Data mining in clinical big data:the frequently used databases,steps,and methodological models

Many high quality studies have emerged from public databases,such as Surveillance,Epidemiology,and End Results(SEER),National Health and Nutrition Examination Survey(NHANES),The Cancer Genome Atlas(TCGA),and Medical Information Mart for Intensive Care(MIMIC);however,these data are often characterized by a high degree of dimensional heterogeneity,timeliness,scarcity,irregularity,and other characteristics,resulting in the value of these data not being fully utilized.Data-mining technology has been a frontier field in medical research,as it demonstrates excellent performance in evaluating patient risks and assisting clinical decision-making in building disease-prediction models.Therefore,data mining has unique advantages in clinical big-data research,especially in large-scale medical public databases.This article introduced the main medical public database and described the steps,tasks,and models of data mining in simple language.Additionally,we described data-mining methods along with their practical applications.The goal of this work was to aid clinical researchers in gaining a clear and intuitive understanding of the application of data-mining technology on clinical big-data in order to promote the production of research results that are beneficial to doctors and patients.

Apolipoprotein E polymorphisms increase the risk of post-stroke depression

Recent reports have shown that apolipoprotein E （APOE） polymorphisms are involved in neurodegenerative disease. However, it is unclear whether APOE affects post-stroke depression. Accordingly, we hypothesized that APOE polymorphisms modify the risk of post-stroke depression. Here, we performed a hospital-based case-control study （including 76 cerebral infarction cases with post-stroke depression, 88 cerebral infarction cases without post-stroke depression, and 109 controls without any evidence of post-stroke depression or cerebral infarction） to determine possible association between APOE rs429358 and rs7412 polymorphisms and risk of post-stroke depression. Our findings show no difference among the groups with regards genotype distribution of the rs7412 polymorphism. In contrast, APOE genotypes with rs429358-C alleles increased the risk of post-stroke depression. Further, the rs429358 polymorphism was associated with significantly decreased regional cerebral blood flow values in the left temporal lobe of post-stroke depression cases. Additionally, the rs429358 polymorphism was not only associated with depression severity, but with increasing serum levels of total cholesterol. These resuits suggest that the APOE rs429358 polymorphism is associated with increased risk of developing post-stroke depression, and that APOE rs429358-C allele genotypes may be detrimental to recovery of nerve function after stoke. Indeed, these findings provide clinical data for future post-stroke depression gene interventions.

How to use the Surveillance,Epidemiology,and End Results(SEER)data:research design and methodology

In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient survival data.This program aims to provide a database about cancer incidence and survival for studies of surveillance and the development of analytical and methodological tools in the cancer field.Currently,the SEER program covers approximately half of the total cancer patients in the US.A growing number of clinical studies have applied the SEER database in various aspects.However,the intrinsic features of the SEER database,such as the huge data volume and complexity of data types,have hindered its application.In this review,we provided a systematic overview of the commonly used methodologies and study designs for retrospective epidemiological research in order to illustrate the application of the SEER database.Therefore,the goal of this review is to assist researchers in the selection of appropriate methods and study designs for enhancing the robustness and reliability of clinical studies by mining the SEER database.

基于爬虫技术获取新型冠状病毒(2019-nCoV)贴吧数据的网络舆情分析及应对策略

新型冠状病毒感染的肺炎是一种急性感染性肺炎,2019新型冠状病毒具有很强的传染性。自2019年年底发现到2020年年初快速扩散到全球数十个国家和地区,引起疫区大众严重的心理恐慌,因此本文使用爬虫获取新型冠状病毒贴吧数据进行舆情分析,其目的是快速获取大量可靠、完整的信息数据,以分析大众心理健康状况,并据此做出应对策略,以期推动疫区大众健康心理干预的研究和发展。

基于SIR模型分析不同强度防控手段在当前武汉市新型冠状病毒(2019-nCoV)感染的肺炎疫情中的作用

新型冠状病毒疫情爆发后,武汉市确诊和疑似病例的人数迅速上升。在目前未发现有良好治疗措施的情况下,如何迅速采取有效的防控措施仍是当务之急。本研究基于官方数据和传染病动力学SIR模型对采取不同强度防控措施的结局进行预测并为制定新一轮防控策略提供建议。

有效控制措施下新型冠状病毒流行趋势模拟

目的模拟新型冠状病毒(2019-nCoV)携带者进入未感染2019-nCoV地区,在有效对发病患者进行治疗与隔离并降低该地区人与人之间密切接触的前提下,模拟2019-nCoV感染的流行趋势。方法通过公开信息获得2019-nCoV感染者的疾病潜伏时间,患病就诊后疾病治愈时间,以及密切接触感染概率。采用主体建模的方法,构建简易交互环境。假设特定易感人群中第一例2019-nCoV感染者出现临床症状后能够得到有效的治疗与隔离,同时该人群中其余人之间相互密切接触降至最低,评估病毒携带者进入未感染2019-nCoV人群后,2019-nCoV感染的流行状况。结果截至2020年1月30日,感染2019-nCoV的患者疾病潜伏时间为6.6天(95%CI:5.9-7.5),感染2019-nCoV发病就诊后疾病治愈时间为9.8天(95%CI:8.8-10.8)。当病毒携带者进入未感染2019-nCoV人群时,随着该人群每日密切接触人数的上升,感染人数增加。当该人群出现第一例感染者发病时,每日密切接触15人造成的感染人数是密切接触5人的42.4倍。潜伏期结束后,2019-nCoV感染人数将保持一定时间的稳定,感染人数在16天开始出现下降,27天后患病人数趋于0。结论在新感染2019-nCoV的区域内,对2019-nCoV感染发病病人有效的治疗与隔离,同时在发现病例后有效减少该区域内人群间密切接触的前提下,2019-nCoV的传播可能不会超过1个月。

Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders:executive summary and 2019 update on organizational stroke management

Aim Stroke is characterised by high morbidity,mortality and disability,which seriously affects the health and safety of the people.Stroke has become a serious public health problem in China.Organisational stroke management can significantly reduce the mortality and disability rates of patients with stroke.We provide this evidence-based guideline to present current and comprehensive recommendations for organisational stroke management.Methods A formal literature search of MEDLINE(1 January 1997 through 30 September 2019)was performed.Data were synthesised with the use of evidence tables.Writing group members met by teleconference to discuss data-derived recommendations.The Chinese Stroke Association’s Levels of Evidence grading algorithm was used to grade each recommendation.results Evidence-based guidelines are presented for the organisational management of patients presenting with stroke.The focus of the guideline was subdivided into prehospital first aid system of stroke,rapid diagnosis and treatment of emergency in stroke centre,organisational management of stroke unit and stroke clinic,construction of regional collaborative network among stroke centres and evaluation and continuous improvement of stroke medical quality.Conclusions The guidelines offer an organisational stroke management model for patients with stroke which might help dramatically.

Ambulatory blood pressure profile and stroke recurrence

Objectives To establish a new ambulatory blood pressure(ABP)parameter(24-hour ABP profile)and evaluated its performance on stroke outcome in ischaemic stroke(IS)or transient ischaemic attack(TIA)patients.Methods The prospective cohort consisted of 1996 IS/TIA patients enrolled for ABP monitoring and a 3-month follow-up for stroke recurrence as outcome.Profile groups of systolic blood pressure(SBP)were identified via an advanced functional clustering method,and the associations of the profile groups and conventional ABP parameters with stroke recurrence were examined in a Cox proportional hazards model.Results Three discrete profile groups(n=604,781 and 611 in profiles 1,2 and 3,respectively)in 24-hour ambulatory SBP were identified.Profile 1 resembled most to the normal diurnal blood pressure pattern;profile 2 also dropped at night,but climbed earlier and with higher morning surge;while profile 3 had sustained higher nocturnal SBP without significant nocturnal SBP decline.The incidence of stroke recurrence was 2.9%,3.9%and 5.5%in profiles 1,2 and 3,respectively.After adjustment for covariates,profile 3 was significantly associated with higher risk of stroke recurrence with profile 1 as reference(HR 1.76,95%CI:1.00 to 3.09),while no significant difference was observed between profiles 2 and 1(HR 1.22,95%CI:0.66 to 2.25).None of conventional ABP parameters showed significant associations with the outcome.Conclusions Ambulatory 24-hour SBP profile is associated with short-term stroke recurrence.Profiles of ABP may help improve identification of stroke recurrence by capturing the additive effects of individual ABP parameters.

China Stroke Statistics 2019:A Report From the National Center for Healthcare Quality Management in Neurological Diseases,China National Clinical Research Center for Neurological Diseases,the Chinese Stroke Association,National Center for Chronic and Non-communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention and Institute for Global Neuroscience and Stroke Collaborations

China faces the greatest challenge from stroke in the world.The death rate for cerebrovascular diseases in China was 149.49 per 100000,accounting for 1.57 million deaths in 2018.It ranked third among the leading causes of death behind malignant tumours and heart disease.The age-standardised prevalence and incidence of stroke in 2013 were 1114.8 per 100000 population and 246.8 per 100000 person-years,respectively.According to the Global Burden of Disease Study 2017,the years of life lost(YLLs)per 100000 population for stroke increased by 14.6%;YLLs due to stroke rose from third highest among all causes in 1990 to the highest in 2017.The absolute numbers and rates per 100000 population for all-age disability-adjusted life years(DALYs)for stroke increased substantially between 1990 and 2017,and stroke was the leading cause of all-age DALYs in 2017.The main contributors to cerebrovascular diseases include behavioural risk factors(smoking and alcohol use)and pre-existing conditions(hypertension,diabetes mellitus,dyslipidaemia and atrial fibrillation(AF)).The most prevalent risk factors among stroke survivors were hypertension(63.0%-84.2%)and smoking(31.7%-47.6%).The least prevalent was AF(2.7%-7.4%).The prevalences for major risk factors for stroke are high and most have increased over time.Based on the latest national epidemiological data,26.6%of adults aged≥15 years(307.6 million adults)smoked tobacco products.For those aged≥18 years,age-adjusted prevalence of hypertension was 25.2%;adjusted prevalence of hypercholesterolaemia was 5.8%;and the standardised prevalence of diabetes was 10.9%.For those aged≥40 years,the standardised prevalence of AF was 2.31%.Data from the Hospital Quality Monitoring System showed that 3010204 inpatients with stroke were admitted to 1853 tertiary care hospitals during 2018.Of those,2466785(81.9%)were ischaemic strokes(ISs);447609(14.9%)were intracerebral haemorrhages(ICHs);and 95810(3.2%)were subarachnoid haemorrhages(SAHs).The average age of patients admitted was 66 years old,and nearly 60%were male.A total of 1555(0.1%),2774(0.6%)and 1347(1.4%)paediatric strokes(age<18 years)were identified among IS,ICH and SAH,respectively.Over one-third(1063892(35.3%))of the patients were covered by urban resident basic medical insurance,followed by urban employee basic medical insurance(699513(23.2%))and new rural cooperative medical schema(489361(16.3%)).The leading risk factor was hypertension(67.4%for IS,77.2%for ICH and 49.1%for SAH),and the leading comorbidity was pneumonia or pulmonary infection(10.1%for IS,31.4%for ICH and 25.2%for SAH).In-hospital death/discharge against medical advice rate was 8.3%for stroke inpatients,ranging from 5.8%for IS to 19.5%for ICH.The median and IQR of length of stay was 10.0(7.0-14.0)days,ranging from 10.0(7.0-13.0)in IS to 14.0(8.0-22.0)in SAH.Data from the Chinese Stroke Center Alliance demonstrated that the composite scores of guideline-recommended key performance indicators for patients with IS,ICH and SAH were 0.77±0.21,0.72±0.28 and 0.59±0.32,respectively.