Using medical language processing to support real-time evaluation of pneumonia guidelines
Using medical language processing to support real-time evaluation of pneumonia guidelines
复制标题
DOI：
--
复制
发表时间：
2000
期刊：
影响因子：
--
通讯作者：
M. Fiszman;P. Haug
中科院分区：
文献类型：
--
作者：
M. Fiszman;P. Haug
目的评价医学语言处理(MLP)系统是否能够支持社区获得性肺炎(CAP)指南的实时计算机化。方法在三级医疗机构的急诊科进行前瞻性验证性研究。在五周的时间内，所有可用于入院决定的实时胸部X光报告都被包括在内。将MLP系统与医生进行比较，以自动选择符合条件的患者，并提取五种不同CAP指南所要求的放射学结果。计算了由三名独立医生和可靠性指标组成的黄金标准。结果衡量指标为选择符合条件的患者的受试者操作特征曲线(AUC)下的面积、用于提取放射学结果的敏感性、阳性预测值(PPV)和特异性。结果在五周的时间里，有243份报告是实时可用的。选择符合条件的CAP患者时，MLP系统的AUC为89.7%(CI：84.2%，93.7%)，内科医生为93.3%(CI：83.9%，97.8%)。评估CAP定位和扩展的平均敏感性、PPV和特异性分别为：94%、87%、96%(内科医生)；34%、90%、95%(MLP系统)。当定位不成问题时，MLP系统和医生的平均敏感度、PPV和特异度分别为97%、97%和99%。金标的可靠性测量在70%以上。结论MLP系统能够通过选择符合条件的患者和提取不评估CAP定位和扩展的放射学结果来支持指南的实时计算机化。
OBJECTIVE To evaluate if a medical language processing (MLP) system is able to support real-time computerization of community-acquired pneumonia (CAP) guidelines. METHODS Prospective validation study in the emergency department of a tertiary care facility. All the chest x-ray reports available in real-time for an admission decision during a five-week period were included. The MLP system was compared to a physician for the automatic selection of eligible patients and on the extraction of radiographic findings required by five different CAP guidelines. The gold standard comprised of three independent physicians and reliability measures were calculated. The outcome measures were the area under the receiver operated characteristic curve (AUC) for selecting eligible patients, sensitivity, positive predictive value (PPV), and specificity for the extraction of radiographic findings. RESULTS During the five-week period, 243 reports were available in real-time. The AUCs on selecting eligible CAP patients were 89.7% (CI: 84.2%, 93.7%) for the MLP system, and 93.3% (CI: 83.9%, 97.8%) for the physician. The average sensitivity, PPV, and specificity for radiographic findings that assessed localization and extension of CAP were respectively: 94%, 87%, 96% (physician); and 34%, 90%, 95% (MLP system). Both, the MLP system and the physician had average sensitivity, PPV, and specificity of 97%, 97%, and 99%, respectively, when localization was not an issue. Reliability measures for the gold standard were above 70%. CONCLUSION The MLP system was able to support real-time computerization of guidelines by selecting eligible patients and extracting radiographic findings that do not assess localization and extension of CAP.