An artificial intelligence framework integrating longitudinal electronic health records with real-world data enables continuous pan-cancer prognostication

Nat Cancer. 2021 Jul;2(7):709-722. doi: 10.1038/s43018-021-00236-2. Epub 2021 Jul 22.

Abstract

Despite widespread adoption of electronic health records (EHRs), most hospitals are not ready to implement data science research in the clinical pipelines. Here, we develop MEDomics, a continuously learning infrastructure through which multimodal health data are systematically organized and data quality is assessed with the goal of applying artificial intelligence for individual prognosis. Using this framework, currently composed of thousands of individuals with cancer and millions of data points over a decade of data recording, we demonstrate prognostic utility of this framework in oncology. As proof of concept, we report an analysis using this infrastructure, which identified the Framingham risk score to be robustly associated with mortality among individuals with early-stage and advanced-stage cancer, a potentially actionable finding from a real-world cohort of individuals with cancer. Finally, we show how natural language processing (NLP) of medical notes could be used to continuously update estimates of prognosis as a given individual's disease course unfolds.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Artificial Intelligence
  • Data Accuracy
  • Electronic Health Records*
  • Humans
  • Natural Language Processing
  • Neoplasms* / diagnosis

Grants and funding