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At least 19 records

Predicting Adverse Events and their Precursors in Aviation Using Multi-Class Multiple-Instance Learning

In recent years, there has been a rapid growth in the application of machine learning techniques that leverage aviation data collected from commercial airline operations to improve safety. Anomaly detection and predictive maintenance have been the main targets for machine learning applications. However, this paper focuses on the identification of precursors, which is a relatively newer application. Precursors are events correlated with adverse events that happen prior to the adverse event itself. Therefore, precursor mining provides many benefits including understanding the reasons behind a safety incident and the ability to identify signatures, which can be tracked throughout a flight to alert the operators of an potential upcoming adverse event. This work proposes using the multiple-instance learning (MIL) framework, a weakly supervised learning task, combined with a carefully designed Multi-Head Convolutional Neural Networks-Recurrent Neural Networks (MHCNN-RNN) architecture to predict different type of adverse events for any given flights and identify their precursors with little to no post-processing.Results obtained show that the MHCNN-RNN is able to accurately forecast high speed and high path angle events during the approach, and that it is also capable of determining the aircraft’s parameters that are correlated to these events. These parameters can be considered precursors to the events.

multiple instance learning↗

Prediction of Adverse Events in Time Series Data Using ACCEPT (Adverse Condition and Critical Event Prediction Toolbox)

Abstract:An open-source toolbox called ACCEPT (Adverse Condition and Critical Event Prediction Toolbox) that operates from within the Matlab programming environment is introduced. The toolbox provides an open source, special-purpose functionality that can be used specifically for the prediction or forecasting of adverse events in time series data. It also provides a single, unifying framework in which to compare a variety of combinations of algorithmic approaches addressing this problem. The architectural framework also offers the flexibility for expansion to accommodate the newest, latest popular regression and detection methods for this particular problem, enabling the development of an infrastructure that can act as a proving ground platform for comparing new techniques to the state of the art. As such, its intention is to act as a catalyst in advancing the state of the art in technologies related to this problem. There are a variety of other toolboxes that offer similar capabilities and features, however they are either more suitable as general purpose machine learning toolboxes or are only available commercially or through agreements. ACCEPT fills that niche by offering visibility into a specific approach for addressing the adverse event prediction problem.

programming environments↗

Predicting potential adverse events using safety data from marketed drugs

Abstract Background While clinical trials are considered the gold standard for detecting adverse events, often these trials are not sufficiently powered to detect difficult to observe adverse events. We developed a preliminary approach to predict 135 adverse events using post-market safety data from marketed drugs. Adverse event information available from FDA product labels and scientific literature for drugs that have the same activity at one or more of the same targets, structural and target similarities, and the duration of post market experience were used as features for a classifier algorithm. The proposed method was studied using 54 drugs and a probabilistic approach of performance evaluation using bootstrapping with 10,000 iterations. Results Out of 135 adverse events, 53 had high probability of having high positive predictive value. Cross validation showed that 32% of the model-predicted safety label changes occurred within four to nine years of approval (median: six years). Conclusions This approach predicts 53 serious adverse events with high positive predictive values where well-characterized target-event relationships exist. Adverse events with well-defined target-event associations were better predicted compared to adverse events that may be idiosyncratic or related to secondary target effects that were poorly captured. Further enhancement of this model with additional features, such as target prediction and drug binding data, may increase accuracy.

Daluwatte, Chathuri↗

Informing selection of drugs for COVID-19 treatment through adverse events analysis

Coronavirus disease 2019 (COVID-19) is an ongoing pandemic and there is an urgent need for safe and effective drugs for COVID-19 treatment. Since developing a new drug is time consuming, many approved or investigational drugs have been repurposed for COVID-19 treatment in clinical trials. Therefore, selection of safe drugs for COVID-19 patients is vital for combating this pandemic. Our goal was to evaluate the safety concerns of drugs by analyzing adverse events reported in post-market surveillance. We collected 296 drugs that have been evaluated in clinical trials for COVID-19 and identified 28,597,464 associated adverse events at the system organ classes (SOCs) level in the FDA adverse events report systems (FAERS). We calculated Z-scores of SOCs that statistically quantify the relative frequency of adverse events of drugs in FAERS to quantitatively measure safety concerns for the drugs. Analyzing the Z-scores revealed that these drugs are associated with different significantly frequent adverse events. Our results suggest that this safety concern metric may serve as a tool to inform selection of drugs with favorable safety profiles for COVID-19 patients in clinical practices. Caution is advised when administering drugs with high Z-scores to patients who are vulnerable to associated adverse events.

59 BASIC BIOLOGICAL SCIENCES↗

Deep Learning Method for Detecting Precursors to Adverse Events

With the recent advancements in Deep Learning methods, the ability to model large complex heterogeneous data sets are fundamentally changing industry and research. Coupled with hardware improvements, and ease of implementation, a wide variety of deep neural network architectures can quickly be developed to solve a sweeping range of problems such as: object detection in images, automatic healthcare diagnosis using heterogenous data sources, real time language translating and sentence prediction, upscaling low resolution images, and forecasting of multivariate timeseries. Generally, many of these architectures outperform classical machine learning approaches in their respective tasks, however, this typically comes at a cost of interpretability. These black box algorithms generally suffer from lack of transparency in both model complexity as well as the rationale behind the prediction. This lack of comprehension, is driving an emerging area of interest in “Explainable AI”. An algorithm called: “Deep Temporal Multiple Instance Learning”1 was a recently developed to identify precursors to adverse events and has been applied in the aviation domain. The deep learning architecture is designed to capture the evolution of the probability of the outcome over the time preceding the adverse event using a multiple instance learning approach as illustrated in Figure 1. Precursors are defined when the probability of the event has exceeded a threshold at some point in the timeseries, at which point, a sensitivity analysis is performed to determine contributing factors. The contributing factors are used to explain and define the precursor during the periods where the probability score is high. The identified contributing factors are then presented to subject matter experts to provide objective insights into the leading factors associated with the particular adverse event. The algorithm has been tested on flight data from a commercial airline and has the ability to discover precursors to known adverse events that take the form of safety critical operations, such as unstable approach events on final approach. Apart from detecting precursors to adverse events, the converse can also be leveraged to discover corrective actions. These positive actions manifest themselves as periods in the timeseries when the precursor score has been lowered from an elevated state; meaning that if the system had been left uncorrected, it would have eventually reached the adverse event state. Characterizing these state changes can help identify successful interventions that may not have been known before. Policy makers and procedure designers can use this additional knowledge to craft more safety and efficient resilient procedures for future operations and therefore improve the overall performance of the National Airspace.

Matthews, Bryan L.↗

Near Real-Time Optimal Prediction of Adverse Events in Aviation Data

The prediction of anomalies or adverse events is a challenging task, and there are a variety of methods which can be used to address the problem. In this paper, we demonstrate how to recast the anomaly prediction problem into a form whose solution is accessible as a level-crossing prediction problem. The level-crossing prediction problem has an elegant, optimal, yet untested solution under certain technical constraints, and only when the appropriate modeling assumptions are made. As such, we will thoroughly investigate the resilience of these modeling assumptions, and show how they affect final performance. Finally, the predictive capability of this method will be assessed by quantitative means, using both validation and test data containing anomalies or adverse events from real aviation data sets that have previously been identified as operationally significant by domain experts. It will be shown that the formulation proposed yields a lower false alarm rate on average than competing methods based on similarly advanced concepts, and a higher correct detection rate than a standard method based upon exceedances that is commonly used for prediction.

Martin, Rodney Alexander↗

Capturing Complex Multivariate Time Series Interactions to Detect High-Risk Adverse Events During Flight

The reduction of aviation safety metrics below target thresholds continue to drive down the number of aviation fatalities and accidents. To meet future safety demands, sustained efforts by aviation agencies promoting safety assurance processes and systems have prompted ongoing research on identifying and mitigating in-flight risks. With the projected increase in passenger load factor and rollout of more autonomous systems into the national airspace, the need to detect high-risk events in-time or ahead-of-time is becoming increasingly crucial. New anomaly detection and precursor identification algorithms will need to scale to different airframes, levels of autonomy, and system complexity. While the pervasiveness of deep learning has resulted in the development of performant anomaly detection methods, these sophisticated models currently suffer from low end-user interpretability. Building off our previous work on identifying adverse events in multivariate flight data during descent, we propose a data-driven approach for detecting in-flight adverse events caused by the complex interplay of flight variables. Our approach utilizes ordinal patterns of important aircraft stability variables (e.g., airspeed and descent rate) to capture multivariate flight dynamics that can be used to predict the onset of unstable approaches, a high-risk adverse event that can occur during approach. Through the use of ordinal patterns, we aim to create more interpretable detection models of in-flight adverse events that can be translated to future autonomous systems without difficulty. Our analysis shows the presence of distinct ordinal pattern distributions that can be used to predict unstable approaches 1 minute ahead of time with an accuracy of 0.69 and a recall of 0.73 and 30 seconds ahead with an accuracy of 0.70 and a recall of 0.86.

Risk detection↗

A systematic analysis and data mining of opioid-related adverse events submitted to the FAERS database

The opioid epidemic has become a serious national crisis in the United States. An indepth systematic analysis of opioid-related adverse events (AEs) can clarify the risks presented by opioid exposure, as well as the individual risk profiles of specific opioid drugs and the potential relationships among the opioids. In this study, 92 opioids were identified from the list of all Food and Drug Administration (FDA)-approved drugs, annotated by RxNorm and were classified into 13 opioid groups: buprenorphine, codeine, dihydrocodeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone, tapentadol, and tramadol. A total of 14,970,399 AE reports were retrieved and downloaded from the FDA Adverse Events Reporting System (FAERS) from 2004, Quarter 1 to 2020, Quarter 3. After data processing, Empirical Bayes Geometric Mean (EBGM) was then applied which identified 3317 pairs of potential risk signals within the 13 opioid groups. Based on these potential safety signals, a comparative analysis was pursued to provide a global overview of opioid-related AEs for all 13 groups of FDA-approved prescription opioids. The top 10 most reported AEs for each opioid class were then presented. Both network analysis and hierarchical clustering analysis were conducted to further explore the relationship between opioids. Results from the network analysis revealed a close association among fentanyl, oxycodone, hydrocodone, and hydromorphone, which shared more than 22 AEs. In addition, much less commonly reported AEs were shared among dihydrocodeine, meperidine, oxymorphone, and tapentadol. On the contrary, the hierarchical clustering analysis further categorized the 13 opioid classes into two groups by comparing the full profiles of presence/absence of AEs. The results of network analysis and hierarchical clustering analysis were not only consistent and cross-validated each other but also provided a better and deeper understanding of the associations and relationships between the 13 opioid groups with respect to their adverse effect profiles.

Research & Experimental Medicine↗

Analysis of Adverse Events in Identifying GPS Human Factors Issues

The purpose of this study was to analyze GPS related adverse events such as accidents and incidents (A/I), Aviation Safety Reporting System (ASRS) reports and Pilots Deviations (PDs) to create a framework for developing a human factors risk awareness program. Although the occurrence of directly related GPS accidents is small the frequency of PDs and ASRS reports indicated there is a growing problem with situational awareness in terminal airspace related to different types of GPs operational issues. This paper addresses the findings of the preliminary research and a brief discussion of some of the literature on related GPS and automation issues.

Adams, Catherine A.↗

Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

Reveley, Mary S.↗

Using ADOPT Algorithm and Operational Data to Discover Precursors to Aviation Adverse Events

The US National Airspace System (NAS) is making its transition to the NextGen system and assuring safety is one of the top priorities in NextGen. At present, safety is managed reactively (correct after occurrence of an unsafe event). While this strategy works for current operations, it may soon become ineffective for future airspace designs and high density operations. There is a need for proactive management of safety risks by identifying hidden and "unknown" risks and evaluating the impacts on future operations. To this end, NASA Ames has developed data mining algorithms that finds anomalies and precursors (high-risk states) to safety issues in the NAS. In this paper, we describe a recently developed algorithm called ADOPT that analyzes large volumes of data and automatically identifies precursors from real world data. Precursors help in detecting safety risks early so that the operator can mitigate the risk in time. In addition, precursors also help identify causal factors and help predict the safety incident. The ADOPT algorithm scales well to large data sets and to multidimensional time series, reduce analyst time significantly, quantify multiple safety risks giving a holistic view of safety among other benefits. This paper details the algorithm and includes several case studies to demonstrate its application to discover the "known" and "unknown" safety precursors in aviation operation.

aviation safet↗

An Examination of Commercial Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

The Integrated Vehicle Health Management (IVHM) Project is one of the four projects within the National Aeronautics and Space Administration's (NASA) Aviation Safety Program (AvSafe). The IVHM Project conducts research to develop validated tools and technologies for automated detection, diagnosis, and prognosis that enable mitigation of adverse events during flight. Adverse events include those that arise from system, subsystem, or component failure, faults, and malfunctions due to damage, degradation, or environmental hazards that occur during flight. Determining the causal factors and adverse events related to IVHM technologies will help in the formulation of research requirements and establish a list of example adverse conditions against which IVHM technologies can be evaluated. This paper documents the results of an examination of the most recent statistical/prognostic accident and incident data that is available from the Aviation Safety Information Analysis and Sharing (ASIAS) System to determine the causal factors of system/component failures and/or malfunctions in U.S. commercial aviation accidents and incidents.

Reveley, Mary S.↗

Are Medications Involved in Vision and Intracrancial Pressure Changes Seen in Spaceflight?

The Food and Drug Association Adverse Event Reports (FDA AER) from 2009-2011 were used to create a database from millions of known and suspected medication-related adverse events among the general public. Vision changes, sometimes associated with intracranial pressure changes (VIIP), have been noted in some long duration crewmembers. Changes in vision and blood pressure (which can subsequently affect intracranial pressure) are fairly common side effects of medications. The purpose of this study was to explore the possibility of medication involvement in crew VIIP symptoms. Reports of suspected medication-related adverse events may be filed with the Food and Drug Administration (FDA) by medical professionals or consumers. Quarterly compilations of these reports are available for public download. Adverse Event Reporting System (AERS) reports from 1/1/2009- 6/30/2012 were downloaded and compiled into a searchable database for this study. Reports involving individuals under the age of 18 and older than 65 were excluded from this analysis. Case reports involving chronic diseases such as cancer, diabetes, multiple sclerosis and other serious conditions were also excluded. A scan of the medical literature for medication-related VIIP-like adverse events was used to create a list of suspect medications. These medications, as well as certain medications used frequently by ISS crew, were used to query the database. Queries for use of suspected medications were run, and the nature of the symptoms reported in those cases were tabulated. Symptoms searched in the FDA AERS were chosen to include the typical symptoms noted in crewmembers with VIIP. Vision symptoms searched were: visual acuity reduced, visual impairment, and vitreous floaters. Pressure changes included: abnormal sensation in eye, intracranial pressure increased, intraocular pressure increased, optic neuritis, optic neuropathy, and papilloedema. Limited demographic information is included with the FDA AERS; relevant data were also sorted by age and sex from each report. RESULTS Steroid-containing oral contraceptives had the highest number of reports associated with vision (n=166) and pressure symptoms (n=54). Corticosteroid-containing medications were also high; prednisone, for example, had 137 reports of vision issues and 79 of pressure issues. Pain relievers were also a medication class with vision and pressure-related adverse events reported. Common over-the-counter medications such as acetaminophen, aspirin and ibuprofen each had multiple reports for both vision and pressure symptoms. Antimicrobial medications ciprofloxacin and diflucan were also associated with a number of vision and pressure-related AERS. Unexpectedly, pseudoephedrine and promethazine were mentioned in fewer than 20 reports each over the 3.5 years of data examined. The FDA AERS represents a wealth of data, but there are several limitations to its use. The data are entered by the public or medical professionals, but are not checked for accuracy or completeness and may even be entered multiple times. The causal relationship between a particular adverse event and a particular medication is not tested. The cases represent a broad spectrum of demographics, occupations, and health histories, and thus do not model the astronaut population well. There is no information on the frequency of use of a medication for comparison purposes; it is not possible to assign a rate for any particular adverse event. Nonetheless, there are compelling trends. Use of corticosteroid-containing medications, pain relievers (even over-the-counter), and oral contraceptives were associated with higher numbers of vision- or intracranial pressure-related adverse events. In general, there were more vision problems than pressure problems reported. Certain medications that were once suspected of playing a role in the crew VIIP syndrome, namely pseudoephedrine and promethazine, were found to have extremely low numbers of VIIP-like AERS in the FDA data. However, crew use of corticosteroid-containing medications and pain relievers may warrant additional investigation

Faust, K. M.↗

Evidence Report: Risk of Crew Adverse Health Event Due to Altered Immune Response

The Risk of Crew Adverse Health Event Due to Altered Immune Response is identified by the National Aeronautics and Space Administration (NASA) Human Research Program (HRP) as a recognized risk to human health and performance in space. The HRP Program Requirements Document (PRD) defines these risks. This Evidence Report provides a summary of the evidence that has been used to identify and characterize this risk. It is known that human immune function is altered in‐ and post‐flight, but it is unclear at present if such alterations lead to increased susceptibility to disease. Reactivation of latent viruses has been documented in crewmembers, although this reactivation has not been directly correlated with immune changes or with observed diseases. As described in this report, further research is required to better characterize the relationships between altered immune response and susceptibility to disease during and after spaceflight. This is particularly important for future deep‐space exploration missions.

Crucian, Brian↗

Patient-Reported Outcomes in Pediatric Cancer Registration Trials: A US Food and Drug Administration Perspective

Pediatric patient-reported outcome (PRO) data can help inform the US Food and Drug Administration’s (FDA’s) benefit-risk assessment of cancer therapeutics by quantifying symptom and functional outcomes from the patient’s perspective. This study assessed use of PROs in commercial pediatric oncology trials submitted to the FDA for regulatory review. FDA databases were searched to identify pediatric oncology product applications approved between 1997 and 2020. Sponsor-submitted documents were reviewed to determine whether PRO data were collected, which instruments were used, and the quality of collected data (ie, sample size, completion rates, and use of fit-for-purpose instruments). The role of PROs in each trial (endpoint hierarchy) was also recorded in addition to whether any PRO endpoints were included in product labeling. We reviewed 17 pediatric oncology applications, 4 of which included PRO data: denosumab, tisagenlecleucel, larotrectinib, and selumetinib. In these 4 instances, PROs served as exploratory endpoints and were not incorporated in product labeling. Trials that collected PRO data were phase II or phase I/II single-arm studies with sample sizes of 28 to 88 patients. Symptomatic adverse events (AEs) were characterized using clinician-reported Common Terminology Criteria for Adverse Events (CTCAE) without additional patient self-report. PROs were infrequently used in pediatric cancer registration trials. When PROs were used, PRO data were limited by lack of a clear research objective and corresponding prospective statistical analysis plan. Contemporary PRO symptom libraries, such as the National Cancer Institute’s Pediatric PRO-CTCAE, may provide an opportunity to better evaluate the occurrence and impact of symptomatic AEs, from the patient’s perspective, in pediatric oncology trials.

Oncology↗