2024
Validation of an Electronic Health Record-Based Machine Learning Model Compared to Clinical Risk Scores for Gastrointestinal Bleeding
Shung D, Chan C, You K, Nakamura S, Saarinen T, Zheng N, Simonov M, Li D, Tsay C, Kawamura Y, Shen M, Hsiao A, Sekhon J, Laine L. Validation of an Electronic Health Record-Based Machine Learning Model Compared to Clinical Risk Scores for Gastrointestinal Bleeding. Gastroenterology 2024 PMID: 38971198, DOI: 10.1053/j.gastro.2024.06.030.Peer-Reviewed Original ResearchElectronic health recordsGlasgow-Blatchford scoreEmergency departmentVery-low-risk patientsRisk scoreOakland scoreMachine learning modelsStructured data fieldsClinical risk scoreGastrointestinal bleedingAll-cause mortalityHealth recordsLearning modelsManual data entrySecondary analysisRisk stratification scoresAssess proportionRed blood-cell transfusionPrimary outcomeProportion of patientsData entryOvert gastrointestinal bleedingPrimary analysisReceiver-operating-characteristic curveVery-low-riskCorrection: Developing and Testing the Usability of a Novel Child Abuse Clinical Decision Support System: Mixed Methods Study
Thomas A, Asnes A, Libby K, Hsiao A, Tiyyagura G. Correction: Developing and Testing the Usability of a Novel Child Abuse Clinical Decision Support System: Mixed Methods Study. Journal Of Medical Internet Research 2024, 26: e60444. PMID: 38801770, PMCID: PMC11165280, DOI: 10.2196/60444.Peer-Reviewed Original ResearchHuman-Algorithmic Interaction Using a Large Language Model-Augmented Artificial Intelligence Clinical Decision Support System
Rajashekar N, Shin Y, Pu Y, Chung S, You K, Giuffre M, Chan C, Saarinen T, Hsiao A, Sekhon J, Wong A, Evans L, Kizilcec R, Laine L, Mccall T, Shung D. Human-Algorithmic Interaction Using a Large Language Model-Augmented Artificial Intelligence Clinical Decision Support System. 2024, 1-20. DOI: 10.1145/3613904.3642024.Peer-Reviewed Original ResearchClinical decision support systemsHuman-computer interactionDecision support systemArtificial intelligenceAI-CDSSIntelligent clinical decision support systemSupport systemIntegration of artificial intelligenceHuman-algorithm interactionsEase-of-useLanguage modelHuman algorithmAI systemsSocio-technological challengesHealth-care providersMedical student participationQualitative themesClinical simulationClinical expertiseUpper gastrointestinal bleedingUsabilityBorderline decisionsLanguageClinical intuitionTrust407 IMPACT OF ARTIFICIAL INTELLIGENCE SYSTEMS FOR UPPER GASTROINTESTINAL BLEEDING ON CLINICIAN TRUST AND LEARNING USING LARGE LANGUAGE MODELS: A RANDOMIZED PILOT SIMULATION STUDY
Chung S, Rajashekar N, Pu Y, Shin Y, Giuffrè M, Chan C, You K, Saarinen T, Hsiao A, Sekhon J, Wong A, Evans L, McCall T, Kizilcec R, Laine L, Shung D. 407 IMPACT OF ARTIFICIAL INTELLIGENCE SYSTEMS FOR UPPER GASTROINTESTINAL BLEEDING ON CLINICIAN TRUST AND LEARNING USING LARGE LANGUAGE MODELS: A RANDOMIZED PILOT SIMULATION STUDY. Gastroenterology 2024, 166: s-95-s-96. DOI: 10.1016/s0016-5085(24)00715-7.Peer-Reviewed Original ResearchDeveloping and Testing the Usability of a Novel Child Abuse Clinical Decision Support System: Mixed Methods Study
Thomas A, Asnes A, Libby K, Hsiao A, Tiyyagura G. Developing and Testing the Usability of a Novel Child Abuse Clinical Decision Support System: Mixed Methods Study. Journal Of Medical Internet Research 2024, 26: e51058. PMID: 38551639, PMCID: PMC11015363, DOI: 10.2196/51058.Peer-Reviewed Original Research
2023
Promoting Collaborative Scholarship During the COVID-19 Pandemic: Creation and Implementation of an Innovative COVID-19 Data Explorer and Repository (DOM- CovX) at Yale School of Medicine (Preprint)
Victoria-Castro A, Arora T, Simonov M, Biswas A, Alausa J, Subair L, Gerber B, Nguyen A, Hsiao A, Hintz R, Yamamoto Y, Soufer R, Desir G, Wilson F, Villanueva M. Promoting Collaborative Scholarship During the COVID-19 Pandemic: Creation and Implementation of an Innovative COVID-19 Data Explorer and Repository (DOM- CovX) at Yale School of Medicine (Preprint). JMIR Formative Research 2023 DOI: 10.2196/52120.Peer-Reviewed Original ResearchNatural Language Processing — A Surveillance Stepping Stone to Identify Child Abuse
Shum M, Hsiao A, Teng W, Asnes A, Amrhein J, Tiyyagura G. Natural Language Processing — A Surveillance Stepping Stone to Identify Child Abuse. Academic Pediatrics 2023, 24: 92-96. PMID: 37652162, PMCID: PMC10840716, DOI: 10.1016/j.acap.2023.08.015.Peer-Reviewed Original ResearchConceptsClinical guidelinesClinical decision support toolSignificant demographic differencesED providersProvider notesInsurance statusGeneral EDsClinical careAbuse evaluationsED typeChild protective servicesChild abuseInjuryAppropriate evaluationChild physical abuseNLP algorithmDemographic differencesPhysical abuseAdherenceDemographic variablesProtective servicesNatural language processing algorithmAbuseMo1365 IDENTIFYING PATIENTS WITH ACUTE GASTROINTESTINAL BLEEDING USING NOTE TEXT IN THE ELECTRONIC HEALTH RECORD: A HYBRID NATURAL LANGUAGE PROCESSING AND DEEP LEARNING APPROACH
Dupont J, Zheng N, Laine L, Hsiao A, Thomas P, Partridge C, Shung D. Mo1365 IDENTIFYING PATIENTS WITH ACUTE GASTROINTESTINAL BLEEDING USING NOTE TEXT IN THE ELECTRONIC HEALTH RECORD: A HYBRID NATURAL LANGUAGE PROCESSING AND DEEP LEARNING APPROACH. Gastroenterology 2023, 164: s-838. DOI: 10.1016/s0016-5085(23)02935-9.Peer-Reviewed Original ResearchUse of an Automated Bilingual Digital Health Tool to Reduce Unhealthy Alcohol Use Among Latino Emergency Department Patients
Vaca F, Dziura J, Abujarad F, Pantalon M, Hsiao A, Reynolds J, Maciejewski K, Field C, D’Onofrio G. Use of an Automated Bilingual Digital Health Tool to Reduce Unhealthy Alcohol Use Among Latino Emergency Department Patients. JAMA Network Open 2023, 6: e2314848. PMID: 37219901, PMCID: PMC10208138, DOI: 10.1001/jamanetworkopen.2023.14848.Peer-Reviewed Original ResearchConceptsStandard care groupNumber of bingesEmergency department patientsStandard careED patientsCare groupBrief interventionDepartment patientsAlcohol screeningDisease burdenUnhealthy drinkingDigital health toolsLevel II trauma centerHealth toolsParticipants 25 yearsAlcohol-related health disparitiesTertiary care centerAdverse health behaviorsUnhealthy alcohol useHigh disease burdenAlcohol use disorderTimeline followback methodEmergency medical careSelf-reported numberHigh-risk drinkingReal-World Observational Evaluation of Common Interventions to Reduce Emergency Department Prescribing of Opioid Medications
Sangal R, Rothenberg C, Hawk K, D'Onofrio G, Hsiao A, Solad Y, Venkatesh A. Real-World Observational Evaluation of Common Interventions to Reduce Emergency Department Prescribing of Opioid Medications. The Joint Commission Journal On Quality And Patient Safety 2023, 49: 239-246. PMID: 36914528, DOI: 10.1016/j.jcjq.2023.01.013.Peer-Reviewed Original ResearchConceptsOpioid prescribingED visitsElectronic health recordsOpioid prescriptionsEmergency department opioid prescriptionsAnalgesia prescriptionOpioid stewardshipOpioid medicationsSecondary outcomesPrimary outcomePreintervention periodInterruptive alertsCommon interventionPrescribingAlert fatigueElectronic prescribingPrevious interventionsHospital systemObservational evaluationHealth recordsVisitsStewardship policiesInterventionOutcomesPrescriptionExploratory Descriptive Analysis of Smart Speaker Utilization in the Emergency Department During the COVID-19 Pandemic
Franco J, Solad Y, Venkatesh A, Van Tonder R, Solod A, Stachowiak T, Hsiao A, Sangal R. Exploratory Descriptive Analysis of Smart Speaker Utilization in the Emergency Department During the COVID-19 Pandemic. Journal Of Emergency Medicine 2023, 64: 506-512. PMID: 36990854, PMCID: PMC9837211, DOI: 10.1016/j.jemermed.2023.01.004.Peer-Reviewed Original ResearchConceptsEmergency departmentRetrospective observational studyNight shift hoursCOVID-19 pandemicHuman Services OfficePatient satisfactionTelehealth deliveryObservational studyCare conversationsPatient communicationHospital roomHealth Insurance PortabilityExploratory descriptive analysisStaff wellbeingFuture studiesInsurance PortabilityDepartmentDescriptive analysisAccountability ActPandemicPatientsHospitalClinicians
2022
COVID-19 surge readiness: use cases demonstrating how hospitals leveraged digital identity access management for infection control and pandemic response
Gellert G, Kelly S, Hsiao A, Herrick B, Weis D, Lutz J, Stanton G, Bonilla S, Borgasano D, Erich M, Reilly C, Johnston D. COVID-19 surge readiness: use cases demonstrating how hospitals leveraged digital identity access management for infection control and pandemic response. BMJ Health & Care Informatics Online 2022, 29: e100680. PMID: 36423933, PMCID: PMC9692137, DOI: 10.1136/bmjhci-2022-100680.Peer-Reviewed Original ResearchConceptsInfection controlCare deliveryCOVID-19SARS-CoV-2Volume of patientsPandemic responseEpidemic infectious diseasesHospitals/health systemsTelehealth consultsClinical careUse casesInfectious diseasesHealth systemPatient safetyContact tracingPatientsVirtual visitsPatient informationHigh infectiousnessIsolation unitHospitalClinical workflowShift startTemperature checksIdentity Access ManagementAlerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure
Ahmad T, Desai NR, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Dhar R, Hsiao A, Kashyap N, Allen L, Velazquez EJ, Wilson FP. Alerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure. JAMA Cardiology 2022, 7: 905-912. PMID: 35947362, PMCID: PMC9366654, DOI: 10.1001/jamacardio.2022.2496.Peer-Reviewed Original ResearchConceptsUsual care groupElectronic health recordsHeart failureAlert groupMedian agePrimary outcomeFemale patientsTerminal pro-brain natriuretic peptide levelsYale New Haven Health SystemPro-brain natriuretic peptide levelsMedian NT-proBNP levelLeft ventricular ejection fractionLarge tertiary care centerHeart failure hospitalizationHeart failure medicationsNatriuretic peptide levelsNT-proBNP levelsHealth recordsHours of admissionTertiary care centerVentricular ejection fractionRate of hospitalizationIntensive care unitEthnicity groupsSmall community hospitalAligning mission to digital health strategy in academic medical centers
Cohen AB, Stump L, Krumholz HM, Cartiera M, Jain S, Scott Sussman L, Hsiao A, Lindop W, Ying AK, Kaul RL, Balcezak TJ, Tereffe W, Comerford M, Jacoby D, Navai N. Aligning mission to digital health strategy in academic medical centers. Npj Digital Medicine 2022, 5: 67. PMID: 35654885, PMCID: PMC9163186, DOI: 10.1038/s41746-022-00608-7.Peer-Reviewed Original Research
2021
Development and Validation of a Natural Language Processing Tool to Identify Injuries in Infants Associated With Abuse
Tiyyagura G, Asnes AG, Leventhal JM, Shapiro ED, Auerbach M, Teng W, Powers E, Thomas A, Lindberg DM, McClelland J, Kutryb C, Polzin T, Daughtridge K, Sevin V, Hsiao AL. Development and Validation of a Natural Language Processing Tool to Identify Injuries in Infants Associated With Abuse. Academic Pediatrics 2021, 22: 981-988. PMID: 34780997, PMCID: PMC9095755, DOI: 10.1016/j.acap.2021.11.004.Peer-Reviewed Original ResearchDisparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act
Sangal RB, Powers E, Rothenberg C, Ndumele C, Ulrich A, Hsiao A, Venkatesh AK. Disparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act. Annals Of Emergency Medicine 2021, 78: 593-598. PMID: 34353651, DOI: 10.1016/j.annemergmed.2021.06.014.Peer-Reviewed Original ResearchConceptsProportion of patientsPatient portal accessEmergency departmentOpen notesClinical notesPortal accessPublic insuranceUrgent care centersCentury Cures ActDifferent patient demographicsSingle health systemPatient demographicsPrimary outcomeCures ActPatient utilizationPatient visitsCare centerObservational studyPatientsDigital health toolsAge 18Health systemHealth toolsUnique barriersNon-English speakersAn Integrated Approach to Deploy Panel-Based Pharmacogenetic Testing and Clinical Decision Support.
Pulk RA, Hsiao AL, Murray MF, Stump L, Schulz WL. An Integrated Approach to Deploy Panel-Based Pharmacogenetic Testing and Clinical Decision Support. The Journal Of Applied Laboratory Medicine 2021, 6: 1094-1096. PMID: 34125206, DOI: 10.1093/jalm/jfab043.Peer-Reviewed Original ResearchREVeAL-HF Design and Rationale of a Pragmatic Randomized Controlled Trial Embedded Within Routine Clinical Practice
Ahmad T, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Hsiao A, Kashyap N, Velazquez EJ, Desai NR, Wilson FP. REVeAL-HF Design and Rationale of a Pragmatic Randomized Controlled Trial Embedded Within Routine Clinical Practice. JACC Heart Failure 2021, 9: 409-419. PMID: 33992566, DOI: 10.1016/j.jchf.2021.03.006.Peer-Reviewed Original ResearchConceptsHeart failurePatient outcomesClinical decision makingN-terminal pro-B-type natriuretic peptide levelsPro-B-type natriuretic peptide levelsPragmatic Randomized Controlled TrialIntravenous diuretic agentsNatriuretic peptide levelsRandomized Controlled TrialsRoutine clinical practiceEvidence-based interventionsElectronic health recordsControlled TrialsPatient populationAccurate prognosticationCommon causeDiuretic agentsPeptide levelsClinical practicePg/TrialsHealth recordsSignificant riskMortalityOutcomesClinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection
McPadden J, Warner F, Young HP, Hurley NC, Pulk RA, Singh A, Durant TJS, Gong G, Desai N, Haimovich A, Taylor RA, Gunel M, Dela Cruz CS, Farhadian SF, Siner J, Villanueva M, Churchwell K, Hsiao A, Torre CJ, Velazquez EJ, Herbst RS, Iwasaki A, Ko AI, Mortazavi BJ, Krumholz HM, Schulz WL. Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection. PLOS ONE 2021, 16: e0243291. PMID: 33788846, PMCID: PMC8011821, DOI: 10.1371/journal.pone.0243291.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionYale New Haven HealthSARS-CoV-2Hospital mortalityRisk of admissionMale sexRisk factorsSARS-CoV-2 testingInvasive mechanical ventilationSevere acute respiratory syndrome virusBurden of diseaseRT-PCR testingAcademic health systemDiverse patient populationsRespiratory syndrome virusEthnic groupsAdult patientsClinical characteristicsDischarge dispositionRespiratory supportPrimary outcomeTreatment guidelinesMechanical ventilationRetrospective studyPatient populationEarly identification of patients with acute gastrointestinal bleeding using natural language processing and decision rules
Shung D, Tsay C, Laine L, Chang D, Li F, Thomas P, Partridge C, Simonov M, Hsiao A, Tay JK, Taylor A. Early identification of patients with acute gastrointestinal bleeding using natural language processing and decision rules. Journal Of Gastroenterology And Hepatology 2021, 36: 1590-1597. PMID: 33105045, DOI: 10.1111/jgh.15313.Peer-Reviewed Original ResearchConceptsNatural language processingElectronic health recordsLanguage processingNLP algorithmSystematized NomenclatureReal timeAcute gastrointestinal bleedingBidirectional Encoder RepresentationsDecision rulesEHR-based phenotyping algorithmsGastrointestinal bleedingRisk stratification scoresEncoder RepresentationsData elementsPhenotyping algorithmStratification scoresHealth recordsAlgorithmPhenotyping of patientsEmergency department patientsTime of presentationRisk stratification modelED reviewDeploymentExternal validation