论文标题
从自由文本医学叙事中进行医学不良事件检测的自然语言处理:检测总髋关节置换位错的案例研究
Natural Language Processing with Deep Learning for Medical Adverse Event Detection from Free-Text Medical Narratives: A Case Study of Detecting Total Hip Replacement Dislocation
论文作者
论文摘要
从自由文本医学叙事中对医疗不良事件(AE)的准确检测是具有挑战性的。具有深度学习的自然语言处理(NLP)已经显示出分析自由文本数据的巨大潜力,但是其医疗AE检测的应用是有限的。在这项研究中,我们提出了基于深度学习的NLP(DL-NLP)模型,以从标准(放射学说明)和非标准(后续电话说明)自由文本医学叙事中全部髋关节置换后有效,准确的髋关节脱位AE检测。我们通过各种基于机器学习的NLP(ML-NLP)模型对这些提出的模型进行了基准测试,还评估了国际疾病分类(ICD)(ICD)和当前程序术语(CPT)代码的准确性,以捕获这些髋关节脱位AES在多中心的骨科中。所有DL-NLP模型都超过了所有ML-NLP模型,其卷积神经网络(CNN)模型可实现最佳的整体性能(放射学注释的Kappa = 0.97,而Kappa = 1.00用于后续电话注释)。另一方面,持续髋关节脱位AE的患者的ICD/CPT代码仅准确75.24%,显示了所提出的模型的潜力,用于在LargesCale骨科注册中使用,以准确有效的髋关节脱位AE检测以提高护理和患者结果的质量。
Accurate and timely detection of medical adverse events (AEs) from free-text medical narratives is challenging. Natural language processing (NLP) with deep learning has already shown great potential for analyzing free-text data, but its application for medical AE detection has been limited. In this study we proposed deep learning based NLP (DL-NLP) models for efficient and accurate hip dislocation AE detection following total hip replacement from standard (radiology notes) and non-standard (follow-up telephone notes) free-text medical narratives. We benchmarked these proposed models with a wide variety of traditional machine learning based NLP (ML-NLP) models, and also assessed the accuracy of International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes in capturing these hip dislocation AEs in a multi-center orthopaedic registry. All DL-NLP models out-performed all of the ML-NLP models, with a convolutional neural network (CNN) model achieving the best overall performance (Kappa = 0.97 for radiology notes, and Kappa = 1.00 for follow-up telephone notes). On the other hand, the ICD/CPT codes of the patients who sustained a hip dislocation AE were only 75.24% accurate, showing the potential of the proposed model to be used in largescale orthopaedic registries for accurate and efficient hip dislocation AE detection to improve the quality of care and patient outcome.