Evidence map›Paper›PMID 41017643›Full record

ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2025

Advancing delirium detection through the Open Health Natural Language Processing Consortium and the Evolve to Next-Gen Accrual to Clinical Trials Network.

Sunyang Fu, Min Ji Kwak, Jaerong Ahn, Zhiyi Yue, Shreyas Ranganath, Joseph R Applegate, Andrew Wen, Liwei Wang, Chenyu Li, Michele Morris and 22 more

Abstract read
In one paragraph

Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 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

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

2 citing papers in PubMed.

  1. Article
  2. 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

32 authors.

Sunyang FuMcWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States.ORCID 0000-0003-1691-5179
Min Ji KwakMcGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, United States.
Jaerong AhnMcWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States.
Zhiyi YueSchool of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, United States.
Shreyas RanganathMcGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, United States.
Joseph R ApplegateMcWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States.
Andrew WenMcWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States.
Liwei WangMcWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States.
Chenyu LiDepartment of Health Information Management, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.ORCID 0000-0001-7434-6571
Michele MorrisDepartment of Health Information Management, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
Kelly M TothCenter for Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) in the Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States.
Timothy D GirardCenter for Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) in the Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States.
John D OsborneDepartment of Biomedical Informatics and Data Science, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Richard E KennedyDepartment of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Nelly-Estefanie Garduno-RappClinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States.
Phillip ReederClinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States.
Justin F RousseauClinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States.ORCID 0000-0002-2817-9124
Chao YanDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States.ORCID 0000-0002-6719-1388
You ChenDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
Mayur B PatelSection of Surgical Sciences, Division of Acute Care Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
Tyler J MurphySection of Surgical Sciences, Division of Acute Care Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States.ORCID 0000-0002-9040-592X
Bradley A MalinDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
Chan Mi ParkDepartment of Gerontology, Hebrew SeniorLife, Marcus Institute for Aging Research, Boston, Massachusetts, United States.ORCID 0000-0003-1880-048X
Heling JiaDepartment of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, United States.
Sandeep PagaliDepartment of Medicine, Mayo Clinic, Rochester, Minnesota, United States.
Allyson K PalmerDepartment of Medicine, Mayo Clinic, Rochester, Minnesota, United States.
Jennifer St SauverDivision of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, United States.
Sunghwan SohnDepartment of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, United States.
Elmer V BernstamMcWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States.ORCID 0000-0001-7643-791X
Shyam VisweswaranClinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.ORCID 0000-0002-2079-8684
Yanshan WangDepartment of Health Information Management, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
Hongfang LiuMcWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States.ORCID 0000-0003-2570-3741

Funding

UT Southwestern Center for Translational MedicineUL1TR003163 · NCATS · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2021 to 2025
$39.3M
BRAIN-ICU-2 Study: Bringing to Light the Risk Factors And Incidence of Neuropsychological Dysfunction (Dementia) in ICU Survivors, 2nd StudyR01AG058639 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ELY, E WESLEY, JEFFERSON, ANGELA L. · 2019 to 2024
$18.3M
Center for Clinical and Translational SciencesUM1TR004906 · NCATS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI Maria Eulalia Fernandez, LORNA H. MCNEILL · 2024 to 2026
$16.7M
Semi-structured Information Retrieval in Clinical Text for Cohort IdentificationR01LM011934 · NLM · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI HERSH, WILLIAM R, LIU, HONGFANG · 2014 to 2025
$5.1M
NIDUS III: Advanced-Stage Development and Utilization of the NIDUS Research Infrastructure to Advance Interdisciplinary Aging Research inDeliriumR33AG071744 · NIA · JOHNS HOPKINS UNIVERSITY · PI John W. Devlin, Esther Seunghee Oh · 2021 to 2026
$4.7M
Early Detection of Mild Cognitive Impairment, Alzheimer’s Disease and Other Dementias using EHRR01AG068007 · NIA · MAYO CLINIC ROCHESTER · PI Yonas E Geda, Sunghwan Sohn · 2020 to 2026
$3.8M
The INSIGHT-ICU Study: Illuminating Neuropsychological dysfunction and Systemic Inflammatory mechanisms Gleaned after Hospitalization in Trauma-ICU StudyR01GM120484 · NIGMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI PATEL, MAYUR B · 2017 to 2021
$3.0M
Interdisciplinary Infrastructure for Aging Research: Rochester Epidemiology ProjectR33AG058738 · NIA · MAYO CLINIC ROCHESTER · PI LEBRASSEUR, NATHAN K, OLSON, JANET E · 2020 to 2022
$2.4M
Automating Delirium Identification and Risk Prediction in Electronic Health Records (Supplement)R01AG060993 · NIA · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI KENNEDY, RICHARD E · 2019 to 2022
$1.8M
Interdisciplinary Training in Injury and Critical IllnessT32GM135094 · NIGMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI PATEL, MAYUR B · 2021 to 2025
$967k
Ingram Chair in Surgical Sciences, Cancer Prevention and Research Institute of Texas RR230020NCATS NIH HHS UL1 TR003163NCATS NIH HHS UM1 TR004906NIA NIH HHS R01 AG058639NIA NIH HHS R01 AG060993NIA NIH HHS R01 AG068007NIA NIH HHS R33 AG058738NIA NIH HHS R33 AG071744NIGMS NIH HHS R01 GM120484NIGMS NIH HHS T32 GM135094NIH NCATS CTSA UL1TR003163NLM NIH HHS R01 LM011934RRD VA I01 RX002992the Mayo Clinic Robert and Arlene Kogod Center on AgingVA IO1 RX002992
6 · The paper itself

Abstract

backgroundDelirium is often underdiagnosed in clinical practice and is not routinely coded for billing. While manual chart review can identify delirium, it is labor-intensive and impractical for large-scale studies. Natural language processing (NLP) can analyze unstructured text in electronic health records (EHRs) to extract meaningful clinical information.

methodsTo support national integration of NLP for EHR-based delirium identification across different institutions, we launched the Delirium Interest Group within the national Evolve to Next-Gen Accrual to Clinical Trials (ENACT) NLP Working Group. This paper outlines our initial efforts to standardize, evaluate, and translate an NLP-based delirium detection model into the i2b2/ENACT platform.

resultsMultisite contextual inquiry identified several key challenges, including variations in local screening practices (eg, tools used, documentation frequency, and quality control), the need for harmonized definitions in the context of EHRs, and the complexity of modeling temporal logic. Multisite NLP evaluation revealed variable performance degradation driven by differences in delirium screening practices, clinical documentation patterns and semantics, and note syntactic structures.

conclusionOur work represents an important first step toward enabling scalable and standardized NLP-based delirium detection across institutions. By engaging diverse institutions through the ENACT NLP Working Group, we identified shared challenges and site-specific variations that impact model implementation and performance. Our collaborative approach enabled the development of a more robust framework for delirium identification across heterogeneous EHR systems. Future efforts will build on this foundation to enhance the validity, usability, and translational impact of delirium detection.

Indexed as

DeliriumElectronic Health RecordsNatural Language ProcessingClinical Trials as TopicHumansArtificial IntelligenceDeliriumElectronic Health RecordsNatural Language ProcessingTranslational AI

Identifiers

PMID41017643
PMCPMC12622219

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.