Evidence map›Paper›PMID 38875566›Full record

ArticleJMIR AI2024

Identifying Symptoms Prior to Pancreatic Ductal Adenocarcinoma Diagnosis in Real-World Care Settings: Natural Language Processing Approach.

Fagen Xie, Jenny Chang, Tiffany Luong, Bechien Wu, Eva Lustigova, Eva Shrader, Wansu Chen

Abstract read
In one paragraph

Article in JMIR AI, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 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

7 authors.

Fagen XieDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.ORCID https://orcid.org/0000-0002-1565-0490
Jenny ChangDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.ORCID https://orcid.org/0009-0009-2881-4691
Tiffany LuongDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.ORCID https://orcid.org/0000-0002-5825-9248
Bechien WuDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.ORCID https://orcid.org/0000-0002-3304-2704
Eva LustigovaDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.ORCID https://orcid.org/0000-0002-6719-6090
Eva ShraderPancreatic Cancer Action Network, Manhattan Beach, CA, United States.ORCID https://orcid.org/0009-0005-8325-814X
Wansu ChenDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.ORCID https://orcid.org/0000-0002-3486-7468

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPancreatic cancer is the third leading cause of cancer deaths in the United States. Pancreatic ductal adenocarcinoma (PDAC) is the most common form of pancreatic cancer, accounting for up to 90% of all cases. Patient-reported symptoms are often the triggers of cancer diagnosis and therefore, understanding the PDAC-associated symptoms and the timing of symptom onset could facilitate early detection of PDAC.

objectiveThis paper aims to develop a natural language processing (NLP) algorithm to capture symptoms associated with PDAC from clinical notes within a large integrated health care system.

methodsWe used unstructured data within 2 years prior to PDAC diagnosis between 2010 and 2019 and among matched patients without PDAC to identify 17 PDAC-related symptoms. Related terms and phrases were first compiled from publicly available resources and then recursively reviewed and enriched with input from clinicians and chart review. A computerized NLP algorithm was iteratively developed and fine-trained via multiple rounds of chart review followed by adjudication. Finally, the developed algorithm was applied to the validation data set to assess performance and to the study implementation notes.

resultsA total of 408,147 and 709,789 notes were retrieved from 2611 patients with PDAC and 10,085 matched patients without PDAC, respectively. In descending order, the symptom distribution of the study implementation notes ranged from 4.98% for abdominal or epigastric pain to 0.05% for upper extremity deep vein thrombosis in the PDAC group, and from 1.75% for back pain to 0.01% for pale stool in the non-PDAC group. Validation of the NLP algorithm against adjudicated chart review results of 1000 notes showed that precision ranged from 98.9% (jaundice) to 84% (upper extremity deep vein thrombosis), recall ranged from 98.1% (weight loss) to 82.8% (epigastric bloating), and F

conclusionsThe developed and validated NLP algorithm could be used for the early detection of PDAC.

Indexed as

abdominal paincancercancer deathclinical notecomputerized algorithmdetectionelectronic health recordnatural language processingpainpancreaspancreatic cancerpancreatic ductal adenocarcinomasymptomvalidation

Identifiers

PMID38875566
PMCPMC11041417

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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.