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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Am+Med+Inform+Assoc
2016 ; 23
(5
): 1007-15
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gab.com Text
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Extracting information from the text of electronic medical records to improve
case detection: a systematic review
#MMPMID26911811
Ford E
; Carroll JA
; Smith HE
; Scott D
; Cassell JA
J Am Med Inform Assoc
2016[Sep]; 23
(5
): 1007-15
PMID26911811
show ga
BACKGROUND: Electronic medical records (EMRs) are revolutionizing health-related
research. One key issue for study quality is the accurate identification of
patients with the condition of interest. Information in EMRs can be entered as
structured codes or unstructured free text. The majority of research studies have
used only coded parts of EMRs for case-detection, which may bias findings, miss
cases, and reduce study quality. This review examines whether incorporating
information from text into case-detection algorithms can improve research
quality. METHODS: A systematic search returned 9659 papers, 67 of which reported
on the extraction of information from free text of EMRs with the stated purpose
of detecting cases of a named clinical condition. Methods for extracting
information from text and the technical accuracy of case-detection algorithms
were reviewed. RESULTS: Studies mainly used US hospital-based EMRs, and extracted
information from text for 41 conditions using keyword searches, rule-based
algorithms, and machine learning methods. There was no clear difference in
case-detection algorithm accuracy between rule-based and machine learning methods
of extraction. Inclusion of information from text resulted in a significant
improvement in algorithm sensitivity and area under the receiver operating
characteristic in comparison to codes alone (median sensitivity 78%
(codes?+?text) vs 62% (codes), P?=?.03; median area under the receiver operating
characteristic 95% (codes?+?text) vs 88% (codes), P?=?.025). CONCLUSIONS: Text in
EMRs is accessible, especially with open source information extraction
algorithms, and significantly improves case detection when combined with codes.
More harmonization of reporting within EMR studies is needed, particularly
standardized reporting of algorithm accuracy metrics like positive predictive
value (precision) and sensitivity (recall).