Machine learning-based natural language processing to extract PD-L1 expression levels from clinical notes.

Journal: Health informatics journal
PMID:

Abstract

PD-L1 expression is used to determine oncology patients' response to and eligibility for immunologic treatments; however, PD-L1 expression status often only exists in unstructured clinical notes, limiting ability to use it in population-level studies. We developed and evaluated a machine learning based natural language processing (NLP) tool to extract PD-L1 expression values from the nationwide Veterans Affairs electronic health record system. The model demonstrated strong evaluation performance across multiple levels of label granularity. Mean precision of the overall PD-L1 positive label was 0.859 (sd, 0.039), recall 0.994 (sd, 0.013), and F1 0.921 (0.024). When a numeric PD-L1 value was identified, the mean absolute error of the value was 0.537 on a scale of 0 to 100. We presented an accurate NLP method for deriving PD-L1 status from clinical notes. By reducing the time and manual effort needed to review medical records, our work will enable future population-level studies in cancer immunotherapy.

Authors

  • Eric Lin
    VA Boston Healthcare System, Boston, MA, USA.
  • Robert Zwolinski
    VA Boston Healthcare System, Boston, MA, USA.
  • Julie Tsu-Yu Wu
    VA Palo Alto Healthcare System, Palo Alto, CA, USA.
  • Jennifer La
    VA Boston Healthcare System, Boston, MA, USA.
  • Sergey Goryachev
  • Linden Huhmann
    VA Boston Healthcare System, Boston, MA, USA.
  • Cenk Yildrim
    VA Boston Healthcare System, Boston, MA, USA.
  • David P Tuck
    VA Boston Healthcare System, Boston, MA, USA.
  • Danne C Elbers
    VA Boston Healthcare System, Boston, MA, USA.
  • Mary T Brophy
    VA Boston Healthcare System, Boston, MA, USA.
  • Nhan V Do
    VA Boston Healthcare System, Boston, MA, USA.
  • Nathanael R Fillmore
    Harvard Medical School, Boston, MA, USA.