通过诊断代码和自由文本电子病历临床笔记估算初级保健中青少年虐待和忽视儿童的普遍程度。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care Pub Date : 2024-11-22 DOI:10.1016/j.pedhc.2024.10.016

Rachel Y. Lee PhD, RN, Aviv Y. Landau PhD, MSW, Paul M. Heider PhD, Rochelle F. Hanson PhD, Hannah C. Espeleta PhD, Kenrick D. Cato PhD, RN, CPHIMS, FAAN, FACMI, Maxim Topaz PhD, RN, MA, FAAN, FIAHSI, FACMI

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引用次数: 0

摘要

导言：青少年虐待和忽视儿童的经历在初级保健中往往记录不足，导致错过干预机会。本研究比较了通过诊断代码和临床笔记自然语言处理方法识别的虐待和忽视儿童病例的发生率：我们回顾性分析了8157名青少年的数据，使用ICD-10编码和自然语言处理算法来识别虐待和忽视儿童病例，并对临床笔记进行主题建模以提取流行主题：结果：与 ICD-10 编码（111 例）相比，自然语言处理方法识别出了更多的虐待和忽视儿童病例（294 例）。此外，临床笔记的主题建模显示了临床叙述中捕捉到的虐待和忽视儿童的多面性：讨论：将自然语言处理与 ICD 代码相结合有可能加强对虐待和忽视儿童的识别和记录，从而更早、更有针对性地进行干预和协调护理。

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Estimating the Prevalence of Child Abuse and Neglect Among Adolescents in Primary Care Through Diagnoses Codes and Free-Text EHR Clinical Notes

Introduction

Adolescents’ child abuse and neglect experiences are often under-documented in primary care, leading to missed opportunities for interventions. This study compares the prevalence of child abuse and neglect cases identified by diagnostic codes versus a natural language processing approach of clinical notes.

Method

We retrospectively analyzed data from 8,157 adolescents, using ICD-10 codes and a natural language processing algorithm to identify child abuse and neglect cases and applied topic modeling on clinical notes to extract prevalent topics.

Results

The natural language processing approach identified more cases of child abuse and neglect cases (n = 294) compared to ICD-10 codes (n = 111). Additionally, topic modeling of clinical notes showed the multifaceted nature of child abuse and neglect as captured in clinical narratives.

Discussion

Integrating natural language processing with ICD codes has the potential to enhance the identification and documentation of child abuse and neglect, which could lead to earlier and more targeted interventions and coordinated care.

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来源期刊

Journal of Pediatric Health Care NURSING-PEDIATRICS

CiteScore

3.40

自引率

10.70%

发文量

140

审稿时长

24 days

期刊介绍： The Journal of Pediatric Health Care, the official journal of the National Association of Pediatric Nurse Practitioners, provides scholarly clinical information and research regarding primary, acute and specialty health care for children of newborn age through young adulthood within a family-centered context. The Journal disseminates multidisciplinary perspectives on evidence-based practice and emerging policy, advocacy and educational issues that are of importance to all healthcare professionals caring for children and their families.