An Automated Method for Identifying Individuals with a Lung Nodule Can Be Feasibly Implemented Across Health Systems.
An Automated Method for Identifying Individuals with a Lung Nodule Can Be Feasibly Implemented Across Health Systems.
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DOI：
10.13063/2327-9214.1254
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发表时间：
2016-01-01
期刊：
影响因子：
--
通讯作者：
Carrell, David S
中科院分区：
文献类型：
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作者：
Farjah, Farhood;Halgrim, Scott;Carrell, David S
前言：偶然发现的肺结节的发生率正在迅速上升，但人们对其处理方法或相关的患者结局知之甚少。研究肺结节护理的一个障碍是无法有效和可靠地确定感兴趣的队列(即病例)。南加州凯撒永久医院(KPSC)的研究人员最近开发了一种自动方法来识别偶然发现的肺结节，但这种方法在其他卫生系统中实施的可行性尚不清楚。方法：随机抽取2012年接受计算机断层扫描的GH成员进行图表检查，以确定放射学报告中是否记录了肺结节。结果：在499名受试者中，156名(31%，95%可信区间[CI]27-36%)意外发现了肺结节。NLP发现189人(38%，95%可信区间33-42%)有结节。NLP对GH的准确性与其在KPSC的准确性相似：敏感性90%(95%可信区间85~95%)和特异性86%(95%可信区间82~89%)，而敏感性96%(95%可信区间88~100%)和特异性86%(95%可信区间75~94%)。使用这些方法可能会促进有效地进行评估实践模式和相关结果的多地点研究。
INTRODUCTION: The incidence of incidentally detected lung nodules is rapidly rising, but little is known about their management or associated patient outcomes. One barrier to studying lung nodule care is the inability to efficiently and reliably identify the cohort of interest (i.e. cases). Investigators at Kaiser Permanente Southern California (KPSC) recently developed an automated method to identify individuals with an incidentally discovered lung nodule, but the feasibility of implementing this method across other health systems is unknown.METHODS: A random sample of Group Health (GH) members who had a computed tomography in 2012 underwent chart review to determine if a lung nodule was documented in the radiology report. A previously developed natural language processing (NLP) algorithm was implemented at our site using only knowledge of the key words, qualifiers, excluding terms, and the logic linking these parameters.RESULTS: Among 499 subjects, 156 (31%, 95% confidence interval [CI] 27-36%) had an incidentally detected lung nodule. NLP identified 189 (38%, 95% CI 33-42%) individuals with a nodule. The accuracy of NLP at GH was similar to its accuracy at KPSC: sensitivity 90% (95% CI 85-95%) and specificity 86% (95% CI 82-89%) versus sensitivity 96% (95% CI 88-100%) and specificity 86% (95% CI 75-94%).CONCLUSION: Automated methods designed to identify individuals with an incidentally detected lung nodule can feasibly and independently be implemented across health systems. Use of these methods will likely facilitate the efficient conduct of multi-site studies evaluating practice patterns and associated outcomes.