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Practice-Based Learning and Improvement: Improving Morbidity and Mortality Review Using Natural Language Processing.

Molly Kobritz1, Vihas Patel1, David Rindskopf2

  • 1Northwell Health North Shore/Long Island Jewish General Surgery, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.

The Journal of Surgical Research
|November 25, 2022
PubMed
Summary
This summary is machine-generated.

Manual-supplemented natural language processing (ms-NLP) and electronic morbidity and mortality (MM) databases both miss many postoperative complications. ms-NLP identifies minor complications, while MM databases identify major ones, suggesting a supplementary role for NLP in MM review.

Keywords:
Morbidity reviewNatural language processingPractice-Based Learning and ImprovementQuality reviewSurgical education

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Area of Science:

  • Medical informatics
  • Surgical quality improvement
  • Natural Language Processing (NLP) in healthcare

Background:

  • Practice-Based Learning and Improvement is crucial for physicians, relying on accurate complication identification.
  • Current methods for identifying surgical complications are insufficient.
  • Machine learning, including NLP, offers potential for improved complication detection.

Approach:

  • Compared manual-supplemented NLP (ms-NLP) of discharge summaries with the electronic Morbidity and Mortality Adverse Event Reporting System (MARS) database.
  • Analyzed data from three academic medical centers.
  • Classified complication severity using Clavien-Dindo (CD) scores (minor CD I-II, major CD III-IV).

Key Points:

  • Out of 7774 admissions, MARS identified 987 cases with 1659 complications; ms-NLP identified 1296 complications.
  • ms-NLP detected more cases (68%) than MARS (62%), with only 30.3% overlap.
  • MARS identified significantly more major complications (46.30%) than ms-NLP (P < 0.0001).

Conclusions:

  • Neither MARS nor ms-NLP alone identifies all postoperative complications, with only one-third overlap.
  • ms-NLP excels at identifying minor complications, whereas MARS is better for major ones.
  • ms-NLP can supplement, but not replace, traditional MM review for educational benefit.