Machine Learning Methods to Extract Documentation of Breast Cancer Symptoms From Electronic Health Records.

Context: Clinicians document cancer patients' symptoms in free-text format within electronic health record visit notes. Although symptoms are critically important to quality of life and often herald clinical status changes, computational methods to assess the trajectory of symptoms over time are woe...

Descripción completa

Detalles Bibliográficos
Publicado en:Journal of Pain & Symptom Management Vol. 55; no. 6; pp. 1492 - 1500
Autores principales: Forsyth, Alexander W., Barzilay, Regina, Hughes, Kevin S., Lui, Dickson, Lorenz, Karl A., Enzinger, Andrea, Tulsky, James A., Lindvall, Charlotta
Formato: research Journal Article
Publicado: Elsevier B.V. Jun2018
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=129566017&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 129566017
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        08853924
        4CB
      jtl: Journal of Pain & Symptom Management
      issn: 08853924
      maglogo: N
    pubinfo:
      dt: Jun2018
      vid: 55
      iid: 6
      pid: 467
      pub: Elsevier B.V.
      place: New York, New York
    artinfo:
      ui:
        129566017
        129566017
        NLM29496537
        129566017
        10.1016/j.jpainsymman.2018.02.016
        NLM29496537
        129566017
      ppf: 1492
      ppct: 8
      formats:
      tig:
        atl: Machine Learning Methods to Extract Documentation of Breast Cancer Symptoms From Electronic Health Records.
      aug:
        au:
          Forsyth, Alexander W.
          Barzilay, Regina
          Hughes, Kevin S.
          Lui, Dickson
          Lorenz, Karl A.
          Enzinger, Andrea
          Tulsky, James A.
          Lindvall, Charlotta
        affil: Department of Electrical Engineering and Computer Science, CSAIL, MIT, Cambridge, Massachusetts
      sug:
        subj:
          Palliative Care
          Breast Neoplasms
          Machine Learning Methods
          Electronic Health Records
          Natural Language Processing
          Human
          Cancer Patients
          Medical Records
          Patient-Reported Outcomes
          Academic Medical Centers
          Models, Statistical
          Descriptive Statistics
          Outcome Assessment
      ab: Context: Clinicians document cancer patients' symptoms in free-text format within electronic health record visit notes. Although symptoms are critically important to quality of life and often herald clinical status changes, computational methods to assess the trajectory of symptoms over time are woefully underdeveloped.Objectives: To create machine learning algorithms capable of extracting patient-reported symptoms from free-text electronic health record notes.Methods: The data set included 103,564 sentences obtained from the electronic clinical notes of 2695 breast cancer patients receiving paclitaxel-containing chemotherapy at two academic cancer centers between May 1996 and May 2015. We manually annotated 10,000 sentences and trained a conditional random field model to predict words indicating an active symptom (positive label), absence of a symptom (negative label), or no symptom at all (neutral label). Sentences labeled by human coder were divided into training, validation, and test data sets. Final model performance was determined on 20% test data unused in model development or tuning.Results: The final model achieved precision of 0.82, 0.86, and 0.99 and recall of 0.56, 0.69, and 1.00 for positive, negative, and neutral symptom labels, respectively. The most common positive symptoms were pain, fatigue, and nausea. Machine-based labeling of 103,564 sentences took two minutes.Conclusion: We demonstrate the potential of machine learning to gather, track, and analyze symptoms experienced by cancer patients during chemotherapy. Although our initial model requires further optimization to improve the performance, further model building may yield machine learning methods suitable to be deployed in routine clinical care, quality improvement, and research applications.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N