Evidence map›Paper›PMID 39276641›Full record

ArticleEpilepsy research2024

Extracting seizure control metrics from clinic notes of patients with epilepsy: A natural language processing approach.

Marta Fernandes, Aidan Cardall, Lidia Mvr Moura, Christopher McGraw, Sahar F Zafar, M Brandon Westover

Abstract read
In one paragraph

Article in Epilepsy research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Review
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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

6 authors.

Marta FernandesDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: mbentofernandes@mgh.harvard.edu.
Aidan CardallDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Lidia Mvr MouraDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Christopher McGrawDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Sahar F ZafarDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
M Brandon WestoverHarvard Medical School, Boston, MA, United States; Beth Israel Deaconess Medical Center (BIDMC), Boston, MA, United States.

Funding

Tradeoffs in the Design of Public Long-Term Care BenefitsP01AG032952 · NIA · HARVARD MEDICAL SCHOOL · PI Leila S. Agha · 2009 to 2026
$39.0M
Data-Driven Sleep Biomarkers of Brain Health, Heart Health, and MortalityR01HL161253 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI CLIFFORD, GARI DAVID, MIGNOT, EMMANUEL J · 2022 to 2025
$8.3M
COVID-19 and Acute Medical Care: Impact on Dementia PatientsR01AG062282 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI HSU, JOHN · 2018 to 2022
$4.5M
Comparative Safety of Seizure Prophylaxis within the Medicare ProgramR01AG073410 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI Lidia Maria Veras Rocha de Moura · 2021 to 2026
$4.1M
Low Neurophysiologic Resistance to Anesthetics as a Marker of Preclinical/Prodromal Alzheimer's Disease and Neurovascular Pathology, Delirium risk and InattentionR01AG073598 · NIA · STANFORD UNIVERSITY · PI Miles Berger · 2022 to 2026
$3.8M
Integrative Motor Activity Biomarker for the Risk of Alzheimer's RiskRF1AG064312 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI HU, KUN · 2019 to 2019
$3.6M
Multimodal Network Connectivity Architecture (MOCA) of the Brain and its Role in the Recovery of Consciousness in Comatose Cardiac Arrest PatientsR01NS102574 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI GREER, DAVID MATTHEW, WU, ONA · 2018 to 2022
$3.4M
Investigation of Sleep in the Intensive Care Unit (ICU-SLEEP)R01NS102190 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI WESTOVER, MICHAEL BRANDON · 2018 to 2022
$3.2M
Prospective Validation of Neurophysiologic Outcome Prediction in Acute Brain InjuryR01NS126282 · NINDS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Aaron F Struck, Michael Brandon Westover · 2023 to 2026
$2.9M
Big Data and Deep Learning for the Interictal-Ictal-Injury ContiuumR01NS107291 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI WESTOVER, MICHAEL BRANDON · 2018 to 2022
$2.8M
Establishing a Brain Health Index from the Sleep ElectroencephalogramRF1NS120947 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI CASH, SYDNEY S, THOMAS, ROBERT JOSEPH · 2021 to 2021
$2.4M
Optimizing anti-epileptic drug treatment in acute brain injuryK23NS114201 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI ZAFAR, SAHAR F · 2019 to 2023
$1.0M
NHLBI NIH HHS R01 HL161253NIA NIH HHS K08 AG053380NIA NIH HHS P01 AG032952NIA NIH HHS R01 AG062282NIA NIH HHS R01 AG073410NIA NIH HHS R01 AG073598NIA NIH HHS RF1 AG064312NINDS NIH HHS K23 NS114201NINDS NIH HHS R01 NS102190NINDS NIH HHS R01 NS102574NINDS NIH HHS R01 NS107291NINDS NIH HHS R01 NS126282NINDS NIH HHS RF1 NS120947
6 · The paper itself

Abstract

objectivesMonitoring seizure control metrics is key to clinical care of patients with epilepsy. Manually abstracting these metrics from unstructured text in electronic health records (EHR) is laborious. We aimed to abstract the date of last seizure and seizure frequency from clinical notes of patients with epilepsy using natural language processing (NLP).

methodsWe extracted seizure control metrics from notes of patients seen in epilepsy clinics from two hospitals in Boston. Extraction was performed with the pretrained model RoBERTa_for_seizureFrequency_QA, for both date of last seizure and seizure frequency, combined with regular expressions. We designed the algorithm to categorize the timing of last seizure ("today", "1-6 days ago", "1-4 weeks ago", "more than 1-3 months ago", "more than 3-6 months ago", "more than 6-12 months ago", "more than 1-2 years ago", "more than 2 years ago") and seizure frequency ("innumerable", "multiple", "daily", "weekly", "monthly", "once per year", "less than once per year"). Our ground truth consisted of structured questionnaires filled out by physicians. Model performance was measured using the areas under the receiving operating characteristic curve (AUROC) and precision recall curve (AUPRC) for categorical labels, and median absolute error (MAE) for ordinal labels, with 95 % confidence intervals (CI) estimated via bootstrapping.

resultsOur cohort included 1773 adult patients with a total of 5658 visits with reported seizure control metrics, seen in epilepsy clinics between December 2018 and May 2022. The cohort average age was 42 years old, the majority were female (57 %), White (81 %) and non-Hispanic (85 %). The models achieved an MAE (95 % CI) for date of last seizure of 4 (4.00-4.86) weeks, and for seizure frequency of 0.02 (0.02-0.02) seizures per day.

conclusionsOur NLP approach demonstrates that the extraction of seizure control metrics from EHR is feasible allowing for large-scale EHR research.

Indexed as

Electronic Health RecordsEpilepsyNatural Language ProcessingSeizuresAdultAlgorithmsFemaleHumansMaleMiddle AgedYoung AdultElectronic health recordsEpilepsyLarge language modelNatural language processingPhenotypingSeizure control

Identifiers

PMID39276641
PMCPMC11499027

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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.