ArticleJournal of the American Medical Informatics Association : JAMIA2025
Comparison of six natural language processing approaches to assessing firearm access in Veterans Health Administration electronic health records.
Article in Journal of the American Medical Informatics Association : JAMIA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Natural Language Processing Identification of Nonprescribed Fentanyl Use in Electronic Health Records: Algorithm Development and Validation Study.Journal of medical Internet research · 2026Article
- Identifying Firearm Violence Exposure in Primary Care Clinical Notes: Protocol for Developing a National Language Processing Text Classifier.JMIR research protocols · 2025Article
- Firearm injury risk detection and prevention.Journal of the American Medical Informatics Association : JAMIA · 2024Article
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Authors and funding
15 authors.
Funding
Abstract
objectiveAccess to firearms is associated with increased suicide risk. Our aim was to develop a natural language processing approach to characterizing firearm access in clinical records. MATERIALS AND
methodsWe used clinical notes from 36 685 Veterans Health Administration (VHA) patients between April 10, 2023 and April 10, 2024. We expanded preexisting firearm term sets using subject matter experts and generated 250-character snippets around each firearm term appearing in notes. Annotators labeled 3000 snippets into three classes. Using these annotated snippets, we compared four nonneural machine learning models (random forest, bagging, gradient boosting, logistic regression with ridge penalization) and two versions of Bidirectional Encoder Representations from Transformers, or BERT (specifically, BioBERT and Bio-ClinicalBERT) for classifying firearm access as "definite access", "definitely no access", or "other".
resultsFirearm terms were identified in 36 685 patient records (41.3%), 33.7% of snippets were categorized as definite access, 9.0% as definitely no access, and 57.2% as "other". Among models classifying firearm access, five of six had acceptable performance, with BioBERT and Bio-ClinicalBERT performing best, with F1s of 0.876 (95% confidence interval, 0.874-0.879) and 0.896 (95% confidence interval, 0.894-0.899), respectively. DISCUSSION AND
conclusionFirearm-related terminology is common in the clinical records of VHA patients. The ability to use text to identify and characterize patients' firearm access could enhance suicide prevention efforts, and five of our six models could be used to identify patients for clinical interventions.
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