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Patell R, Zwicker JI, Singh R, Mantha S. Machine learning in cancer-associated thrombosis: hype or hope in untangling the clot. BLEEDING, THROMBOSIS AND VASCULAR BIOLOGY 2024; 3:21-29. [PMID: 39323613 PMCID: PMC11423546 DOI: 10.4081/btvb.2024.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/22/2024] [Indexed: 09/27/2024]
Abstract
The goal of machine learning (ML) is to create informative signals and useful tasks by leveraging large datasets to derive computational algorithms. ML has the potential to revolutionize the healthcare industry by boosting productivity, enhancing safe and effective patient care, and lightening the load on clinicians. In addition to gaining mechanistic insights into cancer-associated thrombosis (CAT), ML can be used to improve patient outcomes, streamline healthcare delivery, and spur innovation. Our review paper delves into the present and potential applications of this cutting-edge technology, encompassing three areas: i) computer vision-assisted diagnosis of thromboembolism from radiology data; ii) case detection from electronic health records using natural language processing; iii) algorithms for CAT prediction and risk stratification. The availability of large, well-annotated, high-quality datasets, overfitting, limited generalizability, the risk of propagating inherent bias, and a lack of transparency among patients and clinicians are among the challenges that must be overcome in order to effectively develop ML in the health sector. To guarantee that this powerful instrument can be utilized to maximize innovation in CAT, clinicians can collaborate with stakeholders such as computer scientists, regulatory bodies, and patient groups.
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Affiliation(s)
- Rushad Patell
- Division of Medical Oncology and Hematology, Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
| | - Jeffrey I. Zwicker
- Department of Medicine, Hematology Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Rohan Singh
- Department of Digital Informatics & Technology Solutions, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Simon Mantha
- Department of Medicine, Hematology Service, Memorial Sloan Kettering Cancer Center, New York, NY
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Roberts K, Chin AT, Loewy K, Pompeii L, Shin H, Rider NL. Natural language processing of clinical notes enables early inborn error of immunity risk ascertainment. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100224. [PMID: 38439946 PMCID: PMC10910118 DOI: 10.1016/j.jacig.2024.100224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/24/2023] [Accepted: 01/21/2024] [Indexed: 03/06/2024]
Abstract
Background There are now approximately 450 discrete inborn errors of immunity (IEI) described; however, diagnostic rates remain suboptimal. Use of structured health record data has proven useful for patient detection but may be augmented by natural language processing (NLP). Here we present a machine learning model that can distinguish patients from controls significantly in advance of ultimate diagnosis date. Objective We sought to create an NLP machine learning algorithm that could identify IEI patients early during the disease course and shorten the diagnostic odyssey. Methods Our approach involved extracting a large corpus of IEI patient clinical-note text from a major referral center's electronic health record (EHR) system and a matched control corpus for comparison. We built text classifiers with simple machine learning methods and trained them on progressively longer time epochs before date of diagnosis. Results The top performing NLP algorithm effectively distinguished cases from controls robustly 36 months before ultimate clinical diagnosis (area under precision recall curve > 0.95). Corpus analysis demonstrated that statistically enriched, IEI-relevant terms were evident 24+ months before diagnosis, validating that clinical notes can provide a signal for early prediction of IEI. Conclusion Mining EHR notes with NLP holds promise for improving early IEI patient detection.
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Affiliation(s)
- Kirk Roberts
- McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, Tex
| | - Aaron T. Chin
- Division of Immunology, Allergy, and Rheumatology, University of California, Los Angeles, Calif
| | | | - Lisa Pompeii
- Department of Patient Services, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Harold Shin
- College of Osteopathic Medicine, Liberty University, Lynchburg, Va
| | - Nicholas L. Rider
- Division of Health System & Implementation Science, Virginia Tech Carilion School of Medicine, Roanoke, Va
- Section of Allergy and Immunology, Carilion Clinic, Roanoke, Va
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3
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Chen VW, Rosen T, Dong Y, Richardson PA, Kramer JR, Petersen LA, Massarweh NN. Case Sampling for Evaluating Hospital Postoperative Morbidity in US Surgical Quality Improvement Programs. JAMA Surg 2024; 159:315-322. [PMID: 38150240 PMCID: PMC10753439 DOI: 10.1001/jamasurg.2023.6524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/04/2023] [Indexed: 12/28/2023]
Abstract
Importance US surgical quality improvement (QI) programs use data from a systematic sample of surgical cases, rather than universal review of all cases, to assess and compare risk-adjusted hospital postoperative complication rates. Given decreasing postoperative complication rates over time and the types of cases eligible for abstraction, it is unclear whether case sampling is robust for identifying hospitals with higher than expected complications. Objective To compare the assessment of hospital 30-day complication rates derived from sampling strategy used by some US surgical QI programs relative to universal review of all cases. Design, Setting, and Participants This US hospital-level analysis took place from January 1, 2016, through September 30, 2020. Data analysis was performed from July 1, 2022, through December 21, 2022. Quarterly, risk-adjusted, 30-day complication observed to expected (O-E) ratios were calculated for each hospital using the sample (n = 502 730) and universal review (n = 1 725 364). Outlier hospitals (ie, those with higher than expected mortality) were identified using an O-E ratio significantly greater than 1.0. Patients 18 years and older who underwent a noncardiac operation at US Department of Veterans Affairs (VA) hospitals with a record in the VA Surgical Quality Improvement Program (systematic sample) and the VA Corporate Data Warehouse surgical domain (100% of surgical cases) were included. Main Outcome Measure Thirty-day complications. Results Most patients in both the representative sample and the universal sample were men (90.2% vs 91.2%) and White (74.7% vs 74.5%). Overall, 30-day complication rates were 7.6% and 5.3% for the sample and universal review cohorts, respectively (P < .001). Over 2145 hospital quarters of data, hospitals were identified as an outlier in 15.0% of quarters using the sample and 18.2% with universal review. Average hospital quarterly complication rates were 4.7%, 7.2%, and 7.4% for outliers identified using the sample only, universal review only, and concurrent identification in both data sources, respectively. For nonsampled cases, average hospital quarterly complication rates were 7.0% at outliers and 4.4% at nonoutliers. Among outlier hospital quarters in the sample, 54.2% were concurrently identified with universal review. For those identified with universal review, 44.6% were concurrently identified using the sample. Conclusion In this observational study, case sampling identified less than half of hospitals with excess risk-adjusted postoperative complication rates. Future work is needed to ascertain how to best use currently collected data and whether alternative data collection strategies may be needed to better inform local QI efforts.
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Affiliation(s)
- Vivi W. Chen
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas
- Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Tracey Rosen
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas
| | - Yongquan Dong
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas
| | - Peter A. Richardson
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Jennifer R. Kramer
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Laura A. Petersen
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Nader N. Massarweh
- Surgical and Perioperative Care, Atlanta VA Health Care System, Decatur, Georgia
- Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
- Department of Surgery, Morehouse School of Medicine, Atlanta, Georgia
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Wang J, de Vale JS, Gupta S, Upadhyaya P, Lisboa FA, Schobel SA, Elster EA, Dente CJ, Buchman TG, Kamaleswaran R. ClotCatcher: a novel natural language model to accurately adjudicate venous thromboembolism from radiology reports. BMC Med Inform Decis Mak 2023; 23:262. [PMID: 37974186 PMCID: PMC10652606 DOI: 10.1186/s12911-023-02369-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION Accurate identification of venous thromboembolism (VTE) is critical to develop replicable epidemiological studies and rigorous predictions models. Traditionally, VTE studies have relied on international classification of diseases (ICD) codes which are inaccurate - leading to misclassification bias. Here, we developed ClotCatcher, a novel deep learning model that uses natural language processing to detect VTE from radiology reports. METHODS Radiology reports to detect VTE were obtained from patients admitted to Emory University Hospital (EUH) and Grady Memorial Hospital (GMH). Data augmentation was performed using the Google PEGASUS paraphraser. This data was then used to fine-tune ClotCatcher, a novel deep learning model. ClotCatcher was validated on both the EUH dataset alone and GMH dataset alone. RESULTS The dataset contained 1358 studies from EUH and 915 studies from GMH (n = 2273). The dataset contained 1506 ultrasound studies with 528 (35.1%) studies positive for VTE, and 767 CT studies with 91 (11.9%) positive for VTE. When validated on the EUH dataset, ClotCatcher performed best (AUC = 0.980) when trained on both EUH and GMH dataset without paraphrasing. When validated on the GMH dataset, ClotCatcher performed best (AUC = 0.995) when trained on both EUH and GMH dataset with paraphrasing. CONCLUSION ClotCatcher, a novel deep learning model with data augmentation rapidly and accurately adjudicated the presence of VTE from radiology reports. Applying ClotCatcher to large databases would allow for rapid and accurate adjudication of incident VTE. This would reduce misclassification bias and form the foundation for future studies to estimate individual risk for patient to develop incident VTE.
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Affiliation(s)
- Jeffrey Wang
- Department of Biomedical Informatics, Emory University School of Medicine, 1462 Clifton Road, Suite 504, Atlanta, GA, 30322, USA.
| | - Joao Souza de Vale
- Department of Biomedical Informatics, Emory University School of Medicine, 1462 Clifton Road, Suite 504, Atlanta, GA, 30322, USA
| | - Saransh Gupta
- Department of Biomedical Informatics, Emory University School of Medicine, 1462 Clifton Road, Suite 504, Atlanta, GA, 30322, USA
| | - Pulakesh Upadhyaya
- Department of Biomedical Informatics, Emory University School of Medicine, 1462 Clifton Road, Suite 504, Atlanta, GA, 30322, USA
| | - Felipe A Lisboa
- Surgical Critical Care Initiative (SC2i), Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
- Department of Surgery, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MD, 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, 20817, USA
| | - Seth A Schobel
- Surgical Critical Care Initiative (SC2i), Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
- Department of Surgery, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MD, 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, 20817, USA
| | - Eric A Elster
- Surgical Critical Care Initiative (SC2i), Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
- Department of Surgery, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MD, 20814, USA
| | - Christopher J Dente
- Surgical Critical Care Initiative (SC2i), Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
- Emory Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
- Grady Memorial Hospital, Atlanta, GA, USA
| | - Timothy G Buchman
- Surgical Critical Care Initiative (SC2i), Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
- Emory Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
- Emory Critical Care Center, Atlanta, GA, USA
| | - Rishikesan Kamaleswaran
- Department of Biomedical Informatics, Emory University School of Medicine, 1462 Clifton Road, Suite 504, Atlanta, GA, 30322, USA
- Surgical Critical Care Initiative (SC2i), Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
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Jin ZG, Zhang H, Tai MH, Yang Y, Yao Y, Guo YT. Natural Language Processing in a Clinical Decision Support System for the Identification of Venous Thromboembolism: Algorithm Development and Validation. J Med Internet Res 2023; 25:e43153. [PMID: 37093636 PMCID: PMC10167583 DOI: 10.2196/43153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/20/2022] [Accepted: 03/29/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND It remains unknown whether capturing data from electronic health records (EHRs) using natural language processing (NLP) can improve venous thromboembolism (VTE) detection in different clinical settings. OBJECTIVE The aim of this study was to validate the NLP algorithm in a clinical decision support system for VTE risk assessment and integrated care (DeVTEcare) to identify VTEs from EHRs. METHODS All inpatients aged ≥18 years in the Sixth Medical Center of the Chinese People's Liberation Army General Hospital from January 1 to December 31, 2021, were included as the validation cohort. The sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-, respectively), area under the receiver operating characteristic curve (AUC), and F1-scores along with their 95% CIs were used to analyze the performance of the NLP tool, with manual review of medical records as the reference standard for detecting deep vein thrombosis (DVT) and pulmonary embolism (PE). The primary end point was the performance of the NLP approach embedded into the EHR for VTE identification. The secondary end points were the performances to identify VTE among different hospital departments with different VTE risks. Subgroup analyses were performed among age, sex, and the study season. RESULTS Among 30,152 patients (median age 56 [IQR 41-67] years; 14,247/30,152, 47.3% females), the prevalence of VTE, PE, and DVT was 2.1% (626/30,152), 0.6% (177/30,152), and 1.8% (532/30,152), respectively. The sensitivity, specificity, LR+, LR-, AUC, and F1-score of NLP-facilitated VTE detection were 89.9% (95% CI 87.3%-92.2%), 99.8% (95% CI 99.8%-99.9%), 483 (95% CI 370-629), 0.10 (95% CI 0.08-0.13), 0.95 (95% CI 0.94-0.96), and 0.90 (95% CI 0.90-0.91), respectively. Among departments of surgery, internal medicine, and intensive care units, the highest specificity (100% vs 99.7% vs 98.8%, respectively), LR+ (3202 vs 321 vs 77, respectively), and F1-score (0.95 vs 0.89 vs 0.92, respectively) were in the surgery department (all P<.001). Among low, intermediate, and high VTE risks in hospital departments, the low-risk department had the highest AUC (1.00 vs 0.94 vs 0.96, respectively) and F1-score (0.97 vs 0.90 vs 0.90, respectively) as well as the lowest LR- (0.00 vs 0.13 vs 0.08, respectively) (DeLong test for AUC; all P<.001). Subgroup analysis of the age, sex, and season demonstrated consistently good performance of VTE detection with >87% sensitivity and specificity and >89% AUC and F1-score. The NLP algorithm performed better among patients aged ≤65 years than among those aged >65 years (F1-score 0.93 vs 0.89, respectively; P<.001). CONCLUSIONS The NLP algorithm in our DeVTEcare identified VTE well across different clinical settings, especially in patients in surgery units, departments with low-risk VTE, and patients aged ≤65 years. This algorithm can help to inform accurate in-hospital VTE rates and enhance risk-classified VTE integrated care in future research.
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Affiliation(s)
- Zhi-Geng Jin
- Department of Pulmonary Vascular and Thrombotic Disease, Sixth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hui Zhang
- Department of Pulmonary Vascular and Thrombotic Disease, Sixth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Mei-Hui Tai
- Chinese People's Liberation Army Medical School, Beijing, China
| | - Ying Yang
- Quality Management Division, Sixth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yuan Yao
- Institute for Hospital Management Research, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yu-Tao Guo
- Department of Pulmonary Vascular and Thrombotic Disease, Sixth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
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Kobritz M, Patel V, Rindskopf D, Demyan L, Jarrett M, Coppa G, Antonacci AC. Practice-Based Learning and Improvement: Improving Morbidity and Mortality Review Using Natural Language Processing. J Surg Res 2023; 283:351-356. [PMID: 36427445 DOI: 10.1016/j.jss.2022.10.075] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/21/2022] [Accepted: 10/18/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Practice-Based Learning and Improvement, a core competency identified by the Accreditation Council for Graduate Medical Education, carries importance throughout a physician's career. Practice-Based Learning and Improvement is cultivated by a critical review of complications, yet methods to accurately identify complications are inadequate. Machine-learning algorithms show promise in improving identification of complications. We compare a manual-supplemented natural language processing (ms-NLP) methodology against a validated electronic morbidity and mortality (MM) database, the Morbidity and Mortality Adverse Event Reporting System (MARS) to understand the utility of NLP in MM review. METHODS The number and severity of complications were compared between MARS and ms-NLP of surgical hospitalization discharge summaries among three academic medical centers. Clavien-Dindo (CD) scores were assigned to cases with identified complications and classified into minor (CD I-II) or major (CD III-IV) harm. RESULTS Of 7774 admissions, 987 cases were identified to have 1659 complications by MARS and 1296 by ms-NLP. MARS identified 611 (62%) cases, whereas ms-NLP identified 670 (68%) cases. Less than one-third of cases (299, 30.3%) were detected by both methods. MARS identified a greater number of complications with major harm (457, 46.30%) than did ms-NLP (P < 0.0001). CONCLUSIONS Both a prospectively maintained MM database and ms-NLP review of discharge summaries fail to identify a significant proportion of postoperative complications and overlap 1/3 of the time. ms-NLP more frequently identifies cases with minor complications, whereas prospective voluntary reporting more frequently identifies major complications. The educational benefit of reporting and analysis of complication data may be supplemented by ms-NLP but not replaced by it at this time.
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Affiliation(s)
- Molly Kobritz
- Northwell Health North Shore/Long Island Jewish General Surgery, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
| | - Vihas Patel
- Northwell Health North Shore/Long Island Jewish General Surgery, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - David Rindskopf
- City University of New York, Graduate School And University Center, New York, New York
| | - Lyudmyla Demyan
- Northwell Health North Shore/Long Island Jewish General Surgery, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Mark Jarrett
- Northwell Health North Shore/Long Island Jewish General Surgery, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Gene Coppa
- Northwell Health North Shore/Long Island Jewish General Surgery, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Anthony C Antonacci
- Northwell Health North Shore/Long Island Jewish General Surgery, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
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Schumm M, Hu MY, Sant V, Kim J, Tseng CH, Sanz J, Raman S, Yu R, Livhits M. Automated extraction of incidental adrenal nodules from electronic health records. Surgery 2023; 173:52-58. [PMID: 36207197 DOI: 10.1016/j.surg.2022.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/25/2022] [Accepted: 07/19/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Many adrenal incidentalomas do not undergo appropriate biochemical testing and complete imaging characterization to assess for hormone hypersecretion and malignancy. With the growing availability of clinical narratives in the electronic medical record, automated surveillance using advanced data analytic techniques may represent a promising method to improve management. METHODS A data provisioning process using a series of structured query language scripts was used to abstract all chest and abdominal computed tomography and magnetic resonance imaging reports from an academic health care system in 2018. The narratives and impressions were queried for key text relating to the identification of adrenal incidentalomas. Patients with a history of extra-adrenal malignancy undergoing staging or surveillance imaging were excluded. The prevalence and radiographic characteristics were analyzed. Patients with adrenal incidentalomas newly identified in 2018 were assessed for biochemical testing and nodule stability through August 2021. RESULTS Of 36,618 patients queried, 8,557 were excluded owing to a history of extra-adrenal malignancy. Data from 447 patients were flagged by the structured query language scripts and electronically abstracted. On internal validation, 307/447 (69%) patients were correctly identified as having adrenal nodules (1.1% overall prevalence). The median patient age was 67 years, and 56% were female. The median nodule size was 1.7 (IQR 1.3-2.5) cm, 9% were bilateral, and 63% were low density (unenhanced Hounsfield units <10). Adrenal carcinoma was identified in 10 patients. In 2018, 121 patients were diagnosed with a new adrenal incidentaloma. Of 32 (27%) patients who had follow-up imaging at a median of 1.9 years, 97% of nodules were stable in size. Biochemical testing was performed in 53 patients (44%), of which 31 (26%) had complete hormonal assessment; 14 (26%) were functional nodules: 7 aldosterone-secreting, 4 cortisol-secreting, and 3 pheochromocytoma. CONCLUSION Only one-fourth of patients received appropriate biochemical testing after incidental diagnosis of an adrenal nodule, and most nodules with indeterminate imaging characteristics did not undergo follow-up imaging. Advanced data analytic techniques on electronic imaging reports may aid in the clinical identification and improved management of patients with adrenal incidentalomas.
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Affiliation(s)
- Max Schumm
- Section of Endocrine Surgery, Department of Surgery, University of California-Los Angeles (UCLA) David Geffen School of Medicine, CA.
| | - Ming-Yeah Hu
- Section of Endocrine Surgery, Department of Surgery, University of California-Los Angeles (UCLA) David Geffen School of Medicine, CA. https://twitter.com/MingYeahHu
| | - Vivek Sant
- Section of Endocrine Surgery, Department of Surgery, University of California-Los Angeles (UCLA) David Geffen School of Medicine, CA. https://twitter.com/VivekSantMD
| | - Jiyoon Kim
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Chi-Hong Tseng
- Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA David Geffen School of Medicine, CA
| | - Javier Sanz
- Department of Medicine, Clinical and Translational Science Institute, UCLA David Geffen School of Medicine, Los Angeles, CA
| | - Steven Raman
- Department of Interventional and Diagnostic Radiology, UCLA David Geffen School of Medicine, Los Angeles, CA. https://twitter.com/StevenSRaman_MD
| | - Run Yu
- Division of Endocrinology, Diabetes, and Metabolism; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA
| | - Masha Livhits
- Section of Endocrine Surgery, Department of Surgery, University of California-Los Angeles (UCLA) David Geffen School of Medicine, CA. https://twitter.com/mashalivhitsMD
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Andraska E, Neal M, Handzel R. Utilizing natural language processing in the diagnosis and treatment of venous thromboembolism. Surgery 2021; 170:1183. [PMID: 34325905 DOI: 10.1016/j.surg.2021.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Elizabeth Andraska
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Matthew Neal
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
| | - Robert Handzel
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
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