Advanced Care Planning Content Encoding with Natural Language Processing.

Journal: Studies in health technology and informatics
PMID: 38269881

Abstract

While advanced care planning (ACP) is an essential practice for ensuring patient-centered care, its adoption remains poor and the completeness of its documentation variable. Natural language processing (NLP) approaches hold promise for supporting ACP, including its use for decision support to improve ACP gaps at the point of care. ACP themes were annotated on palliative care notes across four annotators (Fleiss kappa = 0.753) and supervised models trained (Huggingface models bert-base-uncased and Bio_ClinicalBERT) using 5-fold cross validation (F1=0.8, precision=0.75, recall=0.86, any theme). When applied across the full note corpus of 12,711 notes, we observed variability in documentation of ACP information. Our findings demonstrate the promise of NLP approaches for informatics-based approaches for ACP and patient-centered care.

Authors

  • Benjamin C Knoll
    Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.
  • Melissa Gunderson
    University of Minnesota, Minneapolis, MN USA.
  • Geetanjali Rajamani
    University of Minnesota, Minneapolis, MN USA.
  • Elizabeth C Wick
    Division of Clinical Informatics and Digital Transformation, Department of Medicine, University of California San Francisco, San Francisco, CA; Division of General Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA.
  • Alexis Colley
    University of California San Francisco, San Francisco, CA USA.
  • Elizabeth Lindemann
    Institute for Health Informatics, University of Minnesota, Minneapolis, MN.
  • Rubina Rizvi
    Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.
  • Molly Diethelm
    University of Minnesota, Minneapolis, MN USA.
  • Gretchen Hultman
    Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.
  • Logan Pierce
    University of California San Francisco, San Francisco, CA USA.
  • Rui Zhang
    Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China.
  • Genevieve B Melton
    Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.

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