自然言語処理と出院時の出血を検出するためのICD-10のコーディング:比較的横断的研究
Frederic Gaspar1,2, Mehdi Zayene3, Claire Coumau1,2,4
1Center for Research and Innovation in Clinical Pharmaceutical Sciences, Rue du Bugnon 19, Lausanne, 1011, Switzerland, 41 763306834.
JMIR medical informatics
|August 29, 2025
まとめ
自然言語処理 (NLP) モデルは,高齢者の出血による薬剤有害事象 (ADEs) の検出において,ICD-10のコードを大幅に上回ります. NLPは出血の重度と病歴を正確に特定し,患者の安全監視を改善します.
科学分野:
- 医療情報工学
- クリニカル・ナチュラル・ランゲージ・処理
- 患者の安全
背景:
- 抗血栓治療を受けている高齢の患者の出血による薬剤副作用 (ADEs) は,病院の安全性に関する主要な懸念事項である.
- ICD-10コードを使用する従来のルールベースのシステムは,限られたデータ粒度のため,これらのイベントを検出することができません.
研究 の 目的:
- 高齢者の退院要約における出血によるADEの検出と分類のための自然言語処理 (NLP) モデルを開発し評価する.
- NLPモデルのパフォーマンスを,ICD-10コードを使用したルールベースのアルゴリズムと比較する.
主な方法:
- "出血なし" "臨床的に有意な出血" "重度の出血" "出血歴"
- クラス加重とルールベースのICD-10アルゴリズムによるNLPモデル (ロジスティック回帰,SVM) の開発.
- 精度,精度,リコール,F1スコア,ROC曲線解析を用いた性能評価
主要な成果:
- NLPモデルはすべての指標でルールベースのアプローチを大幅に上回りました (例えば,マクロ平均F1スコア0.80)
- NLPは重度の出血 (0. 92) と臨床的に有意な出血 (0. 87) の高い精度を達成し,出血の重さを区別するためにAUCは0. 94でした.
- 規則に基づくICD-10モデルでは,重度の出血,欠落した稀な状態のリコールが不十分であった.
結論:
- NLPは,電子医療記録における出血のADEsを検出するためのICD-10ベースの方法よりも重要な利点を提供します.
- NLPモデルは重症度や病歴などの 臨床的ニュアンスを効果的に捉え 患者の安全監視を強化します
- 将来の作業には,複数の機関による検証とNLPの時間的推論の精錬が含まれるべきです.
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