Deep Representation Learning for Individualized Treatment Effect Estimation using Electronic Health Records

Publication date: Available online 11 October 2019Source: Journal of Biomedical InformaticsAuthor(s): Peipei Chen, Wei Dong, Xudong Lu, Uzay Kaymak, Kunlun He, Zhengxing HuangAbstractUtilizing clinical observational data to estimate individualized treatment effects (ITE) is a challenging task, as confounding inevitably exists in clinical data. Most of the existing models for ITE estimation tackle this problem by creating unbiased estimators of the treatment effects. Although valuable, learning a balanced representation is sometimes directly opposed to the objective of learning an effective and discriminative model for ITE estimation. We propose a novel hybrid model bridging multi-task deep learning and K-nearest neighbors (KNN) for ITE estimation. In detail, the proposed model firstly adopts multi-task deep learning to extract both outcome-predictive and treatment-specific latent representations from Electronic Health Records (EHR), by jointly performing the outcome prediction and treatment category classification. Thereafter, we estimate counterfactual outcomes by KNN based on the learned hidden representations. We validate the proposed model on a widely used semi-simulated dataset, i.e. IHDP, and a real-world clinical dataset consisting of 736 heart failure (HF) patients. The performance of our model remains robust and reaches 1.7 and 0.23 in terms of Precision in the estimation of heterogeneous effect (PEHE) and average treatment effect (ATE), respectively, on IHDP dataset...
Source: Journal of Biomedical Informatics - Category: Information Technology Source Type: research

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This study evaluated whether CM improved psychosocial status and prevented rehospitalization in patients with HF in comparison with self-management education (SM), and usual care (UC).We randomly allocated 59 patients into 3 groups; UC (n = 19), SM (n = 20), and CM (n = 20). The UC group received one patient education session, and the SM and CM groups participated in disease management programs for 12 months. The CM group received telemonitoring concurrently. All groups were followed up for another 12 months. Data were collected at baseline and at 6, 12, 18, and 24 months.The primary endpoint was quality of life (QOL). Sec...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Authors: Taniguchi Y, Sakakura K, Yuri K, Nomura Y, Tamanaha Y, Akashi N, Tsukui T, Yamamoto K, Wada H, Momomura SI, Yamaguchi A, Fujita H Abstract Transcatheter aortic valve implantation (TAVI) has been recognized as a standard therapy for severe aortic valve stenosis. However, since some patients who receive TAVI have poor outcomes, the predictors of clinical outcomes after TAVI are important. The aim of this study was to investigate the association between appetite and long-term clinical outcomes.We screened consecutive cases who received TAVI at our medical center between July 2014 and October 2018. A total of ...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Authors: Kawashima K, Hirashiki A, Nomoto K, Kokubo M, Shimizu A, Sakurai T, Kondo I, Washimi Y, Arai H, Toba K, Murohara T Abstract The Kihon Checklist (KCL) is a reliable tool for determining frailty status in the elderly. However, there is no information in the literature about the relationship between frailty status and exercise capacity. Here, we examined the associations between cardiopulmonary exercise testing parameters and frailty status in elderly patients with stable heart failure (HF).Ninety-two elderly patients with stable HF were evaluated using cardiopulmonary exercise testing and the KCL. A KCL scor...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Authors: Fan Q, Tao R, Zhang H, Xie H, Xi R, Wang F, Xu Y, Zhang R, Yan X, Gu G Abstract Inflammatory factors have specific value in acute myocardial infarction (AMI). Our previous studies have identified the prognostic value of interleukin (IL)-34 during chronic heart failure. However, the potential impact of IL-34 on AMI remains unknown.Serum IL-34 was measured in 287 AMI patients, and they were followed up for the composite endpoint, including cardiovascular death, heart failure hospitalization, recurrent nonfatal myocardial infarction (MI), and nonfatal stroke.IL-34 levels were significantly associated with the...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Today on THCB Spotlight, Matthew catches up with Kuldeep Rajput, the founder and CEO of Biofourmis. Biofourmis uses biomarkers and sensors for health management, in pursuit of this dream of predicting disease before it happens so we can improve and health outcomes. The key question here is, how do you take a known pharmacotherapy and combine that with a digital solution so that it can synergistically act on patients to drive meaningful outcomes? Biofourmis announced this week that they are acquiring Biovotion, as well as a commercialization deal with Novartis. Why did a device-agnostic platform decide to acquire a bios...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Tech Health Technology Start-Ups THCB Spotlights Biofourmis Biovotion heart failure Kuldeep Rajput Source Type: blogs
Authors: Stojanovic D, Mitic V, Petrovic D, Stojanovic M, Ignjatovic A, Stefanovic N, Cvetkovic T, Bojanic V, Kocic G, Ilic MD Abstract Heart failure represents a growing health problem, with increasing morbidity and mortality globally. According to the mechanisms involved in the pathogenesis of heart failure, many biomarkers have been proposed for the timely diagnosis and prognostication of patients with heart failure, but other than natriuretic peptides, none of them has gained enough clinical significance. Renalase, a new protein derived from kidneys was demonstrated to metabolize catecholamines and to have a ca...
Source: Disease Markers - Category: Laboratory Medicine Tags: Dis Markers Source Type: research
Conclusion: Our study showed that vitamin D deficiency has a significant impact in heart failure patients; it is an independent predictor of lack of midterm clinical response and long-term mortality in patients undergoing CRT. Therefore, monitoring vitamin D status of heart failure patients could be of clinical significance. PMID: 31737126 [PubMed - in process]
Source: Disease Markers - Category: Laboratory Medicine Tags: Dis Markers Source Type: research
Severe aortic stenosis (AS) is associated with a progressive cardiac remodeling that ultimately leads to heart failure and death if the valve is not replaced. The confirmation of AS severity is therefore crucial to adequately manage patients with AS. Transthoracic echocardiography is the first-line examination to confirm AS severity, but it may be inconclusive in discordant cases. In this setting, AS severity should be confirmed using a multimodality imaging approach. This review gives an overview of how to assess and/or confirm AS severity, especially in case of discordance.
Source: Cardiology Clinics - Category: Cardiology Authors: Source Type: research
(Yale University) A new Yale study shows that some patients being treated for severe heart failure with a battery-operated pump saw significant improvement after additionally using neurohormonal blockade (NHB) drug therapy.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
ConclusionCongruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.
Source: Heart and Lung: The Journal of Acute and Critical Care - Category: Respiratory Medicine Source Type: research
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