自然语言处理和ICD-10编码用于检测出血事件:比较的横截面研究
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
概括
自然语言处理 (NLP) 模型在检测老年患者出血不良药事件 (ADEs) 方面显著优于ICD-10代码. 通过NLP准确地识别出出血的严重程度和病史,改善了患者的安全监测.
科学领域:
- 医疗信息学
- 临床自然语言处理
- 患者安全
背景情况:
- 在接受抗血栓治疗的老年患者中,出血不良药事件 (ADEs) 是一个主要的医院安全问题.
- 使用ICD-10代码的传统基于规则的系统通常无法检测这些事件,因为数据的细节性有限.
研究的目的:
- 开发和评估一种自然语言处理 (NLP) 模型,用于检测和分类老年人出院总结中的出血的ADEs.
- 将NLP模型的性能与使用ICD-10码的基于规则的算法进行比较.
主要方法:
- 手动注释400次出院总结为"没有出血"",临床显著出血"",严重出血"和"出血史".
- 开发一种NLP模型 (逻辑回归,SVM) 具有类权重和基于规则的ICD-10算法.
- 使用准确性,精度,回忆,F1分数和ROC曲线分析进行性能评估.
主要成果:
- 在所有指标上,NLP模型的表现明显优于基于规则的方法 (例如,宏观平均F1得分为0.80).
- 对于严重的 (0. 92) 和临床显著的出血,NLP实现了高精度,AUC为0. 94以区分出血严重程度.
- 基于规则的ICD-10模型显示严重出血,缺少罕见疾病的回忆力较差 (0.03).
结论:
- 在电子病历中检测出出血的ADEs,NLP比基于ICD-10的方法具有显著的优势.
- 这种NLP模型有效地捕捉了严重程度和病史等临床细微差别,从而提高了患者的安全监测.
- 未来的工作应该涉及多机构验证和完善NLP时间推理.
相关概念视频
Assessing Blood pressure using a doppler ultrasound
1.6K
To obtain accurate blood pressure measurements in clinical settings, especially when traditional methods are insufficient, healthcare professionals utilize the Doppler ultrasound technique. This method uses high-frequency sound waves to detect blood flow within the arteries, which is crucial for patients with conditions that complicate circulatory system assessment.
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
1.6K
Pre-Procedural Guidelines for Assessing Blood Pressure
626
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
626
Errors occurring during blood pressure monitoring
964
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
964
Documentation of Nursing Diagnosis
1.3K
The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
1.3K
Data Reporting and Recording
4.9K
Reporting and recording are crucial in data documentation. The timely, thorough, and accurate documentation of facts is essential when recording patient data. Failure to record findings during an assessment or interpretation of a problem will result in loss of information and make the patient document unreliable. The reader is left with general impressions if the information is not specific. A recording is documenting data of the individual's health information in a traceable, secure, and...
4.9K
Guidelines for Nursing Documentation I
1.2K
Quality documentation and reporting share essential characteristics that ensure they are practical and valuable resources for those who use them. These characteristics are:
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
1.2K


