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Eyre H, Alba PR, Gibson CJ, Gatsby E, Lynch KE, Patterson OV, DuVall SL. Bridging information gaps in menopause status classification through natural language processing. JAMIA Open 2024; 7:ooae013. [PMID: 38419670 PMCID: PMC10901606 DOI: 10.1093/jamiaopen/ooae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 01/22/2024] [Accepted: 02/06/2024] [Indexed: 03/02/2024] Open
Abstract
Objective To use natural language processing (NLP) of clinical notes to augment existing structured electronic health record (EHR) data for classification of a patient's menopausal status. Materials and methods A rule-based NLP system was designed to capture evidence of a patient's menopause status including dates of a patient's last menstrual period, reproductive surgeries, and postmenopause diagnosis as well as their use of birth control and menstrual interruptions. NLP-derived output was used in combination with structured EHR data to classify a patient's menopausal status. NLP processing and patient classification were performed on a cohort of 307 512 female Veterans receiving healthcare at the US Department of Veterans Affairs (VA). Results NLP was validated at 99.6% precision. Including the NLP-derived data into a menopause phenotype increased the number of patients with data relevant to their menopausal status by 118%. Using structured codes alone, 81 173 (27.0%) are able to be classified as postmenopausal or premenopausal. However, with the inclusion of NLP, this number increased 167 804 (54.6%) patients. The premenopausal category grew by 532.7% with the inclusion of NLP data. Discussion By employing NLP, it became possible to identify documented data elements that predate VA care, originate outside VA networks, or have no corresponding structured field in the VA EHR that would be otherwise inaccessible for further analysis. Conclusion NLP can be used to identify concepts relevant to a patient's menopausal status in clinical notes. Adding NLP-derived data to an algorithm classifying a patient's menopausal status significantly increases the number of patients classified using EHR data, ultimately enabling more detailed assessments of the impact of menopause on health outcomes.
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Affiliation(s)
- Hannah Eyre
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT 84113, United States
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84112, United States
| | - Patrick R Alba
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT 84113, United States
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84112, United States
| | - Carolyn J Gibson
- San Francisco VA Healthcare System, San Francisco, CA 94121, United States
- University of California, San Francisco, San Francisco, CA 94115, United States
| | - Elise Gatsby
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT 84113, United States
| | - Kristine E Lynch
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT 84113, United States
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84112, United States
| | - Olga V Patterson
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT 84113, United States
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84112, United States
| | - Scott L DuVall
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT 84113, United States
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84112, United States
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