Objective: The aim of this study was to generate synthetic electronic health records (EHRs). The generated EHR data will be more realistic than those generated using the existing medical Generative Adversarial Network (medGAN) method.
Materials And Methods: We modified medGAN to obtain two synthetic data generation models-designated as medical Wasserstein GAN with gradient penalty (medWGAN) and medical boundary-seeking GAN (medBGAN)-and compared the results obtained using the three models. We used 2 databases: MIMIC-III and National Health Insurance Research Database (NHIRD), Taiwan. First, we trained the models and generated synthetic EHRs by using these three 3 models. We then analyzed and compared the models' performance by using a few statistical methods (Kolmogorov-Smirnov test, dimension-wise probability for binary data, and dimension-wise average count for count data) and 2 machine learning tasks (association rule mining and prediction).
Results: We conducted a comprehensive analysis and found our models were adequately efficient for generating synthetic EHR data. The proposed models outperformed medGAN in all cases, and among the 3 models, boundary-seeking GAN (medBGAN) performed the best.
Discussion: To generate realistic synthetic EHR data, the proposed models will be effective in the medical industry and related research from the viewpoint of providing better services. Moreover, they will eliminate barriers including limited access to EHR data and thus accelerate research on medical informatics.
Conclusion: The proposed models can adequately learn the data distribution of real EHRs and efficiently generate realistic synthetic EHRs. The results show the superiority of our models over the existing model.
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http://dx.doi.org/10.1093/jamia/ocy142 | DOI Listing |
JAMIA Open
February 2025
Department of Medicine, University of Wisconsin-Madison, Madison, WI 53792, United States.
Objective: To evaluate large language models (LLMs) for pre-test diagnostic probability estimation and compare their uncertainty estimation performance with a traditional machine learning classifier.
Materials And Methods: We assessed 2 instruction-tuned LLMs, Mistral-7B-Instruct and Llama3-70B-chat-hf, on predicting binary outcomes for Sepsis, Arrhythmia, and Congestive Heart Failure (CHF) using electronic health record (EHR) data from 660 patients. Three uncertainty estimation methods-Verbalized Confidence, Token Logits, and LLM Embedding+XGB-were compared against an eXtreme Gradient Boosting (XGB) classifier trained on raw EHR data.
Contemp Clin Trials Commun
February 2025
Department of Medicine, Division of General Internal Medicine and Center for Health Information Partnerships, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, USA.
Background: Unhealthy alcohol use is a leading cause of preventable mortality and a risk factor for an array of social and health problems. The Intervention in Small primary care Practices to Implement Reduction in unhealthy alcohol use (INSPIRE) study is part of a nationwide campaign to improve the identification and treatment of patients engaging in unhealthy alcohol use.
Methods: We conducted a single arm, pragmatic study consisting of seventeen primary care practices in the Chicago metropolitan area, Wisconsin, and California across two waves with a 6-month latent period, a 12-month intervention period, followed by a 6-month sustainability period.
J Pathol Inform
January 2025
Harvard Medical School, Boston, MA, United States of America.
Objective: Thrombocytopenia is a common complication of hematopoietic stem-cell transplantation (HSCT), though many patients will become immune refractory to platelet transfusions over time. We built and evaluated an electronic health record (EHR)-integrated, standards-based application that enables blood-bank clinicians to match platelet inventory with patients using data previously not available at the point-of-care, like human leukocyte antigen (HLA) data for donors and recipients.
Materials And Methods: The web-based application launches as an EHR-embedded application or as a standalone application.
J Pediatr Nurs
January 2025
Department of Medical Surgical Nursing, College of Nursing, University of Ha'il, Ha'il City, Saudi Arabia; Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida University, Hodeida, Yemen.
Aim: This study aimed to evaluate the knowledge, attitudes, and acceptance of Electronic Health Records (EHRs) among nurses in Egypt.
Methods: A descriptive cross-sectional study was conducted involving 1217 nurses from 33 public and private hospitals. Data were collected using a self-administered online questionnaire, which assessed knowledge, attitudes, and acceptance of EHRs.
Open Heart
January 2025
Department of Internal Medicine I, Universitätsklinikum Würzburg, Würzburg, BY, Germany
Background And Aims: Hypertrophic cardiomyopathy (HCM) has various aetiologies, including genetic conditions like Fabry disease (FD), a lysosomal storage disorder. FD prevalence in high-risk HCM populations ranges from 0.3% to 11.
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