Measuring Use of Evidence Based Psychotherapy for Posttraumatic Stress Disorder in a Large National Healthcare System.
Journal:
Administration and policy in mental health
PMID:
29450781
Abstract
To derive a method of identifying use of evidence-based psychotherapy (EBP) for post-traumatic stress disorder (PTSD), we used clinical note text from national Veterans Health Administration (VHA) medical records. Using natural language processing, we developed machine-learning algorithms to classify note text on a large scale in an observational study of Iraq and Afghanistan veterans with PTSD and one post-deployment psychotherapy visit by 8/5/15 (N = 255,968). PTSD visits were linked to 8.1 million psychotherapy notes. Annotators labeled 3467 randomly-selected psychotherapy notes (kappa = 0.88) to indicate receipt of EBP. We met our performance targets of overall classification accuracy (0.92); 20.2% of veterans received ≥ one session of EBP over the study period. Our method can assist with identifying EBP use and studying EBP-associated outcomes in routine clinical practice.
Authors
Keywords
Algorithms
Cognitive Behavioral Therapy
Evidence-Based Medicine
Family Therapy
Humans
Implosive Therapy
Machine Learning
Natural Language Processing
Psychotherapy
Psychotherapy, Group
Retrospective Studies
Stress Disorders, Post-Traumatic
United States
United States Department of Veterans Affairs
Veterans