J Am Med Inform Assoc - Automated extraction of ejection fraction for quality measurement using regular expressions in Unstructured Information Management Architecture (UIMA) for heart failure.

Tópicos

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Resumo

JECTIVES: Left ventricular ejection fraction (EF) is a key component of heart failure quality measures used within the Department of Veteran Affairs (VA). Our goals were to build a natural language processing system to extract the EF from free-text echocardiogram reports to automate measurement reporting and to validate the accuracy of the system using a comparison reference standard developed through human review. This project was a Translational Use Case Project within the VA Consortium for Healthcare Informatics.MATERIALS AND METHODS: We created a set of regular expressions and rules to capture the EF using a random sample of 765 echocardiograms from seven VA medical centers. The documents were randomly assigned to two sets: a set of 275 used for training and a second set of 490 used for testing and validation. To establish the reference standard, two independent reviewers annotated all documents in both sets; a third reviewer adjudicated disagreements.RESULTS: System test results for document-level classification of EF of <40% had a sensitivity (recall) of 98.41%, a specificity of 100%, a positive predictive value (precision) of 100%, and an F measure of 99.2%. System test results at the concept level had a sensitivity of 88.9% (95% CI 87.7% to 90.0%), a positive predictive value of 95% (95% CI 94.2% to 95.9%), and an F measure of 91.9% (95% CI 91.2% to 92.7%).DISCUSSION: An EF value of <40% can be accurately identified in VA echocardiogram reports.CONCLUSIONS: An automated information extraction system can be used to accurately extract EF for quality measurement.

Resumo Limpo

jectiv left ventricular eject fraction ef key compon heart failur qualiti measur use within depart veteran affair va goal build natur languag process system extract ef freetext echocardiogram report autom measur report valid accuraci system use comparison refer standard develop human review project translat use case project within va consortium healthcar informaticsmateri method creat set regular express rule captur ef use random sampl echocardiogram seven va medic center document random assign two set set use train second set use test valid establish refer standard two independ review annot document set third review adjud disagreementsresult system test result documentlevel classif ef sensit recal specif posit predict valu precis f measur system test result concept level sensit ci posit predict valu ci f measur ci discuss ef valu can accur identifi va echocardiogram reportsconclus autom inform extract system can use accur extract ef qualiti measur

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