Diagnosis clarification by generalization to patient-friendly terms and definitions: Validation study.

Autor: van Mens HJT; Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands; Department of Research & Development, ChipSoft B.V., Amsterdam, Netherlands. Electronic address: h.j.vanmens@amsterdamumc.nl., Martens SSM; SNOMED CT Netherlands National Release Center, Nictiz, The Hague, Netherlands. Electronic address: savine@live.nl., Paiman EHM; SNOMED CT Netherlands National Release Center, Nictiz, The Hague, Netherlands. Electronic address: paiman@nictiz.nl., Mertens AC; SNOMED CT Netherlands National Release Center, Nictiz, The Hague, Netherlands. Electronic address: mail@sandermertens.nl., Nienhuis R; Department of Research & Development, ChipSoft B.V., Amsterdam, Netherlands. Electronic address: r.nienhuis@live.nl., de Keizer NF; Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands. Electronic address: n.f.keizer@amsterdamumc.nl., Cornet R; Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands. Electronic address: r.cornet@amsterdamumc.nl.
Jazyk: angličtina
Zdroj: Journal of biomedical informatics [J Biomed Inform] 2022 May; Vol. 129, pp. 104071. Date of Electronic Publication: 2022 Apr 13.
DOI: 10.1016/j.jbi.2022.104071
Abstrakt: Background: Now that patients increasingly get access to their healthcare records, its contents require clarification. The use of patient-friendly terms and definitions can help patients and their significant others understand their medical data. However, it is costly to make patient-friendly descriptions for the myriad of terms used in the medical domain. Furthermore, a description in more general terms, leaving out some of the details, might already be sufficient for a layperson. We developed an algorithm that employs the SNOMED CT hierarchy to generalize diagnoses to a limited set of concepts with patient-friendly terms for this purpose. However, generalization essentially implies loss of detail and might result in errors, hence these generalizations remain to be validated by clinicians. We aim to assess the medical validity of diagnosis clarification by generalization to concepts with patient-friendly terms and definitions in SNOMED CT. Furthermore, we aim to identify the characteristics that render clarifications invalid.
Results: Two raters identified errors in 12.7% (95% confidence interval - CI: 10.7-14.6%) of a random sample of 1,131 clarifications and they considered 14.3% (CI: 12.3-16.4%) of clarifications to be unacceptable to show to a patient. The intraclass correlation coefficient of the interrater reliability was 0.34 for correctness and 0.43 for acceptability. Errors were mostly related to the patient-friendly terms and definitions used in the clarifications themselves, but also to terminology mappings, terminology modelling, and the clarification algorithm. Clarifications considered to be most unacceptable were those that provide wrong information and might cause unnecessary worry.
Conclusions: We have identified problems in generalizing diagnoses to concepts with patient-friendly terms. Diagnosis generalization can be used to create a large amount of correct and acceptable clarifications, reusing patient-friendly terms and definitions across many medical concepts. However, the correctness and acceptability have a strong dependency on terminology mappings and modelling quality, as well as the quality of the terms and definitions themselves. Therefore, validation and quality improvement are required to prevent incorrect and unacceptable clarifications, before using the generalizations in practice.
(Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: