ArticleJournal of medical Internet research2021
Prediction of Readmission in Geriatric Patients From Clinical Notes: Retrospective Text Mining Study.
Article in Journal of medical Internet research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Improving the Prognostic Evaluation Precision of Hospital Outcomes for Heart Failure Using Admission Notes and Clinical Tabular Data: Multimodal Deep Learning Model.Journal of medical Internet research · 2024Article
- Predicting COVID-19 Symptoms From Free Text in Medical Records Using Artificial Intelligence: Feasibility Study.JMIR medical informatics · 2022Article
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9 authors.
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Abstract
backgroundPrior literature suggests that psychosocial factors adversely impact health and health care utilization outcomes. However, psychosocial factors are typically not captured by the structured data in electronic medical records (EMRs) but are rather recorded as free text in different types of clinical notes.
objectiveWe here propose a text-mining approach to analyze EMRs to identify older adults with key psychosocial factors that predict adverse health care utilization outcomes, measured by 30-day readmission. The psychological factors were appended to the LACE (Length of stay, Acuity of the admission, Comorbidity of the patient, and Emergency department use) Index for Readmission to improve the prediction of readmission risk.
methodsWe performed a retrospective analysis using EMR notes of 43,216 hospitalization encounters in a hospital from January 1, 2017 to February 28, 2019. The mean age of the cohort was 67.51 years (SD 15.87), the mean length of stay was 5.57 days (SD 10.41), and the mean intensive care unit stay was 5% (SD 22%). We employed text-mining techniques to extract psychosocial topics that are representative of these patients and tested the utility of these topics in predicting 30-day hospital readmission beyond the predictive value of the LACE Index for Readmission.
resultsThe added text-mined factors improved the area under the receiver operating characteristic curve of the readmission prediction by 8.46% for geriatric patients, 6.99% for the general hospital population, and 6.64% for frequent admitters. Medical social workers and case managers captured more of the psychosocial text topics than physicians.
conclusionsThe results of this study demonstrate the feasibility of extracting psychosocial factors from EMR clinical notes and the value of these notes in improving readmission risk prediction. Psychosocial profiles of patients can be curated and quantified from text mining clinical notes and these profiles can be successfully applied to artificial intelligence models to improve readmission risk prediction.
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