Locating Youth Exposed to Parental Justice Involvement in the Electronic Health Record: Development of a Natural Language Processing Model

BackgroundParental justice involvement (eg, prison, jail, parole, or probation) is an unfortunately common and disruptive household adversity for many US youths, disproportionately affecting families of color and rural families. Data on this adversity has not been captured ro...

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Main Authors: Samantha Boch, Syed-Amad Hussain, Sven Bambach, Cameron DeShetler, Deena Chisolm, Simon Linwood
Format: Article
Language:English
Published: JMIR Publications 2022-03-01
Series:JMIR Pediatrics and Parenting
Online Access:https://pediatrics.jmir.org/2022/1/e33614
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author Samantha Boch
Syed-Amad Hussain
Sven Bambach
Cameron DeShetler
Deena Chisolm
Simon Linwood
author_facet Samantha Boch
Syed-Amad Hussain
Sven Bambach
Cameron DeShetler
Deena Chisolm
Simon Linwood
author_sort Samantha Boch
collection DOAJ
description BackgroundParental justice involvement (eg, prison, jail, parole, or probation) is an unfortunately common and disruptive household adversity for many US youths, disproportionately affecting families of color and rural families. Data on this adversity has not been captured routinely in pediatric health care settings, and if it is, it is not discrete nor able to be readily analyzed for purposes of research. ObjectiveIn this study, we outline our process training a state-of-the-art natural language processing model using unstructured clinician notes of one large pediatric health system to identify patients who have experienced a justice-involved parent. MethodsUsing the electronic health record database of a large Midwestern pediatric hospital-based institution from 2011-2019, we located clinician notes (of any type and written by any type of provider) that were likely to contain such evidence of family justice involvement via a justice-keyword search (eg, prison and jail). To train and validate the model, we used a labeled data set of 7500 clinician notes identifying whether the patient was ever exposed to parental justice involvement. We calculated the precision and recall of the model and compared those rates to the keyword search. ResultsThe development of the machine learning model increased the precision (positive predictive value) of locating children affected by parental justice involvement in the electronic health record from 61% (a simple keyword search) to 92%. ConclusionsThe use of machine learning may be a feasible approach to addressing the gaps in our understanding of the health and health services of underrepresented youth who encounter childhood adversities not routinely captured—particularly for children of justice-involved parents.
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spelling doaj.art-59259719eeef439891791396981b8fd92023-08-28T21:07:05ZengJMIR PublicationsJMIR Pediatrics and Parenting2561-67222022-03-0151e3361410.2196/33614Locating Youth Exposed to Parental Justice Involvement in the Electronic Health Record: Development of a Natural Language Processing ModelSamantha Bochhttps://orcid.org/0000-0003-1757-1662Syed-Amad Hussainhttps://orcid.org/0000-0002-7529-8644Sven Bambachhttps://orcid.org/0000-0002-0411-6073Cameron DeShetlerhttps://orcid.org/0000-0002-3256-3719Deena Chisolmhttps://orcid.org/0000-0001-5297-9087Simon Linwoodhttps://orcid.org/0000-0003-2876-2042 BackgroundParental justice involvement (eg, prison, jail, parole, or probation) is an unfortunately common and disruptive household adversity for many US youths, disproportionately affecting families of color and rural families. Data on this adversity has not been captured routinely in pediatric health care settings, and if it is, it is not discrete nor able to be readily analyzed for purposes of research. ObjectiveIn this study, we outline our process training a state-of-the-art natural language processing model using unstructured clinician notes of one large pediatric health system to identify patients who have experienced a justice-involved parent. MethodsUsing the electronic health record database of a large Midwestern pediatric hospital-based institution from 2011-2019, we located clinician notes (of any type and written by any type of provider) that were likely to contain such evidence of family justice involvement via a justice-keyword search (eg, prison and jail). To train and validate the model, we used a labeled data set of 7500 clinician notes identifying whether the patient was ever exposed to parental justice involvement. We calculated the precision and recall of the model and compared those rates to the keyword search. ResultsThe development of the machine learning model increased the precision (positive predictive value) of locating children affected by parental justice involvement in the electronic health record from 61% (a simple keyword search) to 92%. ConclusionsThe use of machine learning may be a feasible approach to addressing the gaps in our understanding of the health and health services of underrepresented youth who encounter childhood adversities not routinely captured—particularly for children of justice-involved parents.https://pediatrics.jmir.org/2022/1/e33614
spellingShingle Samantha Boch
Syed-Amad Hussain
Sven Bambach
Cameron DeShetler
Deena Chisolm
Simon Linwood
Locating Youth Exposed to Parental Justice Involvement in the Electronic Health Record: Development of a Natural Language Processing Model
JMIR Pediatrics and Parenting
title Locating Youth Exposed to Parental Justice Involvement in the Electronic Health Record: Development of a Natural Language Processing Model
title_full Locating Youth Exposed to Parental Justice Involvement in the Electronic Health Record: Development of a Natural Language Processing Model
title_fullStr Locating Youth Exposed to Parental Justice Involvement in the Electronic Health Record: Development of a Natural Language Processing Model
title_full_unstemmed Locating Youth Exposed to Parental Justice Involvement in the Electronic Health Record: Development of a Natural Language Processing Model
title_short Locating Youth Exposed to Parental Justice Involvement in the Electronic Health Record: Development of a Natural Language Processing Model
title_sort locating youth exposed to parental justice involvement in the electronic health record development of a natural language processing model
url https://pediatrics.jmir.org/2022/1/e33614
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