Automatic identification of recent high impact clinical articles in PubMed to support clinical decision making using...

Finding recent clinical studies that warrant changes in clinical practice ("high impact" clinical studies) in a timely manner is very challenging. We investigated a machine learning approach to find recent studies with high clinical impact to support clinical decision making and literature surveillance.

To identify recent studies, we developed our classification model using time-agnostic features that are available as soon as an article is indexed in PubMed®, such as journal impact factor, author count, and study sample size. Using a gold standard of 541 high impact treatment studies referenced in 11 disease management guidelines, we tested the following null hypotheses: (1) the high impact classifier with time-agnostic features (HI-TA) performs equivalently to PubMed's Best Match sort and a MeSH-based Naïve Bayes classifier; and (2) HI-TA performs equivalently to the high impact classifier with both time-agnostic and time-sensitive features (HI-TS) enabled in a previous study. The primary outcome for both hypotheses was mean top 20 precision.

The differences in mean top 20 precision between HI-TA and three baselines (PubMed's Best Match, a MeSH-based Naïve Bayes classifier, and HI-TS) were not statistically significant (12% vs. 3%, p = 0.101; 12% vs. 11%, p = 0.720; 12% vs. 25%, p = 0.094, respectively). Recall of HI-TA was low (7%).

HI-TA had equivalent performance to state-of-the-art approaches that depend on time-sensitive features. With the advantage of relying only on time-agnostic features, the proposed approach can be used as an adjunct to help clinicians identify recent high impact clinical studies to support clinical decision-making. However, low recall limits the use of HI-TA for literature surveillance.