Near Real-time Natural Language Processing for the Extraction of Abdominal Aortic Aneurysm Diagnoses From Radiology Reports: Algorithm Development and Validation Study

BackgroundManagement of abdominal aortic aneurysms (AAAs) requires serial imaging surveillance to evaluate the aneurysm dimension. Natural language processing (NLP) has been previously developed to retrospectively identify patients with AAA from electronic health records (EHR...

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Main Authors: Simon Gaviria-Valencia, Sean P Murphy, Vinod C Kaggal, Robert D McBane II, Thom W Rooke, Rajeev Chaudhry, Mateo Alzate-Aguirre, Adelaide M Arruda-Olson
Format: Article
Language:English
Published: JMIR Publications 2023-02-01
Series:JMIR Medical Informatics
Online Access:https://medinform.jmir.org/2023/1/e40964
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author Simon Gaviria-Valencia
Sean P Murphy
Vinod C Kaggal
Robert D McBane II
Thom W Rooke
Rajeev Chaudhry
Mateo Alzate-Aguirre
Adelaide M Arruda-Olson
author_facet Simon Gaviria-Valencia
Sean P Murphy
Vinod C Kaggal
Robert D McBane II
Thom W Rooke
Rajeev Chaudhry
Mateo Alzate-Aguirre
Adelaide M Arruda-Olson
author_sort Simon Gaviria-Valencia
collection DOAJ
description BackgroundManagement of abdominal aortic aneurysms (AAAs) requires serial imaging surveillance to evaluate the aneurysm dimension. Natural language processing (NLP) has been previously developed to retrospectively identify patients with AAA from electronic health records (EHRs). However, there are no reported studies that use NLP to identify patients with AAA in near real-time from radiology reports. ObjectiveThis study aims to develop and validate a rule-based NLP algorithm for near real-time automatic extraction of AAA diagnosis from radiology reports for case identification. MethodsThe AAA-NLP algorithm was developed and deployed to an EHR big data infrastructure for near real-time processing of radiology reports from May 1, 2019, to September 2020. NLP extracted named entities for AAA case identification and classified subjects as cases and controls. The reference standard to assess algorithm performance was a manual review of processed radiology reports by trained physicians following standardized criteria. Reviewers were blinded to the diagnosis of each subject. The AAA-NLP algorithm was refined in 3 successive iterations. For each iteration, the AAA-NLP algorithm was modified based on performance compared to the reference standard. ResultsA total of 360 reports were reviewed, of which 120 radiology reports were randomly selected for each iteration. At each iteration, the AAA-NLP algorithm performance improved. The algorithm identified AAA cases in near real-time with high positive predictive value (0.98), sensitivity (0.95), specificity (0.98), F1 score (0.97), and accuracy (0.97). ConclusionsImplementation of NLP for accurate identification of AAA cases from radiology reports with high performance in near real time is feasible. This NLP technique will support automated input for patient care and clinical decision support tools for the management of patients with AAA.  
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spelling doaj.art-0b07e2770cde4945b22e21b0472cc5d82023-08-28T23:47:06ZengJMIR PublicationsJMIR Medical Informatics2291-96942023-02-0111e4096410.2196/40964Near Real-time Natural Language Processing for the Extraction of Abdominal Aortic Aneurysm Diagnoses From Radiology Reports: Algorithm Development and Validation StudySimon Gaviria-Valenciahttps://orcid.org/0000-0003-3156-2412Sean P Murphyhttps://orcid.org/0000-0002-6582-4065Vinod C Kaggalhttps://orcid.org/0000-0003-0944-2211Robert D McBane IIhttps://orcid.org/0000-0001-8727-8029Thom W Rookehttps://orcid.org/0000-0003-3089-3156Rajeev Chaudhryhttps://orcid.org/0000-0003-1249-5656Mateo Alzate-Aguirrehttps://orcid.org/0000-0003-1129-238XAdelaide M Arruda-Olsonhttps://orcid.org/0000-0001-9541-9899 BackgroundManagement of abdominal aortic aneurysms (AAAs) requires serial imaging surveillance to evaluate the aneurysm dimension. Natural language processing (NLP) has been previously developed to retrospectively identify patients with AAA from electronic health records (EHRs). However, there are no reported studies that use NLP to identify patients with AAA in near real-time from radiology reports. ObjectiveThis study aims to develop and validate a rule-based NLP algorithm for near real-time automatic extraction of AAA diagnosis from radiology reports for case identification. MethodsThe AAA-NLP algorithm was developed and deployed to an EHR big data infrastructure for near real-time processing of radiology reports from May 1, 2019, to September 2020. NLP extracted named entities for AAA case identification and classified subjects as cases and controls. The reference standard to assess algorithm performance was a manual review of processed radiology reports by trained physicians following standardized criteria. Reviewers were blinded to the diagnosis of each subject. The AAA-NLP algorithm was refined in 3 successive iterations. For each iteration, the AAA-NLP algorithm was modified based on performance compared to the reference standard. ResultsA total of 360 reports were reviewed, of which 120 radiology reports were randomly selected for each iteration. At each iteration, the AAA-NLP algorithm performance improved. The algorithm identified AAA cases in near real-time with high positive predictive value (0.98), sensitivity (0.95), specificity (0.98), F1 score (0.97), and accuracy (0.97). ConclusionsImplementation of NLP for accurate identification of AAA cases from radiology reports with high performance in near real time is feasible. This NLP technique will support automated input for patient care and clinical decision support tools for the management of patients with AAA.  https://medinform.jmir.org/2023/1/e40964
spellingShingle Simon Gaviria-Valencia
Sean P Murphy
Vinod C Kaggal
Robert D McBane II
Thom W Rooke
Rajeev Chaudhry
Mateo Alzate-Aguirre
Adelaide M Arruda-Olson
Near Real-time Natural Language Processing for the Extraction of Abdominal Aortic Aneurysm Diagnoses From Radiology Reports: Algorithm Development and Validation Study
JMIR Medical Informatics
title Near Real-time Natural Language Processing for the Extraction of Abdominal Aortic Aneurysm Diagnoses From Radiology Reports: Algorithm Development and Validation Study
title_full Near Real-time Natural Language Processing for the Extraction of Abdominal Aortic Aneurysm Diagnoses From Radiology Reports: Algorithm Development and Validation Study
title_fullStr Near Real-time Natural Language Processing for the Extraction of Abdominal Aortic Aneurysm Diagnoses From Radiology Reports: Algorithm Development and Validation Study
title_full_unstemmed Near Real-time Natural Language Processing for the Extraction of Abdominal Aortic Aneurysm Diagnoses From Radiology Reports: Algorithm Development and Validation Study
title_short Near Real-time Natural Language Processing for the Extraction of Abdominal Aortic Aneurysm Diagnoses From Radiology Reports: Algorithm Development and Validation Study
title_sort near real time natural language processing for the extraction of abdominal aortic aneurysm diagnoses from radiology reports algorithm development and validation study
url https://medinform.jmir.org/2023/1/e40964
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