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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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Case studies in bias reduction and inference for electronic health record data with selection bias and phenotype misclassification

Electronic health records (EHR) are not designed for population‐based research, but they provide easy and quick access to longitudinal health information for a large number of individuals. Many statistical methods have been proposed to account for selection bias, missing data, phenotyping errors, or other problems that arise in EHR data analysis. However, addressing multiple sources of bias simultaneously is challenging. We developed a methodological framework (R package, SAMBA ) for jointly handling both selection bias and phenotype misclassification in the EHR setting that leverages external data sources. These methods assume factors related to selection and misclassification are fully observed, but these factors may be poorly understood and partially observed in practice. As a follow‐up to the methodological work, we demonstrate how to apply these methods for two real‐world case studies, and we evaluate their performance. In both examples, we use individual patient‐level data collected through the University of Michigan Health System and various external population‐based data sources. In case study (a), we explore the impact of these methods on estimated associations between gender and cancer diagnosis. In case study (b), we compare corrected associations between previously identified genetic loci and age‐related macular degeneration with gold standard external summary estimates. These case studies illustrate how to utilize diverse auxiliary information to achieve less biased inference in EHR‐based research.

60 APPLIED LIFE SCIENCES↗

Continuous-time probabilistic models for longitudinal electronic health records

Analysis of longitudinal Electronic Health Record (EHR) data is an important goal for precision medicine. Difficulty in applying Machine Learning (ML) methods, either predictive or unsupervised, stems in part from the heterogeneity and irregular sampling of EHR data. Here, we present an unsupervised probabilistic model that captures nonlinear relationships between variables over continuous-time. This method works with arbitrary sampling patterns and captures the joint probability distribution between variable measurements and the time intervals between them. Inference algorithms are derived that can be used to evaluate the likelihood of future using under a trained model. As an example, we consider data from the United States Veterans Health Administration (VHA) in the areas of diabetes and depression. Likelihood ratio maps are produced showing the likelihood of risk for moderate-severe vs minimal depression as measured by the Patient Health Questionnaire-9 (PHQ-9).

59 BASIC BIOLOGICAL SCIENCES↗

DOME: Directional medical embedding vectors from Electronic Health Records

Motivation: The increasing availability of Electronic Health Record (EHR) systems has created enormous potential for translational research. Recent developments in representation learning techniques have led to effective large-scale representations of EHR concepts along with knowledge graphs that empower downstream EHR studies. However, most existing methods require training with patient-level data, limiting their abilities to expand the training with multi-institutional EHR data. On the other hand, scalable approaches that only require summary-level data do not incorporate temporal dependencies between concepts. Methods: We introduce a DirectiOnal Medical Embedding (DOME) algorithm to encode temporally directional relationships between medical concepts, using summary-level EHR data. Specifically, DOME first aggregates patient-level EHR data into an asymmetric co-occurrence matrix. Then it computes two Positive Pointwise Mutual Information (PPMI) matrices to correspondingly encode the pairwise prior and posterior dependencies between medical concepts. Following that, a joint matrix factorization is performed on the two PPMI matrices, which results in three vectors for each concept: a semantic embedding and two directional context embeddings. They collectively provide a comprehensive depiction of the temporal relationship between EHR concepts. Results: We highlight the advantages and translational potential of DOME through three sets of validation studies. First, DOME consistently improves existing direction-agnostic embedding vectors for disease risk prediction in several diseases, for example achieving a relative gain of 5.5% in the area under the receiver operating characteristic (AUROC) for lung cancer. Second, DOME excels in directional drug-disease relationship inference by successfully differentiating between drug side effects and indications, correspondingly achieving relative AUROC gain over the state-of-the-art methods by 10.8% and 6.6%. Finally, DOME effectively constructs directional knowledge graphs, which distinguish disease risk factors from comorbidities, thereby revealing disease progression trajectories. The source codes are provided at https://github.com/celehs/Directional-EHRembedding.

60 APPLIED LIFE SCIENCES↗

Earth's record-high greenness and its attributions in 2020

Terrestrial vegetation is a crucial component of Earth's biosphere, regulating global carbon and water cycles and contributing to human welfare. Despite an overall greening trend, terrestrial vegetation exhibits a significant inter-annual variability. The mechanisms driving this variability, particularly those related to climatic and anthropogenic factors, remain poorly understood, which hampers our ability to project the long-term sustainability of ecosystem services. Here, in this work, by leveraging diverse remote sensing measurements, we pinpointed 2020 as a historic landmark, registering as the greenest year in modern satellite records from 2001 to 2020. Using ensemble machine learning and Earth system models, we found this exceptional greening primarily stemmed from consistent growth in boreal and temperate vegetation, attributed to rising CO 2 levels, climate warming, and reforestation efforts, alongside a transient tropical green-up linked to the enhanced rainfall. Contrary to expectations, the COVID-19 pandemic lockdowns had a limited impact on this global greening anomaly. Our findings highlight the resilience and dynamic nature of global vegetation in response to diverse climatic and anthropogenic influences, offering valuable insights for optimizing ecosystem management and informing climate mitigation strategies.

54 ENVIRONMENTAL SCIENCES↗

Evolving language of pediatric anxiety in electronic health records

Objectives This study aimed to identify and quantify semantic drift (ie, the change in semantic meaning over time) within expert-defined anxiety-related (AR) terminology and compare it to common electronic health record (EHR) vocabulary across longitudinal pediatric clinical notes. Materials and Methods A corpus of pediatric clinical notes from 2009 to 2022 was analyzed using computational methods. Semantic drift for each term was quantified using cosine similarity between annual temporal word embeddings. Contextual meaning was examined through changes in nearest neighbors across years. The Laws of Semantic Change were applied to assess the influence of word frequency and polysemy. Vocabulary terms were categorized as AR or common EHR. Results 98% of AR terminology maintained a cosine similarity between 0.00 and 0.50, indicating moderate semantic stability, whereas 90% of common EHR terms remained between 0.00 and 0.25, showing greater contextual stability overall. Frequent terms exhibited minimal change (Frequency Coefficient = 0.04), whereas highly polysemous or abbreviated terms showed less stability (Polysemy Coefficient = 0.630). AR terminology drifted more slowly than general EHR vocabulary (Type Coefficient = −0.179), further supported by significant year–type interactions (Coef = −0.09 to −0.523). Discussion Although anxiety-related terminology demonstrates slower semantic drift than general EHR vocabulary, subtle contextual shifts still occur that may affect downstream interpretability and retrieval in automated systems. Conclusion Continuous linguistic monitoring and adaptive modeling are essential to maintain semantic fidelity and ensure the long-term reliability of clinical decision support systems as healthcare documentation evolves.

Pediatric anxiety disorders↗