自然语言处理方法用于识别患有急性病的高风险瘤患者,并提供临床说明
Claudio Fanconi1,2, Marieke van Buchem1,3, Tina Hernandez-Boussard1
1Stanford University, Stanford, California, United States.
自然语言处理 (NLP) 可以预测瘤病人的急性护理使用 (ACU). 虽然结构化健康数据模型略高于NLP,但自由文本分析为患者的风险因素提供了宝贵的见解.
科学领域:
- 医疗信息学 医疗信息学
- 计算语言学 计算语言学
- 在瘤学瘤学.
背景情况:
- 临床笔记对于患者的健康记录至关重要.
- 预测急性护理使用 (ACU) 对瘤患者管理至关重要.
- 结构化健康数据 (SHD) 通常用于风险预测,但自由文本数据存在独特的挑战.
研究的目的:
- 评估自然语言处理 (NLP) 在接受化疗的瘤患者中识别ACU风险的有效性.
- 用自由文本临床笔记与传统的SHD模型比较NLP模型的预测性能.
- 探索深度学习和手动设计的语言功能用于ACU预测的应用.
主要方法:
- 预测模型的比较:用SHD进行后勤回归,用NLP衍生语言特征进行后勤回归,以及基于变压器的深度学习模型.
- 使用自由文本临床笔记作为SHD的替代品来预测风险.
- 通过使用C-统计学来评估模型性能.
主要成果:
- SHD模型在NLP模型上表现出极小的性能优势.
- 使用SHD进行的逻辑回归实现了0.748的C统计值 (95%CI:0.735,0.762).
- 在语言特征的逻辑回归中,NLP模型的C统计值为0.730 (95%-CI:0.717,0.745),在变压器模型中为0.702 (95%-CI:0.688,0.717).
- 观察到风险偏差在不同患者群体之间存在差异,即使仅使用自由文本数据.
结论:
- 在预测ACU的临床应用中,NLP模型是可行的.
- 自由文本临床笔记可以有效地用于风险预测,为SHD提供补充的见解.
- 对于公平的医疗保健应用来说,了解和解决跨不同患者人口统计学NLP模型中的风险偏差至关重要.
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