Use of Natural Language Processing to identify Obsessive Compulsive Symptoms in patients with schizophrenia, schizoaffective disorder or bipolar disorder.

Journal: Scientific reports
PMID:

Abstract

Obsessive and Compulsive Symptoms (OCS) or Obsessive Compulsive Disorder (OCD) in the context of schizophrenia or related disorders are of clinical importance as these are associated with a range of adverse outcomes. Natural Language Processing (NLP) applied to Electronic Health Records (EHRs) presents an opportunity to create large datasets to facilitate research in this area. This is a challenging endeavour however, because of the wide range of ways in which these symptoms are recorded, and the overlap of terms used to describe OCS with those used to describe other conditions. We developed an NLP algorithm to extract OCS information from a large mental healthcare EHR data resource at the South London and Maudsley NHS Foundation Trust using its Clinical Record Interactive Search (CRIS) facility. We extracted documents from individuals who had received a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder. These text documents, annotated by human coders, were used for developing and refining the NLP algorithm (600 documents) with an additional set reserved for final validation (300 documents). The developed NLP algorithm utilized a rules-based approach to identify each of symptoms associated with OCS, and then combined them to determine the overall number of instances of OCS. After its implementation, the algorithm was shown to identify OCS with a precision and recall (with 95% confidence intervals) of 0.77 (0.65-0.86) and 0.67 (0.55-0.77) respectively. The development of this application demonstrated the potential to extract complex symptomatic data from mental healthcare EHRs using NLP to facilitate further analyses of these clinical symptoms and their relevance for prognosis and intervention response.

Authors

  • David Chandran
    Institute of Psychiatry, Psychology and Neuroscience, Academic Department of Psychological Medicine, London, SE5 8AF, United Kingdom.
  • Deborah Ahn Robbins
    Kings College London, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom.
  • Chin-Kuo Chang
    University of Taipei, Department of Health and Welfare, Taipei City, Taiwan.
  • Hitesh Shetty
    South London and Maudsley NHS Foundation Trust, London, United Kingdom.
  • Jyoti Sanyal
    Institute of Psychiatry, Psychology and Neuroscience, Academic Department of Psychological Medicine, London, SE5 8AF, United Kingdom.
  • Johnny Downs
    Department of Psychological Medicine, NIHR Biomedical Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Marcella Fok
    Kings College London, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom.
  • Michael Ball
    Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
  • Richard Jackson
    Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Robert Stewart
    Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
  • Hannah Cohen
    Kings College London, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom.
  • Jentien M Vermeulen
    University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands.
  • Frederike Schirmbeck
    University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands.
  • Lieuwe de Haan
    University of Amsterdam, Academic Medical Center, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. Electronic address: l.dehaan@amc.uva.nl.
  • Richard Hayes
    Kings College London, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom.