Clinical decision support with automated text processing for cervical cancer screening.
Clinical decision support with automated text processing for cervical cancer screening.
复制标题
临床决策支持具有自动化文本处理，用于宫颈癌筛查。
DOI：
10.1136/amiajnl-2012-000820
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发表时间：
2012-09
期刊：
影响因子：
--
通讯作者：
Chaudhry R
中科院分区：
文献类型：
--
作者：
Wagholikar KB;MacLaughlin KL;Henry MR;Greenes RA;Hankey RA;Liu H;Chaudhry R
目的：开发一种用于宫颈癌筛查的计算机临床决策支持系统（CDSS），该系统可以解释自由文本巴氏涂片（Pap）报告。CDSS由两个规则库组成：解释Pap报告的自由文本规则库和指导规则库。自由文本规则库是通过分析49293个Pap报告的语料库而开发的。指南规则库是根据国家宫颈癌筛查指南构建的。CDSS访问电子病历（EMR）系统以生成针对患者的建议。为了评估，一名医生审查了CDSS对74名患者提出的筛查建议。评估显示，CDSS对74名测试患者中的73名输出了最佳筛查建议，并确定了两例被医生遗漏的妇科转诊病例。CDSS协助医生修改6例建议。失败的案例是因为人乳头瘤病毒（HPV）检测有时与巴氏试验分开进行，这些结果是由实验室系统报告的，而CDSS没有查询。随后，CDSS进行了升级，以查找早期遗漏的HPV结果，并为所有74例检测病例提供了最佳建议。单一机构、单一专家研究。鉴于巴氏试验的标准化报告和明确指南的可用性，可以为宫颈癌筛查构建准确的CDSS系统。总体而言，本研究表明，通过自然语言处理，可以有效地利用电子病历中的自由文本来开发临床决策支持工具。
To develop a computerized clinical decision support system (CDSS) for cervical cancer screening that can interpret free-text Papanicolaou (Pap) reports. The CDSS was constituted by two rulebases: the free-text rulebase for interpreting Pap reports and a guideline rulebase. The free-text rulebase was developed by analyzing a corpus of 49 293 Pap reports. The guideline rulebase was constructed using national cervical cancer screening guidelines. The CDSS accesses the electronic medical record (EMR) system to generate patient-specific recommendations. For evaluation, the screening recommendations made by the CDSS for 74 patients were reviewed by a physician. Evaluation revealed that the CDSS outputs the optimal screening recommendations for 73 out of 74 test patients and it identified two cases for gynecology referral that were missed by the physician. The CDSS aided the physician to amend recommendations in six cases. The failure case was because human papillomavirus (HPV) testing was sometimes performed separately from the Pap test and these results were reported by a laboratory system that was not queried by the CDSS. Subsequently, the CDSS was upgraded to look up the HPV results missed earlier and it generated the optimal recommendations for all 74 test cases. Single institution and single expert study. An accurate CDSS system could be constructed for cervical cancer screening given the standardized reporting of Pap tests and the availability of explicit guidelines. Overall, the study demonstrates that free text in the EMR can be effectively utilized through natural language processing to develop clinical decision support tools.
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影响因子：
3.6
作者：
Denny, Joshua C.;Choma, Neesha N.;Peterson, Josh F.;Miller, Randolph A.;Bastarache, Lisa;Li, Ming;Peterson, Neeraja B.
通讯作者：
Peterson, Neeraja B.
DOI：
10.1136/amiajnl-2010-000063
发表时间：
2011-05-01
影响因子：
6.4
作者：
Hoeksema, Laura J.;Bazzy-Asaad, Alia;Horwitzi, Leora I.
通讯作者：
Horwitzi, Leora I.
影响因子：
7.2
作者：
Lee, Jennifer Wai-Yin;Berkowitz, Zahava;Saraiya, Mona
通讯作者：
Saraiya, Mona
影响因子：
12.7
作者：
JANERICH, DT;HADJIMICHAEL, O;POLEDNAK, AP
通讯作者：
POLEDNAK, AP
DOI：
10.1136/amiajnl-2011-000124
发表时间：
2012-01-01
影响因子：
6.4
作者：
Griffey, Richard T.;Lo, Helen G.;Bates, David W.
通讯作者：
Bates, David W.