Extracting information from free-text electronic patient records to identify practice-based evidence of the performance of coronary stents

Autor: Dukyong Yoon, Hojun Park, Hong-Seok Lim, Ahram Lee, Rae Woong Park, Sukhoon Lee, JungHyun Byun, Yoon Seob Kim, Il Hyun Kim
Rok vydání: 2017
Předmět:
Male
Time Factors
Cardiovascular Procedures
Polymers
medicine.medical_treatment
lcsh:Medicine
Blood Pressure
Coronary Artery Disease
030204 cardiovascular system & hematology
Antiplatelet Therapy
Vascular Medicine
Coronary artery disease
Endocrinology
0302 clinical medicine
Medicine and Health Sciences
Data Mining
Electronic Health Records
Medicine
030212 general & internal medicine
lcsh:Science
Coronary Arteries
Multidisciplinary
Pharmaceutics
Hazard ratio
Drug-Eluting Stents
Arteries
Middle Aged
Chemistry
Treatment Outcome
Macromolecules
Physical Sciences
Hypertension
Female
Anatomy
Research Article
medicine.medical_specialty
Coronary Stenting
Materials by Structure
Endocrine Disorders
Materials Science
Surgical and Invasive Medical Procedures
03 medical and health sciences
Percutaneous Coronary Intervention
Drug Therapy
Diabetes Mellitus
Humans
Proportional Hazards Models
Retrospective Studies
Sirolimus
Electronic Data Processing
business.industry
Proportional hazards model
Revascularization
Angioplasty
lcsh:R
Biology and Life Sciences
Percutaneous coronary intervention
Stent
Cardiovascular Agents
Retrospective cohort study
Polymer Chemistry
medicine.disease
Confidence interval
Metabolic Disorders
Stent Implantation
Emergency medicine
Conventional PCI
Cardiovascular Anatomy
Blood Vessels
lcsh:Q
business
Coronary Angioplasty
Zdroj: PLoS ONE, Vol 12, Iss 8, p e0182889 (2017)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0182889
Popis: Background and objective Percutaneous coronary intervention (PCI) using drug-eluting stents (DES) is an indispensable treatment for coronary artery disease. However, to evaluate the performance of various types of stents for PCI, numerous resources are required. We extracted clinical information from free-text records and, using practice-based evidence, compared the efficacy of various DES. Materials and methods We developed a text mining tool based on regular expression and applied it to PCI reports stored in the electronic health records (EHRs) of Ajou University Hospital from 2010–2014. The PCI data were extracted from EHRs with a sensitivity of 0.996, a specificity of 1.000, and an F-measure of 0.995 when compared with a sample of 200 reports. Using these data, we compared the performance of stents by Kaplan-Meier analysis and the Cox hazard proportional regression. Results In the self-validation analysis comparing the first-generation to the second-generation DES, the second-generation DES was superior to the first-generation DES (hazard ratio [HR]: 0.423, 95% confidence interval [CI]: 0.284–0.630) in terms of target vessel revascularization (TVR), showing similar findings to the established results of previous studies. Among the second-generation DES, the biodegradable-polymer DES tended to be superior, with a risk of TVR (HR: 0.568, 95% CI: 0.281–1.147) falling below than that for the durable-polymer DES approximately 1 year after the index procedure. The Endeavor stent had the highest TVR risk among the newer generation DES (HR: 2.576, 95% CI: 1.273–5.210). Conclusions In this study, we demonstrated how to construct a PCI data warehouse of PCI-related parameters obtained from free-text electronic records with high accuracy for use in the post surveillance of coronary stents in a time- and cost effective manner. Post surveillance of the practice based evidence in the PCI data warehouse indicated that the biodegradable-polymer DES might have a lower risk of TVR than the durable-polymer DES.
Databáze: OpenAIRE
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