Clinical InvestigationOutcomes, Health Policy, and Managed CareEpidemiology of angina pectoris: Role of natural language processing of the medical record
Section snippets
Rose Angina Questionnaire as reference
The Rose Angina Questionnaire is the only validated instrument for assessing symptoms of typical angina pectoris in the general population, independent of medical care. It is highly (>90%) specific when compared against physician-diagnosed angina20, 21, 22 and is strongly associated with coronary artery calcification23 and subsequent risk of coronary events.24, 25 The Rose Angina Questionnaire was administered using a survey of a random sample of the Olmsted County, Minnesota, population (124
Rose chest pain and subsequent clinical notes
Of 892 participants, 871 (98%) had at least one clinical note dictated between January 1, 2003, and November 1, 2005. Of these 871, 202 (23%) reported chest pain. Of 871, 85 (10%) reported exertional chest pain. Baseline characteristics are reported in Table I. Restricting the cohort by date and presence of clinical notes in the EMR did not change the results.
Comparison between the EMR-NLP and the ICD codes
The true-positive rate of the EMR-NLP system in identifying patients who reported any chest pain on the questionnaire was 62% (95% CI
Discussion
Our findings indicate that, compared to diagnostic coding, NLP of the EMR results in higher true-positive rate to identify patients in the general population with self-reported exertional chest pain and any chest pain. To the best of our knowledge, this is the first study that relies on an advanced EMR system and expertise in population-based research and medical informatics computer science and linguistics to validate the use of NLP of the EMR to identify a chronic symptomatic condition within
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Cited by (0)
This work was supported in part by grants for the Public Health Service (RO1 HL 59205, HL 72435) (Bethesda, MD), the Rochester Epidemiology Project (GM14321 and AR30582) (Bethesda, MD), and the National Institutes of Health Roadmap Multidisciplinary Clinical Research Career Development Award Grant (K12/NICHD)-HD49078 (Bethesda, MD). Dr Hemingway is supported by a Department of Health Public Health Career Scientist Award (London, UK).