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Peluso, Alina

Publications and source records attributed to Peluso, Alina.

18 records
All sourcesNASA NTRSDOE OSTI
DOE OSTI2024

Health Care Usage During the COVID-19 Pandemic and the Adoption of Telemedicine: Retrospective Study of Chronic Disease Cohorts

Background: The COVID-19 pandemic accelerated telehealth adoption across disease cohorts of patients. For many patients, routine medical care was no longer an option, and others chose not to visit medical offices in order to minimize COVID-19 exposure. In this study, we take a comprehensive multidisease approach in studying the impact of the COVID-19 pandemic on health care usage and the adoption of telemedicine through the first 12 months of the COVID-19 pandemic. Objective: We studied the impact of the COVID-19 pandemic on in-person health care usage and telehealth adoption across chronic diseases to understand differences in telehealth adoption across disease cohorts and patient demographics (such as the Social Vulnerability Index [SVI]). Methods: We conducted a retrospective cohort study of 6 different disease cohorts (anxiety: n=67,578; depression: n=45,570; diabetes: n=81,885; kidney failure: n=29,284; heart failure: n=21,152; and cancer: n=35,460). We used summary statistics to characterize changes in usage and regression analysis to study how patient characteristics relate to in-person health care and telehealth adoption and usage during the first 12 months of the pandemic. Results: We observed a reduction in in-person health care usage across disease cohorts (ranging from 10% to 24%). For most diseases we study, telehealth appointments offset the reduction in in-person visits. Furthermore, for anxiety and depression, the increase in telehealth usage exceeds the reduction in in-person visits (by up to 5%). We observed that younger patients and men have higher telehealth usage after accounting for other covariates. Patients from higher SVI areas are less likely to use telehealth; however, if they do, they have a higher number of telehealth visits, after accounting for other covariates. Conclusions: The COVID-19 pandemic affected health care usage across diseases, and the role of telehealth in replacing in-person visits varies by disease cohort. Understanding these differences can inform current practices and provides opportunities to further guide modalities of in-person and telehealth visits. Critically, further study is needed to understand barriers to telehealth service usage for patients in higher SVI areas. A better understanding of the role of social determinants of health may lead to more support for patients and help individual health care providers improve access to care for patients with chronic conditions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2024

VA EDH Data Curation Documentation FY24-Q4

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. Health outcomes, including suicide, are typically influenced by both genetics and environmental factors, such as air quality, transportation access, food availability, homelessness, and more. Mental health outcomes are associated with various stressors across socioeconomic, economic, and physical environments. Analyzing the connections between these stressors, covariates, and health outcomes relies on standardized data, which can be integrated into models like the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET). The World Health Organization (WHO) defines Environmental Determinants of Health (EDH) as factors like clean air, stable climate, water and sanitation, chemical safety, radiation protection, safe workplaces, sustainable agriculture, healthy urban environments, and nature preservation, all of which are crucial for good health.

99 GENERAL AND MISCELLANEOUS↗
DOE OSTI2024

Explaining Health Risk Behaviors in the U.S. with Social Deprivation at Local and Regional Levels

Health risk behaviors are precursors to many chronic health outcomes, and hence, they pose a challenge to public health. Social deprivation undoubtedly creates circumstances that limit access to healthy habits. Moreover, broad regional effects (weather patterns, political ideology, social norms), and local characteristics (cultural notions and barriers, urban places) also influence lifestyle choices and must be accounted for to truly understand the impact of social deprivation on risky behaviors. This research fills the knowledge gap in epidemiological modeling of health risk behaviors by leveraging machine learning to find associations between social deprivation and health risk behaviors, when adjusted by regional and local effects. Four health risk behaviors, namely, binge drinking, smoking, lack of sleep, and lack of physical activity from the CDC PLACES project are considered in a single framework to understand and compare the interplay between local/regional characteristics and seven measures of social deprivation. Our results indicate that local and/or regional factors rise to the top for three out of four risk behaviors (binge drinking, smoking and lack of sleep) out-competing social deprivation measures. Un-entangling the geographical effects reveals that poverty, educational attainment and non-employment are the three deprivation measures most significantly associated with all four health risk factors. The research thus indicates that public health policies to promote healthy lifestyle behaviors must seek to remedy social deprivation, but using socially and culturally sensitive interventions.

Gokhale, Swapna↗
DOE OSTI2024

VA EDH Data Curation Documentation (FY24-Q3)

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. Health outcomes, including suicide, are typically influenced by both genetics and environmental factors, such as air quality, transportation access, food availability, homelessness, and more. Mental health outcomes are associated with various stressors across socioeconomic, economic, and physical environments. Analyzing the connections between these stressors, covariates, and health outcomes relies on standardized data, which can be integrated into models like the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET). The World Health Organization (WHO) defines Environmental Determinants of Health (EDH) as factors like clean air, stable climate, water and sanitation, chemical safety, radiation protection, safe workplaces, sustainable agriculture, healthy urban environments, and nature preservation, all of which are crucial for good health.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2024

VA EDH Data Curation Documentation (FY24-Q2)

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. Health outcomes, including suicide, are typically influenced by both genetics and environmental factors, such as air quality, transportation access, food availability, homelessness, and more. Mental health outcomes are associated with various stressors across socioeconomic, economic, and physical environments. Analyzing the connections between these stressors, covariates, and health outcomes relies on standardized data, which can be integrated into models like the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET). The World Health Organization (WHO) defines Environmental Determinants of Health (EDH) as factors like clean air, stable climate, water and sanitation, chemical safety, radiation protection, safe workplaces, sustainable agriculture, healthy urban environments, and nature preservation, all of which are crucial for good health.

99 GENERAL AND MISCELLANEOUS↗
DOE OSTI2023

Deep learning uncertainty quantification for clinical text classification

Machine learning algorithms are expected to work side-by-side with humans in decision-making pipelines. Thus, the ability of classifiers to make reliable decisions is of paramount importance. Deep neural networks (DNNs) represent the state-of-the-art models to address real-world classification. Although the strength of activation in DNNs is often correlated with the network’s confidence, in-depth analyses are needed to establish whether they are well calibrated. In this paper, we demonstrate the use of DNN-based classification tools to benefit cancer registries by automating information extraction of disease at diagnosis and at surgery from electronic text pathology reports from the US National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) population-based cancer registries. In particular, we introduce multiple methods for selective classification to achieve a target level of accuracy on multiple classification tasks while minimizing the rejection amount—that is, the number of electronic pathology reports for which the model’s predictions are unreliable. We evaluate the proposed methods by comparing our approach with the current in-house deep learning-based abstaining classifier. Overall, all the proposed selective classification methods effectively allow for achieving the targeted level of accuracy or higher in a trade-off analysis aimed to minimize the rejection rate. On in-distribution validation and holdout test data, with all the proposed methods, we achieve on all tasks the required target level of accuracy with a lower rejection rate than the deep abstaining classifier (DAC). Interpreting the results for the out-of-distribution test data is more complex; nevertheless, in this case as well, the rejection rate from the best among the proposed methods achieving 97% accuracy or higher is lower than the rejection rate based on the DAC. We show that although both approaches can flag those samples that should be manually reviewed and labeled by human annotators, the newly proposed methods retain a larger fraction and do so without retraining—thus offering a reduced computational cost compared with the in-house deep learning-based abstaining classifier.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2023

VA EDH Data Curation Documentation (FY24-Q1)

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. Health outcomes, including suicide, are typically influenced by both genetics and environmental factors, such as air quality, transportation access, food availability, homelessness, and more. Mental health outcomes are associated with various stressors across socioeconomic, economic, and physical environments. Analyzing the connections between these stressors, covariates, and health outcomes relies on standardized data, which can be integrated into models like the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET). The World Health Organization (WHO) defines Environmental Determinants of Health (EDH) as factors like clean air, stable climate, water and sanitation, chemical safety, radiation protection, safe workplaces, sustainable agriculture, healthy urban environments, and nature preservation, all of which are crucial for good health.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2023

VA EDH Data Curation Documentation FY23-Q4

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning service members into their communities. Since its creation, the VA has been working to eliminate suicide among all veterans by developing and implementing innovative suicide prevention approaches and resources. Health outcomes, such as suicide, are typically modeled as a function of genetics and environment, where environment refers to factors beyond medical, e.g., air quality, access to transportation and food, homelessness status, etc. Mental health outcomes for each individual are considered to be associated with multiple stressors that fall under a variety of categories, including socioeconomic, economic, and physical environments. Understanding the relationships between these stressors, covariates, and health outcomes requires curated, standardized data that can be input into the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET) or other health outcomes model. Environmental Determinants of Health (EDH), as defined by the World Health Organization (WHO), refer to clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature, which are all prerequisites for good health.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2023

VA EDH Data Curation Documentation FY23-Q3

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning Service members into their communities. Since its creation, VA has been working to eliminate suicide among all veterans by developing and implementing innovative suicide prevention approaches and resources. Health outcomes, such as suicide are typically modeled as a function of genetics and environment, where environment refers to factors beyond medical, e.g., air quality, access to transportation and food, homelessness status, etc. Mental health outcomes for each individual are considered to be associated with multiple stressors that fall under a variety of categories including socioeconomic, economic, physical environment. Understanding the relationships between these stressors, covariates and health outcomes requires curated, standardized data that can be input into the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET) or other health outcomes model. Environmental Determinants of Health (EDH) as defined by the World Health Organization (WHO) refers to clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2023

VA EDH Data Curation Documentation FY23-Q2

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning Service members into their communities. Since its creation, VA has been working to eliminate suicide among all veterans by developing and implementing innovative suicide prevention approaches and resources. Health outcomes, such as suicide are typically modeled as a function of genetics and environment, where environment refers to factors beyond medical, e.g., air quality, access to transportation and food, homelessness status, etc. Mental health outcomes for each individual are considered to be associated with multiple stressors that fall under a variety of categories including socioeconomic, economic, physical environment. Understanding the relationships between these stressors, covariates and health outcomes requires curated, standardized data that can be input into the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET) or other health outcomes model. Environmental Determinants of Health (EDH) as defined by the World Health Organization (WHO) is clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.

99 GENERAL AND MISCELLANEOUS↗
DOE OSTI2022

VA EDH Data Curation Documentation FY23-Q1

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning Service members into their communities. VA is working to eliminate suicide among all Veterans by developing and implementing innovative suicide prevention approaches and resources.

99 GENERAL AND MISCELLANEOUS↗
DOE OSTI2022

Automatic information extraction from childhood cancer pathology reports

The International Classification of Childhood Cancer (ICCC) facilitates the effective classification of a heterogeneous group of cancers in the important pediatric population. However, there has been no development of machine learning models for the ICCC classification. We developed deep learning-based information extraction models from cancer pathology reports based on the ICD-O-3 coding standard. In this article, we describe extending the models to perform ICCC classification. We developed 2 models, ICD-O-3 classification and ICCC recoding (Model 1) and direct ICCC classification (Model 2), and 4 scenarios subject to the training sample size. We evaluated these models with a corpus consisting of 29206 reports with age at diagnosis between 0 and 19 from 6 state cancer registries. Our findings suggest that the direct ICCC classification (Model 2) is substantially better than reusing the ICD-O-3 classification model (Model 1). Applying the uncertainty quantification mechanism to assess the confidence of the algorithm in assigning a code demonstrated that the model achieved a micro-F1 score of 0.987 while abstaining (not sufficiently confident to assign a code) on only 14.8% of ambiguous pathology reports. Our experimental results suggest that the machine learning-based automatic information extraction from childhood cancer pathology reports in the ICCC is a reliable means of supplementing human annotators at state cancer registries by reading and abstracting the majority of the childhood cancer pathology reports accurately and reliably.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

CTSA MHRI Datasets

Oak Ridge National Laboratory (ORNL) has collaborated with MedStar Health Research Institute (MHRI) to develop, test, and validate health outcomes using electronic health records (EHRs) from hospitals associated with participating Clinical and Translational Science Awards (CTSA). MHRI, the research organization of MedStar Health (MSH), has a history of initiating projects, both in the laboratory and in the field, that serve the needs of medically underserved and disenfranchised groups. In this document, the ORNL team is providing data curation documentation for the following datasets, which are publicly available: 1. Area Deprivation Index (ADI) 2015 block group; 2. Child Opportunity Index 2015 tract; 3. Low food access 2017 block group; 4. Neighborhood deprivation index 2017 tract; 5. Social Capital Index 2014 county; and, 6. Social Vulnerability Index 2014 tract.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2022

VA EDH Data Curation Documentation FY22-Q2, Rev. 2

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning Service members into their communities. VA is working to eliminate suicide among all Veterans by developing and implementing innovative suicide prevention approaches and resources. Health outcomes, such as suicide are typically modeled as a function of genetics and environment, where environment refers to factors beyond medical, e.g., air quality, access to transportation and food, homelessness status, etc. Mental health outcomes for each individual are considered to be associated with multiple stressors that fall under a variety of categories socioeconomic, economic, physical environment. Understanding the relationships between these stressors, covariates and health outcomes, requires curated, standardized data that can be input into the VA’s Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment (REACH VET) or other health outcomes model. Environmental Determinants of Health (EDH) as defined by the World Health Organization (WHO) is clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

Unstructured clinical notes within the 24 hours since admission predict short, mid & long-term mortality in adult ICU patients

Mortality prediction for intensive care unit (ICU) patients is crucial for improving outcomes and efficient utilization of resources. Accessibility of electronic health records (EHR) has enabled data-driven predictive modeling using machine learning. However, very few studies rely solely on unstructured clinical notes from the EHR for mortality prediction. In this work, we propose a framework to predict short, mid, and long-term mortality in adult ICU patients using unstructured clinical notes from the MIMIC III database, natural language processing (NLP), and machine learning (ML) models. Depending on the statistical description of the patients’ length of stay, we define the short-term as 48-hour and 4-day period, the mid-term as 7-day and 10-day period, and the long-term as 15-day and 30-day period after admission. We found that by only using clinical notes within the 24 hours of admission, our framework can achieve a high area under the receiver operating characteristics (AU-ROC) score for short, mid and long-term mortality prediction tasks. The test AU-ROC scores are 0.87, 0.83, 0.83, 0.82, 0.82, and 0.82 for 48-hour, 4-day, 7-day, 10-day, 15-day, and 30-day period mortality prediction, respectively. We also provide a comparative study among three types of feature extraction techniques from NLP: frequency-based technique, fixed embedding-based technique, and dynamic embedding-based technique. Lastly, we provide an interpretation of the NLP-based predictive models using feature-importance scores.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

VA EDH Data Curation Documentation FY2022-Q1, Rev. 2

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning Service members into their communities. VA is working to eliminate suicide among all Veterans by developing and implementing innovative suicide prevention approaches and resources.

60 APPLIED LIFE SCIENCES↗