A Topic Model and Visualization for Automatic Summarization of Patient Records

描述（由申请人提供）：初级保健医生（pcp）负责审查和了解患者的广泛病史，以便在护理方面做出明智的决定。然而，各种因素阻碍了这一进程，包括：诊断测试和治疗的复杂性和数量日益增加，可能向医疗记录添加更多信息的健康信息交换标准，以及需要在更短的时间内有效地看更多的病人。这些障碍可能导致患者和提供者之间的对话受到抑制，甚至可能导致医疗错误。需要新的方法来帮助加快医疗保健提供者对患者病史的理解，总结关键信息。使用主题模型来总结大型非结构化数据集是一个不断发展的研究领域。然而，迄今为止，在使这些模型适应临床报告环境方面所做的工作很少。本提案旨在开发一个主题模型和后续的可视化系统，用于自动汇总医疗记录，以支持pcp。

DESCRIPTION (provided by applicant): Primary care physicians (PCPs) are responsible for reviewing and understanding a wide spectrum of a patient's medical history in order to make informed decisions regarding care. However, a variety of factors impede this process, including: the increasing complexity and number of diagnostic tests and treatments, health information exchange standards that may add more information to the medical record, and the need to efficiently see more patients in less time. These obstructions can lead to an inhibition of dialogue between patients and providers, and possibly even medical errors. New methods are required to help expedite a healthcare provider's understanding of a patient's medical history, summarizing key information. The use of topic models for summarizing large, unstructured data collections is a growing area of research. However, to date little work has been done on adapting these models to the clinical reporting environment. This proposal seeks to develop a topic model and ensuing visualization system for automatically summarizing medical records to support PCPs. Two specific aims guide the proposed work: 1) to create a topic model of free-text clinical documents that integrates contextual patient- and document-level data, and discovers multi-word concepts; and 2) to utilize the proposed model to drive a web application that includes concept-, source-, and time-oriented views for automatically summarizing patient records. The proposed model's innovation is that it is uniquely adapted to clinical records by the incorporation of demographic and discrete data (e.g., lab results), which influences the discovery of topics in documents and allows for adaptation to each patient's specific history. As a test bed for this project, we will gather medical records coded with myocardial infarction (MI), breast cancer, or liver cirrhosis, as these patients will span a spectrum of clinical complexity. We estimate that 68,539 patient records will be included in this study. The developed topic model will be integrated into a web-based visualization that displays clinically pertinent topics over time, as well as other relevant clinical data. This visualization will be evaluated by PCPs to gauge its utility to support the review of medical histories. This R21 proposal breaks new ground in the use of topic models for clinical data, and will provide future avenues of research in new applications of the proposed model.