Faculty Publications
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Publications by NITK Faculty
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Item Foundations of healthcare informatics(Elsevier, 2021) Annappa, B.; Manoj Kumar, M.V.; Thomas, L.Health informatics fundamentally deals with the acquisition (recording), processing, interpreting, and using of healthcare (patient) data by domain experts. Healthcare informatics generally refers to the management of data/information in healthcare rather than the application of computers in it-which is centered on patient care. The sheer amount of data and imperfection in decision making imply the usage of information systems (particularly process-aware information systems, called PAIS) in managing the healthcare process. Health informatics mainly offers tools for controlling the healthcare process and facilitating the acquisition of medical knowledge (recording). It offers a reliable and fast communication path among the people involved in the healthcare process. © 2021 Elsevier Inc. All rights reserved.Item Hybrid text feature modeling for disease group prediction using unstructured physician notes(Springer Science and Business Media Deutschland GmbH, 2020) S. Krishnan, G.S.; Kamath S․, S.Existing Clinical Decision Support Systems (CDSSs) largely depend on the availability of structured patient data and Electronic Health Records (EHRs) to aid caregivers. However, in case of hospitals in developing countries, structured patient data formats are not widely adopted, where medical professionals still rely on clinical notes in the form of unstructured text. Such unstructured clinical notes recorded by medical personnel can also be a potential source of rich patient-specific information which can be leveraged to build CDSSs, even for hospitals in developing countries. If such unstructured clinical text can be used, the manual and time-consuming process of EHR generation will no longer be required, with huge person-hours and cost savings. In this article, we propose a generic ICD9 disease group prediction CDSS built on unstructured physician notes modeled using hybrid word embeddings. These word embeddings are used to train a deep neural network for effectively predicting ICD9 disease groups. Experimental evaluation showed that the proposed approach outperformed the state-of-the-art disease group prediction model built on structured EHRs by 15% in terms of AUROC and 40% in terms of AUPRC, thus proving our hypothesis and eliminating dependency on availability of structured patient data. © Springer Nature Switzerland AG 2020.Item Diagnostic Code Group Prediction by Integrating Structured and Unstructured Clinical Data(Springer Science and Business Media Deutschland GmbH, 2021) Prabhakar, A.; Shidharth, S.; S. Krishnan, G.S.; Kamath S․, S.Diagnostic coding is a process by which written, verbal and other patient-case related documentation are used for enabling disease prediction, accurate documentation, and insurance settlements. It is a prevalently manual process even in countries that have successfully adopted Electronic Health Record (EHR) systems. The problem is exacerbated in developing countries where widespread adoption of EHR systems is still not at par with Western counterparts. EHRs contain a wealth of patient information embedded in numerical, text, and image formats. A disease prediction model that exploits all this information, enabling accurate and faster diagnosis would be quite beneficial. We address this challenging task by proposing mixed ensemble models consisting of boosting and deep learning architectures for the task of diagnostic code group prediction. The models are trained on a dataset created by integrating features from structured (lab test reports) as well as unstructured (clinical text) data. We analyze the proposed model’s performance on MIMIC-III, an open dataset of clinical data using standard multi-label metrics. Empirical evaluations underscored the significant performance of our approach for this task, compared to state-of-the-art works which rely on a single data source. Our novelty lies in effectively integrating relevant information from both data sources thereby ensuring larger ICD-9 code coverage, handling the inherent class imbalance, and adopting a novel approach to form the ensemble models. © 2021, Springer Nature Switzerland AG.Item LATA – Label attention transformer architectures for ICD-10 coding of unstructured clinical notes(Institute of Electrical and Electronics Engineers Inc., 2021) Mayya, V.; Kamath S․, S.S.; Sugumaran, V.Effective code assignment for patient clinical records in a hospital plays a significant role in the process of standardizing medical records, mainly for streamlining clinical care delivery, billing, and managing insurance claims. The current practice employed is manual coding, usually carried out by trained medical coders, making the process subjective, error-prone, inexact, and time-consuming. To alleviate this cost-intensive process, intelligent coding systems built on patients’ structured electronic medical records are critical. Classification of medical diagnostic codes, like ICD-10, is widely employed to categorize patients’ clinical conditions and associated diagnoses. In this work, we present a neural model LATA, built on Label Attention Transformer Architectures for automatic assignment of ICD-10 codes. Our work is benchmarked on the CodiEsp dataset, a dataset for automatic clinical coding systems for multilingual medical documents, used in the eHealth CLEF 2020-Multilingual Information Extraction Shared Task. The experimental results reveal that the proposed LATA variants outperform their basic BERT counterparts by 33-49% in terms of standard metrics like precision, recall, F1-score and mean average precision. The label attention mechanism also enables direct extraction of textual evidence in medical documents that map to the clinical ICD-10 diagnostic codes. © 2021 IEEE.Item Automated microaneurysms detection for early diagnosis of diabetic retinopathy: A Comprehensive review(Elsevier B.V., 2021) Mayya, V.; Kamath S․, S.S.; Kulkarni, U.Diabetic retinopathy (DR), a chronic disease in which the retina is damaged due to small vessel damage caused by diabetes mellitus, is one of the leading causes of vision impairment in diabetic patients. Detection of the earliest clinical sign of the advent of DR is a critical requirement for intervention and effective treatment. Ophthalmologists are trained to identify DR, based on examining specific minute changes in the eye - microaneurysms, retinal haemorrhages, macular edema and changes in the retinal blood vessels. Segmentation of microaneurysms (MA) is a critical requirement for the early diagnosis of DR and has been the primary focus of the research community over the past few years. In this work, a systematic review of existing literature is carried out to examine the diagnostic use of automated MA detection and segmentation for early DR diagnosis. We mainly focus on existing early DR diagnosis techniques to understand their strengths and weaknesses. Though early diagnosis is performed using colour fundus photography, fluorescein angiography or optical coherence tomography angiography images, our study is limited to colour fundus based techniques. The early DR diagnosis methodologies reviewed in this article can be broadly classified into classical image processing, conventional machine learning (ML), and deep learning (DL) based techniques. Though significant progress has been achieved in these three classes of early DR diagnosis, several challenges and gaps still exist, underscoring a considerable scope for the development of fully automated, user-friendly early DR diagnosis and grading systems. We discuss in detail the challenges that need to be addressed in designing such effective, efficient, and robust algorithms for early DR diagnosis systems and also the ample scope for future research in this area. © 2021Item Ontology-driven Text Feature Modeling for Disease Prediction using Unstructured Radiological Notes(Instituto Politecnico Nacional revista@cic.ipn.mx, 2019) S. Krishnan, G.S.; Kamath S?, S.Clinical Decision Support Systems (CDSSs) support medical personnel by offering aid in decision-making and timely interventions in patient care. Typically such systems are built on structured Electronic Health Records (EHRs), which, unfortunately have a very low adoption rate in developing countries at present. In such situations, clinical notes recorded by medical personnel, though unstructured, can be a significant source for rich patient related information. However, conversion of unstructured clinical notes to a structured EHR form is a manual and time consuming task, underscoring a critical need for more efficient, automated methods. In this paper, a generic disease prediction CDSS built on unstructured radiology text reports is proposed. We incorporate word embeddings and clinical ontologies to model the textual features of the patient data for training a feed-forward neural network for ICD9 disease group prediction. The proposed model built on unstructured text outperformed the state-of-the-art model built on structured data by 9% in terms of AUROC and 23% in terms of AUPRC, thus eliminating the dependency on the availability of structured clinical data. © 2019 Instituto Politecnico Nacional. All rights reserved.Item Ensemble neural models for ICD code prediction using unstructured and structured healthcare data(Elsevier Ltd, 2024) Merchant, A.M.; Shenoy, N.; Lanka, S.; Kamath S․, S.Disease coding is the process of assigning one or more standardized diagnostic codes to clinical notes that are maintained by health practitioners (e.g. clinicians) to track patient condition. Such a coding process is often expensive and error-prone, as human medical coders primarily perform it. Automating diagnostic coding using Artificial Intelligence is seen as an essential solution in Hospital Information Management Systems and approaches built on Convolutional Neural Networks currently perform best. In this work, a neural model built on unstructured clinical text for enabling automatic diagnostic coding for given patient discharge summaries is proposed. We incorporate a structured self-attention mechanism designed to boost learning of label-specific vectors and the significant clinical text snippets associated with a certain label for this purpose. These vectors are then combined with a novel code description pipeline leveraging the descriptions provided for each standardized diagnostic code. The proposed model achieved best performance in terms of standard metrics over the MIMIC-III dataset, outperforming models based on Longformers and Knowledge graphs. Furthermore, to leverage structured clinical data to enhance the proposed model, and to enable improved diagnostic code prediction, model ensembling is considered. A neural model built on structured data by leveraging supervised machine learning algorithms such as random forest and boosting, is designed for multi-class code classification. Experimental results revealed that the proposed ensemble models show promising performance compared to traditional models that rely solely on unstructured or structured clinical data, emphasizing their suitability for real-world deployment. © 2024 The Author(s)