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Wagholikar, Kavishwar

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Wagholikar

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Kavishwar

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Wagholikar, Kavishwar

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    Publication
    Evolving Research Data Sharing Networks to Clinical App Sharing Networks
    (American Medical Informatics Association, 2017) Wagholikar, Kavishwar; Jain, Rahul; Oliveira, Eliel; Mandel, Joshua; Klann, Jeffery; Colas, Ricardo; Patil, Prasad; Yadav, Kuladip; Mandl, Kenneth D.; Carton, Thomas; Murphy, Shawn N.
    Research networks for data sharing are growing into a large platform for pragmatic clinical trials to generate quality evidence for shared medical decision-making. Institutions partnering in the networks have made large investments in developing the infrastructure for sharing data. We investigate whether institutions partnering on Patient-Centered Outcomes Research Institute’s (PCORI) network can share clinical apps. At two different sites, we imported patient data in PCORI’s clinical data model (CDM) format into i2b2 repositories, and adapted the SMART-on-FHIR cell to perform CDM-to-FHIR translation, serving demographics, laboratory results and diagnoses. We performed manual validations and tested the platform using four apps from the SMART app gallery. Our study demonstrates an approach to extend the research infrastructure to allow the partnering institutions to run shared clinical apps, and highlights the involved challenges. Our results, tooling and publically accessible data service can potentially transform research networks into clinical app sharing networks and pave the way towards a learning health system.
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    Feasibility of Homomorphic Encryption for Sharing I2B2 Aggregate-Level Data in the Cloud
    (American Medical Informatics Association, 2017) Raisaro, Jean Louis; Klann, Jeffrey; Wagholikar, Kavishwar; Estiri, Hossein; Hubaux, Jean-Pierre; Murphy, Shawn
    The biomedical community is lagging in the adoption of cloud computing for the management of medical data. The primary obstacles are concerns about privacy and security. In this paper, we explore the feasibility of using advanced privacy-enhancing technologies in order to enable the sharing of sensitive clinical data in a public cloud. Our goal is to facilitate sharing of clinical data in the cloud by minimizing the risk of unintended leakage of sensitive clinical information. In particular, we focus on homomorphic encryption, a specific type of encryption that offers the ability to run computation on the data while the data remains encrypted. This paper demonstrates that homomorphic encryption can be used efficiently to compute aggregating queries on the ciphertexts, along with providing end-to-end confidentiality of aggregate-level data from the i2b2 data model.
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    Automating Installation of the Integrating Biology and the Bedside (i2b2) Platform
    (SAGE Publications, 2018) Wagholikar, Kavishwar; Mendis, Michael; Dessai, Pralav; Sanz, Javier; Law, Sindy; Gilson, Micheal; Sanders, Stephan; Vangala, Mahesh; Bell, Douglas S; Murphy, Shawn
    Informatics for Integrating Biology and the Bedside (i2b2) is an open source clinical data analytics platform used at more than 150 institutions for querying patient data. An i2b2 installation (called hive) comprises several i2b2 cells that provide different functionalities. Given the complex architecture of i2b2 installation, creating a working installation of the platform is challenging for new users. This is despite the availability of extensive documentation for i2b2 and access to a large and active mailing list community of i2b2 users. To address this problem, we have created an automated installation package, called i2b2-quickstart, which automatically downloads the latest i2b2 source code and dependencies, and compiles and configures the i2b2 cells to create a functional i2b2 hive installation. This package will serve as a convenient starting point and reference implementation that will facilitate researchers in the installation and exploration of the i2b2 platform.
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    SMART-on-FHIR implemented over i2b2
    (Oxford University Press, 2016) Wagholikar, Kavishwar; Mandel, Joshua; Klann, Jeffery G; Wattanasin, Nich; Mendis, Michael; Chute, Christopher G; Mandl, Kenneth; Murphy, Shawn
    We have developed an interface to serve patient data from Informatics for Integrating Biology and the Bedside (i2b2) repositories in the Fast Healthcare Interoperability Resources (FHIR) format, referred to as a SMART-on-FHIR cell. The cell serves FHIR resources on a per-patient basis, and supports the “substitutable” modular third-party applications (SMART) OAuth2 specification for authorization of client applications. It is implemented as an i2b2 server plug-in, consisting of 6 modules: authentication, REST, i2b2-to-FHIR converter, resource enrichment, query engine, and cache. The source code is freely available as open source. We tested the cell by accessing resources from a test i2b2 installation, demonstrating that a SMART app can be launched from the cell that accesses patient data stored in i2b2. We successfully retrieved demographics, medications, labs, and diagnoses for test patients. The SMART-on-FHIR cell will enable i2b2 sites to provide simplified but secure data access in FHIR format, and will spur innovation and interoperability. Further, it transforms i2b2 into an apps platform.
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    Medical subdomain classification of clinical notes using a machine learning-based natural language processing approach
    (BioMed Central, 2017) Weng, Wei-Hung; Wagholikar, Kavishwar; McCray, Alexa; Szolovits, Peter; Chueh, Henry
    Background: The medical subdomain of a clinical note, such as cardiology or neurology, is useful content-derived metadata for developing machine learning downstream applications. To classify the medical subdomain of a note accurately, we have constructed a machine learning-based natural language processing (NLP) pipeline and developed medical subdomain classifiers based on the content of the note. Methods: We constructed the pipeline using the clinical NLP system, clinical Text Analysis and Knowledge Extraction System (cTAKES), the Unified Medical Language System (UMLS) Metathesaurus, Semantic Network, and learning algorithms to extract features from two datasets — clinical notes from Integrating Data for Analysis, Anonymization, and Sharing (iDASH) data repository (n = 431) and Massachusetts General Hospital (MGH) (n = 91,237), and built medical subdomain classifiers with different combinations of data representation methods and supervised learning algorithms. We evaluated the performance of classifiers and their portability across the two datasets. Results: The convolutional recurrent neural network with neural word embeddings trained-medical subdomain classifier yielded the best performance measurement on iDASH and MGH datasets with area under receiver operating characteristic curve (AUC) of 0.975 and 0.991, and F1 scores of 0.845 and 0.870, respectively. Considering better clinical interpretability, linear support vector machine-trained medical subdomain classifier using hybrid bag-of-words and clinically relevant UMLS concepts as the feature representation, with term frequency-inverse document frequency (tf-idf)-weighting, outperformed other shallow learning classifiers on iDASH and MGH datasets with AUC of 0.957 and 0.964, and F1 scores of 0.932 and 0.934 respectively. We trained classifiers on one dataset, applied to the other dataset and yielded the threshold of F1 score of 0.7 in classifiers for half of the medical subdomains we studied. Conclusion: Our study shows that a supervised learning-based NLP approach is useful to develop medical subdomain classifiers. The deep learning algorithm with distributed word representation yields better performance yet shallow learning algorithms with the word and concept representation achieves comparable performance with better clinical interpretability. Portable classifiers may also be used across datasets from different institutions. Electronic supplementary material The online version of this article (10.1186/s12911-017-0556-8) contains supplementary material, which is available to authorized users.