Prostate cancer is a leading cause of cancer death in American men, but up to 60% of patients who receive treatment may not require it as they would eventually succumb to a different health problem. The focus of this research is to investigate new methods for more accurately detecting cancer and assessing its aggression using medical imaging data, histology data, genetic data, and other risk factors toward reducing overdiagnosis and overtreatment, thus preventing patients from receiving unnecessary treatment and incurring associated negative functional outcomes.
Imaging-based Risk Prediction
Prostate cancer is the second leading cause of cancer death in American men, accounting for 26% of new cancer diagnoses and 9% of cancer deaths in men. The research objective of this R21 is to develop novel techniques using multiparametric magnetic resonance imaging (mp-MRI) and MRI-ultrasound (US) fusion guided biopsy data that provide discriminatory power in distinguishing indolent versus clinically significant prostatic adenocarcinoma based on radiology imaging and digital histology.
Improving Acute Decision Making
Stroke is a leading cause of mortality and morbidity in the United States, with approximately 795,000 Americans experiencing a new or recurrent stroke each year. In this project, we aim to: 1) develop a machine learning framework for classifying treatment eligibility, 2) develop a deep convolutional autoencoder to generate novel multimodal image representations from MR and CT to improve classification, and 3) implement visualization techniques that elucidate the relationship between deep features and pathophysiological stroke processes.
Reducing Unnecessary Biopsies
The thyroid cancer incidence rate has tripled in the past thirty years, with an estimated cost of $18-21 billon in 2019. US is the imaging modality of choice, which consists of multiple 2D images of different locations and orientations. US readings are often vague and subjective in nature, which has resulted in a steady increase in the number of biopsies performed over the past 20 years. It is estimated that about one-third of all thyroid biopsy procedures performed in the United States are medically unnecessary, leading to the unmet need for noninvasive diagnostic tests that can reliably identify which nodules require a biopsy. The research objective of this R21 is to develop a new graph-based approach to leverage spatial information contained within imaging studies that will be combined with biomarkers and other known risk factors.
Heart failure (HF) is a debilitating disease that affects over five million people in the United States and in 2012 had a direct cost of over $30.7 billion annually. Home monitoring of HF patients has the potential to reduce costs and improve quality of life by reducing preventable hospital readmissions. The goals of this R01 are to: 1) demonstrate that patients are adherent to a home monitoring regimen when using minimally-invasive monitoring technologies; 2) combine the minimally-invasive home monitoring regimen with predictive algorithms to forecast hospital readmission; 3) develop models using electronic health record (EHR) data and a baseline survey to predict levels of adherence to the home monitoring regimen; and 4) explore the pragmatic feasibility of using a mobile app for communicating with patients in prospective pilot study
Expediting Chart Review
Primary care physicians (PCPs) are responsible for reviewing and understanding a wide spectrum of a patient’s medical history in order to make informed decisions regarding care. However, a variety of factors impede this process, including: the increasing complexity and number of diagnostic tests and treatments, health information exchange standards that may add more information to the medical record, and the need to efficiently see more patients in less time. These obstructions can lead to an inhibition of dialogue between patients and providers, and possibly even medical errors. New methods are required to help expedite a healthcare provider’s understanding of a patient’s medical history, summarizing key information. This proposal seeks to develop a topic model and ensuing visualization system for automatically summarizing medical records to support PCPs.