Claudia Maria Cabral Moro

Mineração de dados e características da mortalidade infantil

This study aims to identify patterns in maternal and fetal characteristics in the prediction of infant mortality by incorporating innovative techniques like data mining, with proven relevance for public health. A database was developed with infant deaths from 2000 to 2004 analyzed by the Committees for the Prevention of Infant Mortality, based on integration of the Information System on Live Births (SINASC), Mortality Information System, and Investigation of Infant Mortality in the State of Paraná. The data mining software was WEKA (open source). The data mining conducts a database search and provides rules to be analyzed to transform the data into useful information. After mining, 4,230 rules were selected: teenage pregnancy plus birth weight < 2,500 g, or post-term birth plus teenage mother with a previous child or intercurrent conditions increase the risk of neonatal death. The results highlight the need for greater attention to teenage mothers, newborns with birth weight < 2,500 g, post-term neonates, and infants of mothers with intercurrent conditions, thus corroborating other studies.

Essential data set's archetypes for nursing care of endometriosis patients

Objetivou-se elaborar um Conjunto de Dados Essenciais de Enfermagem para Atendimento as Portadoras de Endometriose (CDEEPE) e representa-lo por arquetipos. Pesquisa exploratoria, aplicada com participacao de especialistas, realizada no Laboratorio de Informatica em Saude da PUCPR, entre fevereiro e novembro de 2010. Foi dividida em duas etapas: construcao e avaliacao do CDEEPE, que abordou as fases do Processo de Enfermagem e as Necessidades Humanas Basicas; e desenvolvimento dos arquetipos, a partir do conjunto definido. O CDEEPE foi avaliado, por medicos e enfermeiros, com media consensual de 95,9% e foi especificado contendo 51 dados. Para representa-lo, foi criado o arquetipo “Percepcao dos Orgaos e Sentidos”. Este estudo possibilitou identificar informacoes importantes para a pratica de enfermagem, contribuindo para informatizacao e aplicacao do Processo de Enfermagem no cuidado prestado. O CDEEPE foi base para criacao do arquetipo, que possibilitara os registros de forma estruturada, organizada, eficiente, interoperavel e semântica.

Electronic health record to support Chronic Kidney Disease prevention — Integrating guidelines and archetypes

As Chronic Kidney Disease (CKD) incidence in the world is increasing, preventive actions are necessary. Integration of Clinical Practice Guidelines (CPG) into the Electronic Health Record (EHR) may facilitate prevention. Thereby identification of data described in CPGs and representation of these data into EHR, are difficulties to develop a guideline-based EHR for prevention. Archetypes allow representation of information contained in CPG, applying the same format across all EHRs modules. Therefore, the objective of this research was to develop an EHR including decision support structured in archetypes and based on CPG for CKD prevention. The EHR system developed follows five steps: identification of the data and the rules specified in the guideline; archetype elaboration; definition and inclusion of rules in a rule-based inference engine and elaboration of the DSS; DSS-EHR integration; and DSS validation. Eight archetypes and forty rules composes the resulting system.

Protocol for physical assessment in patients with fibromyalgia syndrome

INTRODUCTION Fibromyalgia syndrome (FMS) is a chronic disease that causes pain and fatigue, presenting a negative impact on quality of life. Exercise helps maintaining physical fitness and influences directly on the improvement of quality of life. OBJECTIVE Develop a protocol for health-related physical fitness assessment of patients with FMS with tests that are feasible and appropriate for this population. METHOD An exploratory and analytical literature review was performed, seeking to determine the tests used by the scientific community. With this in mind, we performed a literature revision through the use of virtual libraries databases: PubMed, Bireme, Banco de Teses e Dissertações da Capes and Biblioteca Digital Brasileira de Teses e Dissertações, published in between 1992-2012. RESULTS A variety of tests was found; the following, by number of citations, stood out: Body Mass Index (BMI) and bioimpedance; 6-minute walk; handgrip strength (dynamometer, 1RM [Repetition Maximum]); Sit and reach and Shoulder flexibility; Foot Up and Go, and Flamingo balance. CONCLUSION These are the tests that should make up the protocol for the physical evaluation of FMS patients, emphasizing their ease of use.

Temporal Tagging of Noisy Clinical Texts in Brazilian Portuguese

Temporal expressions are present in several types of texts, including clinical ones. The current research over temporal expressions has been done by the use of rule-based systems, machine learning or hybrid approaches, in most cases, over annotated (labeled) news texts correctly written in English. In this paper, we propose a method to extract and normalize temporal expressions from noisy and unlabeled clinical texts (discharge summaries) written in Brazilian Portuguese using a rule-based approach. The obtained results are similar to the state-of-the-art researches made with the same purpose in other languages. The proposed method reached a F1 score of 88.92% for the extraction step and, a F1 score of 87.89% for the normalization step.

Mineração de dados na avaliação de óbitos após cirurgia de amputação

Resumo Contexto A amputação e a desarticulação objetivam melhorar a saúde de um indivíduo, mas esses tratamentos apresentam taxas significantes de mortalidade que variam de acordo com os fatores relacionados. Objetivo Identificar as associações entre os determinantes da mortalidade pós-operatória da amputação. Métodos Estudo do tipo caso-controle (óbito versus não óbito) em que foi adotada a descoberta de regras de associação (abordagem da mineração de dados) e métricas epidemiológicas sobre 173 registros de pacientes amputados em um hospital público de Santa Catarina em 2014. Resultados Os principais determinantes foram: idade > 60 anos [odds ratio (OR) = 3,0], sexo feminino (OR = 2,0), baixa escolaridade, hipertensão (OR = 3,0), diabetes (OR = 1,6) e tabagismo (OR = 1,8). Dos pacientes com idade entre 60 a 69 anos (38%), 87,9% evoluíram para alta, estando o óbito associado a doença vascular periférica. Quando a idade foi > 70 anos, embolia e trombose de artérias dos membros inferiores foram o fator de exceção (óbito). As patologias com maior associação ao óbito foram doença vascular (47,0%), diabetes (29,4%), doença cardíaca (razão de risco = 11,4), doença renal (OR = 10,4) e doença pulmonar (OR = 5,2). As cirurgias proximais estiveram mais associadas ao óbito do que as distais. Entre os pacientes que foram a óbito, 76,0% foram submetidos a raquianestesia e 24,0% a anestesia geral. Conclusão A mineração de dados permitiu identificar as associações vinculadas ao óbito entre as diferentes variáveis e diagnósticos, como por exemplo, entre idade > 70 anos e diagnóstico de embolia e trombose de artérias dos membros inferiores.

Numerical eligibility criteria in clinical protocols: annotation, automatic detection and interpretation

Clinical trials are fundamental for evaluating therapies and diagnosis techniques. Yet, recruitment of patients remains a real challenge. Eligibility criteria are related to terms but also to patient laboratory results usually expressed with numerical values. Both types of information are important for patient selection. We propose to address the processing of numerical values. A set of sentences extracted from clinical trials are manually annotated by four annotators. Four categories are distinguished: C (concept), V (numerical value), U (unit), O (out position). According to the pairs of annotators, the inter-annotator agreement on the whole annotation sequence CVU goes up to 0.78 and 0.83. Then, an automatic method using CFRs is exploited for creating a supervised model for the recognition of these categories. The obtained F-measure is 0.60 for C, 0.82 for V, and 0.76 for U.

A Novel Method for Identifying Continuity of Care in Hospital Discharge Summaries

Discharge summary is one of the most important clinical narratives because it provides essential information about the patient, including the continuity of care. Due to its free-form writing and the lack of consensus on its essential content, the identification of data contained on the text becomes a difficult task. In this project, we propose a rule-based method to verify the presence of information related to the continuity of care in Brazilian Portuguese texts, applying Natural Language Processing (NLP) techniques with an opensource tool named CoGrOO, and based on an annotated medical corpus. After the experiments, four rules were defined and applied on 200 summaries to identify the existence of the content ”continuity of care”. This process had resulted in a Precision value of 83%, Recall value of 69% and F-Measure value of 76% related to algorithm evaluation.

Expert support system for occupational therapist in the identification of sensory profile

Introduction Based on the increasing usability of technology in healthcare, this paper discusses the use of an expert system (ES) to identify the sensory profile of patients starting Occupational Therapy, allowing the professional to make assertive decisions in establishing priorities in the therapeutic plan.Objective To develop a decision support system from the Infant/Toddler Sensory Profile.Method Structuring of an ES based on Infant/Toddler Sensory Profile, from terms translation into Portuguese, identification of variables and domain values involved, and construction of production rules.Results Twelve variables were registered for the construction of the ES, 6 of these were treated as goal-variables, 20 rules being built.Conclusion This ES is an important support to the occupational therapist in the decision-making process of treatment plans, determining priorities and respecting the sensory profile of each child. In addition, it must be noted that there is no equivalent system.

Arquetipos de datos clave para la atención de enfermería de pacientes con endometriosis

Objetivou-se elaborar um Conjunto de Dados Essenciais de Enfermagem para Atendimento as Portadoras de Endometriose (CDEEPE) e representa-lo por arquetipos. Pesquisa exploratoria, aplicada com participacao de especialistas, realizada no Laboratorio de Informatica em Saude da PUCPR, entre fevereiro e novembro de 2010. Foi dividida em duas etapas: construcao e avaliacao do CDEEPE, que abordou as fases do Processo de Enfermagem e as Necessidades Humanas Basicas; e desenvolvimento dos arquetipos, a partir do conjunto definido. O CDEEPE foi avaliado, por medicos e enfermeiros, com media consensual de 95,9% e foi especificado contendo 51 dados. Para representa-lo, foi criado o arquetipo “Percepcao dos Orgaos e Sentidos”. Este estudo possibilitou identificar informacoes importantes para a pratica de enfermagem, contribuindo para informatizacao e aplicacao do Processo de Enfermagem no cuidado prestado. O CDEEPE foi base para criacao do arquetipo, que possibilitara os registros de forma estruturada, organizada, eficiente, interoperavel e semântica.