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{userid:"a.april", "refid":"749","repocollections":"","attachment":"","_thumb":"","articletype":"article","sectionheading":"","title":"Electronic Health Record and Semantic Issues Using Fast Healthcare Interoperability Resources: Systematic Mapping Review","year":"2024","author":"F. Amar, A.April, A.Abran","journal":"Journal of Medical Internet Research (JMIR)","volume":"26","number":"e45209","pages":"1-23","month":"","doi":"10.2196\/45209","pubmed":"","pdflink":"","urllink":"https:\/\/www.jmir.org\/2024\/1\/e45209","abstract":"Background: The increasing use of electronic health records and the Internet of Things has led to interoperability issues at different levels (structural and semantic). Standards are important not only for successfully exchanging data but also for appropriately interpreting them (semantic interoperability). Thus, to facilitate the semantic interoperability of data exchanged in health care, considerable resources have been deployed to improve the quality of shared clinical data by structuring and mapping them to the Fast Healthcare Interoperability Resources (FHIR) standard.\r\n\r\nObjective: The aims of this study are 2-fold: to inventory the studies on FHIR semantic interoperability resources and terminologies and to identify and classify the approaches and contributions proposed in these studies.\r\n\r\nMethods: A systematic mapping review (SMR) was conducted using 10 electronic databases as sources of information for inventory and review studies published during 2012 to 2022 on the development and improvement of semantic interoperability using the FHIR standard.\r\n\r\nResults: A total of 70 FHIR studies were selected and analyzed to identify FHIR resource types and terminologies from a semantic perspective. The proposed semantic approaches were classified into 6 categories, namely mapping (31\/126, 24.6%), terminology services (18\/126, 14.3%), resource description framework or web ontology language\u2013based proposals (24\/126, 19%), annotation proposals (18\/126, 14.3%), machine learning (ML) and natural language processing (NLP) proposals (20\/126, 15.9%), and ontology-based proposals (15\/126, 11.9%). From 2012 to 2022, there has been continued research in 6 categories of approaches as well as in new and emerging annotations and ML and NLP proposals. This SMR also classifies the contributions of the selected studies into 5 categories: framework or architecture proposals, model proposals, technique proposals, comparison services, and tool proposals. The most frequent type of contribution is the proposal of a framework or architecture to enable semantic interoperability.\r\n\r\nConclusions: This SMR provides a classification of the different solutions proposed to address semantic interoperability using FHIR at different levels: collecting, extracting and annotating data, modeling electronic health record data from legacy systems, and applying transformation and mapping to FHIR models and terminologies. The use of ML and NLP for unstructured data is promising and has been applied to specific use case scenarios. In addition, terminology services are needed to accelerate their use and adoption; furthermore, techniques and tools to automate annotation and ontology comparison should help reduce human interaction.\r\n","note":"","tags":"electronic health record, EHR, Health Level Seven International Fast Healthcare Interoperability Resources, HL7 FHIR, interoperability, web ontology language, OWL, ontology, semantic, terminology, resource description framework, RDF, machine learning, ML, natural language processing, NLP","weight":749}
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{userid:"david.patch", "articletype":"article","pages":"152-9; discussion 159-60","author":"Shantanu Bhattacharjya, Tanushree Bhattacharjya, Alberto Quaglia, Amar Pal Dhillon, Andrew K Burroughs, David W Patch, Jonathan M Tibballs, Anthony F Watkinson, Keith Rolles, Brian R Davidson","year":"2004","title":"Liver transplantation in cirrhotic patients with small hepatocellular carcinoma: an analysis of pre-operative imaging, explant histology and prognostic histologic indicators.","month":"05","journal":"Dig Surg","publisher":"","volume":"21","number":"2","note":"","tags":"Carcinoma, Hepatocellular,Humans,Liver Cirrhosis,Liver Neoplasms,Liver Transplantation,Neoplasm Staging,Patient Selection,Predictive Value of Tests,Preoperative Care,Prognosis,Retrospective Studies,Survival Analysis,Tomography, X-Ray Computed,Treatment Outcome","booktitle":"","editor":"","abstract":"In recent years, liver transplantation in patients with hepatocellular cancers and cirrhosis has been restricted to those with small cancers (<5 cm for solitary and <3 cm for multifocal HCC with <3 nodules). The selection of patients for liver transplantation is based on pre-operative imaging. The accuracy of imaging correlated with explant histology and the effect of tumour stage has not been evaluated in this selected population.","address":"","school":"","issn":"0253-4886","doi":"10.1159\/000078741","isi":"","pubmed":"15166485","key":"Bhattacharjya2004","howpublished":"","urllink":"","refid":116}
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{userid:"david.patch", "articletype":"article","pages":"805-813","author":"Rafael F Duarte, Julio Delgado, Bronwen E Shaw, David J Wrench, Mark Ethell, David Patch, Amar P Dhillon, Stephen Mackinnon, Mike N Potter, Alberto F Quaglia","year":"2005","title":"Histologic features of the liver biopsy predict the clinical outcome for patients with graft-versus-host disease of the liver.","month":"Oct","journal":"Biol Blood Marrow Transplant","publisher":"","volume":"11","number":"10","note":"","tags":"Adolescent,Adult,Biopsy,Child,Child, Preschool,Female,Graft vs Host Disease,Hematopoietic Stem Cell Transplantation,Humans,Liver Diseases,Male,Middle Aged,Multivariate Analysis,Prognosis,Retrospective Studies,Risk Factors,Survival Analysis","booktitle":"","editor":"","abstract":"We reviewed liver histologic results from all allogeneic hematopoietic stem cell transplant recipients from our institution with a confirmed diagnosis of liver graft-versus-host disease (L-GVHD), no concomitant causes of liver dysfunction, and at least 1 diagnostic liver biopsy sample (n=33) to ascertain whether histologic features predicted clinical outcome. The 1-year probability of nonrelapse mortality (NRM) from the onset of liver dysfunction was 68.15%, with a median overall survival (OS) of 6.2 months for the entire group. Histologic features traditionally linked to the diagnosis of L-GVHD (eg, bile duct damage, bile duct lymphocytic infiltration, portal inflammation, and ductopenia) had no association with patient outcome. However, an extended histologic analysis showed that a high level of lobular inflammation (LI) and a low level of hepatocyte ballooning (HB) were independent favorable prognostic factors for NRM (RR, 5.14; P=.033; and relative risk (RR), 0.18; P=.018, respectively) and OS (RR, 3.99; P=.032; and RR, 0.23; P=.037, respectively). The presence and severity of LI and HB were not associated with patient- or transplant-related characteristics or L-GVHD clinical factors such as timing of the biopsy from the onset of L-GVHD, acute versus chronic presentation, or whether the patients had started immunosuppressive treatment with steroids at the time of the biopsy. In multivariate analysis that included clinical prognostic factors, the combined histologic risk posed by high LI and low HB retained independent favorable prognostic value for NRM (RR, 5.05; P=.015) and OS (RR, 3.31; P=.038). This information, if replicated in other studies, could expand current indications for liver biopsy in patients with L-GVHD, not only to exclude other causes of liver injury, but also to predict clinical outcome, and should be considered in the selection of patients and the design of future trials with new experimental therapies for this complication. Prospective validation of our findings is warranted.","address":"","school":"","issn":"1083-8791","doi":"10.1016\/j.bbmt.2005.06.008","isi":"","pubmed":"16182181","key":"Duarte2005","howpublished":"","urllink":"","refid":99}
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