Harvard Medical School, Boston, MA, USA.
Massachusetts General Hospital, Boston, MA, USA.
J Med Syst. 2018 Sep 25;42(11):209. doi: 10.1007/s10916-018-1066-7.
Left ventricular ejection fraction (LVEF) is an important prognostic indicator of cardiovascular outcomes. It is used clinically to determine the indication for several therapeutic interventions. LVEF is most commonly derived using in-line tools and some manual assessment by cardiologists from standardized echocardiographic views. LVEF is typically documented in free-text reports, and variation in LVEF documentation pose a challenge for the extraction and utilization of LVEF in computer-based clinical workflows. To address this problem, we developed a computerized algorithm to extract LVEF from echocardiography reports for the identification of patients having heart failure with reduced ejection fraction (HFrEF) for therapeutic intervention at a large healthcare system. We processed echocardiogram reports for 57,158 patients with coded diagnosis of Heart Failure that visited the healthcare system over a two-year period. Our algorithm identified a total of 3910 patients with reduced ejection fraction. Of the 46,634 echocardiography reports processed, 97% included a mention of LVEF. Of these reports, 85% contained numerical ejection fraction values, 9% contained ranges, and the remaining 6% contained qualitative descriptions. Overall, 18% of extracted numerical LVEFs were ≤ 40%. Furthermore, manual validation for a sample of 339 reports yielded an accuracy of 1.0. Our study demonstrates that a regular expression-based approach can accurately extract LVEF from echocardiograms, and is useful for delineating heart-failure patients with reduced ejection fraction.
左心室射血分数（LVEF）是心血管结局的重要预后指标。它在临床上用于确定几种治疗干预的适应证。LVEF 通常通过在线工具和心脏病专家从标准化超声心动图视图进行一些手动评估来获得。LVEF 通常记录在自由文本报告中，LVEF 记录的变化对基于计算机的临床工作流程中 LVEF 的提取和利用构成了挑战。为了解决这个问题，我们开发了一种计算机算法，从超声心动图报告中提取 LVEF，以识别在大型医疗保健系统中接受治疗干预的射血分数降低的心力衰竭（HFrEF）患者。我们处理了在两年期间访问医疗保健系统的编码诊断为心力衰竭的 57158 名患者的超声心动图报告。我们的算法总共确定了 3910 名射血分数降低的患者。在处理的 46634 份超声心动图报告中，97%包含 LVEF 的提及。在这些报告中，85%包含数值射血分数值，9%包含范围，其余 6%包含定性描述。总体而言，提取的数值 LVEF 的 18%≤40%。此外，对 339 份报告的样本进行手动验证的准确率为 1.0。我们的研究表明，基于正则表达式的方法可以从超声心动图中准确提取 LVEF，并且对于描绘射血分数降低的心力衰竭患者很有用。
