Salience of Medical Concepts of Inside Clinical Texts and Outside Medical Records for Referred Cardiovascular Patients.

IF 4.6 Q1 COMPUTER SCIENCE, INFORMATION SYSTEMS
Journal of healthcare informatics research Pub Date : 2019-01-28 eCollection Date: 2019-06-01 DOI:10.1007/s41666-019-00044-5
Sungrim Moon, Sijia Liu, David Chen, Yanshan Wang, Douglas L Wood, Rajeev Chaudhry, Hongfang Liu, Paul Kingsbury
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Abstract

Outside medical records (OMRs) accompanying referred patients are frequently sent as faxes from external healthcare providers. Accessing useful and relevant information from these OMRs in a timely manner is a challenging task due to a combination of the presence of machine-illegible information and the limited system interoperability inherent in healthcare. Little research has been done on investigating information in OMRs. This paper evaluated overlapping and non-overlapping medical concepts captured from digitally faxed OMRs for patients transferring to the Department of Cardiovascular Medicine and from clinical consultant notes generated at the Mayo Clinic. We used optical character recognition (OCR) techniques to make faxed OMRs machine-readable and used natural language processing (NLP) techniques to capture clinical concepts from both machine-readable OMRs and Mayo clinical notes. We measured the level of overlap in medical concepts between OMRs and Mayo clinical narratives in the quantitative approaches and assessed the salience of concepts specific to Cardiovascular Medicine by calculating the ratio of those mentioned concepts relative to an independent clinical corpus. Among the concepts collected from the OMRs, 11.19% of those were also present in the Mayo clinical narratives that were generated within the 3 months after their initial encounter at the Mayo Clinic. For those common concepts, 73.97% were identified in initial consultant notes (ICNs) and 26.03% were captured over subsequent follow-up consultant notes (FCNs). These findings implied that information collected from the OMRs is potentially informative for patient care, but some valuable information (additionally identified in FCNs) collected from the OMRs is not fully used in an earlier stage of the care process. The concepts collected from the ICNs have the highest salience to Cardiovascular Medicine (0.112) compared to concepts in OMRs and concepts in FCNs. Additionally, unique concepts captured in ICNs (unseen in OMRs or FCNs) carried the most salient information (0.094), which demonstrated that ICNs provided the most informative concepts for the care of transferred patients.

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转诊心血管病人的临床文献和外部医疗记录中医疗概念的显著性。
转诊病人的外部医疗记录(OMR)经常以传真形式从外部医疗机构发送过来。由于存在机器无法识别的信息和医疗保健系统固有的有限互操作性,及时从这些外部医疗记录中获取有用的相关信息是一项具有挑战性的任务。目前,有关 OMR 中信息调查的研究还很少。本文评估了从转到心血管内科的患者的数字传真 OMR 和梅奥诊所生成的临床顾问笔记中获取的重叠和非重叠医疗概念。我们使用光学字符识别 (OCR) 技术使传真的 OMR 具有机器可读性,并使用自然语言处理 (NLP) 技术从机器可读的 OMR 和梅奥临床笔记中捕获临床概念。我们在定量方法中测量了 OMR 和梅奥临床叙述之间医学概念的重叠程度,并通过计算相对于独立临床语料库的被提及概念的比例来评估心血管内科特有概念的显著性。在从 OMR 中收集到的概念中,有 11.19% 也出现在梅奥临床叙述中,这些叙述是在梅奥诊所初次就诊后 3 个月内产生的。在这些常见的概念中,73.97% 是在首次咨询记录(ICN)中发现的,26.03% 是在随后的随访咨询记录(FCN)中发现的。这些研究结果表明,从手术记录中收集到的信息对病人护理具有潜在的参考价值,但从手术记录中收集到的一些有价值的信息(另外在 FCN 中也有发现)并没有在护理过程的早期阶段得到充分利用。与 OMR 和 FCN 中的概念相比,ICN 中收集的概念对心血管内科的显著性最高(0.112)。此外,在 ICN 中捕捉到的独特概念(在 OMR 或 FCN 中未出现过)具有最显著的信息(0.094),这表明 ICN 为转院病人的护理提供了最有价值的概念。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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