Use of Deep Learning to Identify Peripheral Arterial Disease Cases From Narrative Clinical Notes.

Journal: The Journal of surgical research
PMID:

Abstract

INTRODUCTION: Peripheral arterial disease (PAD) is the leading cause of amputation in the United States. Despite affecting 8.5 million Americans and more than 200 million people globally, there are significant gaps in awareness by both patients and providers. Ongoing efforts to raise PAD awareness among both the public and health-care professionals have not met widespread success. Thus, there is a need for alternative methods for identifying PAD patients. One potentially promising strategy leverages natural language processing (NLP) to digitally screen patients for PAD. Prior approaches have applied keyword search (KWS) to billing codes or unstructured clinical narratives to identify patients with PAD. However, KWS is limited by its lack of flexibility, the need for manual algorithm development, inconsistent validation, and an inherent failure to capture patients with undiagnosed PAD. Recent advances in deep learning (DL) allow modern NLP models to learn a conceptual representation of the verbiage associated with PAD. This capability may overcome the characteristic constraints of applying strict rule-based algorithms (i.e., searching for a disease-defining set of keywords or billing codes) to real-world clinical data. Herein, we investigate the use of DL to identify patients with PAD from unstructured notes in the electronic health record (EHR).

Authors

  • Shantanu Dev
    Department of Computer Science and Engineering, College of Engineering, The Ohio State University, Columbus, Ohio; Center for Health Services Research, Regenstrief Institute, Indianapolis, Indiana.
  • Andrew Zolensky
    Center for Health Services Research, Regenstrief Institute, Indianapolis, Indiana; Department of Computer and Information Science, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Hanaa Dakour Aridi
    American University of Beirut Medical Center, Beirut, Lebanon.
  • Catherine Kelty
    Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana.
  • Mackenzie K Madison
    Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
  • Anush Motaganahalli
    Center for Health Services Research, Regenstrief Institute, Indianapolis, Indiana.
  • Benjamin S Brooke
    Department of Surgery, Utah Intervention Quality & Implementation Research Group (U-INQUIRE), University of Utah, Salt Lake City, Utah.
  • Brian Dixon
    Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana.
  • Malaz Boustani
    School of Medicine, Indiana University, Indianapolis, IN, 46202, USA.
  • Zina Ben Miled
    Regenstrief Institute, Indianapolis, IN, 46202, USA. zmiled@iupui.edu.
  • Ping Zhang
    Department of Computer Science and Engineering, The Ohio State University, USA.
  • Andrew A Gonzalez
    Regenstrief Institute Center for Health Services Research and Indiana University School of Medicine.