scholarly journals A Natural Language Processing Approach to Automated Highlighting of New Information in Clinical Notes

2020 ◽  
Vol 10 (8) ◽  
pp. 2824
Author(s):  
Yu-Hsiang Su ◽  
Ching-Ping Chao ◽  
Ling-Chien Hung ◽  
Sheng-Feng Sung ◽  
Pei-Ju Lee

Electronic medical records (EMRs) have been used extensively in most medical institutions for more than a decade in Taiwan. However, information overload associated with rapid accumulation of large amounts of clinical narratives has threatened the effective use of EMRs. This situation is further worsened by the use of “copying and pasting”, leading to lots of redundant information in clinical notes. This study aimed to apply natural language processing techniques to address this problem. New information in longitudinal clinical notes was identified based on a bigram language model. The accuracy of automated identification of new information was evaluated using expert annotations as the reference standard. A two-stage cross-over user experiment was conducted to evaluate the impact of highlighting of new information on task demands, task performance, and perceived workload. The automated method identified new information with an F1 score of 0.833. The user experiment found a significant decrease in perceived workload associated with a significantly higher task performance. In conclusion, automated identification of new information in clinical notes is feasible and practical. Highlighting of new information enables healthcare professionals to grasp key information from clinical notes with less perceived workload.

AERA Open ◽  
2021 ◽  
Vol 7 ◽  
pp. 233285842110286
Author(s):  
Kylie L. Anglin ◽  
Vivian C. Wong ◽  
Arielle Boguslav

Though there is widespread recognition of the importance of implementation research, evaluators often face intense logistical, budgetary, and methodological challenges in their efforts to assess intervention implementation in the field. This article proposes a set of natural language processing techniques called semantic similarity as an innovative and scalable method of measuring implementation constructs. Semantic similarity methods are an automated approach to quantifying the similarity between texts. By applying semantic similarity to transcripts of intervention sessions, researchers can use the method to determine whether an intervention was delivered with adherence to a structured protocol, and the extent to which an intervention was replicated with consistency across sessions, sites, and studies. This article provides an overview of semantic similarity methods, describes their application within the context of educational evaluations, and provides a proof of concept using an experimental study of the impact of a standardized teacher coaching intervention.


Heart ◽  
2021 ◽  
pp. heartjnl-2021-319769
Author(s):  
Meghan Reading Turchioe ◽  
Alexander Volodarskiy ◽  
Jyotishman Pathak ◽  
Drew N Wright ◽  
James Enlou Tcheng ◽  
...  

Natural language processing (NLP) is a set of automated methods to organise and evaluate the information contained in unstructured clinical notes, which are a rich source of real-world data from clinical care that may be used to improve outcomes and understanding of disease in cardiology. The purpose of this systematic review is to provide an understanding of NLP, review how it has been used to date within cardiology and illustrate the opportunities that this approach provides for both research and clinical care. We systematically searched six scholarly databases (ACM Digital Library, Arxiv, Embase, IEEE Explore, PubMed and Scopus) for studies published in 2015–2020 describing the development or application of NLP methods for clinical text focused on cardiac disease. Studies not published in English, lacking a description of NLP methods, non-cardiac focused and duplicates were excluded. Two independent reviewers extracted general study information, clinical details and NLP details and appraised quality using a checklist of quality indicators for NLP studies. We identified 37 studies developing and applying NLP in heart failure, imaging, coronary artery disease, electrophysiology, general cardiology and valvular heart disease. Most studies used NLP to identify patients with a specific diagnosis and extract disease severity using rule-based NLP methods. Some used NLP algorithms to predict clinical outcomes. A major limitation is the inability to aggregate findings across studies due to vastly different NLP methods, evaluation and reporting. This review reveals numerous opportunities for future NLP work in cardiology with more diverse patient samples, cardiac diseases, datasets, methods and applications.


2021 ◽  
Author(s):  
Ye Seul Bae ◽  
Kyung Hwan Kim ◽  
Han Kyul Kim ◽  
Sae Won Choi ◽  
Taehoon Ko ◽  
...  

BACKGROUND Smoking is a major risk factor and important variable for clinical research, but there are few studies regarding automatic obtainment of smoking classification from unstructured bilingual electronic health records (EHR). OBJECTIVE We aim to develop an algorithm to classify smoking status based on unstructured EHRs using natural language processing (NLP). METHODS With acronym replacement and Python package Soynlp, we normalize 4,711 bilingual clinical notes. Each EHR notes was classified into 4 categories: current smokers, past smokers, never smokers, and unknown. Subsequently, SPPMI (Shifted Positive Point Mutual Information) is used to vectorize words in the notes. By calculating cosine similarity between these word vectors, keywords denoting the same smoking status are identified. RESULTS Compared to other keyword extraction methods (word co-occurrence-, PMI-, and NPMI-based methods), our proposed approach improves keyword extraction precision by as much as 20.0%. These extracted keywords are used in classifying 4 smoking statuses from our bilingual clinical notes. Given an identical SVM classifier, the extracted keywords improve the F1 score by as much as 1.8% compared to those of the unigram and bigram Bag of Words. CONCLUSIONS Our study shows the potential of SPPMI in classifying smoking status from bilingual, unstructured EHRs. Our current findings show how smoking information can be easily acquired and used for clinical practice and research.


Author(s):  
Clifford Nangle ◽  
Stuart McTaggart ◽  
Margaret MacLeod ◽  
Jackie Caldwell ◽  
Marion Bennie

ABSTRACT ObjectivesThe Prescribing Information System (PIS) datamart, hosted by NHS National Services Scotland receives around 90 million electronic prescription messages per year from GP practices across Scotland. Prescription messages contain information including drug name, quantity and strength stored as coded, machine readable, data while prescription dose instructions are unstructured free text and difficult to interpret and analyse in volume. The aim, using Natural Language Processing (NLP), was to extract drug dose amount, unit and frequency metadata from freely typed text in dose instructions to support calculating the intended number of days’ treatment. This then allows comparison with actual prescription frequency, treatment adherence and the impact upon prescribing safety and effectiveness. ApproachAn NLP algorithm was developed using the Ciao implementation of Prolog to extract dose amount, unit and frequency metadata from dose instructions held in the PIS datamart for drugs used in the treatment of gastrointestinal, cardiovascular and respiratory disease. Accuracy estimates were obtained by randomly sampling 0.1% of the distinct dose instructions from source records, comparing these with metadata extracted by the algorithm and an iterative approach was used to modify the algorithm to increase accuracy and coverage. ResultsThe NLP algorithm was applied to 39,943,465 prescription instructions issued in 2014, consisting of 575,340 distinct dose instructions. For drugs used in the gastrointestinal, cardiovascular and respiratory systems (i.e. chapters 1, 2 and 3 of the British National Formulary (BNF)) the NLP algorithm successfully extracted drug dose amount, unit and frequency metadata from 95.1%, 98.5% and 97.4% of prescriptions respectively. However, instructions containing terms such as ‘as directed’ or ‘as required’ reduce the usability of the metadata by making it difficult to calculate the total dose intended for a specific time period as 7.9%, 0.9% and 27.9% of dose instructions contained terms meaning ‘as required’ while 3.2%, 3.7% and 4.0% contained terms meaning ‘as directed’, for drugs used in BNF chapters 1, 2 and 3 respectively. ConclusionThe NLP algorithm developed can extract dose, unit and frequency metadata from text found in prescriptions issued to treat a wide range of conditions and this information may be used to support calculating treatment durations, medicines adherence and cumulative drug exposure. The presence of terms such as ‘as required’ and ‘as directed’ has a negative impact on the usability of the metadata and further work is required to determine the level of impact this has on calculating treatment durations and cumulative drug exposure.


2021 ◽  
Author(s):  
Sena Chae ◽  
Jiyoun Song ◽  
Marietta Ojo ◽  
Maxim Topaz

The goal of this natural language processing (NLP) study was to identify patients in home healthcare with heart failure symptoms and poor self-management (SM). The preliminary lists of symptoms and poor SM status were identified, NLP algorithms were used to refine the lists, and NLP performance was evaluated using 2.3 million home healthcare clinical notes. The overall precision to identify patients with heart failure symptoms and poor SM status was 0.86. The feasibility of methods was demonstrated to identify patients with heart failure symptoms and poor SM documented in home healthcare notes. This study facilitates utilizing key symptom information and patients’ SM status from unstructured data in electronic health records. The results of this study can be applied to better individualize symptom management to support heart failure patients’ quality-of-life.


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