BMC Med Inform Decis Mak - Automated identification of pneumonia in chest radiograph reports in critically ill patients.

Tópicos

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Resumo

CKGROUND: Prior studies demonstrate the suitability of natural language processing (NLP) for identifying pneumonia in chest radiograph (CXR) reports, however, few evaluate this approach in intensive care unit (ICU) patients.METHODS: From a total of 194,615 ICU reports, we empirically developed a lexicon to categorize pneumonia-relevant terms and uncertainty profiles. We encoded lexicon items into unique queries within an NLP software application and designed an algorithm to assign automated interpretations ('positive', 'possible', or 'negative') based on each report's query profile. We evaluated algorithm performance in a sample of 2,466 CXR reports interpreted by physician consensus and in two ICU patient subgroups including those admitted for pneumonia and for rheumatologic/endocrine diagnoses.RESULTS: Most reports were deemed 'negative' (51.8%) by physician consensus. Many were 'possible' (41.7%); only 6.5% were 'positive' for pneumonia. The lexicon included 105 terms and uncertainty profiles that were encoded into 31 NLP queries. Queries identified 534,322 'hits' in the full sample, with 2.7 ? 2.6 'hits' per report. An algorithm, comprised of twenty rules and probability steps, assigned interpretations to reports based on query profiles. In the validation set, the algorithm had 92.7% sensitivity, 91.1% specificity, 93.3% positive predictive value, and 90.3% negative predictive value for differentiating 'negative' from 'positive'/'possible' reports. In the ICU subgroups, the algorithm also demonstrated good performance, misclassifying few reports (5.8%).CONCLUSIONS: Many CXR reports in ICU patients demonstrate frank uncertainty regarding a pneumonia diagnosis. This electronic tool demonstrates promise for assigning automated interpretations to CXR reports by leveraging both terms and uncertainty profiles.

Resumo Limpo

ckground prior studi demonstr suitabl natur languag process nlp identifi pneumonia chest radiograph cxr report howev evalu approach intens care unit icu patientsmethod total icu report empir develop lexicon categor pneumoniarelev term uncertainti profil encod lexicon item uniqu queri within nlp softwar applic design algorithm assign autom interpret posit possibl negat base report queri profil evalu algorithm perform sampl cxr report interpret physician consensus two icu patient subgroup includ admit pneumonia rheumatologicendocrin diagnosesresult report deem negat physician consensus mani possibl posit pneumonia lexicon includ term uncertainti profil encod nlp queri queri identifi hit full sampl hit per report algorithm compris twenti rule probabl step assign interpret report base queri profil valid set algorithm sensit specif posit predict valu negat predict valu differenti negat positiveposs report icu subgroup algorithm also demonstr good perform misclassifi report conclus mani cxr report icu patient demonstr frank uncertainti regard pneumonia diagnosi electron tool demonstr promis assign autom interpret cxr report leverag term uncertainti profil

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