识别胰腺癌的迹象和症状:使用电子健康记录和自然语言处理的基于人口的研究
Wansu Chen1, Fagen Xie1, Tiffany Q Luong1
1Kaiser Permanente Southern California Research and Evaluation, 100 South Los Robles Ave, Pasadena, CA, USA.
概括
患者报告的腹痛和体重减轻等症状在胰腺癌 (PC) 中很常见. 焦虑和抑郁等心理健康症状可能在PC诊断之前超过一年,有助于更早的检测.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 医疗信息学 医疗信息学
背景情况:
- 患者报告的症状经常启动胰腺癌 (PC) 的诊断过程.
- 了解症状的流行和时间对于早期PC检测至关重要.
研究的目的:
- 通过使用电子健康记录 (EHR) 来确定与胰腺管腺癌 (PDAC) 相关的症状的流行率和引领时间.
主要方法:
- 一项嵌套病例控制研究确定了2611例PDAC病例和10,085例对照 (年龄在50-84岁之间).
- 自然语言处理从EHR中的临床笔记和患者-提供者通信中提取了17个预定义的症状.
主要成果:
- 在PDAC病例中最常见的症状包括腹痛 (85.5%),体重减轻 (71.4%) 和疲劳 (66.5%).
- 胃肠道,全身症状和精神/睡眠障碍与PC有显著的关联.
- 虽然精神健康症状 (焦虑,抑郁,失眠) 较早出现 (中位数为8.2-16.5个月),但肠道/全身症状的中位数预先时间较短 (4.1个月).
结论:
- 通过NLP处理的EHR数据可以系统地识别患有PC症状的患者.
- 这种方法有可能增强早期胰腺癌检测策略.
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