TY - JOUR
T1 - Deep learning detects and visualizes bleeding events in electronic health records
AU - Pedersen, Jannik Skyttegaard
AU - Laursen, Martin Sundahl
AU - Savarimuthu, Thiusius Rajeeth
AU - Søgaard Hansen, Rasmus
AU - Alnor, Anne Bryde
AU - Bjerre, Kristian Voss
AU - Kjær, Ina M.
AU - Gils, Charlotte
AU - Thorsen, Anne-Sofie Faarvang
AU - Sandvig Andersen, Eline
AU - Nielsen, Cathrine Brødsgaard
AU - Andersen, Lou-Ann Christensen
AU - Just, Søren Andreas
AU - Vinholt, Pernille Just
PY - 2021/5
Y1 - 2021/5
N2 - Background: Bleeding is associated with a significantly increased morbidity and mortality. Bleeding events are often described in the unstructured text of electronic health records, which makes them difficult to identify by manual inspection. Objectives: To develop a deep learning model that detects and visualizes bleeding events in electronic health records. Patients/Methods: Three hundred electronic health records with International Classification of Diseases, Tenth Revision diagnosis codes for bleeding or leukemia were extracted. Each sentence in the electronic health record was annotated as positive or negative for bleeding. The annotated sentences were used to develop a deep learning model that detects bleeding at sentence and note level. Results: On a balanced test set of 1178 sentences, the best-performing deep learning model achieved a sensitivity of 0.90, specificity of 0.90, and negative predictive value of 0.90. On a test set consisting of 700 notes, of which 49 were positive for bleeding, the model achieved a note-level sensitivity of 1.00, specificity of 0.52, and negative predictive value of 1.00. By using a sentence-level model on a note level, the model can explain its predictions by visualizing the exact sentence in a note that contains information regarding bleeding. Moreover, we found that the model performed consistently well across different types of bleedings. Conclusions: A deep learning model can be used to detect and visualize bleeding events in the free text of electronic health records. The deep learning model can thus facilitate systematic assessment of bleeding risk, and thereby optimize patient care and safety.
AB - Background: Bleeding is associated with a significantly increased morbidity and mortality. Bleeding events are often described in the unstructured text of electronic health records, which makes them difficult to identify by manual inspection. Objectives: To develop a deep learning model that detects and visualizes bleeding events in electronic health records. Patients/Methods: Three hundred electronic health records with International Classification of Diseases, Tenth Revision diagnosis codes for bleeding or leukemia were extracted. Each sentence in the electronic health record was annotated as positive or negative for bleeding. The annotated sentences were used to develop a deep learning model that detects bleeding at sentence and note level. Results: On a balanced test set of 1178 sentences, the best-performing deep learning model achieved a sensitivity of 0.90, specificity of 0.90, and negative predictive value of 0.90. On a test set consisting of 700 notes, of which 49 were positive for bleeding, the model achieved a note-level sensitivity of 1.00, specificity of 0.52, and negative predictive value of 1.00. By using a sentence-level model on a note level, the model can explain its predictions by visualizing the exact sentence in a note that contains information regarding bleeding. Moreover, we found that the model performed consistently well across different types of bleedings. Conclusions: A deep learning model can be used to detect and visualize bleeding events in the free text of electronic health records. The deep learning model can thus facilitate systematic assessment of bleeding risk, and thereby optimize patient care and safety.
KW - Decision support system
KW - Deep Learning
KW - Electronic Health Record
KW - Hemorrhage
KW - International Classification of Diseases
KW - Machine learning
U2 - 10.1002/rth2.12505
DO - 10.1002/rth2.12505
M3 - Journal article
C2 - 34013150
AN - SCOPUS:85105044505
VL - 5
JO - Research and Practice in Thrombosis and Haemostasis
JF - Research and Practice in Thrombosis and Haemostasis
SN - 2475-0379
IS - 4
M1 - e12505
ER -