Defining Effective Engagement For Enhancing Cancer Patients' Well-being with Mobile Digital Behavior Change Interventions

Digital Behavior Change Interventions (DBCIs) are supporting development of new health behaviors. Evaluating their effectiveness is crucial for their improvement and understanding of success factors. However, comprehensive guidance for developers, particularly in small-scale studies with ethical constraints, is limited. Building on the CAPABLE project, this study aims to define effective engagement with DBCIs for supporting cancer patients in enhancing their quality of life. We identify metrics for measuring engagement, explore the interest of both patients and clinicians in DBCIs, and propose hypotheses for assessing the impact of DBCIs in such contexts. Our findings suggest that clinician prescriptions significantly increase sustained engagement with mobile DBCIs. In addition, while one weekly engagement with a DBCI is sufficient to maintain well-being, transitioning from extrinsic to intrinsic motivation may require a higher level of engagement.

Leveraging Generative AI for Clinical Evidence Summarization Needs to Achieve Trustworthiness

Evidence-based medicine aims to improve the quality of healthcare by empowering medical decisions and practices with the best available evidence. The rapid growth of medical evidence, which can be obtained from various sources, poses a challenge in collecting, appraising, and synthesizing the evidential information. Recent advancements in generative AI, exemplified by large language models, hold promise in facilitating the arduous task. However, developing accountable, fair, and inclusive models remains a complicated undertaking. In this perspective, we discuss the trustworthiness of generative AI in the context of automated summarization of medical evidence.

Can Large Language Models Augment a Biomedical Ontology with missing Concepts and Relations?

Ontologies play a crucial role in organizing and representing knowledge. However, even current ontologies do not encompass all relevant concepts and relationships. Here, we explore the potential of large language models (LLM) to expand an existing ontology in a semi-automated fashion. We demonstrate our approach on the biomedical ontology SNOMED-CT utilizing semantic relation types from the widely used UMLS semantic network. We propose a method that uses conversational interactions with an LLM to analyze clinical practice guidelines (CPGs) and detect the relationships among the new medical concepts that are not present in SNOMED-CT. Our initial experimentation with the conversational prompts yielded promising preliminary results given a manually generated gold standard, directing our future potential improvements.

Personalizing Digital Health Behavior Change Interventions using Machine Learning and Domain Knowledge

We are developing a virtual coaching system that helps patients adhere to behavior change interventions (BCI). Our proposed system predicts whether a patient will perform the targeted behavior and uses counterfactual examples with feature control to guide personalizsation of BCI. We evaluated our prediction model using simulated patient data with varying levels of receptivity to intervention.

Supervised Machine Learning Algorithm for Detecting Consistency between Reported Findings and the Conclusions of Mammography Reports

Objective. Mammography reports document the diagnosis of patients' conditions. However, many reports contain non-standard terms (non-BI-RADS descriptors) and incomplete statements, which can lead to conclusions that are not well-supported by the reported findings. Our aim was to develop a tool to detect such discrepancies by comparing the reported conclusions to those that would be expected based on the reported radiology findings. Materials and Methods. A deidentified data set from an academic hospital containing 258 mammography reports supplemented by 120 reports found on the web was used for training and evaluation. Spell checking and term normalization was used to unambiguously determine the reported BI-RADS descriptors. The resulting data were input into seven classifiers that classify mammography reports, based on their Findings sections, into seven BI-RADS final assessment categories. Finally, the semantic similarity score of a report to each BI-RADS category is reported. Results. Our term normalization algorithm correctly identified 97% of the BI-RADS descriptors in mammography reports. Our system provided 76% precision and 83% recall in correctly classifying the reports according to BI-RADS final assessment category. Discussion. The strength of our approach relies on providing high importance to BI-RADS terms in the summarization phase, on the semantic similarity that considers the complex data representation, and on the classification into all seven BI-RADs categories. Conclusion. BI-RADS descriptors and expected final assessment categories could be automatically detected by our approach with fairly good accuracy, which could be used to make users aware that their reported findings do not match well with their conclusion.