海角社区

海角社区 Biological & Agricultural Engineering Assistant Professor recently received a Collaboration in Action Program (CAP) Award from 海角社区 and Health for his proposal to leverage electronic health records and advanced image processing to identify and address disparities in the diagnosis and treatment of heart valve disease.  

Rego, who serves as the principal investigator on the project, is working with Our Lady of the Lake Structural Heart Program Director Dr. Jorge Castellanos to investigate how patients鈥� medical records and clinical images can be automatically screened to more accurately and quickly diagnose aortic stenosis (AS) and mitral regurgitation (MR), two of the most common forms of heart valve disease.  

鈥淭here is a big prevalence of aortic stenosis and mitral regurgitation, and we think that the patients who come to the hospital aren鈥檛 all having these conditions captured,鈥� Castellanos said. 鈥淪o, we鈥檙e trying to study the referral patterns鈥攚hy patients may not be referred for treatment鈥攁nd try to establish better tools to identify these patients earlier and before they get too sick.鈥�  

鈥淚f left untreated, AS and MR can lead to severe pathological outcomes, including heart failure, stroke, thromboembolism, arrhythmias, endocarditis, and pulmonary hypertension,鈥� Rego said. 鈥淢any patients with AS or MR can benefit greatly from minimally-invasive surgical interventions like transcatheter aortic valve replacement and transcatheter edge-to-edge repair.鈥� 

Even though these effective treatment options have grown in popularity in recent years, long-term clinical experience at Our Lady of the Lake suggests that some patients with either diagnosed or undiagnosed AS and MR have not been referred for these procedures. 

鈥淎 lot of patients undergo cardiovascular imaging for all sorts of reasons, and the main concern at the time of imaging might not be AS or MR, especially if it鈥檚 still relatively mild,鈥� Rego said. 鈥淎nother problem is that there are different types of AS and MR, and some are more difficult to properly diagnose. The images exist in the Our Lady of the Lake database, but people just haven鈥檛 necessarily looked at them in the right way. Dr. Castellanos suspects there are patients who have one or both of these issues and should be referred to these modern minimally-invasive surgical corrections.鈥� 

鈥淲hen you do an ultrasound of the heart, you look at pump function, valve function and dozens of measurements that may not necessarily make it to the final report,鈥� Castellanos said. 鈥淭he data is there that could indicate the patient has a condition that has not been diagnosed.鈥� 

The first thing Rego and Castellanos will do is sort through an anonymized database of Our Lady of the Lake鈥檚 electronic health records and clinical images, and use statistical analysis to figure out who is getting referred to these particular surgeries, who is not, and why.  

鈥淥ne big focus of CAP for this first round of projects is social determinants of health,鈥� Rego said. 鈥淲hat is it about patient A that gets them referred while patient B does not? How can we predict that based on not just healthcare setting and a patient鈥檚 individual medical history, but also any number of social factors that can correlate with health outcomes?鈥� 

The second part of their project is to develop a software tool based on artificial intelligence (AI) techniques to screen through images from the database, automatically detect patients with AS and MR, and provide personalized guidance on possible next steps, ranging from periodic follow-ups to minimally-invasive interventions or even open-heart surgery in some cases, based on a patient鈥檚 individual disease characteristics and other factors. A physician would then confirm the diagnosis themselves and make specific treatment recommendations.   

鈥淚f you start missing these problems for a long period of time, it鈥檚 harder to fix, and the patient鈥檚 outcome is much less favorable because the heart itself is trying to adapt to these diseases,鈥� Rego said.  

Patient privacy and confidentiality will not be an issue with this project. The medical records will be anonymized before the analysis begins, so 海角社区 will have the data and images, and social and demographic markers, but not direct identifiable information like a patient鈥檚 name or exact address.  

鈥淭here鈥檚 a lot of data that needs to be reviewed, but we have the resources to do it now that this project has been funded through CAP,鈥� Rego said.  

鈥淥ur Lady of the Lake is really excited about this collaboration,鈥� Castellanos said. 鈥淚 think it鈥檚 extremely important. Moving forward, I think this is going to change the way we practice.鈥� 

The 海角社区 System, through the 海角社区 Agricultural and Mechanical Campus, and in collaboration with , has launched a new, unprecedented research opportunity called Collaboration in Action (CAP). Generously funded by Our Lady of the Lake Health, , this program seeks to advance research in the priority focus areas of Cardiovascular Disease and Care, Comprehensive Cancer Care, Trauma and Neuroscience, Chronic Respiratory Disease, and Sports Medicine and Performance. 

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