在老年住院患者中检测与抗血栓相关的出血:使用结构化和非结构化电子健康记录数据的多中心回顾性研究.
Claire Coumau1,2,3, Frederic Gaspar1,2,3, Mehdi Zayene4
1Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 19, Lausanne, Switzerland, 1 021 314 42 63.
Journal of medical Internet research
|January 29, 2026
概括
结合结构化数据和NLP的自动化算法有效地检测抗血栓药物治疗的老年患者的出血事件. 这种方法改善了对重大出血 (MB) 和临床相关非重大出血 (CRNMB) 的药物安全监测和临床风险管理.
科学领域:
- 医疗信息学 医疗信息学
- 药物监督 药物监督 药物监督
- 临床数据科学 临床数据科学
背景情况:
- 在使用抗血栓剂的老年住院患者中,出血并发症是显著的风险.
- 精确检测出血事件对于药物安全和患者风险管理至关重要.
研究的目的:
- 开发和验证用于检测重大出血 (MB) 和临床相关非重大出血 (CRNMB) 的自动化算法.
- 将基于数据的结构化规则模型与自然语言处理 (NLP) 结合起来,以提高出血事件的检测.
- 用黄金标准和外部数据集来评估算法性能和通用性.
主要方法:
- 使用来自瑞士大学医院的电子病历 (EMR) 进行的回顾性多中心研究.
- 使用结构化数据 (ICD-10-GM代码,实验室,输血,处方) 开发基于规则的算法.
- 应用监督的NLP模型来处理摘要,并与结构化数据算法 (SDA+NLP) 结合用于验证.
主要成果:
- 在检测MB和CRNMB方面,SDA+NLP组合模型实现了最佳性能 (灵敏度为0.84,PPV为0.51,F1得分为0.64).
- 实验室数据是结构化数据算法中事件检测的最重要贡献者.
- 外部验证证实了算法可重现性,随着临床实践的变化,流行率的演变反映了临床实践的变化.
结论:
- 结合结构化数据算法 (SDA) 和NLP的综合方法提高了抗血栓药物治疗的老年住院患者的出血事件检测.
- 这种方法显示了改善药物安全监测和临床风险管理的潜在实用性.
- 这些发现强调了先进的数据分析对药监测的重要性.
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