Background: Hip replacement procedures improve patient lives by relieving pain and restoring mobility. Predicting hip replacement in advance could reduce pain by enabling timely interventions, prioritising individuals for surgery or rehabilitation, and utilising physiotherapy to potentially delay the need for joint replacement. This study predicts hip replacement a year in advance to enhance quality of life and health service efficiency. Methods: Adapting previous work using Temporal Graph Convolutional Neural Network (TG-CNN) models, we construct temporal graphs from primary care medical event codes, sourced from ResearchOne EHRs of 40-75-year-old patients, to predict hip replacement risk. We match hip replacement cases to controls by age, sex, and Index of Multiple Deprivation. The model, trained on 9,187 cases and 9,187 controls, predicts hip replacement one year in advance. We validate the model on two unseen datasets, recalibrating for class imbalance. Additionally, we conduct an ablation study and compare against four baseline models. Results: Our best model predicts hip replacement risk one year in advance with an AUROC of 0.724 (95% CI: 0.715-0.733) and an AUPRC of 0.185 (95% CI: 0.160-0.209), achieving a calibration slope of 1.107 (95% CI: 1.074-1.139) after recalibration. Conclusions: The TG-CNN model effectively predicts hip replacement risk by identifying patterns in patient trajectories, potentially improving understanding and management of hip-related conditions.

BACKGROUND AND OBJECTIVE: Using graph theory, Electronic Health Records (EHRs) can be represented graphically to exploit the relational dependencies of the multiple information formats to improve Machine Learning (ML) prediction models. In this systematic qualitative review, we explore the question: How are graphs used on EHRs, to predict diagnosis and health outcomes? METHODOLOGY: The search strategy identified studies that used patient-level graph representations of EHRs to utilise ML to predict health outcomes and diagnoses. We conducted our search on MEDLINE, Web of Science and Scopus. RESULTS: 832 studies were identified by the search strategy, of which 27 studies were selected for data extraction. Following data extraction, 18 studies used ML with patient-level graph-based representations of EHRs to predict health outcomes and diagnoses. Models ranged from traditional ML to neural network-based models. MIMIC-III was the most used dataset (n = 6, where n is the number of occurrences), followed by National Health Insurance Research Database (NHIRD) (n = 4) and eICU Collaborative Research Database (eICU) (n = 4). The most predicted health outcomes were mortality (n = 9; 21%), hospital readmission (n = 9; 21%), and treatment success (n = 4; 9%). Model performances ranged across outcomes, mortality prediction (Area Under the Receiver Operating Characteristic (AUROC): 72.1 - 91.6; Area Under Precision-Recall Curve (AUPRC): 34.8 - 81.3) and readmission prediction (AUROC: 63.7 - 85.8; AUPRC 39.86 - 84.7). Only one paper had a low Risk of Bias (RoB) that applied to our research question (4%). CONCLUSION: Graph-based representations using EHRs, for individual health outcomes and diagnoses requires further research before we can see the results applied clinically. The use of graph representations appears to improve EHR representation and predictive performance compared to baseline ML methods in multiple fields of medicine.

This special issue of the Proceedings of the IEEE focuses on the challenges and opportunities related to future access to the radio spectrum. The importance of this topic is underscored by the tremendous growth in spectrum-consuming technology, driven in part by the global growth in smartphones and tablets. But demand is also driven by an enormous variety of other important applications, such as command and payload signals for unmanned aerial vehicles; vehicular radars for improved safety on the roads; radionavigation-satellite applications including GPS and Galileo; TV and Internet service through terrestrial and satellite delivery; science applications such as remote sensing and radio astronomy; and countless others.