Using Clinical Notes and Natural Language Processing for Automated HIV Risk Assessment

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Daniel J FellerNoémie Elhadad

Abstract

Universal HIV screening programs are costly, labor intensive, and often fail to identify high-risk individuals. Automated risk assessment methods that leverage longitudinal electronic health records (EHRs) could catalyze targeted screening programs. Although social and behavioral determinants of health are typically captured in narrative documentation, previous analyses have considered only structured EHR fields. We examined whether natural language processing (NLP) would improve predictive models of HIV diagnosis. One hundred eighty-one HIV+ individuals received care at New York Presbyterian Hospital before a confirmatory HIV diagnosis and 543 HIV negative controls were selected using propensity score matching and included in the study cohort. EHR data including demographics, laboratory tests, diagnosis codes, and unstructured notes before HIV diagnosis were extracted for modeling. Three predictive algorithms were developed using machine-learning algorithms: (1) a baseline model with only structured EHR data, (2) baseline plus NLP topics, and (3) baseline plus NLP clinical keywords. Predictive models demonstrated a range of performance with F measures of 0.59 for the baseline model, 0.63 for the baseline + NLP topic model, and...Continue Reading

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Citations

Sep 17, 2020·International Journal of STD & AIDS·Maria PowellM John Gill
Sep 29, 2019·Journal of the American Medical Informatics Association : JAMIA·Amber StubbsÖzlem Uzuner
Apr 30, 2020·Current HIV/AIDS Reports·Julia L MarcusDouglas S Krakower
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Nov 6, 2020·Journal of the American Medical Informatics Association : JAMIA·Tomasz OliwaJessica P Ridgway
Nov 8, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Douglas S Krakower, Julia L Marcus
Jan 6, 2021·AIDS Patient Care and STDs·Jessica P RidgwayLisa R Hirschhorn
Nov 18, 2020·Journal of the American Medical Informatics Association : JAMIA·Min ChenRema Padman
Mar 5, 2021·Current HIV/AIDS Reports·Jessica P RidgwayAnoop Mayampurath
Jul 11, 2021·Drug Discovery Today·Michel L LeiteFabricio F Costa
Jan 11, 2022·Journal of the International Association of Providers of AIDS Care·Ryan BonnerJessica L Taylor

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