Evidence map›Paper›PMID 38433189›Full record

ArticleBMC medical informatics and decision making2024

Natural language processing to identify lupus nephritis phenotype in electronic health records.

Yu Deng, Jennifer A Pacheco, Anika Ghosh, Anh Chung, Chengsheng Mao, Joshua C Smith, Juan Zhao, Wei-Qi Wei, April Barnado, Chad Dorn and 9 more

Abstract read
In one paragraph

Article in BMC medical informatics and decision making, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Review
  6. Article
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

19 authors.

Yu DengCenter for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Jennifer A PachecoCenter for Genetic Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Anika GhoshCenter for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Anh ChungCenter for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Chengsheng MaoCenter for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Joshua C SmithDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, USA.
Juan ZhaoDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, USA.
Wei-Qi WeiDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, USA.
April BarnadoDepartment of Medicine, Vanderbilt University Medical Center, Nashville, USA.
Chad DornDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, USA.
Chunhua WengDepartment of Biomedical Informatics, Columbia University, New York City, USA.
Cong LiuDepartment of Biomedical Informatics, Columbia University, New York City, USA.
Adam CordonCenter for Genetic Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Jingzhi YuCenter for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Yacob TedlaCenter for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Abel KhoCenter for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Rosalind Ramsey-GoldmanDepartment of Medicine/Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Theresa Walunas *Center for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, USA. t-walunas@northwestern.edu.
Yuan Luo *Center for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, USA. yuan.luo@northwestern.edu.ORCID 0000-0003-0195-7456

Funding

OMOP information model for eMERGE phenotypingU01HG008680 · NHGRI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Wendy K Chung, GEORGE M HRIPCSAK · 2015 to 2026
$13.3M
Resource CoreP30AR072579 · NIAMS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Leena Sharma · 2017 to 2026
$8.3M
Northwestern University Clinical and Translational Science Institute (NUCATS)KL2TR001424 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI SHARMA, LEENA · 2015 to 2023
$8.1M
VGER, the Vanderbilt Genome-Electronic Records ProjectU01HG008672 · NHGRI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI DENNY, JOSHUA C., RODEN, DAN M · 2015 to 2019
$5.1M
Genomic Medicine at Northwestern: Discovery and ImplementationU01HG008673 · NHGRI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI CHISHOLM, REX L, SMITH, MAUREEN E · 2015 to 2019
$4.1M
Predicting risk of systemic autoimmune disease in patients with positive antinuclear antibodiesR01AR080629 · NIAMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Tracy Minan Frech · 2022 to 2026
$2.0M
Using the electronic health record to risk-stratify patients with systemic lupus erythematosusK08AR072757 · NIAMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BARNADO, APRIL LYNN · 2018 to 2022
$817k
An In Silico, Medical Record-based Model for Understanding the INitiation of Autoimmune Events (IMMUNE)R61AR076824 · NIAMS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI KHO, ABEL N., WALUNAS, THERESA L · 2019 to 2019
$395k
NCATS NIH HHS KL2 TR001424NHGRI NIH HHS U01 HG008672NHGRI NIH HHS U01HG008672NHGRI NIH HHS U01 HG008673NHGRI NIH HHS U01HG008673NHGRI NIH HHS U01 HG008680NHGRI NIH HHS U01HG008680NIAMS NIH HHS 1K08 AR072757-01NIAMS NIH HHS 5R21AR072262NIAMS NIH HHS K08 AR072757NIAMS NIH HHS P30 AR072579NIAMS NIH HHS R01 AR080629NIAMS NIH HHS R61 AR076824
6 · The paper itself

Abstract

backgroundSystemic lupus erythematosus (SLE) is a rare autoimmune disorder characterized by an unpredictable course of flares and remission with diverse manifestations. Lupus nephritis, one of the major disease manifestations of SLE for organ damage and mortality, is a key component of lupus classification criteria. Accurately identifying lupus nephritis in electronic health records (EHRs) would therefore benefit large cohort observational studies and clinical trials where characterization of the patient population is critical for recruitment, study design, and analysis. Lupus nephritis can be recognized through procedure codes and structured data, such as laboratory tests. However, other critical information documenting lupus nephritis, such as histologic reports from kidney biopsies and prior medical history narratives, require sophisticated text processing to mine information from pathology reports and clinical notes. In this study, we developed algorithms to identify lupus nephritis with and without natural language processing (NLP) using EHR data from the Northwestern Medicine Enterprise Data Warehouse (NMEDW).

methodsWe developed five algorithms: a rule-based algorithm using only structured data (baseline algorithm) and four algorithms using different NLP models. The first NLP model applied simple regular expression for keywords search combined with structured data. The other three NLP models were based on regularized logistic regression and used different sets of features including positive mention of concept unique identifiers (CUIs), number of appearances of CUIs, and a mixture of three components (i.e. a curated list of CUIs, regular expression concepts, structured data) respectively. The baseline algorithm and the best performing NLP algorithm were externally validated on a dataset from Vanderbilt University Medical Center (VUMC).

resultsOur best performing NLP model incorporated features from both structured data, regular expression concepts, and mapped concept unique identifiers (CUIs) and showed improved F measure in both the NMEDW (0.41 vs 0.79) and VUMC (0.52 vs 0.93) datasets compared to the baseline lupus nephritis algorithm.

conclusionOur NLP MetaMap mixed model improved the F-measure greatly compared to the structured data only algorithm in both internal and external validation datasets. The NLP algorithms can serve as powerful tools to accurately identify lupus nephritis phenotype in EHR for clinical research and better targeted therapies.

Indexed as

Lupus Erythematosus, SystemicLupus NephritisElectronic Health RecordsHumansNatural Language ProcessingPhenotypeRare DiseasesComputational phenotypingElectronic health recordsLupus nephritisNatural language processing

Identifiers

PMID38433189
PMCPMC10910523

What OpenQuestion holds

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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.