Predicting the target specialty of referral notes to estimate per-specialty wait times with machine learning

<h4>Background</h4> Currently, in Canada, existing health administrative data and hospital-inputted portal systems are used to measure the wait times to receiving a procedure or therapy after a specialist visit. However, due to missing and inconsistent labelling, estimating the wait time...

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Main Authors: Mohamed Abdalla, Hong Lu, Bogdan Pinzaru, Frank Rudzicz, Liisa Jaakkimainen
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9098074/?tool=EBI
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author Mohamed Abdalla
Hong Lu
Bogdan Pinzaru
Frank Rudzicz
Liisa Jaakkimainen
author_facet Mohamed Abdalla
Hong Lu
Bogdan Pinzaru
Frank Rudzicz
Liisa Jaakkimainen
author_sort Mohamed Abdalla
collection DOAJ
description <h4>Background</h4> Currently, in Canada, existing health administrative data and hospital-inputted portal systems are used to measure the wait times to receiving a procedure or therapy after a specialist visit. However, due to missing and inconsistent labelling, estimating the wait time prior to seeing a specialist physician requires costly manual coding to label primary care referral notes. <h4>Methods</h4> In this work, we represent the notes using word-count vectors and develop a logistic regression machine learning model to automatically label the target specialist physician from a primary care referral note. These labels are not available in the administrative system. We also study the effects of note length (measured in number of tokens) and dataset size (measured in number of notes per target specialty) on model performance to help other researchers determine if such an approach may be feasible for them. We then calculate the wait time by linking the specialist type from a primary care referral to a full consultation visit held in Ontario, Canada health administrative data. <h4>Results</h4> For many target specialties, we can reliably (F1Score ≥ 0.70) predict the target specialist type. Doing so enables the automated measurement of wait time from family physician referral to specialist physician visit. Of the six specialties with wait times estimated using both 2008 and 2015 data, two had a substantial increase (defined as a change such that the original value lay outside the 95% confidence interval) in both median and 75th percentile wait times, one had a substantial decrease in both median and 75th percentile wait times, and three has non-substantial increases. <h4>Conclusions</h4> Automating these wait time measurements, which had previously been too time consuming and costly to evaluate at a population level, can be useful for health policy researchers studying the effects of policy decisions on patient access to care.
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spelling doaj.art-7e084183e3d24d038f87492b57e3bae32022-12-22T02:22:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01175Predicting the target specialty of referral notes to estimate per-specialty wait times with machine learningMohamed AbdallaHong LuBogdan PinzaruFrank RudziczLiisa Jaakkimainen<h4>Background</h4> Currently, in Canada, existing health administrative data and hospital-inputted portal systems are used to measure the wait times to receiving a procedure or therapy after a specialist visit. However, due to missing and inconsistent labelling, estimating the wait time prior to seeing a specialist physician requires costly manual coding to label primary care referral notes. <h4>Methods</h4> In this work, we represent the notes using word-count vectors and develop a logistic regression machine learning model to automatically label the target specialist physician from a primary care referral note. These labels are not available in the administrative system. We also study the effects of note length (measured in number of tokens) and dataset size (measured in number of notes per target specialty) on model performance to help other researchers determine if such an approach may be feasible for them. We then calculate the wait time by linking the specialist type from a primary care referral to a full consultation visit held in Ontario, Canada health administrative data. <h4>Results</h4> For many target specialties, we can reliably (F1Score ≥ 0.70) predict the target specialist type. Doing so enables the automated measurement of wait time from family physician referral to specialist physician visit. Of the six specialties with wait times estimated using both 2008 and 2015 data, two had a substantial increase (defined as a change such that the original value lay outside the 95% confidence interval) in both median and 75th percentile wait times, one had a substantial decrease in both median and 75th percentile wait times, and three has non-substantial increases. <h4>Conclusions</h4> Automating these wait time measurements, which had previously been too time consuming and costly to evaluate at a population level, can be useful for health policy researchers studying the effects of policy decisions on patient access to care.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9098074/?tool=EBI
spellingShingle Mohamed Abdalla
Hong Lu
Bogdan Pinzaru
Frank Rudzicz
Liisa Jaakkimainen
Predicting the target specialty of referral notes to estimate per-specialty wait times with machine learning
PLoS ONE
title Predicting the target specialty of referral notes to estimate per-specialty wait times with machine learning
title_full Predicting the target specialty of referral notes to estimate per-specialty wait times with machine learning
title_fullStr Predicting the target specialty of referral notes to estimate per-specialty wait times with machine learning
title_full_unstemmed Predicting the target specialty of referral notes to estimate per-specialty wait times with machine learning
title_short Predicting the target specialty of referral notes to estimate per-specialty wait times with machine learning
title_sort predicting the target specialty of referral notes to estimate per specialty wait times with machine learning
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9098074/?tool=EBI
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