Using natural language processing to identify problem usage of prescription opioids.
Background: Accurate and scalable surveillance methods are critical to understand widespread problems associated with misuse and abuse of prescription opioids and for implementing effective prevention and control measures. Traditional diagnostic coding incompletely documents problem use. Relevant in...
| Publicado en: | International Journal of Medical Informatics Vol. 84; no. 12; pp. 1057 - 1065 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Elsevier B.V.
Dec2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=110577864&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 110577864 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13865056 JR4 jtl: International Journal of Medical Informatics issn: 13865056 maglogo: N pubinfo: dt: Dec2015 vid: 84 iid: 12 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 110577864 110577864 NLM26456569 10.1016/j.ijmedinf.2015.09.002 NLM26456569 110577864 ppf: 1057 ppct: 8 formats: tig: atl: Using natural language processing to identify problem usage of prescription opioids. aug: au: Carrell, David S. Cronkite, David Palmer, Roy E. Saunders, Kathleen Gross, David E. Masters, Elizabeth T. Hylan, Timothy R. Von Korff, Michael affil: Group Health Research Institute, 1700 Minor Ave., Suite 1500, Seattle, WA 98101, United States sug: subj: Pain Prevention and Control Electronic Health Records Statistics and Numerical Data Substance Use Disorders Epidemiology Inappropriate Prescribing Statistics and Numerical Data Pain Epidemiology Narcotic Antagonists Therapeutic Use Prevalence Risk Factors Vocabulary, Controlled Prescriptions, Drug Statistics and Numerical Data Information Science Methods Washington Substance Use Disorders Prevention and Control Natural Language Processing Data Mining Methods Scales ab: Background: Accurate and scalable surveillance methods are critical to understand widespread problems associated with misuse and abuse of prescription opioids and for implementing effective prevention and control measures. Traditional diagnostic coding incompletely documents problem use. Relevant information for each patient is often obscured in vast amounts of clinical text.Objectives: We developed and evaluated a method that combines natural language processing (NLP) and computer-assisted manual review of clinical notes to identify evidence of problem opioid use in electronic health records (EHRs).Methods: We used the EHR data and text of 22,142 patients receiving chronic opioid therapy (≥70 days' supply of opioids per calendar quarter) during 2006-2012 to develop and evaluate an NLP-based surveillance method and compare it to traditional methods based on International Classification of Disease, Ninth Edition (ICD-9) codes. We developed a 1288-term dictionary for clinician mentions of opioid addiction, abuse, misuse or overuse, and an NLP system to identify these mentions in unstructured text. The system distinguished affirmative mentions from those that were negated or otherwise qualified. We applied this system to 7336,445 electronic chart notes of the 22,142 patients. Trained abstractors using a custom computer-assisted software interface manually reviewed 7751 chart notes (from 3156 patients) selected by the NLP system and classified each note as to whether or not it contained textual evidence of problem opioid use.Results: Traditional diagnostic codes for problem opioid use were found for 2240 (10.1%) patients. NLP-assisted manual review identified an additional 728 (3.1%) patients with evidence of clinically diagnosed problem opioid use in clinical notes. Inter-rater reliability among pairs of abstractors reviewing notes was high, with kappa=0.86 and 97% agreement for one pair, and kappa=0.71 and 88% agreement for another pair.Conclusions: Scalable, semi-automated NLP methods can efficiently and accurately identify evidence of problem opioid use in vast amounts of EHR text. Incorporating such methods into surveillance efforts may increase prevalence estimates by as much as one-third relative to traditional methods. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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