Azra Bihorac

Azra Bihorac, MD, MS (born April 2, 1965) is a Bosnian-American professor, nephrologist, and critical care intensivist who is the senior associate dean of research at the University of Florida College of Medicine[1] and the R. Glenn Davis Professor of Medicine, Surgery, Anesthesiology, and Physiology & Functional Genomics.[2] She co-founded the Intelligent Critical Care Center (IC3) research center at the University of Florida in 2021 with Parisa Rashidi.

Azra Bihorac
Born April 2, 1965

Brčko, Yugoslavia

Nationality Bosnian-American
Education University of Sarajevo (MD)

University of Florida (MS)

Occupation Doctor • Professor of medicine • Dean
Years active 1990–Present
Field Nephrology • Intensive Care • Internal Medicine
Institutions University of Florida Health Shands Hospital

University of Florida College of Medicine • Intelligent Critical Care Center (IC3)

Notable Works Biomarkers of acute kidney injury (AKI)[3][4]

Intensive Intelligent Care Unit (I2CU)[5][6] • MySurgeryRisk[7][8][9]

DeepSOFA[10][11]

Website https://ic3.center.ufl.edu/

Early life and education

Bihorac grew up near Brčko and earned her medical degree from the University of Sarajevo in 1990[12] (a year before the Yugoslav Wars began) and started working at a hospital in Brčko.[13] On April 29, 1992, weeks after the start of the Bosnian War, Bihorac fled the Bosnian genocide by escaping across the Sava river with her son, her medical degree, and 2,000 deutschmarks “sown in the underlining of [her] trench coat.”[14] At 5 a.m. the following morning, the Brčko bridge massacre occurred and killed 100 civilians crossing the bridge.[15]

Residencies and fellowships in Turkey and the United States

At Marmara University in Istanbul, Turkey, Bihorac was an internal medicine resident and a nephrology fellow.[12][16]

In 2000, Bihorac came to the United States as a research fellow of the International Society of Nephrology and began a nephrology training fellowship at the University of Florida College of Medicine.[2][16] After completing her fellowship at the University of Florida, she remained in the United States. “I got political asylum because I couldn't go back to Turkey, couldn't go back to Bosnia,” Bihorac said, “so in order to practice medicine, I had to repeat all of my training.”[16]

At the University of Florida, Bihorac began a residency in internal medicine in 2003 and a fellowship in critical care medicine in 2006.[12] She completed a Master of Science for Health Sciences in Clinical Research in 2011.[2][12]

Research and writing

Since 2010, Bihorac’s labs have received continuous funding from the National Institutes of Health (NIH).[17] Her research focuses on using artificial intelligence, machine learning, and deep learning to augment patient diagnostics and monitoring in intensive care medicine.[17][18][19] Some of her most well-known work involves identifying biomarkers for acute kidney injury (AKI), treatment of AKI, and AI and machine learning techniques for predicting health outcomes for critically ill patients. As of May 2023, Bihorac’s most cited publication is a 2013 study on AKI biomarkers, which has 812 citations.[20]

Under Bihorac’s direction, the (IC3) at the University of Florida has gained attention for developments involving the use of AI to

  • monitor and sense patient pain levels through cameras and sensors,[21][18]
  • predict postoperative complications for surgical patients,[22] and
  • continuously monitor ICU patients and provide a more accurate assessment of "illness severity at any point during an ICU stay."[23]

Bihorac has edited or contributed chapters to the following textbooks:

  • Encyclopedia of Sensors and Biosensors, 2023, Elsevier, chapter “Sensors in Hospitals”
  • Evidence-Based Critical Care, 2020, Springer, chapter “Renal Disease: Rhabdomyolysis”
  • Critical Care Nephrology, 3rd edition, 2017, Elsevier, chapter “AKI after Major Surgery”
  • Current Concepts in Adult Critical Care, 3rd edition, 2014, editor and chapter “Complications after Surgery: The Perspective of the Injured Kidney”
  • Textbook of Neurointensive Care, 2013, Springer, chapters “Acute Kidney Injury and Renal Replacement Therapy in the Neurologically Injured Patient” and “Water and Electrolyte Management in Neurological Disease”

Bihorac's work at the University of Florida has yielded more than 200 peer-reviewed scientific articles—including Scientific Reports,[24] Nature Reviews Nephrology,[25][26] Critical Care,[3] PLOS ONE,[27] IEEE Journal of Biomedical and Health Informatics,[28] Annals of Surgery,[7][29] and JAMA Surgery[30]—and over 10,000 citations in other articles.[31]

Professional organizations

Bihorac is a Fellow of the American College of Critical Care Medicine (FCCM),[12] a designation given to “practitioners, researchers, administrators, and educators who have made outstanding contributions to the collaborative field of critical care.”[32] She is also a Fellow of the American Society of Nephrology (FASN),[12] a designation given to members of the American Society of Nephrology “who have distinguished themselves through excellence in practice or research.”[33]

Awards and honors
  • American Society of Nephrology Fellow (2007)[12]
  • Teaching Award, University of Florida (2008)[34]
  • Faculty Research Award, University of Florida College of Medicine (2010)[35]
  • American College of Critical Care Medicine Fellow (2012)[12]
  • Society of Critical Care Medicine, Vision Grant Award and President Citation (2013)[35]
  • Society of Critical Care Medicine, President Citation Award for Outstanding Contribution to SCCM (2018, 2019)[35]
  • Alpha Omega Alpha Honor Medical Society (2022)[36]

Personal life

Bihorac is married to surgeon Charles Hobson and lives in Gainesville, Florida, with their children.[37]

References
  1. "Dr. Azra Bihorac named senior associate dean for research affairs". Doctor Gator. Retrieved 2023-01-31.
  2. "Azra Bihorac » Intelligent Critical Care Center (IC3) » » University of Florida". Retrieved 2023-01-31.
  3. Kashani, Kianoush; Al-Khafaji, Ali; Ardiles, Thomas; Artigas, Antonio; Bagshaw, Sean M.; Bell, Max; Bihorac, Azra; Birkhahn, Robert; Cely, Cynthia M.; Chawla, Lakhmir S.; Davison, Danielle L.; Feldkamp, Thorsten; Forni, Lui G.; Gong, Michelle Ng; Gunnerson, Kyle J. (2013-02-06). "Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury". Critical Care. 17 (1): R25. doi:10.1186/cc12503. ISSN 1364-8535. PMC 4057242. PMID 23388612.
  4. Bihorac, Azra; Chawla, Lakhmir S.; Shaw, Andrew D.; Al-Khafaji, Ali; Davison, Danielle L.; DeMuth, George E.; Fitzgerald, Robert; Gong, Michelle Ng; Graham, Derrel D.; Gunnerson, Kyle; Heung, Michael; Jortani, Saeed; Kleerup, Eric; Koyner, Jay L.; Krell, Kenneth (2014-04-15). "Validation of Cell-Cycle Arrest Biomarkers for Acute Kidney Injury Using Clinical Adjudication". American Journal of Respiratory and Critical Care Medicine. 189 (8): 932–939. doi:10.1164/rccm.201401-0077OC. ISSN 1073-449X. PMID 24559465. S2CID 25918415.
  5. Davoudi, Anis; Malhotra, Kumar Rohit; Shickel, Benjamin; Siegel, Scott; Williams, Seth; Ruppert, Matthew; Bihorac, Emel; Ozrazgat-Baslanti, Tezcan; Tighe, Patrick J.; Bihorac, Azra; Rashidi, Parisa (2019-05-29). "Intelligent ICU for Autonomous Patient Monitoring Using Pervasive Sensing and Deep Learning". Scientific Reports. 9 (1): 8020. doi:10.1038/s41598-019-44004-w. ISSN 2045-2322. PMC 6541714. PMID 31142754.
  6. Davoudi, Anis; Shickel, Benjamin; Tighe, Patrick James; Bihorac, Azra; Rashidi, Parisa (2022). "Potentials and Challenges of Pervasive Sensing in the Intensive Care Unit". Frontiers in Digital Health. 4. doi:10.3389/fdgth.2022.773387. ISSN 2673-253X. PMID 35656333.
  7. Bihorac, Azra; Ozrazgat-Baslanti, Tezcan; Ebadi, Ashkan; Motaei, Amir; Madkour, Mohcine; Pardalos, Panagote M.; Lipori, Gloria; Hogan, William R.; Efron, Philip A.; Moore, Frederick; Moldawer, Lyle L.; Wang, Daisy Zhe; Hobson, Charles E.; Rashidi, Parisa; Li, Xiaolin (April 2019). "MySurgeryRisk: Development and Validation of a Machine-learning Risk Algorithm for Major Complications and Death After Surgery". Annals of Surgery. 269 (4): 652–662. doi:10.1097/SLA.0000000000002706. ISSN 0003-4932. PMC 6110979. PMID 29489489.
  8. Ren, Yuanfang; Loftus, Tyler J.; Shickel, Benjamin; Upchurch Jr., Gilbert R.; Rashidi, Parisa; Ozrazgat-Baslanti, Tezcan; Bihorac, Azra (May 16, 2022). "Performance of a Machine Learning Algorithm Using Electronic Health Record Data to Predict Postoperative Complications and Report on a Mobile Platform". JAMA Network Open. 5 (5): e2211973. doi:10.1001/jamanetworkopen.2022.11973. PMC 9112066. PMID 35576007. S2CID 248812592. Retrieved 2023-01-31.
  9. Landro, Laura (12 March 2023). "Why Hospitals Still Make Serious Medical Errors—and How They Are Trying to Reduce Them". Wall Street Journal. Retrieved 2023-03-13.
  10. Shickel, Benjamin; Loftus, Tyler J.; Adhikari, Lasith; Ozrazgat-Baslanti, Tezcan; Bihorac, Azra; Rashidi, Parisa (2019-02-12). "DeepSOFA: A Continuous Acuity Score for Critically Ill Patients using Clinically Interpretable Deep Learning". Scientific Reports. 9 (1): 1879. doi:10.1038/s41598-019-38491-0. ISSN 2045-2322. PMC 6372608. PMID 30755689. S2CID 52134035.
  11. Bennett, Doug (May 8, 2019). "DeepSOFA". The POST. Retrieved 2023-01-31.
  12. "ORCID Profile: Azra Bihorac". orcid.org. Retrieved 2023-02-16.
  13. "LinkedIn profile: Azra Bihorac". LinkedIn.
  14. Bihorac, Azra (June 20, 2020). "@AzraBihorac". Twitter. Retrieved 2023-01-31.
  15. Rovcanin, Haris (2021-04-30). "Brcko Bridge Blast Deaths Commemorated in Bosnia". Balkan Insight. Retrieved 2023-01-31.
  16. Hills & Valleys Podcast (2019-03-25). "Ep3: Dr. Azra Bihorac, MD, MS, on How Acute Kidney Injury Should Be Treated". Potrero. Retrieved 2023-01-31.
  17. "Q&A: Azra Bihorac". Cell Reports Medicine. 3 (12): 100836. 2022-12-20. doi:10.1016/j.xcrm.2022.100836. ISSN 2666-3791. PMC 9813827. PMID 36543114.
  18. "High-tech hospital uses artificial intelligence in patient care". NBC News. Retrieved 2023-02-06.
  19. "Know It All: Where AI helps and hurts in health care". 1A. Retrieved 2023-03-13.
  20. "SpringerCitations - Details Page". doi:10.1186/cc12503. PMC 4057242. PMID 23388612. {{cite journal}}: Cite journal requires |journal= (help)
  21. Halliday, Maureen (February 18, 2022). "Your Health: AI and the ICU". WILX 10. Retrieved 2023-01-31.
  22. "UF researchers develop tool to predict complications during surgery". Florida Trend. Retrieved 2023-01-31.
  23. Shickel, Benjamin; Loftus, Tyler J.; Adhikari, Lasith; Ozrazgat-Baslanti, Tezcan; Bihorac, Azra; Rashidi, Parisa (2019-02-12). "DeepSOFA: A Continuous Acuity Score for Critically Ill Patients using Clinically Interpretable Deep Learning". Scientific Reports. 9 (1): 1879. doi:10.1038/s41598-019-38491-0. ISSN 2045-2322. PMC 6372608. PMID 30755689. S2CID 52134035.
  24. Shickel, Benjamin; Loftus, Tyler J.; Ruppert, Matthew; Upchurch, Gilbert R.; Ozrazgat-Baslanti, Tezcan; Rashidi, Parisa; Bihorac, Azra (2023-01-21). "Dynamic predictions of postoperative complications from explainable, uncertainty-aware, and multi-task deep neural networks". Scientific Reports. 13 (1): 1224. doi:10.1038/s41598-023-27418-5. ISSN 2045-2322. PMC 9867692. PMID 36681755.
  25. Nadim, Mitra K.; Forni, Lui G.; Mehta, Ravindra L.; Connor, Michael J.; Liu, Kathleen D.; Ostermann, Marlies; Rimmelé, Thomas; Zarbock, Alexander; Bell, Samira; Bihorac, Azra; Cantaluppi, Vincenzo; Hoste, Eric; Husain-Syed, Faeq; Germain, Michael J.; Goldstein, Stuart L. (October 15, 2020). "COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup". Nature Reviews Nephrology. 16 (12): 747–764. doi:10.1038/s41581-020-00356-5. hdl:2445/173871. ISSN 1759-507X. PMID 33060844. S2CID 222415986.
  26. Chawla, Lakhmir S.; Bellomo, Rinaldo; Bihorac, Azra; Goldstein, Stuart L.; Siew, Edward D.; Bagshaw, Sean M.; Bittleman, David; Cruz, Dinna; Endre, Zoltan; Fitzgerald, Robert L.; Forni, Lui; Kane-Gill, Sandra L.; Hoste, Eric; Koyner, Jay; Liu, Kathleen D. (February 27, 2017). "Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup". Nature Reviews Nephrology. 13 (4): 241–257. doi:10.1038/nrneph.2017.2. hdl:1854/LU-8516228. ISSN 1759-507X. PMID 28239173. S2CID 217702946.
  27. Thottakkara, Paul; Ozrazgat-Baslanti, Tezcan; Hupf, Bradley B.; Rashidi, Parisa; Pardalos, Panos; Momcilovic, Petar; Bihorac, Azra (2016-05-27). "Application of Machine Learning Techniques to High-Dimensional Clinical Data to Forecast Postoperative Complications". PLOS ONE. 11 (5): e0155705. doi:10.1371/journal.pone.0155705. ISSN 1932-6203. PMC 4883761. PMID 27232332.
  28. Shickel, Benjamin; Tighe, Patrick James; Bihorac, Azra; Rashidi, Parisa (October 27, 2017). "Deep EHR: A Survey of Recent Advances in Deep Learning Techniques for Electronic Health Record (EHR) Analysis". IEEE Journal of Biomedical and Health Informatics. 22 (5): 1589–1604. doi:10.1109/JBHI.2017.2767063. ISSN 2168-2208. PMC 6043423. PMID 29989977.
  29. Ozrazgat-Baslanti, Tezcan; Loftus, Tyler J.; Mohandas, Rajesh; Wu, Quran; Brakenridge, Scott; Brumback, Babette; Efron, Philip A.; Anton, Stephen; Moore, Frederick A.; Moldawer, Lyle L.; Segal, Mark S.; Bihorac, Azra (June 2022). "Clinical Trajectories of Acute Kidney Injury in Surgical Sepsis: A Prospective Observational Study". Annals of Surgery. 275 (6): 1184–1193. doi:10.1097/SLA.0000000000004360. ISSN 0003-4932. PMC 8116352. PMID 33196489.
  30. Loftus, Tyler J.; Tighe, Patrick J.; Filiberto, Amanda C.; Efron, Philip A.; Brakenridge, Scott C.; Mohr, Alicia M.; Rashidi, Parisa; Upchurch, Gilbert R., Jr; Bihorac, Azra (2020-02-01). "Artificial Intelligence and Surgical Decision-making". JAMA Surgery. 155 (2): 148–158. doi:10.1001/jamasurg.2019.4917. ISSN 2168-6254. PMC 7286802.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  31. "ResearchGate: Azra Bihorac profile".
  32. "SCCM | American College of Critical Care Medicine". Society of Critical Care Medicine (SCCM). Retrieved 2023-01-31.
  33. Nesbitt, Hal. "American Society of Nephrology | Member Services - FASN". www.asn-online.org. Retrieved 2023-01-31.
  34. "VIVO | Azra Bihorac". VIVO: University of Florida.
  35. "Loop | Azra Bihorac". loop.frontiersin.org. Retrieved 2023-02-16.
  36. Ivanov, Danielle (March 31, 2022). "AOA Honor Medical Society celebrates new members". Doctor Gator. Retrieved 2023-02-16.
  37. Bihorac, Azra. "Kidney Love". Kidney Love: Azra Bihorac website. Retrieved 2023-02-16.
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