Identification of social determinants of health using multi-label classification of electronic health record clinical notes
| Autor: | Jaime Arguello, Rachel Stemerman, Jane H. Brice, Mary Houston, Rebecca R. Kitzmiller, Ashok Krishnamurthy |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Multi-label classification
Receiver operating characteristic business.industry Computer science 030503 health policy & services Lexical diversity Health Informatics computer.software_genre Research and Applications Random forest Support vector machine 03 medical and health sciences 0302 clinical medicine 030212 general & internal medicine Social determinants of health Metric (unit) Artificial intelligence 0305 other medical science F1 score business computer Natural language processing |
| Zdroj: | JAMIA Open |
| Popis: | Objectives Social determinants of health (SDH), key contributors to health, are rarely systematically measured and collected in the electronic health record (EHR). We investigate how to leverage clinical notes using novel applications of multi-label learning (MLL) to classify SDH in mental health and substance use disorder patients who frequent the emergency department. Methods and Materials We labeled a gold-standard corpus of EHR clinical note sentences (N = 4063) with 6 identified SDH-related domains recommended by the Institute of Medicine for inclusion in the EHR. We then trained 5 classification models: linear-Support Vector Machine, K-Nearest Neighbors, Random Forest, XGBoost, and bidirectional Long Short-Term Memory (BI-LSTM). We adopted 5 common evaluation measures: accuracy, average precision–recall (AP), area under the curve receiver operating characteristic (AUC-ROC), Hamming loss, and log loss to compare the performance of different methods for MLL classification using the F1 score as the primary evaluation metric. Results Our results suggested that, overall, BI-LSTM outperformed the other classification models in terms of AUC-ROC (93.9), AP (0.76), and Hamming loss (0.12). The AUC-ROC values of MLL models of SDH related domains varied between (0.59–1.0). We found that 44.6% of our study population (N = 1119) had at least one positive documentation of SDH. Discussion and Conclusion The proposed approach of training an MLL model on an SDH rich data source can produce a high performing classifier using only unstructured clinical notes. We also provide evidence that model performance is associated with lexical diversity by health professionals and the auto-generation of clinical note sentences to document SDH. |
| Databáze: | OpenAIRE |
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