Coded clinical data are crucial in biomedical informatics research. While it is well known that electronic medical records often contain coding errors, numerous studies rely on International Classification of Diseases (ICD) codes for phenotyping in cohort assembly, statistical analysis, and AI modeling. Although fairness hasbecome an important focus in AI research, the potential biases embedded in coded clinical data have received less attention. In this study, we employed a race- and sex-agnostic AI phenotyping model to assess coding fairness across 203 ICD code blocks within the Veterans Health Administration Clinical Data Warehouse. Our findings revealed variability in coding consistency across demographic subgroups, including sex, race, and ethnicity. Notably, over 50% of the code blocks exhibitedstatisticallysignificant differences in discrepancies between AI-generated and ICD-based phenotypesacross these demographic groups. These results suggest the need to recognize and address demographic-related coding discrepancies to ensure coding fairness.
Lung cancer remains a significant challenge in public health, ranking among the leading causes of cancer-related mortality. Low-dose computed tomography (LDCT) -based lung cancer screening has emerged as an effective tool for early detection, particularly in high-risk populations. However, interpreting lung nodule characteristics from radiology reports can often be time-consuming and labor-intensive due to the length and inherent ambiguity of the reports, even with standardized reporting requirements like Lung-RADS. Generating Lung-RADS assessments from original radiology reports is a significant task for radiologists. This study addresses these challenges by developing an in-context learning framework utilizing large language models (LLMs). In this process, we aimed to identify the best approach that accurately categorizes lung nodules and streamlines management decisions, providing robust and interpretable decision support. Overall, this research aims to reduce the time and effort of the radiologist in lung cancer screening, ultimately enhancing efficiency and accuracy and enabling timely and precise interventions.
Intimate partner homicide (IPH) remains a major yet understudied cause of maternal mortality among U.S. women of childbearing age (WCBA). We leveraged the National Violent Death Reporting System (NVDRS) and county-level Maternal Vulnerability Index (MVI) data from 2018-2022 to train three machine learning models-logistic regression, random forest, and XGBoost-to classify whether homicides were IPH. Among 11,498 homicides involving WCBA, 33% were IPH. XGBoost achieved the best performance (F1-score = 0.83, AUPRC = 0.87), prompting further examination of key predictors via model explainability. Results indicated that acute interpersonal conflicts (e.g., arguments, jealousy), prior IPV victimization, and structural vulnerabilities (e.g., reproductive healthcare access, physical environment) were influential predictors of IPH. By illustrating the interplay of individual, interpersonal, and broader community-level risk factors, our study shows how machine learning can inform multilevel strategies to prevent IPH and improve maternal health.
Documenting clients, screenings and vaccinations administered is of particular importance during mass vaccination, since information regarding uptake is critical for monitoring adverse effects and vaccine efficacy. This is especially essential when a newly-developed vaccine is being dispensed or when multiple doses of vaccine are needed per person. Despite these needs, there is no uniform or integrated system for effective vaccine data collection. This work focuses on modernizing public health infrastructure through informatics. In this paper, we describe and analyze five types of electronic technologies for registration and screening in vaccination clinics. We contrast their functionalities, usability and operations performance based on time-motion studies and service data collected during actual influenza vaccination campaigns. We evaluate their dispensing performance under an optimal dispensing clinic design. Our analysis shows that each of these electronic technologies can improve overall throughput by 16% to 45%. Based on our findings, we design a prototypical registration and screening system with integrated information flow that can be used for dispensing, monitoring and assessing mass vaccination. The system connects to the local Immunization Information System and electronic medical record systems. The design is flexible and adaptable for different types of medical countermeasures, and is suitable for regional public health departments. Our approach bridges research and public health informatics in a practical way, demonstrating how data can guide both system design and public health response planning.
Researchers have developed pharmacogenomics datasets for various purposes, such as biomarker identification, yet drug response prediction models often underperform due to dataset inconsistencies. These variations arise from inter-tumoral heterogeneity, experimental conditions, and cell subtype complexity, limiting model generalizability. To address this, we propose a computational model based on Aggregated Learning (AL) to enhance drug response prediction by learning from inconsistencies across multiple datasets. Our model minimizes discrepancies by training on overlapping inconsistent data points from three pharmacogenomic datasets-CCLE, GDSC2, and gCSI. Compared to four baseline methods-Selecting Better (SB), Result Average (RA), Combining Data (CD), and Model Average (MA)-our approach achieved superior performance with lower Mean Absolute Error (MAE) scores: 0.090 (CCLE-GDSC), 0.096 (CCLE-gCSI), and 0.081 (GDSC-gCSI). These results demonstrate that addressing inconsistencies enhances prediction accuracy and generalizability, making our model a promising solution for robust drug response predictions.
