Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Alberta Strategy for Patient-Oriented Research Patient Engagement Platform, Calgary, Alberta, Canada.
BMJ Health Care Inform. 2021 Jun;28(1). doi: 10.1136/bmjhci-2020-100274.
OBJECTIVES: Patient feedback is critical to identify and resolve patient safety and experience issues in healthcare systems. However, large volumes of unstructured text data can pose problems for manual (human) analysis. This study reports the results of using a semiautomated, computational topic-modelling approach to analyse a corpus of patient feedback. METHODS: Patient concerns were received by Alberta Health Services between 2011 and 2018 (n=76 163), regarding 806 care facilities in 163 municipalities, including hospitals, clinics, community care centres and retirement homes, in a province of 4.4 million. Their existing framework requires manual labelling of pre-defined categories. We applied an automated latent Dirichlet allocation (LDA)-based topic modelling algorithm to identify the topics present in these concerns, and thereby produce a framework-free categorisation. RESULTS: The LDA model produced 40 topics which, following manual interpretation by researchers, were reduced to 28 coherent topics. The most frequent topics identified were communication issues causing delays (frequency: 10.58%), community care for elderly patients (8.82%), interactions with nurses (8.80%) and emergency department care (7.52%). Many patient concerns were categorised into multiple topics. Some were more specific versions of categories from the existing framework (eg, communication issues causing delays), while others were novel (eg, smoking in inappropriate settings). DISCUSSION: LDA-generated topics were more nuanced than the manually labelled categories. For example, LDA found that concerns with community care were related to concerns about nursing for seniors, providing opportunities for insight and action. CONCLUSION: Our findings outline the range of concerns patients share in a large health system and demonstrate the usefulness of using LDA to identify categories of patient concerns.
目的:患者反馈对于识别和解决医疗系统中的患者安全和体验问题至关重要。然而,大量的非结构化文本数据可能会给人工(手动)分析带来问题。本研究报告了使用半自动计算主题建模方法分析患者反馈语料库的结果。
方法:2011 年至 2018 年间,艾伯塔省卫生服务部门收到了来自 806 个护理设施的 76163 名患者的意见,这些意见涉及 163 个城市,包括医院、诊所、社区护理中心和养老院,覆盖了一个拥有 440 万人口的省份。该省现有的框架要求对预定义类别进行手动标记。我们应用了一种自动化潜在狄利克雷分配(LDA)为基础的主题建模算法来识别这些意见中的主题,并由此产生一个无框架的分类。
结果:LDA 模型产生了 40 个主题,经过研究人员的手动解释,这些主题被减少到 28 个连贯的主题。确定的最常见主题是导致延误的沟通问题(频率:10.58%)、老年患者的社区护理(8.82%)、与护士的互动(8.80%)和急诊科护理(7.52%)。许多患者的意见被归入多个主题。有些是现有框架中更具体的类别(例如,导致延误的沟通问题),而另一些则是新颖的(例如,在不合适的场所吸烟)。
讨论:LDA 生成的主题比手动标记的类别更为细致入微。例如,LDA 发现,社区护理方面的问题与老年人护理方面的问题有关,为洞察和行动提供了机会。
结论:我们的研究结果概述了在一个大型卫生系统中患者所共同关注的问题范围,并展示了使用 LDA 识别患者关注类别有用性。
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