Akbilgic, O.; Homayouni, R.; Heinrich, K.; Langham, M.R., Jr.; Davis, R.L. Unstructured Text in EMR Improves Prediction of Death after Surgery in Children. Informatics2019, 6, 4.
Akbilgic, O.; Homayouni, R.; Heinrich, K.; Langham, M.R., Jr.; Davis, R.L. Unstructured Text in EMR Improves Prediction of Death after Surgery in Children. Informatics 2019, 6, 4.
Akbilgic, O.; Homayouni, R.; Heinrich, K.; Langham, M.R., Jr.; Davis, R.L. Unstructured Text in EMR Improves Prediction of Death after Surgery in Children. Informatics2019, 6, 4.
Akbilgic, O.; Homayouni, R.; Heinrich, K.; Langham, M.R., Jr.; Davis, R.L. Unstructured Text in EMR Improves Prediction of Death after Surgery in Children. Informatics 2019, 6, 4.
Abstract
Text fields in electronic medical records (EMR) contain information on important factors that influence health outcomes, however, they are underutilized in clinical decision making due to their unstructured nature. We analyzed 6,497 inpatient surgical cases with 719,308 free text notes from Le Bonheur Children’s Hospital EMR. We used a text mining approach on preoperative notes to obtain the text-based risk score algorithm as predictive of death within 30 days of surgery. We studied the additional performance obtained by including text-based risk score as a predictor of death along with other structured data based clinical risk factors. The C-statistic of a logistic regression model with 5-fold cross-validation significantly improved from 0.76 to 0.92 when text-based risk scores were included in addition to structured data. We conclude that preoperative free text notes in EMR include significant information that can predict adverse surgery outcomes.
Keywords
post-operative death; unstructured data; logistic regression; text mining; surgery outcome
Subject
Medicine and Pharmacology, Pediatrics, Perinatology and Child Health
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
