| 1. |
- Kanai, M, et al.
(författare)
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- 2023
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swepub:Mat__t
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| 2. |
- De Silva, Kushan, et al.
(författare)
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Clinical notes as prognostic markers of mortality associated with diabetes mellitus following critical care : A retrospective cohort analysis using machine learning and unstructured big data
- 2021
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Ingår i: Computers in Biology and Medicine. - : Elsevier. - 0010-4825 .- 1879-0534. ; 132
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Tidskriftsartikel (refereegranskat)abstract
- Background: Clinical notes are ubiquitous resources offering potential value in optimizing critical care via data mining technologies. Objective: To determine the predictive value of clinical notes as prognostic markers of 1-year all-cause mortality among people with diabetes following critical care. Materials and methods: Mortality of diabetes patients were predicted using three cohorts of clinical text in a critical care database, written by physicians (n = 45253), nurses (159027), and both (n = 204280). Natural language processing was used to pre-process text documents and LASSO-regularized logistic regression models were trained and tested. Confusion matrix metrics of each model were calculated and AUROC estimates between models were compared. All predictive words and corresponding coefficients were extracted. Outcome probability associated with each text document was estimated. Results: Models built on clinical text of physicians, nurses, and the combined cohort predicted mortality with AUROC of 0.996, 0.893, and 0.922, respectively. Predictive performance of the models significantly differed from one another whereas inter-rater reliability ranged from substantial to almost perfect across them. Number of predictive words with non-zero coefficients were 3994, 8159, and 10579, respectively, in the models of physicians, nurses, and the combined cohort. Physicians & rsquo; and nursing notes, both individually and when combined, strongly predicted 1-year all-cause mortality among people with diabetes following critical care. Conclusion: Clinical notes of physicians and nurses are strong and novel prognostic markers of diabetes-associated mortality in critical care, offering potentially generalizable and scalable applications. Clinical text-derived personalized risk estimates of prognostic outcomes such as mortality could be used to optimize patient care.
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| 3. |
- Gonzalez-Ericsson, Paula, et al.
(författare)
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The path to a better biomarker: application of a risk management framework for the implementation of PD‐L1 and TILs as immuno‐oncology biomarkers into breast cancer clinical trials and daily practice
- 2020
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Ingår i: Journal of Pathology. - : Wiley. - 1096-9896 .- 0022-3417. ; 250:5, s. 667-684
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Forskningsöversikt (refereegranskat)abstract
- Immune checkpoint inhibitor therapies targeting PD‐1/PD‐L1 are now the standard of care in oncology across several hematologic and solid tumor types, including triple negative breast cancer (TNBC). Patients with metastatic or locally advanced TNBC with PD‐L1 expression on immune cells occupying ≥1% of tumor area demonstrated survival benefit with the addition of atezolizumab to nab‐paclitaxel. However, concerns regarding variability between immunohistochemical PD‐L1 assay performance and inter‐reader reproducibility have been raised. High tumor‐infiltrating lymphocytes (TILs) have also been associated with response to PD‐1/PD‐L1 inhibitors in patients with breast cancer (BC). TILs can be easily assessed on hematoxylin and eosin–stained slides and have shown reliable inter‐reader reproducibility. As an established prognostic factor in early stage TNBC, TILs are soon anticipated to be reported in daily practice in many pathology laboratories worldwide. Because TILs and PD‐L1 are parts of an immunological spectrum in BC, we propose the systematic implementation of combined PD‐L1 and TIL analyses as a more comprehensive immuno‐oncological biomarker for patient selection for PD‐1/PD‐L1 inhibition‐based therapy in patients with BC. Although practical and regulatory considerations differ by jurisdiction, the pathology community has the responsibility to patients to implement assays that lead to optimal patient selection. We propose herewith a risk‐management framework that may help mitigate the risks of suboptimal patient selection for immuno‐therapeutic approaches in clinical trials and daily practice based on combined TILs/PD‐L1 assessment in BC.
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| 4. |
- Swanson, Heather Anne, et al.
(författare)
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History as grounds for interdisciplinarity : promoting sustainable woodlands via an integrative ecological and socio-cultural perspective
- 2021
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Ingår i: One Earth. - : Elsevier. - 2590-3330 .- 2590-3322. ; 4:2, s. 226-237
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Tidskriftsartikel (refereegranskat)abstract
- While calls for interdisciplinary research in environmental contexts are common, it often remains a struggle to integrate humanities/qualitative social sciences insights with those of bio-physical approaches. We propose that cross-disciplinary historical perspectives can open new avenues for collaboration among social and natural scientists while expanding visions of possible future environments and management scenarios. We make these arguments through attention to woodlands, which are under pressure from complex socio-ecological stressors that can best be understood from interdisciplinary perspectives. By combining deep ecological and shallower social historical approaches, we show how history can both enrich our understandings of woodland pasts and provide a ground for better combining the case-based insights of humanistic history with those of deep-time ecological history. We conclude that such interdisciplinary historical approaches are important not only for research, but also for management (especially rewilding and scenario-building), as the surprisingly large range of past changes reminds us that future conditions can be more varied than typically acknowledged.
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