Patient-level temporal aggregation for text-based asthma status ascertainment.

Objective: To specify the problem of patient-level temporal aggregation from clinical text and introduce several probabilistic methods for addressing that problem. The patient-level perspective differs from the prevailing natural language processing (NLP) practice of evaluating at the term, event, s...

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Published in:Journal of the American Medical Informatics Association Vol. 21; no. 5; pp. 876 - 885
Main Authors: Wu, Stephen T, Juhn, Young J, Sohn, Sunghwan, Liu, Hongfang
Format: research Journal Article
Published: Oxford University Press / USA Sep2014
Online Access:View this record in EBSCOhost
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      jtl: Journal of the American Medical Informatics Association
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      dt: Sep2014
      vid: 21
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      pub: Oxford University Press / USA
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        NLM24833775
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        10.1136/amiajnl-2013-002463
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        103985577
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      tig:
        atl: Patient-level temporal aggregation for text-based asthma status ascertainment.
      aug:
        au:
          Wu, Stephen T
          Juhn, Young J
          Sohn, Sunghwan
          Liu, Hongfang
        affil: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
      sug:
        subj:
          Algorithms
          Asthma Classification
          Natural Language Processing
          Artificial Intelligence
          Asthma Diagnosis
          Child
          Classification Methods
          Decision Making, Computer Assisted
          Human
          Mathematics
          Pediatrics
          Time
          Child: 6-12 years
      ab: Objective: To specify the problem of patient-level temporal aggregation from clinical text and introduce several probabilistic methods for addressing that problem. The patient-level perspective differs from the prevailing natural language processing (NLP) practice of evaluating at the term, event, sentence, document, or visit level.Methods: We utilized an existing pediatric asthma cohort with manual annotations. After generating a basic feature set via standard clinical NLP methods, we introduce six methods of aggregating time-distributed features from the document level to the patient level. These aggregation methods are used to classify patients according to their asthma status in two hypothetical settings: retrospective epidemiology and clinical decision support.Results: In both settings, solid patient classification performance was obtained with machine learning algorithms on a number of evidence aggregation methods, with Sum aggregation obtaining the highest F1 score of 85.71% on the retrospective epidemiological setting, and a probability density function-based method obtaining the highest F1 score of 74.63% on the clinical decision support setting. Multiple techniques also estimated the diagnosis date (index date) of asthma with promising accuracy.Discussion: The clinical decision support setting is a more difficult problem. We rule out some aggregation methods rather than determining the best overall aggregation method, since our preliminary data set represented a practical setting in which manually annotated data were limited.Conclusion: Results contrasted the strengths of several aggregation algorithms in different settings. Multiple approaches exhibited good patient classification performance, and also predicted the timing of estimates with reasonable accuracy.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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