scholarly journals Analyzing Patient Secure Messages Using a Fast Health Care Interoperability Resources (FIHR)–Based Data Model: Development and Topic Modeling Study (Preprint)

2021 ◽  
Author(s):  
Amrita De ◽  
Ming Huang ◽  
Tinghao Feng ◽  
Xiaomeng Yue ◽  
Lixia Yao
Keyword(s):  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Data Model ◽  
Topic Modeling ◽  
Patient Visit ◽  
Patient Centered ◽  
Health Records ◽  
Centered Care ◽  
Medical Concepts

BACKGROUND Patient portals tethered to electronic health records systems have become attractive web platforms since the enacting of the Medicare Access and Children’s Health Insurance Program Reauthorization Act and the introduction of the <i>Meaningful Use</i> program in the United States. Patients can conveniently access their health records and seek consultation from providers through secure web portals. With increasing adoption and patient engagement, the volume of patient secure messages has risen substantially, which opens up new research and development opportunities for patient-centered care. OBJECTIVE This study aims to develop a data model for patient secure messages based on the Fast Healthcare Interoperability Resources (FHIR) standard to identify and extract significant information. METHODS We initiated the first draft of the data model by analyzing FHIR and manually reviewing 100 sentences randomly sampled from more than 2 million patient-generated secure messages obtained from the online patient portal at the Mayo Clinic Rochester between February 18, 2010, and December 31, 2017. We then annotated additional sets of 100 randomly selected sentences using the Multi-purpose Annotation Environment tool and updated the data model and annotation guideline iteratively until the interannotator agreement was satisfactory. We then created a larger corpus by annotating 1200 randomly selected sentences and calculated the frequency of the identified medical concepts in these sentences. Finally, we performed topic modeling analysis to learn the hidden topics of patient secure messages related to 3 highly mentioned microconcepts, namely, fatigue, prednisone, and patient visit, and to evaluate the proposed data model independently. RESULTS The proposed data model has a 3-level hierarchical structure of health system concepts, including 3 macroconcepts, 28 mesoconcepts, and 85 microconcepts. Foundation and base macroconcepts comprise 33.99% (841/2474), clinical macroconcepts comprise 64.38% (1593/2474), and financial macroconcepts comprise 1.61% (40/2474) of the annotated corpus. The top 3 mesoconcepts among the 28 mesoconcepts are condition (505/2474, 20.41%), medication (424/2474, 17.13%), and practitioner (243/2474, 9.82%). Topic modeling identified hidden topics of patient secure messages related to fatigue, prednisone, and patient visit. A total of 89.2% (107/120) of the top-ranked topic keywords are actually the health concepts of the data model. CONCLUSIONS Our data model and annotated corpus enable us to identify and understand important medical concepts in patient secure messages and prepare us for further natural language processing analysis of such free texts. The data model could be potentially used to automatically identify other types of patient narratives, such as those in various social media and patient forums. In the future, we plan to develop a machine learning and natural language processing solution to enable automatic triaging solutions to reduce the workload of clinicians and perform more granular content analysis to understand patients’ needs and improve patient-centered care.

Development of algorithm for classification smoking status from unstructured bilingual electronic health records based on natural language processing (Preprint)

2021 ◽  
Author(s):  
Ye Seul Bae ◽  
Kyung Hwan Kim ◽  
Han Kyul Kim ◽  
Sae Won Choi ◽  
Taehoon Ko ◽  
...  
Keyword(s):  
Natural Language Processing ◽  
Electronic Health Records ◽  
Natural Language ◽  
Language Processing ◽  
Smoking Status ◽  
Svm Classifier ◽  
Keyword Extraction ◽  
Health Records ◽  
Clinical Notes ◽  
Electronic Health

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.

Probing Patient Messages Enhanced by Natural Language Processing: A Top-Down Message Corpus Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
George Mastorakos ◽  
Aditya Khurana ◽  
Ming Huang ◽  
Sunyang Fu ◽  
Ahmad P. Tafti ◽  
...  
Keyword(s):  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Named Entity Recognition ◽  
Corpus Analysis ◽  
Entity Recognition ◽  
Message Content ◽  
Named Entity ◽  
Medical Concepts ◽  
Insight Into

Background. Patients increasingly use asynchronous communication platforms to converse with care teams. Natural language processing (NLP) to classify content and automate triage of these messages has great potential to enhance clinical efficiency. We characterize the contents of a corpus of portal messages generated by patients using NLP methods. We aim to demonstrate descriptive analyses of patient text that can contribute to the development of future sophisticated NLP applications. Methods. We collected approximately 3,000 portal messages from the cardiology, dermatology, and gastroenterology departments at Mayo Clinic. After labeling these messages as either Active Symptom, Logistical, Prescription, or Update, we used NER (named entity recognition) to identify medical concepts based on the UMLS library. We hierarchically analyzed the distribution of these messages in terms of departments, message types, medical concepts, and keywords therewithin. Results. Active Symptom and Logistical content types comprised approximately 67% of the message cohort. The “Findings” medical concept had the largest number of keywords across all groupings of content types and departments. “Anatomical Sites” and “Disorders” keywords were more prevalent in Active Symptom messages, while “Drugs” keywords were most prevalent in Prescription messages. Logistical messages tended to have the lower proportions of “Anatomical Sites,”, “Disorders,”, “Drugs,”, and “Findings” keywords when compared to other message content types. Conclusions. This descriptive corpus analysis sheds light on the content and foci of portal messages. The insight into the content and differences among message themes can inform the development of more robust NLP models.

An Evaluation of Patient Safety Event Report Categories Using Unsupervised Topic Modeling

2015 ◽  
Vol 54 (04) ◽  
pp. 338-345 ◽  
Author(s):  
A. Fong ◽  
R. Ratwani
Keyword(s):  
Patient Safety ◽  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Topic Modeling ◽  
Free Text ◽  
Event Data ◽  
Event Type ◽  
Modeling Approach ◽  
Safety Event

SummaryObjective: Patient safety event data repositories have the potential to dramatically improve safety if analyzed and leveraged appropriately. These safety event reports often consist of both structured data, such as general event type categories, and unstructured data, such as free text descriptions of the event. Analyzing these data, particularly the rich free text narratives, can be challenging, especially with tens of thousands of reports. To overcome the resource intensive manual review process of the free text descriptions, we demonstrate the effectiveness of using an unsupervised natural language processing approach.Methods: An unsupervised natural language processing technique, called topic modeling, was applied to a large repository of patient safety event data to identify topics, or themes, from the free text descriptions of the data. Entropy measures were used to evaluate and compare these topics to the general event type categories that were originally assigned by the event reporter.Results: Measures of entropy demonstrated that some topics generated from the un-supervised modeling approach aligned with the clinical general event type categories that were originally selected by the individual entering the report. Importantly, several new latent topics emerged that were not originally identified. The new topics provide additional insights into the patient safety event data that would not otherwise easily be detected.Conclusion: The topic modeling approach provides a method to identify topics or themes that may not be immediately apparent and has the potential to allow for automatic reclassification of events that are ambiguously classified by the event reporter.

scholarly journals Implementation of a Cohort Retrieval System for Clinical Data Repositories Using the Observational Medical Outcomes Partnership Common Data Model: Proof-of-Concept System Validation (Preprint)

2019 ◽  
Author(s):  
Sijia Liu ◽  
Yanshan Wang ◽  
Andrew Wen ◽  
Liwei Wang ◽  
Na Hong ◽  
...  
Keyword(s):  
Information Retrieval ◽  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Data Model ◽  
Structured Data ◽  
Common Data Model ◽  
Concept System ◽  
Unstructured Text ◽  
Electronic Health

BACKGROUND Widespread adoption of electronic health records has enabled the secondary use of electronic health record data for clinical research and health care delivery. Natural language processing techniques have shown promise in their capability to extract the information embedded in unstructured clinical data, and information retrieval techniques provide flexible and scalable solutions that can augment natural language processing systems for retrieving and ranking relevant records. OBJECTIVE In this paper, we present the implementation of a cohort retrieval system that can execute textual cohort selection queries on both structured data and unstructured text—Cohort Retrieval Enhanced by Analysis of Text from Electronic Health Records (CREATE). METHODS CREATE is a proof-of-concept system that leverages a combination of structured queries and information retrieval techniques on natural language processing results to improve cohort retrieval performance using the Observational Medical Outcomes Partnership Common Data Model to enhance model portability. The natural language processing component was used to extract common data model concepts from textual queries. We designed a hierarchical index to support the common data model concept search utilizing information retrieval techniques and frameworks. RESULTS Our case study on 5 cohort identification queries, evaluated using the precision at 5 information retrieval metric at both the patient-level and document-level, demonstrates that CREATE achieves a mean precision at 5 of 0.90, which outperforms systems using only structured data or only unstructured text with mean precision at 5 values of 0.54 and 0.74, respectively. CONCLUSIONS The implementation and evaluation of Mayo Clinic Biobank data demonstrated that CREATE outperforms cohort retrieval systems that only use one of either structured data or unstructured text in complex textual cohort queries.

scholarly journals Forty-two Million Ways to Describe Pain: Topic Modeling of 200,000 PubMed Pain-Related Abstracts Using Natural Language Processing and Deep Learning–Based Text Generation

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3133-3160
Author(s):  
Patrick J Tighe ◽  
Bharadwaj Sannapaneni ◽  
Roger B Fillingim ◽  
Charlie Doyle ◽  
Michael Kent ◽  
...  
Keyword(s):  
Deep Learning ◽  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Topic Modeling ◽  
Taxonomic Structure ◽  
Generation Model ◽  
Pain Research ◽  
Embedded Model ◽  
Gated Recurrent Units

Abstract Objective Recent efforts to update the definitions and taxonomic structure of concepts related to pain have revealed opportunities to better quantify topics of existing pain research subject areas. Methods Here, we apply basic natural language processing (NLP) analyses on a corpus of &gt;200,000 abstracts published on PubMed under the medical subject heading (MeSH) of “pain” to quantify the topics, content, and themes on pain-related research dating back to the 1940s. Results The most common stemmed terms included “pain” (601,122 occurrences), “patient” (508,064 occurrences), and “studi-” (208,839 occurrences). Contrarily, terms with the highest term frequency–inverse document frequency included “tmd” (6.21), “qol” (6.01), and “endometriosis” (5.94). Using the vector-embedded model of term definitions available via the “word2vec” technique, the most similar terms to “pain” included “discomfort,” “symptom,” and “pain-related.” For the term “acute,” the most similar terms in the word2vec vector space included “nonspecific,” “vaso-occlusive,” and “subacute”; for the term “chronic,” the most similar terms included “persistent,” “longstanding,” and “long-standing.” Topic modeling via Latent Dirichlet analysis identified peak coherence (0.49) at 40 topics. Network analysis of these topic models identified three topics that were outliers from the core cluster, two of which pertained to women’s health and obstetrics and were closely connected to one another, yet considered distant from the third outlier pertaining to age. A deep learning–based gated recurrent units abstract generation model successfully synthesized several unique abstracts with varying levels of believability, with special attention and some confusion at lower temperatures to the roles of placebo in randomized controlled trials. Conclusions Quantitative NLP models of published abstracts pertaining to pain may point to trends and gaps within pain research communities.

Natural Language Processing for Automatic Identification of Major Depressive Disorders in Free-Text Electronic Health Records

2021 ◽  
Vol 89 (9) ◽  
pp. S155
Author(s):  
Nicolas Nunez ◽  
Joanna M. Biernacka ◽  
Manuel Gardea-Resendez ◽  
Bhavani Singh Agnikula Kshatriya ◽  
Euijung Ryu ◽  
...  
Keyword(s):  
Natural Language Processing ◽  
Electronic Health Records ◽  
Natural Language ◽  
Language Processing ◽  
Depressive Disorders ◽  
Automatic Identification ◽  
Free Text ◽  
Major Depressive ◽  
Health Records ◽  
Major Depressive Disorders
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