Natural Language Processing of Medical Alert Service Notes Reveals Reasons for Emergency Admissions
Notice bibliographique
Résumé
Background A Personal Emergency Response Service (PERS) enables an aging population to receive help quickly when an emergency situation occurs. The reasons that trigger a PERS alert are varied, including a sudden worsening of a chronic condition, a fall, or other injury. Every PERS case is documented by the response center using a combination of structured variables and free text notes. The text notes, in particular, contain a wealth of information in case of an incident such as contextual information, details about the situation, symptoms and more. Analysis of these notes at a population level could provide insight into the various situations that cause PERS medical alerts. Objective The objectives of this study were to (1) develop methods to enable the large-scale analysis of text notes from a PERS response center, and (2) to apply these methods to a large dataset and gain insight into the different situations that cause medical alerts. Methods More than 2.5 million deidentified PERS case text notes were used to train a document embedding model (ie, a deep learning Recurrent Neural Network [RNN] that takes the medical alert text note as input and produces a corresponding fixed length vector representation as output). We applied this model to 100,000 PERS text notes related to medical incidents that resulted in emergency department admission. Finally, we used t-SNE, a nonlinear dimensionality reduction method, to visualize the vector representation of the text notes in 2D as part of a graphical user interface that enabled interactive exploration of the dataset and visual analytics. Results Visual analysis of the vectors revealed the existence of several well-separated clusters of incidents such as fall, stroke/numbness, seizure, breathing problems, chest pain, and nausea, each of them related to the emergency situation encountered by the patient as recorded in an existing structured variable. In addition, subclusters were identified within each cluster which grouped cases based on additional features extracted from the PERS text notes and not available in the existing structured variables. For example, the incidents labeled as falls (n=37,842) were split into several subclusters corresponding to falls with bone fracture (n=1437), falls with bleeding (n=4137), falls caused by dizziness (n=519), etc. Conclusions The combination of state-of-the-art natural language processing, deep learning, and visualization techniques enables the large-scale analysis of medical alert text notes. This analysis demonstrates that, in addition to falls alerts, the PERS service is broadly used to signal for help in situations often related to underlying chronic conditions and acute symptoms such as respiratory distress, chest pain, diabetic reaction, etc. Moreover, the proposed techniques enable the extraction of structured information related to the medical alert from unstructured text with minimal human supervision. This structured information could be used, for example, to track trends over time, to generate concise medical alert summaries, and to create predictive models for desired outcomes.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».