Topic Modeling on Triage Notes With Semiorthogonal Nonnegative Matrix Factorization
Bibliographic record
Abstract
Emergency department (ED) crowding is a universal health issue that affects the efficiency of hospital management and patient care quality. ED crowding frequently occurs when a request for a ward-bed for a patient is delayed until a doctor makes an admission decision. In this case study, we build a classifier to predict the disposition of patients using manually typed nurse notes collected during triage as provided by the Alberta Medical Center. These predictions can potentially be incorporated to early bed coordination and fast track streaming strategies to alleviate overcrowding and waiting times in the ED. However, these triage notes involve high dimensional, noisy, and sparse text data, which make model-fitting and interpretation difficult. To address this issue, we propose a novel semiorthogonal nonnegative matrix factorization for both continuous and binary predictors to reduce the dimensionality and derive word topics. The triage notes can then be interpreted as a non-subtractive linear combination of orthogonal basis topic vectors. Our real data analysis shows that the triage notes contain strong predictive information toward classifying the disposition of patients for certain medical complaints, such as altered consciousness or stroke. Additionally, we show that the document-topic vectors generated by our method can be used as features to further improve classification accuracy by up to 1% across different medical complaints, for example, 74.3%–75.3% accuracy for patients with stroke symptoms. This improvement could be clinically impactful for certain patients, especially when the scale of hospital patients is large. Furthermore, the generated word-topic vectors provide a bi-clustering interpretation under each topic due to the orthogonal formulation, which can be beneficial for hospitals in better understanding the symptoms and reasons behind patients’ visits. Supplementary materials for this article are available online.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".