Natural Language Processing to Identify Abnormal Breast, Lung, and Cervical Cancer Screening Test Results from Unstructured Reports to Support Timely Follow-up.

Journal: Studies in health technology and informatics
Published Date:

Abstract

Cancer screening and timely follow-up of abnormal results can reduce mortality. One barrier to follow-up is the failure to identify abnormal results. While EHRs have coded results for certain tests, cancer screening results are often stored in free-text reports, which limit capabilities for automated decision support. As part of the multilevel Follow-up of Cancer Screening (mFOCUS) trial, we developed and implemented a natural language processing (NLP) tool to assist with real-time detection of abnormal cancer screening test results (including mammograms, low-dose chest CT scans, and Pap smears) and identification of gynecological follow-up for higher risk abnormalities (i.e. colposcopy) from free-text reports. We demonstrate the integration and implementation of NLP, within the mFOCUS system, to improve the follow-up of abnormal cancer screening results in a large integrated healthcare system. The NLP pipelines have detected scenarios when guideline-recommended care was not delivered, in part because the provider mis-identified the text-based result reports.

Authors

  • Courtney J Diamond
    Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.
  • John Laurentiev
    Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
  • Jie Yang
    Key Laboratory of Development and Maternal and Child Diseases of Sichuan Province, Department of Pediatrics, Sichuan University, Chengdu, China.
  • Amy Wint
    Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.
  • Kimberly A Harris
    Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.
  • Tin H Dang
    Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.
  • Amrita Mecker
    Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.
  • Emily B Carpenter
    Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.
  • Anna N Tosteson
    The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, United States.
  • Adam Wright
    Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA.
  • Jennifer S Haas
    Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.
  • Steven J Atlas
    Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.
  • Li Zhou
    School of Education, China West Normal University, Nanchong, Sichuan, China.