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Data Mining Applications In Healthcare

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Introduction

Goals of today’s presentation:

Provide an overview of the
technologies that are
relevant to the development
and deployment of data
mining solutions in
healthcare

Allow participants
to evaluate where
the technology is
useful

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What is
Divining knowledge
Data mining?
from data

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.
Topic Outline

Data mining
• Uses
• Algorithms
• Technology

• Applications in
healthcare

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.
Data Mining Uses

• Descriptive
Understand and characterize
Clustering
Summarization
Association Rules
Sequence Discovery

• Predictive
Extrapolate and forecast
Classification
Regression
Time-Series

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
Data Mining Algorithms

• Classification
> Statistical
> K-nearest
neighbors
> Decision trees
▲
▲

ID3
C4.5

> Neural
Networks (Self
Organizing
Maps)

• Clustering
> Hierarchical
> Partitioned
> Genetic
• Association
> Apriori
Algorithm
> If….Then rules

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
Technology solutions

Technology
Data Mining Infrastructure Technologies

• Database Technologies

• On-Line Analytical Processing
(OLAP)
• Visualization Technologies

• Data scrubbing technologies
• Natural Language Processing
(NLP)

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
Database Technologies

•Database
•OLAP

• Data warehouse vs. Data mart

•Visualization

• Relational technologies
> Oracle
> Microsoft

•Scrubbing
•NLP

• XML-databases
> Raining Data

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
On-Line Analytical Processing

•Database
•OLAP

•Visualization

• Analyze multi-dimensional
data

•Scrubbing

• N-dimensional data cubes

•NLP

• Operations
> Roll-up
> Drill-down
> Slice and dice
> Pivot

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Visualization

•Database
•OLAP

• 2D/3D Charts

•Visualization

• Topographic displays

•Scrubbing

• Cluster displays

•NLP

• Histograms

• Scatter plots
• Advanced visualization (genomic data
patterns)

• http://www.ncbi.nlm.nih.gov/Tools/

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
•Database
•OLAP

•Visualization
•Scrubbing
•NLP

• Data cleansing
• Filling in missing data
• In healthcare, there is a
strong need for deidentification to protect
privacy

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De-Identification of Medical Records *

•

Names;

•

social security numbers;

•

all elements of a street address, city, county,
precinct, zip code, & their equivalent

•

medical record numbers;

•

health plan beneficiary numbers;

geocodes, except for the initial three digits of
a zip code for areas that contain over 20,000
people;

•

account numbers;

•

certificate/license numbers;

all elements of dates (except year) for dates
directly related to the individual, (e.g., birth
date, admission/discharge dates, date of
death); and all ages over 89

•

license plate numbers, vehicle identifiers
and serial numbers;

•

device identifiers and serial numbers;

and all elements of dates (including year)
indicative of such age, except that such
ages and elements may be aggregated into
a single category of age 90 or older;

•

URL addresses;

•

Internet Protocol (IP) address numbers;

•

biometric identifiers, including finger and
voice prints;

•
•

•

•

telephone numbers;

•

fax numbers;

•

•

full face photographic images and
comparable images;

e-mail addresses;

•

any other unique identifying number except
as created by IHS to re-identify information.

* Source: Policy and Procedures for De-Identification of Protected Health Information and Subsequent Re-Identification 45
CFR 164.514(a)-(c) posted by IHS (Indian Health Services)

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
Natural Language Processing

•Database
•OLAP

•Visualization
•Scrubbing
•NLP

• NLP Uses
> translation,
summarization,
information
extraction,
document
retrieval or
categorization

• NLP Companies in
health care
> A-Life
> Language and
Computing

• NLP Approaches
> Clustering,
Classification,
Linguistic
analysis,
knowledge-based
analysis

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Applications in Healthcare

• Safety and quality

• Clinical Research
• Financial
• Public Health

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
“To err is Human” IOM Report

•Safety and Quality
•Clinical Research

•Financial
•Public Health

• Characterization
> JCAHO Core Measures
> CMS Quality measures starter
set
> Improves patient care –
reactive response
• Prediction
> Identifying cases that can
result in bad clinical outcomes
and raising appropriate alarms
> Impacts patient care –
proactive response

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
Quality Measures – Initial Set*
Starter Set of 10 Hospital Quality Measures
Measure
Aspirin at arrival

Condition
Acute Myocardial Infarction (AMI)/Heart attack

Aspirin at discharge
Beta-Blocker at arrival
Beta-Blocker at discharge
ACE Inhibitor for left ventricular systolic dysfunction
Left ventricular function assessment

Heart Failure

ACE inhibitor for left ventricular systolic dysfunction
Initial antibiotic timing

Pneumonia

Pneumococcal vaccination
Oxygenation assessment

*Source: http://www.cms.hhs.gov/quality/hospital/overview.pdf

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
Safety and Quality

• University of Mississippi Medical Center
> Data Warehouse Technologies to understand
Medication Errors – Funded by AHRQ
> Anonymous report data collection
> Data mining technologies
> Use of Neural networks and associative rule inference

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
Clinical Research & Clinical Trials

•Safety and Quality
•Clinical Research

•Financial
•Public Health

• Pharmacy and medical
claims data
• Drug efficacy and clinical
trials – for example how
effective is a particular drug
regimen
• Protein structure analysis
• Genomic data mining

• Diagnostic Imaging data
research

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
The bottom line on cost

•Safety and Quality
•Clinical Research

•Financial
•Public Health

• General Utilization review –
does the care provided meet
accepted clinical and cost
guidelines
• Drug Utilization review

• Outlier analysis – exceptions
to treatment – analyzing
treatments which cost more
than the normal or less than
normal.

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
Data mining in public health

•Safety and Quality
•Clinical Research

• Syndromatic surveillance

•Financial

• Bio-terrorism detection

•Public Health

• Communicable disease
reporting (Centers for Disease
Control (CDC))

Example effort: AEGIS

• DAWN (Drug Awareness and
Warning Network)
• Federal Drug Agency (FDA) –
reporting of adverse drug
events.

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01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
Conclusion

•Descriptive
•Predictive

•Classification
•Clustering

Data mining

• Uses

•Database

•OLAP
•Association rules
•Visualization

•Scrubbing

• Algorithms

•NLP
•Safety and Quality

• Technology

•Clinical Research

• Applications in
healthcare

•Financial
•Public Health

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Technology solutions

Conclusion

uestions?

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Data

  • 1. Data Mining Applications In Healthcare 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 2. Introduction Goals of today’s presentation: Provide an overview of the technologies that are relevant to the development and deployment of data mining solutions in healthcare Allow participants to evaluate where the technology is useful 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 3. What is Divining knowledge Data mining? from data 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 4. . Topic Outline Data mining • Uses • Algorithms • Technology • Applications in healthcare 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 5. . Data Mining Uses • Descriptive Understand and characterize Clustering Summarization Association Rules Sequence Discovery • Predictive Extrapolate and forecast Classification Regression Time-Series 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 6. Data Mining Algorithms • Classification > Statistical > K-nearest neighbors > Decision trees ▲ ▲ ID3 C4.5 > Neural Networks (Self Organizing Maps) • Clustering > Hierarchical > Partitioned > Genetic • Association > Apriori Algorithm > If….Then rules 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 7. Technology solutions Technology Data Mining Infrastructure Technologies • Database Technologies • On-Line Analytical Processing (OLAP) • Visualization Technologies • Data scrubbing technologies • Natural Language Processing (NLP) 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 8. Database Technologies •Database •OLAP • Data warehouse vs. Data mart •Visualization • Relational technologies > Oracle > Microsoft •Scrubbing •NLP • XML-databases > Raining Data 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 9. On-Line Analytical Processing •Database •OLAP •Visualization • Analyze multi-dimensional data •Scrubbing • N-dimensional data cubes •NLP • Operations > Roll-up > Drill-down > Slice and dice > Pivot 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 10. Visualization •Database •OLAP • 2D/3D Charts •Visualization • Topographic displays •Scrubbing • Cluster displays •NLP • Histograms • Scatter plots • Advanced visualization (genomic data patterns) • http://www.ncbi.nlm.nih.gov/Tools/ 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 11. •Database •OLAP •Visualization •Scrubbing •NLP • Data cleansing • Filling in missing data • In healthcare, there is a strong need for deidentification to protect privacy 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 12. De-Identification of Medical Records * • Names; • social security numbers; • all elements of a street address, city, county, precinct, zip code, & their equivalent • medical record numbers; • health plan beneficiary numbers; geocodes, except for the initial three digits of a zip code for areas that contain over 20,000 people; • account numbers; • certificate/license numbers; all elements of dates (except year) for dates directly related to the individual, (e.g., birth date, admission/discharge dates, date of death); and all ages over 89 • license plate numbers, vehicle identifiers and serial numbers; • device identifiers and serial numbers; and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older; • URL addresses; • Internet Protocol (IP) address numbers; • biometric identifiers, including finger and voice prints; • • • • telephone numbers; • fax numbers; • • full face photographic images and comparable images; e-mail addresses; • any other unique identifying number except as created by IHS to re-identify information. * Source: Policy and Procedures for De-Identification of Protected Health Information and Subsequent Re-Identification 45 CFR 164.514(a)-(c) posted by IHS (Indian Health Services) 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 13. Natural Language Processing •Database •OLAP •Visualization •Scrubbing •NLP • NLP Uses > translation, summarization, information extraction, document retrieval or categorization • NLP Companies in health care > A-Life > Language and Computing • NLP Approaches > Clustering, Classification, Linguistic analysis, knowledge-based analysis 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 14. Applications in Healthcare • Safety and quality • Clinical Research • Financial • Public Health 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 15. “To err is Human” IOM Report •Safety and Quality •Clinical Research •Financial •Public Health • Characterization > JCAHO Core Measures > CMS Quality measures starter set > Improves patient care – reactive response • Prediction > Identifying cases that can result in bad clinical outcomes and raising appropriate alarms > Impacts patient care – proactive response 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 16. Quality Measures – Initial Set* Starter Set of 10 Hospital Quality Measures Measure Aspirin at arrival Condition Acute Myocardial Infarction (AMI)/Heart attack Aspirin at discharge Beta-Blocker at arrival Beta-Blocker at discharge ACE Inhibitor for left ventricular systolic dysfunction Left ventricular function assessment Heart Failure ACE inhibitor for left ventricular systolic dysfunction Initial antibiotic timing Pneumonia Pneumococcal vaccination Oxygenation assessment *Source: http://www.cms.hhs.gov/quality/hospital/overview.pdf 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 17. Safety and Quality • University of Mississippi Medical Center > Data Warehouse Technologies to understand Medication Errors – Funded by AHRQ > Anonymous report data collection > Data mining technologies > Use of Neural networks and associative rule inference 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 18. Clinical Research & Clinical Trials •Safety and Quality •Clinical Research •Financial •Public Health • Pharmacy and medical claims data • Drug efficacy and clinical trials – for example how effective is a particular drug regimen • Protein structure analysis • Genomic data mining • Diagnostic Imaging data research 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 19. The bottom line on cost •Safety and Quality •Clinical Research •Financial •Public Health • General Utilization review – does the care provided meet accepted clinical and cost guidelines • Drug Utilization review • Outlier analysis – exceptions to treatment – analyzing treatments which cost more than the normal or less than normal. 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 20. Data mining in public health •Safety and Quality •Clinical Research • Syndromatic surveillance •Financial • Bio-terrorism detection •Public Health • Communicable disease reporting (Centers for Disease Control (CDC)) Example effort: AEGIS • DAWN (Drug Awareness and Warning Network) • Federal Drug Agency (FDA) – reporting of adverse drug events. 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010
  • 21. Conclusion •Descriptive •Predictive •Classification •Clustering Data mining • Uses •Database •OLAP •Association rules •Visualization •Scrubbing • Algorithms •NLP •Safety and Quality • Technology •Clinical Research • Applications in healthcare •Financial •Public Health 01010010010100100101001010101000101010101000101010010101010101010100101001001010100101010010010010001001001010010010000101010101001010101001001001001001010010101 01010010010010010100101010010010010010010010010010101000101000101001010010010010010101010010100100100100100100100100100100100100100101001010010010010010001010010