Evidence map›Paper›PMID 38587875›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2024

Automated stratification of trauma injury severity across multiple body regions using multi-modal, multi-class machine learning models.

Jifan Gao, Guanhua Chen, Ann P O'Rourke, John Caskey, Kyle A Carey, Madeline Oguss, Anne Stey, Dmitriy Dligach, Timothy Miller, Anoop Mayampurath and 2 more

Abstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

12 authors.

Jifan GaoDepartment of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI 53726, United States.
Guanhua ChenDepartment of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI 53726, United States.
Ann P O'RourkeDepartment of Surgery, University of Wisconsin-Madison, Madison, WI 53792, United States.
John CaskeyDepartment of Medicine, University of Wisconsin-Madison, Madison, WI 53705, United States.
Kyle A CareyDepartment of Medicine, University of Wisconsin-Madison, Madison, WI 53705, United States.
Madeline OgussDepartment of Medicine, University of Wisconsin-Madison, Madison, WI 53705, United States.
Anne SteyDepartment of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States.
Dmitriy DligachDepartment of Computer Science, Loyola University Chicago, Chicago, IL 60660, United States.
Timothy MillerComputational Health Informatics Program, Boston Children's Hospital, Boston, MA 02115, United States.ORCID 0000-0003-4513-403X
Anoop MayampurathDepartment of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI 53726, United States.
Matthew M ChurpekDepartment of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI 53726, United States.
Majid AfsharDepartment of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI 53726, United States.

Funding

Temporal relation discovery for clinical textR01LM010090 · NLM · BOSTON CHILDREN'S HOSPITAL · PI MARTIN, JAMES H., SAVOVA, GUERGANA K. · 2010 to 2022
$7.1M
Data Driven Strategies for Substance Misuse Identification in Hospitalized PatientsR01DA051464 · NIDA · UNIVERSITY OF WISCONSIN-MADISON · PI Majid Afshar · 2020 to 2026
$4.5M
Learning Universal Patient Representations with Hierarchical TransformersR01LM012973 · NLM · BOSTON CHILDREN'S HOSPITAL · PI Timothy A Miller · 2019 to 2026
$3.5M
Using causal machine learning for personalized treatment recommendations in critically ill patientsR01HL157262 · NHLBI · UNIVERSITY OF WISCONSIN-MADISON · PI Matthew Michael Churpek · 2021 to 2026
$3.1M
Timeliness of Management of Trauma Related Hemorrhage and Trauma Related CoagulopathyK23HL157832 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI STEY, ANNE M · 2021 to 2025
$929k
NHLBI NIH HHS K23 HL157832NHLBI NIH HHS R01 HL157262NIDA NIH HHS R01 DA051464NIDA NIH HHS R01DA051464NIGMS NIH HHS R01HL157262NLM NIH HHS K23HL157832NLM NIH HHS R01 LM010090NLM NIH HHS R01 LM012973Research Design Support: the Protocol Development, Informatics, and Biostatistics ModuleUniversity of Wisconsin School of Medicine and Public HealthWisconsin Partnership Program
6 · The paper itself

Abstract

objectiveThe timely stratification of trauma injury severity can enhance the quality of trauma care but it requires intense manual annotation from certified trauma coders. The objective of this study is to develop machine learning models for the stratification of trauma injury severity across various body regions using clinical text and structured electronic health records (EHRs) data. MATERIALS AND

methodsOur study utilized clinical documents and structured EHR variables linked with the trauma registry data to create 2 machine learning models with different approaches to representing text. The first one fuses concept unique identifiers (CUIs) extracted from free text with structured EHR variables, while the second one integrates free text with structured EHR variables. Temporal validation was undertaken to ensure the models' temporal generalizability. Additionally, analyses to assess the variable importance were conducted.

resultsBoth models demonstrated impressive performance in categorizing leg injuries, achieving high accuracy with macro-F1 scores of over 0.8. Additionally, they showed considerable accuracy, with macro-F1 scores exceeding or near 0.7, in assessing injuries in the areas of the chest and head. We showed in our variable importance analysis that the most important features in the model have strong face validity in determining clinically relevant trauma injuries. DISCUSSION: The CUI-based model achieves comparable performance, if not higher, compared to the free-text-based model, with reduced complexity. Furthermore, integrating structured EHR data improves performance, particularly when the text modalities are insufficiently indicative.

conclusionsOur multi-modal, multiclass models can provide accurate stratification of trauma injury severity and clinically relevant interpretations.

Indexed as

Electronic Health RecordsMachine LearningWounds and InjuriesHumansInjury Severity ScoreNatural Language ProcessingRegistriesTrauma Severity Indicesartificial intelligencemultimodality deep learningtrauma

Identifiers

PMID38587875
PMCPMC11105131

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.