Grant Number:	1R01CA183962-01A1 Interpret this number
Primary Investigator:	Hernandez-Boussard, Tina
Organization:	Stanford University
Project Title:	Utilizing Electronic Health Records to Measure and Improve Prostate Cancer Care
Fiscal Year:	2015

¿ DESCRIPTION (provided by applicant): Prostate cancer is the most common malignancy in men. Newly diagnosed men face complex treatment choices, each with different risks of acquired patient-centered outcomes (e.g. urinary and erectile dysfunction). Currently, patients and clinicians cannot easily compare the trade-offs among patient-centered outcomes across different treatments because the empirical evidence regarding these trade-offs does not exist, because patient centered outcomes are not routinely recorded in assessable formats. However, electronic healthcare records (EHR) free text is a rich, untapped source of patient centered outcomes. We propose to assemble a robust data-mining workflow to efficiently and accurately capture treatment and outcome quality metrics from structured data and free-text in EHRs. We will put this evidence in the hands of both clinicians and patients through a web-based risk assessment tool. Our proposal has three innovative aspects. First, we will develop an EHR prostate cancer database that will allow for clinical care data to be analyzed alongside diagnostic details. Second, we will create novel ontological representations of quality metrics that will be public and reliably calculable across EHR-systems. Third, we will assemble a robust data- mining workflow that expands on existing methods by focusing on ontology-based dictionaries to annotate free text. Combining this set of innovative components will uniquely allow us to use existing EHRs to efficiently study the trade-offs among patient-centered outcomes across different treatments. In Aim 1 we will create the building blocks needed to identify quality metric data in EHRs. We will develop an EHR-database, map quality metrics to medical vocabularies and ontologies, and create electronic quality metric phenotypes. In Aim 2, we will expand our data-mining workflow with quality metric vocabulary and use it to gather data relevant to quality metrics. In Aim 3 we will develop a web-based tool that integrates the empirical evidence assessed in our first two aims with patient and clinical characteristics to estimate patients' personalized risks of patient centered outcomes across treatments. Our web tool will display such personalized risk predictions, to help clinicians and patients choose a treatment option that offers the best predicted quality of life given the importance they assign to each patient-centered outcome. This proposal will address a critical gap in evidence for prostate cancer treatment and research by providing clinicians and patients with empirical evidence needed to compare the trade-offs among patient centered outcomes across different treatments. Our work is consistent with our nation's focus on EHR `meaningful use' and the comprehensive assessment of healthcare delivery, and with NCI's focus on improving the quality of cancer care delivery.




Cost-Effectiveness Analysis and Microsimulation of Serial Multiparametric Magnetic Resonance Imaging in Active Surveillance of Localized Prostate Cancer.
Authors: Magnani C.J. , Hernandez-Boussard T. , Baker L.C. , Goldhaber-Fiebert J.D. , Brooks J.D. .
Source: The Journal Of Urology, 2022-02-25 00:00:00.0; , p. 101097JU0000000000002490.
EPub date: 2022-02-25 00:00:00.0.
PMID: 35212570
Related Citations

Expanding the Secondary Use of Prostate Cancer Real World Data: Automated Classifiers for Clinical and Pathological Stage.
Authors: Bozkurt S. , Magnani C.J. , Seneviratne M.G. , Brooks J.D. , Hernandez-Boussard T. .
Source: Frontiers In Digital Health, 2022; 4, p. 793316.
EPub date: 2022-06-02 00:00:00.0.
PMID: 35721793
Related Citations

Clinical concept recognition: Evaluation of existing systems on EHRs.
Authors: Lossio-Ventura J.A. , Sun R. , Boussard S. , Hernandez-Boussard T. .
Source: Frontiers In Artificial Intelligence, 2022; 5, p. 1051724.
EPub date: 2023-01-13 00:00:00.0.
PMID: 36714202
Related Citations

Digital twins for predictive oncology will be a paradigm shift for precision cancer care.
Authors: Hernandez-Boussard T. , Macklin P. , Greenspan E.J. , Gryshuk A.L. , Stahlberg E. , Syeda-Mahmood T. , Shmulevich I. .
Source: Nature Medicine, 2021-11-25 00:00:00.0; , .
EPub date: 2021-11-25 00:00:00.0.
PMID: 34824458
Related Citations

Machine Learning Applied to Electronic Health Records: Identification of Chemotherapy Patients at High Risk for Preventable Emergency Department Visits and Hospital Admissions.
Authors: Peterson D.J. , Ostberg N.P. , Blayney D.W. , Brooks J.D. , Hernandez-Boussard T. .
Source: Jco Clinical Cancer Informatics, 2021 Oct; 5, p. 1106-1126.
PMID: 34752139
Related Citations

Prevalence of Postprostatectomy Incontinence Requiring Anti-incontinence Surgery After Radical Prostatectomy for Prostate Cancer: A Retrospective Population-Based Analysis.
Authors: Kim J.H. , Jeong I.G. , Khandwala Y.S. , Hernandez-Boussard T. , Brooks J.D. , Chung B.I. .
Source: International Neurourology Journal, 2021 Sep; 25(3), p. 263-270.
EPub date: 2021-03-09 00:00:00.0.
PMID: 33705635
Related Citations

Diverse patient trajectories during cytotoxic chemotherapy: Capturing longitudinal patient-reported outcomes.
Authors: Azad A.D. , Yilmaz M. , Bozkurt S. , Brooks J.D. , Blayney D.W. , Hernandez-Boussard T. .
Source: Cancer Medicine, 2021-07-13 00:00:00.0; , .
EPub date: 2021-07-13 00:00:00.0.
PMID: 34254459
Related Citations

Evaluation of clustering and topic modeling methods over health-related tweets and emails.
Authors: Lossio-Ventura J.A. , Gonzales S. , Morzan J. , Alatrista-Salas H. , Hernandez-Boussard T. , Bian J. .
Source: Artificial Intelligence In Medicine, 2021 07; 117, p. 102096.
EPub date: 2021-05-07 00:00:00.0.
PMID: 34127235
Related Citations

Clinical Trial Outcomes in Urology: Assessing Early Discontinuation, Results Reporting and Publication in ClinicalTrials.Gov Registrations 2007-2019.
Authors: Magnani C.J. , Steinberg J.R. , Harmange C.I. , Zhang X. , Driscoll C. , Bell A. , Larson J. , You J.G. , Weeks B.T. , Hernandez-Boussard T. , et al. .
Source: The Journal Of Urology, 2021 04; 205(4), p. 1159-1168.
EPub date: 2020-10-20 00:00:00.0.
PMID: 33079618
Related Citations

Assessment of a Clinical Trial-Derived Survival Model in Patients With Metastatic Castration-Resistant Prostate Cancer.
Authors: Coquet J. , Bievre N. , Billaut V. , Seneviratne M. , Magnani C.J. , Bozkurt S. , Brooks J.D. , Hernandez-Boussard T. .
Source: Jama Network Open, 2021-01-04 00:00:00.0; 4(1), p. e2031730.
EPub date: 2021-01-04 00:00:00.0.
PMID: 33481032
Related Citations

Real-world Evidence to Estimate Prostate Cancer Costs for First-line Treatment or Active Surveillance.
Authors: Magnani C.J. , Bievre N. , Baker L.C. , Brooks J.D. , Blayney D.W. , Hernandez-Boussard T. .
Source: European Urology Open Science, 2021 Jan; 23, p. 20-29.
EPub date: 2020-12-10 00:00:00.0.
PMID: 33367287
Related Citations

MINIMAR (MINimum Information for Medical AI Reporting): Developing reporting standards for artificial intelligence in health care.
Authors: Hernandez-Boussard T. , Bozkurt S. , Ioannidis J.P.A. , Shah N.H. .
Source: Journal Of The American Medical Informatics Association : Jamia, 2020-12-09 00:00:00.0; 27(12), p. 2011-2015.
PMID: 32594179
Related Citations

Phenotyping severity of patient-centered outcomes using clinical notes: A prostate cancer use case.
Authors: Bozkurt S. , Paul R. , Coquet J. , Sun R. , Banerjee I. , Brooks J.D. , Hernandez-Boussard T. .
Source: Learning Health Systems, 2020 Oct; 4(4), p. e10237.
EPub date: 2020-07-17 00:00:00.0.
PMID: 33083539
Related Citations

Association between patient-initiated emails and overall 2-year survival in cancer patients undergoing chemotherapy: Evidence from the real-world setting.
Authors: Coquet J. , Blayney D.W. , Brooks J.D. , Hernandez-Boussard T. .
Source: Cancer Medicine, 2020-09-28 00:00:00.0; , .
EPub date: 2020-09-28 00:00:00.0.
PMID: 32986931
Related Citations

Leveraging Digital Data to Inform and Improve Quality Cancer Care.
Authors: Hernandez-Boussard T. , Blayney D.W. , Brooks J.D. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2020 Apr; 29(4), p. 816-822.
EPub date: 2020-02-17 00:00:00.0.
PMID: 32066619
Related Citations

Clinical Documentation to Predict Factors Associated with Urinary Incontinence Following Prostatectomy for Prostate Cancer.
Authors: Li K. , Banerjee I. , Magnani C.J. , Blayney D.W. , Brooks J.D. , Hernandez-Boussard T. .
Source: Research And Reports In Urology, 2020; 12, p. 7-14.
EPub date: 2020-01-23 00:00:00.0.
PMID: 32158720
Related Citations

Real world evidence in cardiovascular medicine: ensuring data validity in electronic health record-based studies.
Authors: Hernandez-Boussard T. , Monda K.L. , Crespo B.C. , Riskin D. .
Source: Journal Of The American Medical Informatics Association : Jamia, 2019-11-01 00:00:00.0; 26(11), p. 1189-1194.
PMID: 31414700
Related Citations

Clinical named-entity recognition: A short comparison.
Authors: Lossio-Ventura J.A. , Boussard S. , Morzan J. , Hernandez-Boussard T. .
Source: Proceedings. Ieee International Conference On Bioinformatics And Biomedicine, 2019 Nov; 2019, p. 1548-1550.
EPub date: 2020-02-06 00:00:00.0.
PMID: 35463810
Related Citations

Clustering and topic modeling over tweets: A comparison over a health dataset.
Authors: Lossio-Ventura J.A. , Morzan J. , Alatrista-Salas H. , Hernandez-Boussard T. , Bian J. .
Source: Proceedings. Ieee International Conference On Bioinformatics And Biomedicine, 2019 Nov; 2019, p. 1544-1547.
EPub date: 2020-02-06 00:00:00.0.
PMID: 35463811
Related Citations

Machine Learning Approaches for Extracting Stage from Pathology Reports in Prostate Cancer.
Authors: Lenain R. , Seneviratne M.G. , Bozkurt S. , Blayney D.W. , Brooks J.D. , Hernandez-Boussard T. .
Source: Studies In Health Technology And Informatics, 2019-08-21 00:00:00.0; 264, p. 1522-1523.
PMID: 31438212
Related Citations

Extracting Patient-Centered Outcomes from Clinical Notes in Electronic Health Records: Assessment of Urinary Incontinence After Radical Prostatectomy.
Authors: Gori D. , Banerjee I. , Chung B.I. , Ferrari M. , Rucci P. , Blayney D.W. , Brooks J.D. , Hernandez-Boussard T. .
Source: Egems (washington, Dc), 2019-08-20 00:00:00.0; 7(1), p. 43.
EPub date: 2019-08-20 00:00:00.0.
PMID: 31497615
Related Citations

Is it possible to automatically assess pretreatment digital rectal examination documentation using natural language processing? A single-centre retrospective study.
Authors: Bozkurt S. , Kan K.M. , Ferrari M.K. , Rubin D.L. , Blayney D.W. , Hernandez-Boussard T. , Brooks J.D. .
Source: Bmj Open, 2019-07-18 00:00:00.0; 9(7), p. e027182.
EPub date: 2019-07-18 00:00:00.0.
PMID: 31324681
Related Citations

PSA Testing Use and Prostate Cancer Diagnostic Stage After the 2012 U.S. Preventive Services Task Force Guideline Changes.
Authors: Magnani C.J. , Li K. , Seto T. , McDonald K.M. , Blayney D.W. , Brooks J.D. , Hernandez-Boussard T. .
Source: Journal Of The National Comprehensive Cancer Network : Jnccn, 2019-07-01 00:00:00.0; 17(7), p. 795-803.
PMID: 31319390
Related Citations

Comparison of Orthogonal NLP Methods for Clinical Phenotyping and Assessment of Bone Scan Utilization among Prostate Cancer Patients.
Authors: Coquet J. , Bozkurt S. , Kan K.M. , Ferrari M.K. , Blayney D.W. , Brooks J.D. , Hernandez-Boussard T. .
Source: Journal Of Biomedical Informatics, 2019-04-20 00:00:00.0; , p. 103184.
EPub date: 2019-04-20 00:00:00.0.
PMID: 31014980
Related Citations

Weakly supervised natural language processing for assessing patient-centered outcome following prostate cancer treatment.
Authors: Banerjee I. , Li K. , Seneviratne M. , Ferrari M. , Seto T. , Brooks J.D. , Rubin D.L. , Hemandez-Boussard T. .
Source: Jamia Open, 2019 Apr; 2(1), p. 150-159.
EPub date: 2019-01-04 00:00:00.0.
PMID: 31032481
Related Citations

Utilization of Prostate Cancer Quality Metrics for Research and Quality Improvement: A Structured Review.
Authors: Gori D. , Dulal R. , Blayney D.W. , Brooks J.D. , Fantini M.P. , McDonald K.M. , Hernandez-Boussard T. .
Source: Joint Commission Journal On Quality And Patient Safety, 2019 Mar; 45(3), p. 217-226.
EPub date: 2018-09-18 00:00:00.0.
PMID: 30236510
Related Citations

Merging heterogeneous clinical data to enable knowledge discovery.
Authors: Seneviratne M.G. , Kahn M.G. , Hernandez-Boussard T. .
Source: Pacific Symposium On Biocomputing. Pacific Symposium On Biocomputing, 2019; 24, p. 439-443.
PMID: 30864344
Related Citations

Distribution of global health measures from routinely collected PROMIS surveys in patients with breast cancer or prostate cancer.
Authors: Seneviratne M.G. , Bozkurt S. , Patel M.I. , Seto T. , Brooks J.D. , Blayney D.W. , Kurian A.W. , Hernandez-Boussard T. .
Source: Cancer, 2018-12-04 00:00:00.0; , .
EPub date: 2018-12-04 00:00:00.0.
PMID: 30512191
Related Citations

Advances in Electronic Phenotyping: From Rule-Based Definitions to Machine Learning Models.
Authors: Banda J.M. , Seneviratne M. , Hernandez-Boussard T. , Shah N.H. .
Source: Annual Review Of Biomedical Data Science, 2018 Jul; 1, p. 53-68.
EPub date: 2018-05-23 00:00:00.0.
PMID: 31218278
Related Citations

Architecture and Implementation of a Clinical Research Data Warehouse for Prostate Cancer.
Authors: Seneviratne M.G. , Seto T. , Blayney D.W. , Brooks J.D. , Hernandez-Boussard T. .
Source: Egems (washington, Dc), 2018-06-01 00:00:00.0; 6(1), p. 13.
EPub date: 2018-06-01 00:00:00.0.
PMID: 30094285
Related Citations

Secondary use of electronic medical records for clinical research: Challenges and Opportunities.
Authors: Yim W.W. , Wheeler A.J. , Curtin C. , Wagner T.H. , Hernandez-Boussard T. .
Source: Convergent Science Physical Oncology, 2018 Mar; 4(1), .
EPub date: 2018-02-12 00:00:00.0.
PMID: 29732166
Related Citations

An Automated Feature Engineering for Digital Rectal Examination Documentation using Natural Language Processing.
Authors: Bozkurt S. , Park J.I. , Kan K.M. , Ferrari M. , Rubin D.L. , Brooks J.D. , Hernandez-Boussard T. .
Source: Amia ... Annual Symposium Proceedings. Amia Symposium, 2018; 2018, p. 288-294.
EPub date: 2018-12-05 00:00:00.0.
PMID: 30815067
Related Citations

Identifying Cases of Metastatic Prostate Cancer Using Machine Learning on Electronic Health Records.
Authors: Seneviratne M.G. , Banda J.M. , Brooks J.D. , Shah N.H. , Hernandez-Boussard T.M. .
Source: Amia ... Annual Symposium Proceedings. Amia Symposium, 2018; 2018, p. 1498-1504.
EPub date: 2018-12-05 00:00:00.0.
PMID: 30815195
Related Citations

Mining Electronic Health Records to Extract Patient-Centered Outcomes Following Prostate Cancer Treatment.
Authors: Hernandez-Boussard T. , Kourdis P.D. , Seto T. , Ferrari M. , Blayney D.W. , Rubin D. , Brooks J.D. .
Source: Amia ... Annual Symposium Proceedings. Amia Symposium, 2017; 2017, p. 876-882.
EPub date: 2018-04-16 00:00:00.0.
PMID: 29854154
Related Citations

Electronic Health Records and Quality of Care: An Observational Study Modeling Impact on Mortality, Readmissions, and Complications.
Authors: Yanamadala S. , Morrison D. , Curtin C. , McDonald K. , Hernandez-Boussard T. .
Source: Medicine, 2016 May; 95(19), p. e3332.
PMID: 27175631
Related Citations

New Paradigms for Patient-Centered Outcomes Research in Electronic Medical Records: An Example of Detecting Urinary Incontinence Following Prostatectomy.
Authors: Hernandez-Boussard T. , Tamang S. , Blayney D. , Brooks J. , Shah N. .
Source: Egems (washington, Dc), 2016; 4(3), p. 1231.
PMID: 27347492
Related Citations