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  • 标题:Unstructured Text in EMR Improves Prediction of Death after Surgery in Children
  • 作者:Oguz Akbilgic ; Oguz Akbilgic ; Ramin Homayouni
  • 期刊名称:Informatics
  • 电子版ISSN:2227-9709
  • 出版年度:2019
  • 卷号:6
  • 期号:1
  • 页码:4
  • DOI:10.3390/informatics6010004
  • 语种:English
  • 出版社:MDPI Publishing
  • 摘要: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 6497 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 a text-based risk score to predict death within 30 days of surgery. In addition, we evaluated the performance of a hybrid model that included the text-based risk score along with structured data pertaining to clinical risk factors. The C-statistic of a logistic regression model with five-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.
  • 关键词:post-operative death; unstructured data; logistic regression; text mining; surgery outcome post-operative death ; unstructured data ; logistic regression ; text mining ; surgery outcome
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