Assessing Information Congruence of Documented Cardiovascular Disease between Electronic Dental and Medical Records

Dentists are more often treating patients with Cardiovascular Diseases (CVD) in their clinics; therefore, dentists may need to alter treatment plans in the presence of CVD. However, it’s unclear to what extent patient-reported CVD information is accurately captured in Electronic Dental Records (EDRs). In this pilot study, we aimed to measure the reliability of patient-reported CVD conditions in EDRs. We assessed information congruence by comparing patients’ self-reported dental histories to their original diagnosis assigned by their medical providers in the Electronic Medical Record (EMR). To enable this comparison, we encoded patients CVD information from the free-text data of EDRs into a structured format using natural language processing (NLP). Overall, our NLP approach achieved promising performance extracting patients’ CVD-related information. We observed disagreement between self-reported EDR data and physician-diagnosed EMR data

Doctor of Philosophy

dissertationThe primary objective of cancer registries is to capture clinical care data of cancer populations and aid in prevention, allow early detection, determine prognosis, and assess quality of various treatments and interventions. Furthermore, the role of cancer registries is paramount in supporting cancer epidemiological studies and medical research. Existing cancer registries depend mostly on humans, known as Cancer Tumor Registrars (CTRs), to conduct manual abstraction of the electronic health records to find reportable cancer cases and extract other data elements required for regulatory reporting. This is often a time-consuming and laborious task prone to human error affecting quality, completeness and timeliness of cancer registries. Central state cancer registries take responsibility for consolidating data received from multiple sources for each cancer case and to assign the most accurate information. The Utah Cancer Registry (UCR) at the University of Utah, for instance, leads and oversees more than 70 cancer treatment facilities in the state of Utah to collect data for each diagnosed cancer case and consolidate multiple sources of information.Although software tools helping with the manual abstraction process exist, they mainly focus on cancer case findings based on pathology reports and do not support automatic extraction of other data elements such as TNM cancer stage information, an important prognostic factor required before initiating clinical treatment. In this study, I present novel applications of natural language processing (NLP) and machine learning (ML) to automatically extract clinical and pathological TNM stage information from unconsolidated clinical records of cancer patients available at the central Utah Cancer Registry. To further support CTRs in their manual efforts, I demonstrate a new approach based on machine learning to consolidate TNM stages from multiple records at the patient level

The Revival of the Notes Field: Leveraging the Unstructured Content in Electronic Health Records

Problem: Clinical practice requires the production of a time- and resource-consuming great amount of notes. They contain relevant information, but their secondary use is almost impossible, due to their unstructured nature. Researchers are trying to address this problems, with traditional and promising novel techniques. Application in real hospital settings seems not to be possible yet, though, both because of relatively small and dirty dataset, and for the lack of language-specific pre-trained models.Aim: Our aim is to demonstrate the potential of the above techniques, but also raise awareness of the still open challenges that the scientific communities of IT and medical practitioners must jointly address to realize the full potential of unstructured content that is daily produced and digitized in hospital settings, both to improve its data quality and leverage the insights from data-driven predictive models.Methods: To this extent, we present a narrative literature review of the most recent and relevant contributions to leverage the application of Natural Language Processing techniques to the free-text content electronic patient records. In particular, we focused on four selected application domains, namely: data quality, information extraction, sentiment analysis and predictive models, and automated patient cohort selection. Then, we will present a few empirical studies that we undertook at a major teaching hospital specializing in musculoskeletal diseases.Results: We provide the reader with some simple and affordable pipelines, which demonstrate the feasibility of reaching literature performance levels with a single institution non-English dataset. In such a way, we bridged literature and real world needs, performing a step further toward the revival of notes fields

Bruk av naturlig språkprosessering i psykiatri: En systematisk kartleggingsoversikt

Bakgrunn: Bruk av kunstig intelligens (AI) har et stadig økende fokus, også i helsevesenet. En metode som virker lovende, er naturlig språkprosessering (NLP), som kan brukes til analysering av skriftlig tekst, for eksempel tekst i elektroniske pasientjournaler. Denne undersøkelsen har som formål å undersøke forskning som er gjort på bruk av naturlig språkprosessering for analysering av elektroniske journaler fra pasienter med alvorlige psykiske lidelser, som affektive lidelser og psykoselidelser. Den overordnete hensikten med dette, er å få et inntrykk av om noe av forskningen som er gjort har fokus på forbedring av pasientenes helsesituasjon. Materiale og metode: Det ble gjennomført en systematisk kartleggingsoversikt («scoping review»). Litteratursøket ble gjort i én database for medisinsk forskning, PubMed, med søketermene «psychiatry», «electronic medical records» og «natural language processing». Søket var ikke avgrenset i tid. For at en artikkel skulle bli inkludert i undersøkelsen måtte den være empirisk, ha utført analyser på journaldata i fritekst, ha brukt elektroniske journaler fra psykiatriske pasienter med psykoselidelser og/eller affektive lidelser og være skrevet på engelsk språk. Resultater: Litteratursøket resulterte i totalt 211 unike artikler, av disse oppfylte 37 artikler inklusjonskriteriene i kartleggingsoversikten, og ble undersøkt videre. De fleste av studiene var gjennomført i Storbritannia og USA. Størrelsen på studiepopulasjonen varierte mye, fra noen hundre til flere hundre tusen inkluderte pasienter i studiene. Det var lite av forskningen som var gjort på spesifikke dokumenttyper fra pasientjournal, som for eksempel epikriser eller innkomstjournaler. Hensikten for studiene varierte mye, men kunne deles inn i noen felles kategorier: 1) identifisering av informasjon fra journal, 2) kvantitative undersøkelser av populasjonen eller journalene, 3) seleksjon av pasienter til kohorter og 4) vurdering av risiko. Fortolkning: Det trengs mer grunnforskning før teknologi for naturlig språkprosessering til analyse av elektronisk journal vil bidra med forbedring av psykiatriske pasienters helsesituasjon