初步开发工具,以识别儿童虐待和忽视在儿科初级保健中的工具
Rochelle F Hanson1, Vivienne Zhu2, Funlola Are3
1Medical University of South Carolina, Charleston, SC, USA. hansonrf@musc.edu.
BMC medical informatics and decision making
|November 18, 2023
概括
这项研究开发了一种自然语言处理 (NLP) 工具,用于在电子健康记录 (EHR) 中识别虐待和忽视儿童 (CAN),显示了初级保健机构早期检测的希望.
科学领域:
- 医疗信息学 医疗信息学
- 公共卫生 公共卫生
- 儿科 儿科 儿科
背景情况:
- 虐待和忽视儿童 (CAN) 是一个重大的公共卫生问题,具有持久的后果,往往没有被发现.
- 初级保健机构对于识别CAN和促进转诊至关重要,但供应商的时间限制限制了电子健康记录 (EHR) 的彻底审查.
- 需要创新的策略来总结EHR数据,并提醒提供者潜在的CAN病例,减轻不良结果.
研究的目的:
- 使用专家共识和自然语言处理 (NLP) 开发和验证词典,以识别患有或患有CAN的儿童.
- 为了比较NLP-lexicon方法的性能与机器学习方法用于在EHR中识别CAN.
主要方法:
- 一个跨学科的专家小组验证了90个CAN术语的初始列表,将其扩展到133个术语.
- 开发了NLP管道,并对来自儿科初级保健 EHR 的 14,393 份临床笔记进行了测试.
- 使用支持矢量机 (SVM) 算法来探索用于CAN识别的机器学习方法.
主要成果:
- 在NLP词典中,在0.03%的笔记中识别了CAN,鉴别因临床笔记类型而异.
- NLP管道评估显示,训练组的正确CAN率为93.8%,测试组的正确CAN率为71.4%,假阳性影响精度.
- 在SVM机器学习方法中,CAN+识别达到92%,非CAN识别达到100%,显示出高灵敏度.
结论:
- 开发的NLP算法显示了通过EHR数据分析来识别患有癌症风险的年轻人的潜力.
- 需要进一步完善NLP算法,以便有效地将这些信息整合到护理提供者的临床决策中.
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