Publications

2022

Kim, Jeongeun, Mitchell Izower, and Yuri Quintana. (2022) 2022. “Parsable Clinical Trial Eligibility Criteria Representation Using Natural Language Processing.”. AMIA . Annual Symposium Proceedings. AMIA Symposium 2022: 616-24.

Successful clinical trials offer better treatments to current or future patients and advance scientific research.1,2,3 Clinical trials define the target population using specific eligibility criteria to ensure an optimal enrollment sample.4 Clinical trial eligibility criteria are often described in unstructured free-text5 which makes automation of the recruitment process challenging. This contributes to the long-standing problem of insufficient enrollment of clinical trials.6,7 This study uses a machine learning approach to extract clinical trial eligibility criteria, and convert them into structured queryable formats using descriptive statistics based on medical entity frequency and binary entity relationships. We present a JSON-based structural representation of clinical trials eligibility criteria for clinical trials to follow.

2021

EM, Borycki, Kushniruk AW, Kletke R, Vimarlund V, Sentharijah Y, and Y. Quintana. 2021. “Enhancing Safety During a Pandemic Using Virtual Care Remote Monitoring Technologies”. IMIA Yearbook of Medical Informatics - International Medical Informatics Association.

Objectives: This paper describes a methodology for gathering requirements and early design of remote monitoring technology (RMT) for enhancing patient safety during pandemics using
virtual care technologies. As pandemics such as COrona VIrus Disease (COVID-19) progress there is an increasing need for effective virtual care and RMT to support patient care while they are at home.


Methods: The authors describe their work in conducting literature reviews by searching PubMed.gov and the grey literature for articles, and government websites with guidelines describing the signs and symptoms of COVID-19, as well as the progression of the disease. The reviews focused on identifying gaps where RMT could be applied in novel ways and formed the basis for the subsequent modelling of use cases for applying RMT described in this paper.


Results: The work was conducted in the context of a new Home of the Future laboratory which has been set up at the University of Victoria. The literature review led to the development of
a number of object-oriented models for deploying RMT. This modeling is being used for a number of purposes, including for education of students in health infomatics as well as testing of new use cases for RMT with industrial collaborators and projects within the smart home of the future laboratory.


Conclusions: Object-oriented modeling, based on analysis of gaps in the literature, was found to be a useful approach for describing, communicating and teaching about potential new
uses of RMT.

Keywords: Remote monitoring technology, assistive living, COVID-19, pandemics, user requirements, safety, public health informatics, health informatics


Yearb Med Inform 2021: http://dx.doi.org/10.1055/s-0041-1726485

L, Zoe, and Quintana Y. 2021. “Challenges to Global Standardization of Outcome Measures”. In AMIA 2021 Virtual Informatics Summit. American Medical Informatics Association.
Global standardization of outcome measures for disease states can help researchers and healthcare providers compare healthcare institutions’ and populations' health outcomes. Despite the creation of standardized outcome sets, clinical institutions' adoption of these sets is not common. A literature review shows that among the challenges to standardizing outcome measures include the difficulties of achieving consensus in the working groups creating these outcome sets, the tradeoffs made when selecting outcome measurement tools, and the high costs of implementing a new or different set of outcome measures. The duplication of effort to create these standard sets can also limit standardization, which could be minimized through increased transparency of how these standard sets are developed. We propose some approaches to improve how to create and implement standard sets to broaden their usability across institutions.
BR, South, Chapman WW, Dankwa-Mullan I, Matheny M, and Quintana Y. 2021. “Challenges and Opportunities for Implementing Artificial Intelligence at the Speed of Technology Innovation During the COVID-19 Era”. In AMIA 2021 Virtual Informatics Summit. American Medical Informatics Association Conference.
The COVID-19 pandemic has created multiple opportunities to implement Artificial Intelligence (AI) technologies in new ways that address the initial infectious curve (e.g., triaging patients and disseminating information during disease outbreaks), as well as the subsequent curves of pandemic sequelae (managing gaps in care of chronic conditions, addressing new and exacerbated mental health needs, and rectifying worsening health disparities. However,
numerous challenges limit scaling development and application of AI technologies in healthcare settings, especially in the context of a rapidly evolving public health emergency. Data representing diverse patient cohorts are necessary both to train and to test systems but often are labor intensive to create and deidentify. The need for new codes and concepts can delay data availability. Biases in data must be identified, evaluated, and managed to mitigate
downstream effects. System performance must be continuously monitored and validated as clinical information, such as disease transmission characteristics, become available. This panel will discuss these challenges and propose solutions that include ensuring adequate, equitable, and unbiased data sources are used for AI development, validation of AI in clinical settings, with the context of the rapidly evolving COVID-19 public health crisis as a discussion focus.
BZ, Fite, Hinostroza V, States L, Hicks-Nelson A, Baratto L, Kallianos K, Codari M, et al. 2021. “Increasing Diversity in Radiology and Molecular Imaging: Current Challenges”. Molecular Imaging and Biology , no. Apr 26, 2021: 1–14.
This paper summarizes the 2020 Diversity in Radiology and Molecular Imaging: What We Need to Know Conference, a three-day virtual conference held September 9-11, 2020. The World Molecular Imaging Society (WMIS) and Stanford University jointly organized this event to provide a forum for WMIS members and affiliates worldwide to openly discuss diversity in science, technology, engineering, and mathematics (STEM). The participants discussed three main conference themes, “Racial Diversity in STEM,” “Women in STEM,” and “Global Health,” which were discussed through seven plenary lectures, twelve scientific presentations, and nine roundtable discussions. Breakout sessions were designed to flip the classroom and seek input from attendees on important topics such as increasing the representation of underrepresented minority (URM) members and women in STEM, generating pipeline programs in the fields of molecular imaging, supporting existing URM and women members in their career pursuits, developing mechanisms to effectively address microaggressions, providing leadership opportunities for URM and women STEM members, improving global health research, and developing strategies to advance culturally competent healthcare.
I, Dankwa-Mullan, Scheufele E, Matheny ME, Quintana Y, Chapman WW, Jackson G, and South BR. 2021. “A Proposed Strategy on Integrating Health Equity and Racial Justice into the Artificial Intelligence Development Lifecycle”. Journal of Health Care for the Poor and Underserved 32: 300–317.

The COVID-19 pandemic has created multiple opportunities to deploy artificial intelligence (AI)-driven tools and applied interventions to understand, mitigate, and manage the pandemic and its consequences. The disproportionate impact of COVID-19 on racial-ethnic and socially disadvantaged populations underscores the need to anticipate and address social inequalities and health disparities in AI development and application. Before the pandemic, there was growing optimism about AI's role in addressing inequities and enhancing personalized care. Unfortunately, ethical and social issues that are encountered in scaling, developing, and applying advanced technologies in healthcare settings have intensified during the rapidly evolving public health crisis. Critical voices concerned with the 'disruptive' potentials and risk for 'engineered inequities' have called for reexamining ethical guidelines in the development and application of AI. This paper proposes a framework to incorporate ethical AI principles into the development process in ways that intentionally promote racial health equity and social justice.  Without centering on equity, justice and ethical AI, these tools may exacerbate structural inequities that can lead to disparate health outcomes.

Izower, Mitchell, Zoe Liao, Jeongeun Kim, and Yuri Quintana. (2021) 2021. “A Proposed Patient-Inclusive Methodology for Developing and Validating Telehealth Surveys That Include Social Determinants of Health.”. AMIA . Annual Symposium Proceedings. AMIA Symposium 2021: 565-70.

This paper discusses a method to develop and validate telehealth surveys that include social determinants of health domains. We performed a scoping review of literature on measuring social determinants of health and extracted 50 social determinants of health domains. We evaluated 14 validated telehealth surveys for questions associated with social determinants of health. We categorized the questions from the validated telehealth surveys using our extracted social determinants of health. We found that current validated telehealth-specific surveys only cover 16 (32%) of social determinants of health domains, with the most commonly evaluated domains being "Medical Needs" and "Social Connections/Isolation". Telehealth services are a valuable modality to provide care to patients. Surveying patients is integral to performing quality improvement and improving patient outcomes. Social determinants of health are important factors in determining patient outcomes. We propose an approach to validating the missing domains and evaluating survey validity.

2020

Y, Quintana, and Torous J. 2020. “A Framework for Evaluation of Mobile Apps for Youth Mental Health”. Guelph, Ontario, Canada: Homewood Research Institute.
This report represents a key step toward that goal. It presents a Framework that a) identifies critical issues that must be addressed in designing and evaluating apps, and b) outlines criteria and protocols for rigorously evaluating these issues to generate the evidence needed by those looking for credible apps. This type of Framework is novel and groundbreaking.
M, Nasr, Karray F, and Quintana Y. 2020. “Human-Machine Interaction Platform for Home Care Support System”. In 2020 IEEE International Conference on Systems, Man, and Cybernetics (SMC), 4210-15. Toronto, ON, Canada, October 14, 2020: IEEE.

Abstract—There has been a tremendous increase in the costs of caring for older adults owing to the fact that societies are aging around around the world. This has led to a decrease in the number of caregivers who are able to assist. Investigative studies indicate that older adults require social as well as physical support for their well-being which prompted researchers to use social and cognitive robots and advanced human machine interaction devices. However, most of these studies have shortcomings when it comes to providing means of a natural interaction with the machine. With speech being the most natural way for human communication and the huge developments in the Internet of Things and smart homes, equipping a robotic system with powerful natural speech interaction capabilities to maintain a conversation with an elderly while being linked to other smart home devices shows a promising direction. This paper describes a scalable and expandable system with main goal of designing a natural speech-enabled system for older adults that is capable of linking to multiple active agents with minimal integration efforts. The system makes use of the power of commercially available digital assistant systems, integrated with an intelligent conversational agent, robotics, and smart wearables. The main advantage of the system is that it could provide a portion of the population, namely older adults and the disabled, the flexibility of interacting naturally with powerful social robots in smart home environments, hence providing them with much needed independence.


Index Terms—Social robots, Human-Robot Interaction, Elderly care, Artificial Intelligence, Speech Interaction, Ambient Assisted Living

C, Tassone, Keshavjee K, Paglialonga A, Moreira N, Pinto J, and Quintana Y. 2020. “Evaluation of Mobile Apps for Treatment of Patients at Risk of Developing Gestational Diabetes.”. Health Informatics J 26 (3): 1983-94.
Keywords: app evaluation, diabetes, gestational diabetes, health apps, mHealth, patient empowerment, prediabetes