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Accelerated curation of checkpoint inhibitor-induced colitis cases from electronic health records.

作者信息

Rahman Protiva, Ye Cheng, Mittendorf Kathleen F, Lenoue-Newton Michele, Micheel Christine, Wolber Jan, Osterman Travis, Fabbri Daniel

机构信息

Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

出版信息

JAMIA Open. 2023 Apr 1;6(1):ooad017. doi: 10.1093/jamiaopen/ooad017. eCollection 2023 Apr.


DOI:10.1093/jamiaopen/ooad017
PMID:37012912
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10066800/
Abstract

OBJECTIVE: Automatically identifying patients at risk of immune checkpoint inhibitor (ICI)-induced colitis allows physicians to improve patientcare. However, predictive models require training data curated from electronic health records (EHR). Our objective is to automatically identify notes documenting ICI-colitis cases to accelerate data curation. MATERIALS AND METHODS: We present a data pipeline to automatically identify ICI-colitis from EHR notes, accelerating chart review. The pipeline relies on BERT, a state-of-the-art natural language processing (NLP) model. The first stage of the pipeline segments long notes using keywords identified through a logistic classifier and applies BERT to identify ICI-colitis notes. The next stage uses a second BERT model tuned to identify false positive notes and remove notes that were likely positive for mentioning colitis as a side-effect. The final stage further accelerates curation by highlighting the colitis-relevant portions of notes. Specifically, we use BERT's attention scores to find high-density regions describing colitis. RESULTS: The overall pipeline identified colitis notes with 84% precision and reduced the curator note review load by 75%. The segment BERT classifier had a high recall of 0.98, which is crucial to identify the low incidence (<10%) of colitis. DISCUSSION: Curation from EHR notes is a burdensome task, especially when the curation topic is complicated. Methods described in this work are not only useful for ICI colitis but can also be adapted for other domains. CONCLUSION: Our extraction pipeline reduces manual note review load and makes EHR data more accessible for research.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/699f/10066800/a84a80d4ed41/ooad017f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/699f/10066800/f0ae35ad5d26/ooad017f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/699f/10066800/99d8964e705f/ooad017f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/699f/10066800/8e3d47bd0a79/ooad017f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/699f/10066800/a84a80d4ed41/ooad017f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/699f/10066800/f0ae35ad5d26/ooad017f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/699f/10066800/99d8964e705f/ooad017f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/699f/10066800/8e3d47bd0a79/ooad017f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/699f/10066800/a84a80d4ed41/ooad017f4.jpg

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Accelerated curation of checkpoint inhibitor-induced colitis cases from electronic health records.

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引用本文的文献

[1]
Shareable artificial intelligence to extract cancer outcomes from electronic health records for precision oncology research.

Nat Commun. 2024-11-12

[2]
Health Care Language Models and Their Fine-Tuning for Information Extraction: Scoping Review.

JMIR Med Inform. 2024-10-21

[3]
Prediction of Effectiveness and Toxicities of Immune Checkpoint Inhibitors Using Real-World Patient Data.

JCO Clin Cancer Inform. 2024-2

本文引用的文献

[1]
Amplifying Domain Expertise in Clinical Data Pipelines.

JMIR Med Inform. 2020-11-5

[2]
Snorkel: Rapid Training Data Creation with Weak Supervision.

Proceedings VLDB Endowment. 2017-11

[3]
Immune checkpoint inhibitor-induced gastrointestinal and hepatic injury: pathologists' perspective.

J Clin Pathol. 2018-4-27

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