Identifying Patients with Depression Using Free-text Clinical Documents.

Journal: Studies in health technology and informatics
Published Date:

Abstract

About 1 in 10 adults are reported to exhibit clinical depression and the associated personal, societal, and economic costs are significant. In this study, we applied the MTERMS NLP system and machine learning classification algorithms to identify patients with depression using discharge summaries. Domain experts reviewed both the training and test cases, and classified these cases as depression with a high, intermediate, and low confidence. For depression cases with high confidence, all of the algorithms we tested performed similarly, with MTERMS' knowledge-based decision tree slightly better than the machine learning classifiers, achieving an F-measure of 89.6%. MTERMS also achieved the highest F-measure (70.6%) on intermediate confidence cases. The RIPPER rule learner was the best performing machine learning method, with an F-measure of 70.0%, and a higher precision but lower recall than MTERMS. The proposed NLP-based approach was able to identify a significant portion of the depression cases (about 20%) that were not on the coded diagnosis list.

Authors

  • Li Zhou
    School of Education, China West Normal University, Nanchong, Sichuan, China.
  • Amy W Baughman
    Division of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Victor J Lei
    Clinical Informatics, Partners eCare, Partners Healthcare Inc. Boston, MA, USA.
  • Kenneth H Lai
    Division of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Amol S Navathe
    Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Frank Chang
    Shady Grove Fertility, Rockville, Maryland.
  • Margarita Sordo
    Clinical Informatics, Partners eCare, Partners Healthcare Inc. Boston, MA, USA.
  • Maxim Topaz
    Division of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Feiran Zhong
    Division of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Madhavan Murrali
    School of Computer Science, College of Computing, Georgia Institute of Technology, Atlanta, GA, USA.
  • Shamkant Navathe
    School of Computer Science, College of Computing, Georgia Institute of Technology, Atlanta, GA, USA.
  • Roberto A Rocha
    Clinical Informatics, Partners eCare, Partners Healthcare Inc. Boston, MA, USA.