to the public; we focus on the medical examiner case archive which provides information about deaths recorded by Cook County's Office of the Medical Examiner, including overdoses invaluable to substance use disorder research. Our pipeline derives key variables from open data and links to other publicly available data sets in support of accelerating translational research on substance use disorders.

Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, Illinois.

Introduction: Stay-at-home orders during the COVID-19 pandemic decreased population mobility to reduce SARS-CoV-2 infection rates. We empirically tested the hypothesis that this public health measure was associated with a higher likelihood of opioid- and stimulant-involved deaths occurring in homes located in Cook County, Illinois.

Methods: The stay-at-home period was from March 21, 2020 to May 30, 2020.

Substance use disorders and social determinants of health from electronic medical records obtained during Kentucky's "triple wave".

Social determinants of health (SDOH) play a critical role in the risk of harmful drug use. Examining SDOH as a means of differentiating populations with multiple co-occurring substance use disorders (SUDs) is particularly salient in the era of prevalent opioid and stimulant use known as the "Third Wave". This study uses electronic medical records (EMRs) from a safety net hospital system from 14,032 patients in Kentucky from 2017 to 2019 in order to 1) define three types of SUD cohorts with shared/unique risk factors, 2) identify patients with unstable housing using novel methods for EMRs and 3) link patients to their residential neighborhood to obtain quantitative perspective on social vulnerability.

Enhancing research data infrastructure to address the opioid epidemic: the Opioid Overdose Network (O2-Net).

Opioid Overdose Network is an effort to generalize and adapt an existing research data network, the Accrual to Clinical Trials (ACT) Network, to support design of trials for survivors of opioid overdoses presenting to emergency departments (ED). Four institutions (Medical University of South Carolina [MUSC], Dartmouth Medical School [DMS], University of Kentucky [UK], and University of California San Diego [UCSD]) worked to adapt the ACT network. The approach that was taken to enhance the ACT network focused on 4 activities: cloning and extending the ACT infrastructure, developing an e-phenotype and corresponding registry, developing portable natural language processing tools to enhance data capture, and developing automated documentation templates to enhance extended data capture.

Pharmacovigilance Signals of the Opioid Epidemic over 10 Years: Data Mining Methods in the Analysis of Pharmacovigilance Datasets Collecting Adverse Drug Reactions (ADRs) Reported to EudraVigilance (EV) and the FDA Adverse Event Reporting System (FAERS).

In the past twenty years, the consumption of opioid medications has reached significant proportions, leading to a rise in drug misuse and abuse and increased opioid dependence and related fatalities. Thus, the purpose of this study was to determine whether there are pharmacovigilance signals of abuse, misuse, and dependence and their nature for the following prescription opioids: codeine, dihydrocodeine, fentanyl, oxycodone, pentazocine, and tramadol. Both the pharmacovigilance datasets EudraVigilance (EV) and the FDA Adverse Events Reporting System (FAERS) were analyzed to identify and describe possible misuse-/abuse-/dependence-related issues.

Improving the Utility of Tobacco-Related Problem List Entries Using Natural Language Processing.

We present findings on using natural language processing to classify tobacco-related entries from problem lists found within patient's electronic health records. Problem lists describe health-related issues recorded during a patient's medical visit; these problems are typically followed up upon during subsequent visits and are updated for relevance or accuracy. The mechanics of problem lists vary across different electronic health record systems.

"Doctor and pharmacy shopping": A fading signal for prescription opioid use monitoring?

Background: The term "doctor and pharmacy shopping" colloquially describes patients with high multiple provider episodes (MPEs)-a threshold count of distinct prescribers and/or pharmacies involved in prescription fulfillment. Opioid-related MPEs are implicated in the global opioid crisis and heavily monitored by government databases such as U.S.

Extracting Semantics from Census-based Reference Data.

We present preliminary findings in extracting semantics from reference data generated by the United States Census Bureau. US Census reference data is based upon surveys designed to collect demographics and other socioeconomic factors by geographical regions. These data sets contain thousands of variables; this complexity makes the reference data difficult to learn, query, and integrate into analyses.

Challenges and Barriers in Applying Natural Language Processing to Medical Examiner Notes from Fatal Opioid Poisoning Cases.

We detail the challenges and barriers in applying natural language processing techniques to a collection of medical examiner case investigation notes related to fatal opioid poisonings. Major advances in biomedical informatics have made natural language processing (NLP) of medical texts both a realistic and useful task. Biomedical NLP tools are typically designed to process documents originating from biomedical libraries or electronic health records (EHRs).

Leveraging Differential Privacy in Geospatial Analyses of Standardized Healthcare Data.

We present a collection of geodatabase functions which expedite utilizing differential privacy for privacy-aware geospatial analysis of healthcare data. The healthcare domain has a long history of standardization and research communities have developed open-source common data models to support the larger goals of interoperability, reproducibility, and data sharing; these models also standardize geospatial patient data. However, patient privacy laws and institutional regulations complicate geospatial analyses and dissemination of research findings due to protective restrictions in how data and results are shared.

sig2db: a Workflow for Processing Natural Language from Prescription Instructions for Clinical Data Warehouses.

We present sig2db as an open-source solution for clinical data warehouses desiring to process natural language from prescription instructions, often referred to as "sigs". In electronic prescribing, the sig is typically an unstructured text field intended to capture all requirements for medication administration. The sig captures certain fields that the structured data may lack such as days supply, time of day, or meal-time considerations.

bench4gis: Benchmarking Privacy-aware Geocoding with Open Big Data.

Geocoding, the process of translating addresses to geographic coordinates, is a relatively straight-forward and well-studied process, but limitations due to privacy concerns may restrict usage of geographic data. The impact of these limitations are further compounded by the scale of the data, and in turn, also limits viable geocoding strategies. For example, healthcare data is protected by patient privacy laws in addition to possible institutional regulations that restrict external transmission and sharing of data.

Retrospective analysis of health claims to evaluate pharmacotherapies with potential for repurposing: Association of bupropion and stimulant use disorder remission.

Drug repurposing is the identification of novel indication(s) for existing medications. Health claims data provide a burgeoning resource to evaluate pharmacotherapies with repurposing potential. To demonstrate a workflow for drug repurposing using claims data, we assessed the association between prescription of bupropion and stimulant use disorder (StUD) remission.

Modeling Terminologies for Reusability in Faceted Systems.

We integrate heterogeneous terminologies into our category-theoretic model of faceted browsing and show that existing terminologies and vocabularies can be reused as facets in a cohesive, interactive system. Commonly found in online search engines and digital libraries, faceted browsing systems depend upon one or more taxonomies which outline the structure and content of the facets available for user interaction. Controlled vocabularies or terminologies are often curated externally and are available as a reusable resource across systems.

Rapid and Reusable Text Visualization and Exploration Development with DELVE.

We present DELVE (Document ExpLoration and Visualization Engine), a framework for developing interactive visualizations as modular Web-applications to assist researchers with exploratory literature search. The goal for web-applications driven by DELVE is to better satisfy the information needs of researchers and to help explore and understand the state of research in scientific liter ature by providing immersive visualizations that both contain facets and are driven by facets derived from the literature. We base our framework on principles from user-centered design and human-computer interaction (HCI).

Using Closure Tables to Enable Cross-Querying of Ontologies in Database-Driven Applications.

We demonstrate that closure tables are an effective data structure for developing database-driven applications that query biomedical ontologies and that require cross-querying between multiple ontologies. A closure table stores all available paths within a tree, even those without a direct parent-child relationship; additionally, a node can have multiple ancestors which gives the foundation for supporting linkages between controlled ontologies. We augment the meta-data structure of the ICD9 and ICD10 ontologies included in i2b2, an open source query tool for identifying patient cohorts, to utilize a closure table.

Modeling Integration and Reuse of Heterogeneous Terminologies in Faceted Browsing Systems.

We integrate heterogeneous terminologies into our category-theoretic model of faceted browsing and show that existing terminologies and vocabularies can be reused as facets in a cohesive, interactive system. Commonly found in online search engines and digital libraries, faceted browsing systems depend upon one or more taxonomies which outline the structure and content of the facets available for user interaction. Controlled vocabularies or terminologies are often externally curated and are available as a reusable resource across systems.

Using i2b2 to Bootstrap Rural Health Analytics and Learning Networks.

We demonstrate that the open-source i2b2 (Informatics for Integrating Biology and the Bedside) data model can be used to bootstrap rural health analytics and learning networks. These networks promote communication and research initiatives by providing the infrastructure necessary for sharing data and insights across a group of healthcare and research partners. Data integration remains a crucial challenge in connecting rural healthcare sites with a common data sharing and learning network due to the lack of interoperability and standards within electronic health records.