Publications by authors named "Marco Spruit"

Objective: Population health management (PHM) is a promising data-driven approach to address the challenges faced by health care systems worldwide. Although Business Intelligence (BI) systems are known to be relevant for a data-driven approach, the usage for PHM is limited in its elaboration. To explore available scientific publications, a systematic review guided by PRISMA was conducted of mature BI initiatives to investigate their decision contexts and BI capabilities.

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Background: There are numerous papers focusing on diagnosing mental health disorders using unimodal and multimodal approaches. However, our literature review shows that the majority of these studies either use unimodal approaches to diagnose a variety of mental disorders or employ multimodal approaches to diagnose a single mental disorder instead. In this research we combine these approaches by first identifying and compiling an extensive list of mental health disorder markers for a wide range of mental illnesses which have been used for both unimodal and multimodal methods, which is subsequently used for determining whether the multimodal approach can outperform the unimodal approaches.

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Data-driven technologies have improved the efficiency, reliability and effectiveness of healthcare services, but come with an increasing demand for data, which is challenging due to privacy-related constraints on sharing data in healthcare contexts. Synthetic data has recently gained popularity as potential solution, but in the flurry of current research it can be hard to oversee its potential. This paper proposes a novel taxonomy of synthetic data in healthcare to navigate the landscape in terms of three main varieties.

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Aims: Adults with type 2 diabetes have an increased risk of cardiovascular events (CVE), the world's leading cause of mortality. The SCORE2-Diabetes model is a tool designed to estimate the 10-year risk of CVE specifically in individuals with type 2 diabetes. However, the performance of such models may vary across different demographic and socioeconomic groups, necessitating validation and assessment in diverse populations.

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Background And Objective: Generative Deep Learning has emerged in recent years as a significant player in the Artificial Intelligence field. Synthesizing new data while maintaining the features of reality has revolutionized the field of Deep Learning, proving to be particularly useful in contexts where obtaining data is challenging. The objective of this study is to employ the DoppelGANger algorithm, a cutting-edge approach based on Generative Adversarial Networks for time series, to enhance patient admissions forecasting in a hospital Emergency Department.

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Digital health solutions hold promise for enhancing healthcare delivery and patient outcomes, primarily driven by advancements such as machine learning, artificial intelligence, and data science, which enable the development of integrated care systems. Techniques for generating synthetic data from real datasets are highly advanced and continually evolving. This paper aims to present the INSAFEDARE project's ambition regarding medical devices' regulation and how real and synthetic data can be used to check if devices are safe and effective.

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Background: Synthetic Electronic Health Records (EHRs) are becoming increasingly popular as a privacy enhancing technology. However, for longitudinal EHRs specifically, little research has been done into how to properly evaluate synthetically generated samples. In this article, we provide a discussion on existing methods and recommendations when evaluating the quality of synthetic longitudinal EHRs.

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Background: BERT models have seen widespread use on unstructured text within the clinical domain. However, little to no research has been conducted into classifying unstructured clinical notes on the basis of patient lifestyle indicators, especially in Dutch. This article aims to test the feasibility of deep BERT models on the task of patient lifestyle classification, as well as introducing an experimental framework that is easily reproducible in future research.

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Background: Electronic clinical decision support systems (eCDSS), such as the 'Systematic Tool to Reduce Inappropriate Prescribing' Assistant (STRIPA), have become promising tools for assisting general practitioners (GPs) with conducting medication reviews in older adults. Little is known about how GPs perceive eCDSS-assisted recommendations for pharmacotherapy optimization. The aim of this study was to explore the implementation of a medication review intervention centered around STRIPA in the 'Optimising PharmacoTherapy In the multimorbid elderly in primary CAre' (OPTICA) trial.

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Objective: To study the effects of a primary care medication review intervention centred around an electronic clinical decision support system (eCDSS) on appropriateness of medication and the number of prescribing omissions in older adults with multimorbidity and polypharmacy compared with a discussion about medication in line with usual care.

Design: Cluster randomised clinical trial.

Setting: Swiss primary care, between December 2018 and February 2021.

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The clinical notes in electronic health records have many possibilities for predictive tasks in text classification. The interpretability of these classification models for the clinical domain is critical for decision making. Using topic models for text classification of electronic health records for a predictive task allows for the use of topics as features, thus making the text classification more interpretable.

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Background: Knowledge about adverse drug reactions (ADRs) in the population is limited because of underreporting, which hampers surveillance and assessment of drug safety. Therefore, gathering accurate information that can be retrieved from clinical notes about the incidence of ADRs is of great relevance. However, manual labeling of these notes is time-consuming, and automatization can improve the use of free-text clinical notes for the identification of ADRs.

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Background: The Screening Tool of Older Persons' Prescriptions (STOPP)/Screening Tool to Alert to Right Treatment (START) instrument is used to evaluate the appropriateness of medication in older people. STOPP/START criteria have been converted into software algorithms and implemented in a clinical decision support system (CDSS) to facilitate their use in clinical practice.

Objective: Our objective was to determine the frequency of CDSS-generated STOPP/START signals and their subsequent acceptance by a pharmacotherapy team in a hospital setting.

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Objective: To examine the effect of optimising drug treatment on drug related hospital admissions in older adults with multimorbidity and polypharmacy admitted to hospital.

Design: Cluster randomised controlled trial.

Setting: 110 clusters of inpatient wards within university based hospitals in four European countries (Switzerland, Netherlands, Belgium, and Republic of Ireland) defined by attending hospital doctors.

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Objectives: Recruiting general practitioners (GPs) and their multimorbid older patients for trials is challenging for multiple reasons (e.g., high workload, limited mobility).

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Research output has grown significantly in recent years, often making it difficult to see the forest for the trees. Systematic reviews are the natural scientific tool to provide clarity in these situations. However, they are protracted processes that require expertise to execute.

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There has been an increase in the use of machine learning and artificial intelligence (AI) for the analysis of image-based cellular screens. The accuracy of these analyses, however, is greatly dependent on the quality of the training sets used for building the machine learning models. We propose that unsupervised exploratory methods should first be applied to the data set to gain a better insight into the quality of the data.

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Background: Several approaches to medication optimisation by identifying drug-related problems in older people have been described. Although some interventions have shown reductions in drug-related problems (DRPs), evidence supporting the effectiveness of medication reviews on clinical and economic outcomes is lacking. Application of the STOPP/START (version 2) explicit screening tool for inappropriate prescribing has decreased inappropriate prescribing and significantly reduced adverse drug reactions (ADRs) and associated healthcare costs in older patients with multi-morbidity and polypharmacy.

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Text representations ar one of the main inputs to various Natural Language Processing (NLP) methods. Given the fast developmental pace of new sentence embedding methods, we argue that there is a need for a unified methodology to assess these different techniques in the biomedical domain. This work introduces a comprehensive evaluation of novel methods across ten medical classification tasks.

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Natural language processing (NLP) has become essential for secondary use of clinical data. Over the last two decades, many clinical NLP systems were developed in both academia and industry. However, nearly all existing systems are restricted to specific clinical settings mainly because they were developed for and tested with specific datasets, and they often fail to scale up.

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