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      Real Time Influenza Monitoring Using Hospital Big Data in Combination with Machine Learning Methods: Comparison Study

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          Abstract

          Background

          Traditional surveillance systems produce estimates of influenza-like illness (ILI) incidence rates, but with 1- to 3-week delay. Accurate real-time monitoring systems for influenza outbreaks could be useful for making public health decisions. Several studies have investigated the possibility of using internet users’ activity data and different statistical models to predict influenza epidemics in near real time. However, very few studies have investigated hospital big data.

          Objective

          Here, we compared internet and electronic health records (EHRs) data and different statistical models to identify the best approach (data type and statistical model) for ILI estimates in real time.

          Methods

          We used Google data for internet data and the clinical data warehouse eHOP, which included all EHRs from Rennes University Hospital (France), for hospital data. We compared 3 statistical models—random forest, elastic net, and support vector machine (SVM).

          Results

          For national ILI incidence rate, the best correlation was 0.98 and the mean squared error (MSE) was 866 obtained with hospital data and the SVM model. For the Brittany region, the best correlation was 0.923 and MSE was 2364 obtained with hospital data and the SVM model.

          Conclusions

          We found that EHR data together with historical epidemiological information (French Sentinelles network) allowed for accurately predicting ILI incidence rates for the entire France as well as for the Brittany region and outperformed the internet data whatever was the statistical model used. Moreover, the performance of the two statistical models, elastic net and SVM, was comparable.

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          Most cited references40

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            Serving the enterprise and beyond with informatics for integrating biology and the bedside (i2b2).

            Informatics for Integrating Biology and the Bedside (i2b2) is one of seven projects sponsored by the NIH Roadmap National Centers for Biomedical Computing (http://www.ncbcs.org). Its mission is to provide clinical investigators with the tools necessary to integrate medical record and clinical research data in the genomics age, a software suite to construct and integrate the modern clinical research chart. i2b2 software may be used by an enterprise's research community to find sets of interesting patients from electronic patient medical record data, while preserving patient privacy through a query tool interface. Project-specific mini-databases ("data marts") can be created from these sets to make highly detailed data available on these specific patients to the investigators on the i2b2 platform, as reviewed and restricted by the Institutional Review Board. The current version of this software has been released into the public domain and is available at the URL: http://www.i2b2.org/software.
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              Google trends: a web-based tool for real-time surveillance of disease outbreaks.

              Google Flu Trends can detect regional outbreaks of influenza 7-10 days before conventional Centers for Disease Control and Prevention surveillance systems. We describe the Google Trends tool, explain how the data are processed, present examples, and discuss its strengths and limitations. Google Trends shows great promise as a timely, robust, and sensitive surveillance system. It is best used for surveillance of epidemics and diseases with high prevalences and is currently better suited to track disease activity in developed countries, because to be most effective, it requires large populations of Web search users. Spikes in search volume are currently hard to interpret but have the benefit of increasing vigilance. Google should work with public health care practitioners to develop specialized tools, using Google Flu Trends as a blueprint, to track infectious diseases. Suitable Web search query proxies for diseases need to be established for specialized tools or syndromic surveillance. This unique and innovative technology takes us one step closer to true real-time outbreak surveillance.
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                Author and article information

                Contributors
                Journal
                JMIR Public Health Surveill
                JMIR Public Health Surveill
                JPH
                JMIR Public Health and Surveillance
                JMIR Publications (Toronto, Canada )
                2369-2960
                Oct-Dec 2018
                21 December 2018
                : 4
                : 4
                : e11361
                Affiliations
                [1 ] Laboratoire Traitement du Signal et de l'Image Université de Rennes 1 Rennes France
                [2 ] INSERM U1099 Rennes France
                [3 ] Centre d'Investigation Clinique de Rennes Université de Rennes 1 Rennes France
                [4 ] Centre Hospitalier Universitaire de Rennes Centre de Données Cliniques Rennes France
                [5 ] Comprehensive Cancer Regional Center Eugene Marquis Rennes France
                [6 ] Centre d'Etudes et de Recherche en Informatique Médicale EA2694 Université de Lille Lille France
                [7 ] Public Health Department Centre Hospitalier Régional Universitaire de Lille Lille France
                Author notes
                Corresponding Author: Canelle Poirier canelle.poirier@ 123456outlook.fr
                Author information
                http://orcid.org/0000-0002-6972-2621
                http://orcid.org/0000-0002-0049-2397
                http://orcid.org/0000-0003-0293-5531
                http://orcid.org/0000-0002-2329-5265
                http://orcid.org/0000-0001-7841-5925
                http://orcid.org/0000-0001-6943-3937
                http://orcid.org/0000-0002-3637-6558
                Article
                v4i4e11361
                10.2196/11361
                6320394
                30578212
                9ab63a51-2b5f-42c5-8d29-55c069672f4c
                ©Canelle Poirier, Audrey Lavenu, Valérie Bertaud, Boris Campillo-Gimenez, Emmanuel Chazard, Marc Cuggia, Guillaume Bouzillé. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 21.12.2018.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on http://publichealth.jmir.org.as well as this copyright and license information must be included.

                History
                : 21 June 2018
                : 8 August 2018
                : 10 September 2018
                : 10 September 2018
                Categories
                Original Paper
                Original Paper

                electronic health records,big data,infodemiology,infoveillance,influenza,machine learning,sentinelles network

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