IU Indianapolis ScholarWorks :: Browsing by Author "Storey, Susan"

Browsing by Author "Storey, Susan"

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A Deep Language Model for Symptom Extraction From Clinical Text and its Application to Extract COVID-19 Symptoms From Social Media
(IEEE, 2022) Luo, Xiao; Gandhi, Priyanka; Storey, Susan; Huang, Kun; Biostatistics and Health Data Science, School of Medicine
Patients experience various symptoms when they have either acute or chronic diseases or undergo some treatments for diseases. Symptoms are often indicators of the severity of the disease and the need for hospitalization. Symptoms are often described in free text written as clinical notes in the Electronic Health Records (EHR) and are not integrated with other clinical factors for disease prediction and healthcare outcome management. In this research, we propose a novel deep language model to extract patient-reported symptoms from clinical text. The deep language model integrates syntactic and semantic analysis for symptom extraction and identifies the actual symptoms reported by patients and conditional or negation symptoms. The deep language model can extract both complex and straightforward symptom expressions. We used a real-world clinical notes dataset to evaluate our model and demonstrated that our model achieves superior performance compared to three other state-of-the-art symptom extraction models. We extensively analyzed our model to illustrate its effectiveness by examining each component’s contribution to the model. Finally, we applied our model on a COVID-19 tweets data set to extract COVID-19 symptoms. The results show that our model can identify all the symptoms suggested by CDC ahead of their timeline and many rare symptoms.
Acceptability of computerized cognitive training and global cognitive stimulating-based games delivered remotely: Results from a randomized controlled trial to address cancer and cancer-related cognitive impairment in breast cancer survivors
(Wiley, 2023) Von Ah, Diane; Crouch, Adele; Storey, Susan; School of Nursing
Background: Although the cancer-related cognitive impairment (CRCI) is a common symptom incurred by the breast cancer survivors (BCS), more emphasis is needed in identifying acceptable interventions for survivors. Purpose: The purpose of this qualitative descriptive study was to examine the acceptability of cognitive programs by identifying the facilitators and barriers for implementing computerized cognitive training (BrainHQ) and computerized global cognitive stimulating-based games (e.g., computerized word-find, puzzles, etc.) comparator delivered remotely to improve CRCI from the perspective of BCS. Methods: BCS (n = 35) who enrolled and completed a randomized controlled trial of computerized cognitive training: 19 cognitive training (BrainHQ) and 16 global cognitive stimulating-based games (crosswords, puzzles, etc.) were interviewed post-training. Semi-structured questions were used, recorded, and transcribed verbatim. Qualitative data were analyzed using standard content analytic procedures for each intervention. Results: Facilitators of training varied by intervention with cognitive training seen as challenging, engaging, and gave a sense of accomplishment whereas global stimulating games were seen as a way of taking mind off issues, enjoyable, and easy to navigate. Barriers of cognitive training included an awareness of failing whereas global stimulating games were deemed to be too repetitive. Both groups endorsed the convenience/flexibility of online training and common concerns of time constraints and fatigue to complete the training. Each group also provided recommendations for improvement. Conclusions: Cognitive training and global stimulating games were generally well received by BCS. Designing more support elements to promote engagement may be key to successful long-term implementation.
Analyzing the symptoms in colorectal and breast cancer patients with or without type 2 diabetes using EHR data
(Sage, 2021) Luo, Xiao; Storey, Susan; Gandhi, Priyanka; Zhang, Zuoyi; Metzger, Megan; Huang, Kun; Computer Information and Graphics Technology, School of Engineering and Technology
This research extracted patient-reported symptoms from free-text EHR notes of colorectal and breast cancer patients and studied the correlation of the symptoms with comorbid type 2 diabetes, race, and smoking status. An NLP framework was developed first to use UMLS MetaMap to extract all symptom terms from the 366,398 EHR clinical notes of 1694 colorectal cancer (CRC) patients and 3458 breast cancer (BC) patients. Semantic analysis and clustering algorithms were then developed to categorize all the relevant symptoms into eight symptom clusters defined by seed terms. After all the relevant symptoms were extracted from the EHR clinical notes, the frequency of the symptoms reported from colorectal cancer (CRC) and breast cancer (BC) patients over three time-periods post-chemotherapy was calculated. Logistic regression (LR) was performed with each symptom cluster as the response variable while controlling for diabetes, race, and smoking status. The results show that the CRC and BC patients with Type 2 Diabetes (T2D) were more likely to report symptoms than CRC and BC without T2D over three time-periods in the cancer trajectory. We also found that current smokers were more likely to report anxiety (CRC, BC), neuropathic symptoms (CRC, BC), anxiety (BC), and depression (BC) than non-smokers.
Association between Cognitive Function and Physical Function, Frailty, and Quality of Life in Older Breast Cancer Survivors
(MDPI, 2024-07-31) Von Ah, Diane; Rio, Carielle Joy; Carter, Allie; Perkins, Susan M.; Stevens, Erin; Rosko, Ashley; Davenport, Ashley; Kalady, Mathew; Noonan, Anne M.; Crouch, Adele; Storey, Susan; Overcash, Janine; Han, Claire J.; Yang, Yesol; Li, Haiying; Saligan, Leorey N.; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
Background: Older cancer survivors in general are at greater risk for cancer-related cognitive impairment (CRCI), yet few studies have explored its association with health outcomes. This study examined the association between subjective and objective measures of cognitive function and physical function, frailty, and quality of life (QoL) among older breast cancer survivors. Materials and methods: Older breast cancer survivors who reported cognitive concerns completed surveys on patient-reported cognitive function, physical function, frailty, and QoL as well as objective tests of visuospatial working memory and sustained attention. Data were analyzed using descriptive statistics and separate linear regression models. Results: A total of 219 female breast cancer survivors completed the study. Perceived cognitive abilities were associated with better physical function, frailty, and QoL (p ≤ 0.001) while cognitive concerns were negatively related with these metrics (p ≤ 0.001). Poorer visuospatial working memory and sustained attention were linked to increased frailty (p ≤ 0.001-0.01), whereas poorer sustained attention was associated with poorer physical function (p < 0.01). Conclusions: Older breast cancer survivors with perceived cognitive impairment and poorer cognitive performance reported poorer physical functioning, increased frailty, and poorer QoL. These findings underscore the importance of assessing cognitive concerns and their associated outcomes in older breast cancer survivors.
Association of cognitive impairment and breast cancer survivorship on quality of life in younger breast cancer survivors
(Springer, 2021) Von Ah, Diane; Crouch, Adele D.; Monahan, Patrick O.; Stump, Timothy E; Unverzagt, Frederick W.; Storey, Susan; Cohee, Andrea A.; Cella, David; Champion, Victoria L.
Purpose Younger breast cancer survivors (BCS) often report cognitive impairment and poor quality of life (QoL), which could be interrelated. The purpose of this study was to examine the association of cognitive impairment and breast cancer status (BCS versus healthy control (HC)), with QoL, which included psychological (depressive symptoms, well-being, perceived stress, and personal growth) and physical well-being (physical functioning and fatigue). Methods Four hundred ninety-eight BCS (≤45 years at diagnosis) who were 3 to 8 years post-chemotherapy treatment and 394 HC completed subjective questionnaires and a one-time neuropsychological assessment, including tests of attention, memory, processing speed, and verbal fluency. For each test, cognitive impairment was defined as scoring 1.5 and 2.0 standard deviations below the mean of the HC group. Separate linear regression models for each outcome were ran controlling for known covariates. Results BCS reported significantly more memory problems than HC (p < 0.0001), with up to 23% having significant impairment. Cognitive performance did not differ significantly between BCS and HCs. BCS vs. HCs had greater depression and fatigue, yet more personal growth. Objective and subjective cognitive impairment were significantly related to greater depressive symptoms and perceived stress and lower well-being and physical functioning; whereas, objective impairment was related to less personal growth and subjective impairment was related to greater fatigue. Conclusions Younger BCS report significant cognitive impairment years after treatment which may relate to greater decrements in QoL.
Building Evidence-Based Nursing Practice Capacity in a Large Statewide Health System
(Wolters Kluwer, 2019-04) Storey, Susan; Wagnes, Lisa; LaMothe, Julie; Pittman, Joyce; Cohee, Andrea A.; Newhouse, Robin; School of Nursing
Integration of evidence-based practice (EBP) into the culture of a healthcare organization is essential to provide safe patient care and promote a thriving culture for the nurses within the healthcare organization. Collaboration and utilization of both clinical and academic experts facilitate the removal of barriers to EBP. This article describes the successful partnership between a healthcare system and school of nursing in executing a 3-phased multimodal approach to an EBP training program.
Cancer, Cognitive Impairment, and Work-Related Outcomes: An Integrative Review
(ONS, 2016-09) Von Ah, Diane; Storey, Susan; Tallman, Eileen; Nielsen, Adele; Johns, Shelley A.; Pressler, Susan J.; IU School of Nursing
Problem Identification: Cancer survivors often report concerns regarding their memory, attention, and ability to process information and make decisions. These problems, which have also been demonstrated on objective neuropsychological assessments, may have a significant impact on work-related outcomes.  Literature Search: A literature review was conducted using the following electronic databases: Ovid (MEDLINE®), PubMed, CINAHL®, and Web of Science. Search terms included cancer, survivors, cognitive, work, and work ability. Empirical research published in English from January 2002 to August 2015 that focused on cognitive impairment in adult cancer survivors was included in the review.  Data Evaluation: Articles were evaluated by two independent researchers.  Synthesis: Twenty-six studies met the inclusion criteria. Ten were qualitative, 15 were quantitative, and 1 had a mixed-methods design. Quantitative articles were synthesized using the integrative methodology strategies proposed by Whittemore and Knafl. Synthesis of qualitative articles was conducted using the criteria established by the Swedish Agency for Health Technology Assessment and Assessment of Social Services.   Conclusions: To date, research in this context has been limited by cognitive assessments focusing primarily on patient self-assessments of attention, concentration, and memory. Additional research is needed to examine the impact of cognitive performance and to expand work-related outcomes measures to include perceived work ability, productivity, and actual performance.  Implications for Nursing: Lack of information regarding cognitive impairment inhibits survivors’ ability to prepare, understand, and accept impending cognitive changes and how they may affect work ability. Oncology nurses can assist cancer survivors by preparing and educating them on how to better manage impairment associated with cancer and its treatment.
A cohort study of quality of life in partners of young breast cancer survivors compared to partners of healthy controls
(Springer, 2020-03-06) Cohee, Andrea A.; Storey, Susan; Winger, Joseph; Cella, David; Stump, Timothy; Monahan, Patrick; Champion, Victoria
Background Partners of young breast cancer survivors (BCS) are at increased risk for deficits in quality of life (QoL). To intervene effectively, it is important to understand how the breast cancer experience impacts partners. The purpose of this study was to compare QoL between partners of young BCS and partners of healthy acquaintance controls. Methods Partners of young BCS (3–8 years post treatment and ≤ 45 years old at diagnosis) and partners of age-matched healthy acquaintance controls completed questionnaires on overall, physical (physical function, sexual difficulty), social (personal resources, sexual enjoyment, marital satisfaction, partner social support, social constraints, parenting satisfaction), psychological (depressive symptoms), and spiritual (behaviors, beliefs, and activities) QoL. Analyses included descriptive statistics and one-way ANOVA to compare partner groups on all study variables. Results Although partners of young BCS (n = 227) reported fewer social constraints (p < .001), they reported lower overall QoL (p < .001), fewer personal resources (p < .001), more sexual difficulty (p = .019), less sexual enjoyment (p = .002), less marital satisfaction (p = .019), more depressive symptoms (p = .024), and fewer spiritual behaviors (p < .001), beliefs (p = .001) and activities (p = .003) compared to partners of healthy acquaintance controls (n = 170). Additional analysis showed that perceptions that the relationship changed for the better since cancer, social constraints, partner social support, and depression predicted marital satisfaction among partners of young BCS. Conclusions Partners of young BCS are at risk for poorer overall, physical, social, psychological, and spiritual QoL compared to partners of healthy women. Interventions targeting QoL domains may enable partners to effectively support their partner and improve their QoL.
Comorbidity, Physical Function, and Quality of Life in Older Adults with Acute Myeloid Leukemia
(Springer, 2017-12) Storey, Susan; Gray, Tamryn Fowler; Bryant, Ashley Leak; School of Nursing
Purpose of review: To describe the pathology, impact of comorbidities, functional limitations, symptoms, and quality of life (QOL) related to treatment of acute myeloid leukemia (AML) in older adults. Recent findings: AML is a rare aggressive hematologic disease that occurs most often in older adults. The prognosis for older patients with AML is markedly worse due to genetic mutations and patient characteristics such as comorbidities and functional limitations. Patient characteristics may influence treatment decisions, as well as impact symptoms, functional ability, health-related outcomes and (QOL). Summary: As the population continues to age, the number of people diagnosed with AML is expected to increase. Better management of comorbidities is imperative to improving QOL and other treatment related outcomes. Prospective, longitudinal and multi-site studies are warranted to further understand the interaction between these characteristics on symptoms, outcomes and QOL.
A Comparative Evaluation of Antimicrobial Coated versus Non-antimicrobial Coated Peripherally Inserted Central Catheters on Associated Outcomes: A Randomized Controlled Trial
(Elsevier, 2016-06) Storey, Susan; Brown, Jamie; Foley, Angela; Newkirk, Erica; Powers, Jan; Barger, Julie; Paige, Karen; IU School of Nursing
Background Central line–associated bloodstream infections (CLABSIs) are a common life-threatening risk factor associated with central venous catheters (CVCs). Research has demonstrated benefit in reducing CLABSIs when CVCs coated with antimicrobials are inserted. The impact of chlorhexidine (CHG)-impregnated versus non-CHG peripherally inserted central catheters (PICCs) on risk of CLABSI is unknown. Venous thromboembolism (VTE) is also a complication associated with CVCs. This study compares the impact of both PICC lines on these outcomes. Methods Patients in 3 high-risk units were randomly assigned to receive either a CHG-impregnated or non-CHG PICC line. Laboratory data were collected and reviewed daily on all study patients. The PICC dressing site was assessed daily. Medical record documentation was reviewed to determine presence of CLABSI or VTE. Results There were 167 patients who completed the study. Three patients developed CLABSI (2 in the CHG group, and 1 in the non-CHG group), and 3 patients developed VTE (2 in the non-CHG group, and 1 in the CHG group). No significant relationship was noted between the type of PICC line on development of a CLABSI (P = .61) or VTE (P > .99). A significant difference was noted in moderate bleeding (P ≤ .001) requiring thrombogenic dressing in the patients who had the CHG PICC line. Conclusions No differences were noted in the development of CLABSI and VTE between the CHG and non-CHG groups.

Browsing by Author "Storey, Susan"

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