Computational Biomedicine Lab, Computer and Information Sciences, University of Delaware, Newark, DE, USA.
Value Institute, Christiana Care Health System, Newark, DE, USA.
J Biomed Inform. 2018 Jun;82:31-40. doi: 10.1016/j.jbi.2018.04.008. Epub 2018 Apr 12.
Patients associated with multiple co-occurring health conditions often face aggravated complications and less favorable outcomes. Co-occurring conditions are especially prevalent among individuals suffering from kidney disease, an increasingly widespread condition affecting 13% of the general population in the US. This study aims to identify and characterize patterns of co-occurring medical conditions in patients employing a probabilistic framework. Specifically, we apply topic modeling in a non-traditional way to find associations across SNOMED-CT codes assigned and recorded in the EHRs of >13,000 patients diagnosed with kidney disease. Unlike most prior work on topic modeling, we apply the method to codes rather than to natural language. Moreover, we quantitatively evaluate the topics, assessing their tightness and distinctiveness, and also assess the medical validity of our results. Our experiments show that each topic is succinctly characterized by a few highly probable and unique disease codes, indicating that the topics are tight. Furthermore, inter-topic distance between each pair of topics is typically high, illustrating distinctiveness. Last, most coded conditions grouped together within a topic, are indeed reported to co-occur in the medical literature. Notably, our results uncover a few indirect associations among conditions that have hitherto not been reported as correlated in the medical literature.
患有多种并存健康状况的患者往往面临加重的并发症和不太有利的结果。并存状况在患有肾脏疾病的患者中尤为普遍，肾脏疾病是一种日益普遍的疾病，影响了美国总人口的 13%。本研究旨在采用概率框架识别和描述患者并存医疗状况的模式。具体来说，我们以非传统的方式应用主题建模来发现跨越>13000 名被诊断患有肾脏疾病的患者的电子健康记录中分配和记录的 SNOMED-CT 代码之间的关联。与主题建模的大多数先前工作不同，我们将该方法应用于代码而不是自然语言。此外，我们对主题进行定量评估，评估它们的紧密性和独特性，并评估我们结果的医学有效性。我们的实验表明，每个主题都可以用少数几个高度可能和独特的疾病代码简洁地描述，这表明主题是紧密的。此外，每个主题对之间的主题间距离通常很高，说明其独特性。最后，大多数在主题内分组的编码条件确实在医学文献中报告为同时发生。值得注意的是，我们的结果揭示了一些在医学文献中迄今未报告为相关的条件之间的间接关联。
