Evidence map›Paper›PMID 40073425›Full record

ArticleJMIR medical informatics2025

Assessing Total Hip Arthroplasty Outcomes and Generating an Orthopedic Research Outcome Database via a Natural Language Processing Pipeline: Development and Validation Study.

Nicholas H Mast, Clara L Oeste, Dries Hens

Abstract readValidation Study
In one paragraph

Article in JMIR medical informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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

2 citing papers in PubMed.

  1. Review
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4 · The record

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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

3 authors.

Nicholas H MastHip and Pelvis Institute, 2250 Hayes St # 208, San Francisco, CA, 94117, United States, 1 415-530-5330.ORCID 0009-0007-6942-5268
Clara L OesteLynxCare Inc, Leuven, Belgium.ORCID 0000-0002-7035-132X
Dries HensLynxCare Inc, Leuven, Belgium.ORCID 0000-0002-6183-5007

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Processing data from electronic health records (EHRs) to build research-grade databases is a lengthy and expensive process. Modern arthroplasty practice commonly uses multiple sites of care, including clinics and ambulatory care centers. However, most private data systems prevent obtaining usable insights for clinical practice. Objective: This study aims to create an automated natural language processing (NLP) pipeline for extracting clinical concepts from EHRs related to orthopedic outpatient visits, hospitalizations, and surgeries in a multicenter, single-surgeon practice. The pipeline was also used to assess therapies and complications after total hip arthroplasty (THA). Methods: EHRs of 1290 patients undergoing primary THA from January 1, 2012 to December 31, 2019 (operated and followed by the same surgeon) were processed using artificial intelligence (AI)-based models (NLP and machine learning). In addition, 3 independent medical reviewers generated a gold standard using 100 randomly selected EHRs. The algorithm processed the entire database from different EHR systems, generating an aggregated clinical data warehouse. An additional manual control arm was used for data quality control. Results: The algorithm was as accurate as human reviewers (0.95 vs 0.94; P=.01), achieving a database-wide average F1-score of 0.92 (SD 0.09; range 0.67-0.99), validating its use as an automated data extraction tool. During the first year after direct anterior THA, 92.1% (1188/1290) of our population had a complication-free recovery. In 7.9% (102/1290) of cases where surgery or recovery was not uneventful, lateral femoral cutaneous nerve sensitivity (47/1290, 3.6%), intraoperative fractures (13/1290, 1%), and hematoma (9/1290, 0.7%) were the most common complications. Conclusions: Algorithm evaluation of this dataset accurately represented key clinical information swiftly, compared with human reviewers. This technology may provide substantial value for future surgeon practice and patient counseling. Furthermore, the low early complication rate of direct anterior THA in this surgeon's hands was supported by the dataset, which included data from all treated patients in a multicenter practice.

Indexed as

Arthroplasty, Replacement, HipDatabases, FactualNatural Language ProcessingAgedAlgorithmsElectronic Health RecordsFemaleHumansMachine LearningMaleMiddle Agedcomplication ratedirect anterior approachEHRelectronic health recordship arthroplastyhospitalizationsnatural language processingNLPorthopedicoutpatient visitssingle-surgeon registrysurgeonsurgeryTHAtotal hip arthroplastyvalidation

Identifiers

PMID40073425
PMCPMC11922490

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