scholarly journals Natural language processing to measure the frequency and mode of communication between healthcare professionals and family members of critically ill patients

2020 ◽  
Author(s):  
Filipe R Lucini ◽  
Karla D Krewulak ◽  
Kirsten M Fiest ◽  
Sean M Bagshaw ◽  
Danny J Zuege ◽  
...  
Keyword(s):  
Machine Learning ◽  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Critically Ill Patients ◽  
Healthcare Professionals ◽  
Free Text ◽  
Learning Approach ◽  
Rule Based ◽  
Machine Learning Approach

Abstract Objective To apply natural language processing (NLP) techniques to identify individual events and modes of communication between healthcare professionals and families of critically ill patients from electronic medical records (EMR). Materials and Methods Retrospective cohort study of 280 randomly selected adult patients admitted to 1 of 15 intensive care units (ICU) in Alberta, Canada from June 19, 2012 to June 11, 2018. Individual events and modes of communication were independently abstracted using NLP and manual chart review (reference standard). Preprocessing techniques and 2 NLP approaches (rule-based and machine learning) were evaluated using sensitivity, specificity, and area under the receiver operating characteristic curves (AUROC). Results Over 2700 combinations of NLP methods and hyperparameters were evaluated for each mode of communication using a holdout subset. The rule-based approach had the highest AUROC in 65 datasets compared to the machine learning approach in 21 datasets. Both approaches had similar performance in 17 datasets. The rule-based AUROC for the grouped categories of patient documented to have family or friends (0.972, 95% CI 0.934–1.000), visit by family/friend (0.882 95% CI 0.820–0.943) and phone call with family/friend (0.975, 95% CI: 0.952–0.998) were high. Discussion We report an automated method to quantify communication between healthcare professionals and family members of adult patients from free-text EMRs. A rule-based NLP approach had better overall operating characteristics than a machine learning approach. Conclusion NLP can automatically and accurately measure frequency and mode of documented family visitation and communication from unstructured free-text EMRs, to support patient- and family-centered care initiatives.

scholarly journals Use of Natural Language Processing to Improve Identification of Patients With Peripheral Artery Disease

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
E. Hope Weissler ◽  
Jikai Zhang ◽  
Steven Lippmann ◽  
Shelley Rusincovitch ◽  
Ricardo Henao ◽  
...  
Keyword(s):  
Machine Learning ◽  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Operating Characteristic ◽  
Structured Data ◽  
Learning Approach ◽  
Peripheral Artery ◽  
Machine Learning Approach ◽  
Artery Disease

Background: Peripheral artery disease (PAD) is underrecognized, undertreated, and understudied: each of these endeavors requires efficient and accurate identification of patients with PAD. Currently, PAD patient identification relies on diagnosis/procedure codes or lists of patients diagnosed or treated by specific providers in specific locations and ways. The goal of this research was to leverage natural language processing to more accurately identify patients with PAD in an electronic health record system compared with a structured data–based approach. Methods: The clinical notes from a cohort of 6861 patients in our health system whose PAD status had previously been adjudicated were used to train, test, and validate a natural language processing model using 10-fold cross-validation. The performance of this model was described using the area under the receiver operating characteristic and average precision curves; its performance was quantitatively compared with an administrative data–based least absolute shrinkage and selection operator (LASSO) approach using the DeLong test. Results: The median (SD) of the area under the receiver operating characteristic curve for the natural language processing model was 0.888 (0.009) versus 0.801 (0.017) for the LASSO-based approach alone (DeLong P <0.0001). The median (SD) of the area under the precision curve was 0.909 (0.008) versus 0.816 (0.012) for the structured data–based approach. When sensitivity was set at 90%, the precision for LASSO was 65% and the machine learning approach was 74%, while the specificity for LASSO was 41% and for the machine learning approach was 62%. Conclusions: Using a natural language processing approach in addition to partial cohort preprocessing with a LASSO-based model, we were able to meaningfully improve our ability to identify patients with PAD compared with an approach using structured data alone. This model has potential applications to both interventions targeted at improving patient care as well as efficient, large-scale PAD research. Graphic Abstract: A graphic abstract is available for this article.

scholarly journals Applying natural language processing and machine learning techniques to patient experience feedback: a systematic review

2021 ◽  
Vol 28 (1) ◽  
pp. e100262
Author(s):  
Mustafa Khanbhai ◽  
Patrick Anyadi ◽  
Joshua Symons ◽  
Kelsey Flott ◽  
Ara Darzi ◽  
...  
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Social Media ◽  
Natural Language Processing ◽  
Natural Language ◽  
Patient Experience ◽  
Language Processing ◽  
Performance Metrics ◽  
Free Text ◽  
Patient Feedback

ObjectivesUnstructured free-text patient feedback contains rich information, and analysing these data manually would require a lot of personnel resources which are not available in most healthcare organisations.To undertake a systematic review of the literature on the use of natural language processing (NLP) and machine learning (ML) to process and analyse free-text patient experience data.MethodsDatabases were systematically searched to identify articles published between January 2000 and December 2019 examining NLP to analyse free-text patient feedback. Due to the heterogeneous nature of the studies, a narrative synthesis was deemed most appropriate. Data related to the study purpose, corpus, methodology, performance metrics and indicators of quality were recorded.ResultsNineteen articles were included. The majority (80%) of studies applied language analysis techniques on patient feedback from social media sites (unsolicited) followed by structured surveys (solicited). Supervised learning was frequently used (n=9), followed by unsupervised (n=6) and semisupervised (n=3). Comments extracted from social media were analysed using an unsupervised approach, and free-text comments held within structured surveys were analysed using a supervised approach. Reported performance metrics included the precision, recall and F-measure, with support vector machine and Naïve Bayes being the best performing ML classifiers.ConclusionNLP and ML have emerged as an important tool for processing unstructured free text. Both supervised and unsupervised approaches have their role depending on the data source. With the advancement of data analysis tools, these techniques may be useful to healthcare organisations to generate insight from the volumes of unstructured free-text data.

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