在退伍军人中识别患者报告的结果测量文档 卫生管理 手术诊所 笔记:自然语言处理分析
Brian C Coleman1,2,3, Kelsey L Corcoran1,3, Cynthia A Brandt1,2,3
1Pain Research, Informatics, Multimorbidities, and Education Center, VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 06516, United States, 1 2039325711.
自然语言处理 (NLP) 有效地识别了退伍军人卫生管理局的手术笔记中的患者报告的结果措施 (PROM). 这种方法有助于监测护理质量,尽管PROM记录率仍然很低.
科学领域:
- 医疗信息学 医疗信息学
- 自然语言处理自然语言处理.
- 临床质量测量临床质量测量
背景情况:
- 患者报告的结果测量 (PROM) 对于高质量的手术护理至关重要.
- 退伍军人卫生管理局 (VHA) 由于非结构化的临床笔记,在监测PROM使用方面面临挑战.
- 自然语言处理 (NLP) 提供了一个从文本中提取PROM数据的解决方案.
研究的目的:
- 评估NLP技术用于识别VHA手术笔记中的PROM.
- 评估使用NLP用于手术护理中的质量指标监测的可行性.
主要方法:
- 使用了来自大量患者队列的VHA手术笔记 (2017-2020年).
- 开发和评估一个基于规则的NLP模型,使用medspaCy和spaCy.
- 基于规则的模型与机器学习方法 (词袋,CNN,合奏) 进行比较,以对笔记进行分类.
主要成果:
- 基于规则的NLP模型在文本匹配和笔记分类方面表现出很高的表现.
- 基于规则的模型在文本匹配方面实现了88.2%的F-测量,在笔记分类方面达到94.7%.
- 在VHA手术笔记中记录的PROM使用率很低,患病率为17.0%.
结论:
- 基于规则的NLP方法是最佳的在非结构化的临床笔记中识别PROM.
- NLP可以克服数据提取挑战,使PROM使用的持续监控成为可能.
- 低PROM文档表明需要在老兵手术治疗中采取质量改善举措.
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