Concept Recognition and Characterization of Patients Undergoing Resection of Vestibular Schwannoma Using Natural Language Processing.

Journal: Journal of neurological surgery. Part B, Skull base
Published Date: May 11, 2024

Abstract

 Natural language processing (NLP), a subset of artificial intelligence (AI), aims to decipher unstructured human language. This study showcases NLP's application in surgical health care, focusing on vestibular schwannoma (VS). By employing an NLP platform, we identify prevalent text concepts in VS patients' electronic health care records (EHRs), creating concept panels covering symptomatology, comorbidities, and management. Through a case study, we illustrate NLP's potential in predicting postoperative cerebrospinal fluid (CSF) leaks.  An NLP model analyzed EHRs of surgically managed VS patients from 2008 to 2018 in a single center. The model underwent unsupervised (trained on one million documents from EHR) and supervised (300 documents annotated in duplicate) learning phases, extracting text concepts and generating concept panels related to symptoms, comorbidities, and management. Statistical analysis correlated concept occurrences with postoperative complications, notably CSF leaks.  Analysis included 292 patients' records, yielding 6,901 unique concepts and 360,929 occurrences. Concept panels highlighted key associations with postoperative CSF leaks, including "antibiotics," "sepsis," and "intensive care unit admission." The NLP model demonstrated high accuracy (precision 0.92, recall 0.96, macro F1 0.93).  Our NLP model effectively extracted concepts from VS patients' EHRs, facilitating personalized concept panels with diverse applications. NLP shows promise in surgical settings, aiding in early diagnosis, complication prediction, and patient care. Further validation of NLP's predictive capabilities is warranted.

Authors

  • Simon C Williams
    Department of Neurosurgery, St George's Hospital, London, United Kingdom.
  • Kawsar Noor
    Health Data Research UK London, University College London, London, UK; Institute of Health Informatics, University College London, London, UK; NIHR BRC Clinical Research Informatics Unit, University College London Hospitals, NHS Foundation Trust, London, UK.
  • Siddharth Sinha
    Ministry of Education Frontiers Science Center for Precision Oncology, Faculty of Health Sciences, University of Macau, Macau SAR, China.
  • Richard J B Dobson
    Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK.
  • Thomas Searle
    Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
  • Jonathan P Funnell
    Department of Neurosurgery, St George's Hospital, London, United Kingdom.
  • John G Hanrahan
    Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom.
  • William R Muirhead
    Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom.
  • Neil Kitchen
    Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH Foundation Trust, London, UK.
  • Hala Kanona
    Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
  • Sherif Khalil
    Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
  • Shakeel R Saeed
    Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom; The Ear Institute, University College London, London, United Kingdom; Department of Otolaryngology, The Royal National Throat, Nose, and Ear Hospital, London, United Kingdom.
  • Hani J Marcus
    The Hamlyn Centre for Robotic Surgery, Institute of Global Health Innovation, Imperial College London, Paterson Building (Level 3), Praed Street, London, W2 1NY, UK, hani.marcus10@imperial.ac.uk.
  • Patrick Grover
    Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.

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