PheProb improves statistical power for association studies relative to standard thresholding approaches by leveraging information about the phenotype in the billing code counts. The PheProb approach has direct applications where efficient approaches are required, such as in Phenome-Wide Association Studies.
Recent advancements in wearable technology have improved lifestyle and medical practices, enabling personalized care ranging from fitness tracking, to real-time health monitoring, to predictive sensing. Wearable devices serve as an interface between humans and technology; however, this integration is far from seamless. These devices face various limitations such as size, biocompatibility, and battery constraints wherein batteries are bulky, are expensive, and require regular replacement. On-body energy harvesting presents a promising alternative to battery power by utilizing the human body's continuous generation of energy. This review paper begins with an investigation of contemporary energy harvesting methods, with a deep focus on piezoelectricity. We then highlight the materials, configurations, and structures of such methods for self-powered devices. Here, we propose a novel combination of thin-film composites, kirigami patterns, and auxetic structures to lay the groundwork for an integrated piezoelectric system to monitor and sense. This approach has the potential to maximize energy output by amplifying the piezoelectric effect and manipulating the strain distribution. As a departure from bulky, rigid device design, we explore compositions and microfabrication processes for conformable energy harvesters. We conclude by discussing the limitations of these harvesters and future directions that expand upon current applications for wearable technology. Further exploration of materials, configurations, and structures introduce interdisciplinary applications for such integrated systems. Considering these factors can revolutionize the production and consumption of energy as wearable technology becomes increasingly prevalent in everyday life.
Objective Efficiently identifying eligible patients is a crucial first step for a successful clinical trial. The objective of this study was to test whether an approach using electronic health record (EHR) data and an ensemble machine learning algorithm incorporating billing codes and data from clinical notes processed by natural language processing (NLP) can improve the efficiency of eligibility screening. Methods We studied patients screened for a clinical trial of rheumatoid arthritis (RA) with one or more International Classification of Diseases (ICD) code for RA and age greater than 35 years, from a tertiary care center and a community hospital. The following three groups of EHR features were considered for the algorithm: 1) structured features, 2) the counts of NLP concepts from notes, 3) health care utilization. All features were linked to dates. We applied random forest and logistic regression with least absolute shrinkage and selection operator penalty against the following two standard approaches: 1) one or more RA ICD code and no ICD codes related to exclusion criteria (ScreenRAICD1+EX) and 2) two or more RA ICD codes (ScreenRAICD2). To test the portability, we trained the algorithm at one institution and tested it at the other. Results In total, 3359 patients at Brigham and Women’s Hospital (BWH) and 642 patients at Faulkner Hospital (FH) were studied, with 461 (13.7%) eligible patients at BWH and 84 (13.4%) at FH. The application of the algorithm reduced ineligible patients from chart review by 40.5% at the tertiary care center and by 57.0% at the community hospital. In contrast, ScreenRAICD2 reduced patients for chart review by 2.7% to 11.3%; ScreenRAICD1+EX reduced patients for chart review by 63% to 65% but excluded 22% to 27% of eligible patients. Conclusion The ensemble machine learning algorithm incorporating billing codes and NLP data increased the efficiency of eligibility screening by reducing the number of patients requiring chart review while not excluding eligible patients. Moreover, this approach can be trained at one institution and applied at another for multicenter clinical trials.
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