Patient Similarity: Emerging Concepts in Systems and Precision Medicine
Sherry-Ann N. Brown · Frontiers in Physiology · 2016
Healthcare data generates a huge volume of information in various formats at high velocity with sometimes questionable veracity (Barkhordari and Niamanesh, 2015) (4V).As a result, big data tools such as patient similarity are necessary to facilitate analytics, which reduces costs (Srinivasan and Arunasalam, 2013) and improves healthcare systems (Jee and Kim, 2013).Patient similarity investigates distances between a variety of components of patient data, and determines methods of clustering patients, based on short distances between some of their characteristics.Although patient similarity is in its early stages, ultimately information about diseases, risk factors, lifestyle habits, medication use, co-morbidities, molecular and histopathological information, hospitalizations, or death are compared with laboratory investigations, imaging, and other clinical data assessing medical evidence of human behavior (Figure 1).Such analytics consist of efficient computational analyses with patient stratification by multiple co-occurrence statistics, based on clinical characteristics.Algorithms create subgroups of patients based on similarities among their electronic avatars.Among electronic avatars found to be similar, subgroups of patients can be evaluated by further stratification guided by individual diagnoses, risk factors, medications, and so on.Because of the multiple networks of subgroups of patients, patient similarity can be considered an application of network medicine, with the output termed "patient similarity networks."Thus, data mining extracts clinically relevant information hidden in clinical notes and embedded in other areas of the electronic health record (EHR) coupled with International Classification of Disease codes.The result is a systematic individualized analysis of a subset of patients that can improve outcome prediction and help guide management for a particular patient currently being cared for by a clinician (Lee et al., 2015).The communication or output from the algorithms can be used to identify and predict disease correlations and occurrence, and potentially for clinical decision support at the point of care.Patient similarity analytics are not restricted to global findings from large clinical trials consisting of somewhat heterogeneous patient populations (Roque et al., 2011).In this way, patient similarity represents a paradigm shift that introduces disruptive innovation to optimize personalization of patient care.Some promising examples are regarding mental and behavioral disorders (Roque et al.