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Automatic International Classification of Diseases Coding System: Deep Contextualized Language Model With Rule-Based

Pei-Fu Chen1,2, Kuan-Chih Chen1,3, Wei-Chih Liao1

  • 1Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.

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Summary
This summary is machine-generated.

This study enhances International Classification of Diseases (ICD-10) coding accuracy using a contextual language model and rule-based preprocessing. The improved model significantly boosts performance for both ICD-10 Clinical Modification (CM) and Procedure Coding System (PCS).

Keywords:
International Classification of Diseasesalgorithmcoding systemdata miningdeep learningelectronic health recordmedical recordsmultilabel text classificationnatural language processing

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Area of Science:

  • Medical Informatics
  • Natural Language Processing
  • Health Data Science

Background:

  • The International Classification of Diseases (ICD-10) is crucial for health management and research.
  • Increasing code complexity in ICD-10 Clinical Modification (CM) and Procedure Coding System (PCS) leads to time-consuming and less accurate coding.
  • Deep contextual word embeddings offer potential for automatic multilabel text classification of ICD-10 codes.

Purpose of the Study:

  • To develop an improved model for ICD-10 multilabel classification.
  • To establish a contextual language model integrated with rule-based preprocessing methods.
  • To enhance the accuracy and efficiency of ICD-10 CM and PCS coding.

Main Methods:

  • Compared various word embedding models including BioBERT, Clinical XLNet, AttentionXLM, and Word2Vec.
  • Evaluated rule-based preprocessing techniques such as definition training, external cause code removal, number conversion, and combination code filtering for ICD-10-CM.
  • Trained models using combinations of discharge diagnoses, surgical methods, and special examination keywords for ICD-10-PCS.
  • Utilized micro F1 score and micro area under the receiver operating characteristic curve for performance comparison.

Main Results:

  • BioBERT demonstrated superior performance with an F1 score of 0.701.
  • Rule-based preprocessing significantly improved ICD-10-CM prediction F1 score from 0.749 to 0.769.
  • For ICD-10-PCS, F1 score increased from 0.670 to 0.726 with combined data inputs.
  • Achieved high AUC scores of 0.853 for ICD-10-CM and 0.831 for ICD-10-PCS.

Conclusions:

  • The developed model, combining a pretrained contextualized language model with rule-based preprocessing, outperforms state-of-the-art methods for ICD-10-CM and ICD-10-PCS.
  • Rule-based preprocessing methods, aligned with coder coding rules, are vital for enhancing the performance of automated ICD-10 classification.