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Structuring clinical text with AI: Old versus new natural language processing techniques evaluated on eight common cardiovascular diseases.

ABSTRACT: Free-text clinical notes in electronic health records are more difficult for data mining while the structured diagnostic codes can be missing or erroneous. To improve the quality of diagnostic codes, this work extracts diagnostic codes from free-text notes: five old and new word vectorization methods were used to vectorize Stanford progress notes and predict eight ICD-10 codes of common cardiovascular diseases with logistic regression. The models showed good performance, with TF-IDF as the best vectorization model showing the highest AUROC (0.9499-0.9915) and AUPRC (0.2956-0.8072). The models also showed transferability when tested on MIMIC-III data with AUROC from 0.7952 to 0.9790 and AUPRC from 0.2353 to 0.8084. Model interpretability was shown by the important words with clinical meanings matching each disease. This study shows the feasibility of accurately extracting structured diagnostic codes, imputing missing codes, and correcting erroneous codes from free-text clinical notes for information retrieval and downstream machine-learning applications.

SUBMITTER: Zhan X

PROVIDER: S-EPMC8276012 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Structuring clinical text with AI: Old versus new natural language processing techniques evaluated on eight common cardiovascular diseases.

Zhan Xianghao X Humbert-Droz Marie M Mukherjee Pritam P Gevaert Olivier O

Patterns (New York, N.Y.) 20210617 7

Free-text clinical notes in electronic health records are more difficult for data mining while the structured diagnostic codes can be missing or erroneous. To improve the quality of diagnostic codes, this work extracts diagnostic codes from free-text notes: five old and new word vectorization methods were used to vectorize Stanford progress notes and predict eight ICD-10 codes of common cardiovascular diseases with logistic regression. The models showed good performance, with TF-IDF as the best ...[more]

PMID: 34286303

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Project description:Periodontitis is a complex and microbiome-related inflammatory condition impacting dental supporting tissues. Emphasizing the potential of Clinical Decision Support Systems (CDSS), this study aims to facilitate early diagnosis of periodontitis by extracting patients' information collected as dental charts and notes. We developed a CDSS to predict the stage and grade of periodontitis using natural language processing (NLP) techniques including bidirectional encoder representation for transformers (BERT). We compared the performance of BERT with that of a baseline feature-engineered model. A secondary data analysis was conducted using 309 anonymized patient periodontal charts and corresponding clinician's notes obtained from the university periodontal clinic. After data preprocessing, we added a classification layer on top of the pre-trained BERT model to classify the clinical notes into their corresponding stage and grades. Then, we fine-tuned the pre-trained BERT model on 70% of our data. The performance of the model was evaluated on 32 unseen new patients' clinical notes. The results were compared with the output of a baseline feature-engineered algorithm coupled with MLP techniques to classify the stage and grade of periodontitis. Our proposed BERT model predicted the patients' stage and grade with 77% and 75% accuracy, respectively. MLP model showed that the accuracy of correct classification of stage and grade of the periodontitis on a set of 32 new unseen data was 59.4% and 62.5%, respectively. The BERT model could predict the periodontitis stage and grade on the same new dataset with higher accuracy (66% and 72%, respectively). The utilization of BERT in this context represents a groundbreaking application in dentistry, particularly in CDSS. Our BERT model outperformed baseline models, even with reduced information, promising efficient review of patient notes. This integration of advanced NLP techniques with CDSS frameworks holds potential for timely interventions, preventing complications and reducing healthcare costs.

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Structuring clinical text with AI: Old versus new natural language processing techniques evaluated on eight common cardiovascular diseases.

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Structuring clinical text with AI: Old versus new natural language processing techniques evaluated on eight common cardiovascular diseases.

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