Evidence map›Paper›PMID 32348287›Full record

ArticleJMIR medical informatics2020

The Development of the Military Service Identification Tool: Identifying Military Veterans in a Clinical Research Database Using Natural Language Processing and Machine Learning.

Daniel Leightley, David Pernet, Sumithra Velupillai, Robert J Stewart, Katharine M Mark, Elena Opie, Dominic Murphy, Nicola T Fear, Sharon A M Stevelink

Abstract read
In one paragraph

Article in JMIR medical informatics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Daniel LeightleyKing's Centre for Military Health Research, King's College London, London, United Kingdom.ORCID https://orcid.org/0000-0001-9512-752X
David PernetKing's Centre for Military Health Research, King's College London, London, United Kingdom.ORCID https://orcid.org/0000-0002-7469-0150
Sumithra VelupillaiInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.ORCID https://orcid.org/0000-0002-4178-2980
Robert J StewartInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.ORCID https://orcid.org/0000-0002-4435-6397
Katharine M MarkKing's Centre for Military Health Research, King's College London, London, United Kingdom.ORCID https://orcid.org/0000-0002-8527-665X
Elena OpieKing's Centre for Military Health Research, King's College London, London, United Kingdom.ORCID https://orcid.org/0000-0002-7065-1509
Dominic MurphyKing's Centre for Military Health Research, King's College London, London, United Kingdom.ORCID https://orcid.org/0000-0002-9530-2743
Nicola T FearKing's Centre for Military Health Research, King's College London, London, United Kingdom.ORCID https://orcid.org/0000-0002-5792-2925
Sharon A M StevelinkKing's Centre for Military Health Research, King's College London, London, United Kingdom.ORCID https://orcid.org/0000-0002-7655-7986

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElectronic health care records (EHRs) are a rich source of health-related information, with potential for secondary research use. In the United Kingdom, there is no national marker for identifying those who have previously served in the Armed Forces, making analysis of the health and well-being of veterans using EHRs difficult.

objectiveThis study aimed to develop a tool to identify veterans from free-text clinical documents recorded in a psychiatric EHR database.

methodsVeterans were manually identified using the South London and Maudsley (SLaM) Biomedical Research Centre Clinical Record Interactive Search-a database holding secondary mental health care electronic records for the SLaM National Health Service Foundation Trust. An iterative approach was taken; first, a structured query language (SQL) method was developed, which was then refined using natural language processing and machine learning to create the Military Service Identification Tool (MSIT) to identify if a patient was a civilian or veteran. Performance, defined as correct classification of veterans compared with incorrect classification, was measured using positive predictive value, negative predictive value, sensitivity, F1 score, and accuracy (otherwise termed Youden Index).

resultsA gold standard dataset of 6672 free-text clinical documents was manually annotated by human coders. Of these documents, 66.00% (4470/6672) were then used to train the SQL and MSIT approaches and 34.00% (2202/6672) were used for testing the approaches. To develop the MSIT, an iterative 2-stage approach was undertaken. In the first stage, an SQL method was developed to identify veterans using a keyword rule-based approach. This approach obtained an accuracy of 0.93 in correctly predicting civilians and veterans, a positive predictive value of 0.81, a sensitivity of 0.75, and a negative predictive value of 0.95. This method informed the second stage, which was the development of the MSIT using machine learning, which, when tested, obtained an accuracy of 0.97, a positive predictive value of 0.90, a sensitivity of 0.91, and a negative predictive value of 0.98.

conclusionsThe MSIT has the potential to be used in identifying veterans in the United Kingdom from free-text clinical documents, providing new and unique insights into the health and well-being of this population and their use of mental health care services.

Indexed as

electronic health care recordsmachine learningmental healthmilitary personnelnatural language processingveteran

Identifiers

PMID32348287
PMCPMC7281146

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.