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Clinical Significance of Marital Status and Changes in Status Extracted from Unstructured Clinical Notes Using
Abstract:
Marital status and its dynamics significantly influence health outcomes. This study aims to demonstrate clinical utility of marital status and improve its extraction from electronic health records (EHR) by developing ensembles capable of using structured and unstructured EHR data. Four ensembles based on different voting rules (unanimous vote, majority vote, precision-based vote, and vote based on random forest) were assembled using structured marital status data, off-the-shelf CNN, and hybrid models, capable of detecting marital status from clinical notes, followed by BERT-based fine-tuning to increase recall. Associations of marital status and its changes with depression, substance abuse, and other health outcomes derived from MIMIC-III were reported using frequency statistics. Patients experiencing any marital status change (n=139, including getting married n=40), compared to patients with no change in status (n=2500) of similar age (M=57 years), had higher incidences of depression, but also higher recovery rates, suggesting dual health impacts of marital dynamics.
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