A Semiautomated Chart Review for Assessing the Development of Radiation Pneumonitis Using Natural Language Processing: Diagnostic Accuracy and Feasibility Study
Notice bibliographique
Résumé
BACKGROUND: Health research frequently requires manual chart reviews to identify patients in a study-specific cohort and examine their clinical outcomes. Manual chart review is a labor-intensive process that requires significant time investment for clinical researchers. OBJECTIVE: This study aims to evaluate the feasibility and accuracy of an assisted chart review program, using an in-house rule-based text-extraction program written in Python, to identify patients who developed radiation pneumonitis (RP) after receiving curative radiotherapy. METHODS: A retrospective manual chart review was completed for patients who received curative radiotherapy for stage 2-3 lung cancer from January 1, 2013 to December 31, 2015, at British Columbia Cancer, Kelowna Centre. In the manual chart review, RP diagnosis and grading were recorded using the Common Terminology Criteria for Adverse Events version 5.0. From the charts of 50 sample patients, a total of 1413 clinical documents were obtained for review from the electronic medical record system. The text-extraction program was built using the Natural Language Toolkit Python platform (and regular expressions, also known as RegEx). Python version 3.7.2 was used to run the text-extraction program. The output of the text-extraction program was a list of the full sentences containing the key terms, document IDs, and dates from which these sentences were extracted. The results from the manual review were used as the gold standard in this study, with which the results of the text-extraction program were compared. RESULTS: Fifty percent (25/50) of the sample patients developed grade ≥1 RP; the natural language processing program was able to ascertain 92% (23/25) of these patients (sensitivity 0.92, 95% CI 0.74-0.99; specificity 0.36, 95% CI 0.18-0.57). Furthermore, the text-extraction program was able to correctly identify all 9 patients with grade ≥2 RP, which are patients with clinically significant symptoms (sensitivity 1.0, 95% CI 0.66-1.0; specificity 0.27, 95% CI 0.14-0.43). The program was useful for distinguishing patients with RP from those without RP. The text-extraction program in this study avoided unnecessary manual review of 22% (11/50) of the sample patients, as these patients were identified as grade 0 RP and would not require further manual review in subsequent studies. CONCLUSIONS: This feasibility study showed that the text-extraction program was able to assist with the identification of patients who developed RP after curative radiotherapy. The program streamlines the manual chart review further by identifying the key sentences of interest. This work has the potential to improve future clinical research, as the text-extraction program shows promise in performing chart review in a more time-efficient manner, compared with the traditional labor-intensive manual chart review.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,023 | 0,053 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,004 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
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 source (Gemma direct ou Codex distillé), 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 ».