This study explores the creation of a machine learning model to automatically identify whether a Neonatal Intensive Care Unit (NICU) patient was diagnosed with neonatal jaundice during a particular hospitalization based on their associated clinical notes. We develop a number of techniques for text preprocessing and feature selection and compare the effectiveness of different classification models. We show that using ensemble decision tree classification, both with AdaBoost and with bagging, outperforms support vector machines (SVM), the current state-of-the-art technique for neonatal jaundice coding.
Given the importance and time-intensive nature of medical coding, many scientists have started developing techniques for automated coding @cite_3 . For most of these attempts, the task was narrow (i.e. attempting to predict a single ICD code or a small set of related codes) and utilized a relatively small dataset.
@cite_3
1982243179 2119315254 2096664202 2963639714
This study proposes a methodology to support coding professionals in assigning ICD-9-CM codes to inpatient episodes. This subject has been predominantly addressed through the use of natural language processing methods, which show limited generalizability. To surpass this issue, this paper proposes a methodology entailing an adaptive data processing method based on structured electronic health record data, whereby raw clinical data is mapped into a feature set, and based on which supervised learning algorithms are trained. After applying a filter method for feature selection, support vector machine (SVM) classifiers are trained to obtain predictions for assigning codes to each episode. This approach is tested using a dataset of inpatient episodes from a department of Internal Medicine. Classifiers exhibited F1-measure values around 52 . Recall was generally higher than precision, which is considered valuable for coding support purposes. Analyzing results on an individual code basis sheds light on some key-issues regarding the use of structured electronic health record data in supporting clinical coding. Abstract Widespread use of medical information systems and explosive growth of medical databases require traditional manual data analysis to be coupled with methods for efficient computer-assisted analysis. This paper presents selected data mining techniques that can be applied in medicine, and in particular some machine learning techniques including the mechanisms that make them better suited for the analysis of medical databases (derivation of symbolic rules, use of background knowledge, sensitivity and specificity of induced descriptions). The importance of the interpretability of results of data analysis is discussed and illustrated on selected medical applications. Background and objective The volume of healthcare data is growing rapidly with the adoption of health information technology. We focus on automated ICD9 code assignment from discharge summary content and methods for evaluating such assignments. Methods We study ICD9 diagnosis codes and discharge summaries from the publicly available Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC II) repository. We experiment with two coding approaches: one that treats each ICD9 code independently of each other (flat classifier), and one that leverages the hierarchical nature of ICD9 codes into its modeling (hierarchy-based classifier). We propose novel evaluation metrics, which reflect the distances among gold-standard and predicted codes and their locations in the ICD9 tree. Experimental setup, code for modeling, and evaluation scripts are made available to the research community. Results The hierarchy-based classifier outperforms the flat classifier with F-measures of 39.5 and 27.6 , respectively, when trained on 20 533 documents and tested on 2282 documents. While recall is improved at the expense of precision, our novel evaluation metrics show a more refined assessment: for instance, the hierarchy-based classifier identifies the correct sub-tree of gold-standard codes more often than the flat classifier. Error analysis reveals that gold-standard codes are not perfect, and as such the recall and precision are likely underestimated. Conclusions Hierarchy-based classification yields better ICD9 coding than flat classification for MIMIC patients. Automated ICD9 coding is an example of a task for which data and tools can be shared and for which the research community can work together to build on shared models and advance the state of the art. Despite tremendous progress in computer vision, there has not been an attempt to apply machine learning on very large-scale medical image databases. We present an interleaved text image deep learning system to extract and mine the semantic interactions of radiology images and reports from a national research hospital's Picture Archiving and Communication System. With natural language processing, we mine a collection of ∼216K representative two-dimensional images selected by clinicians for diagnostic reference and match the images with their descriptions in an automated manner. We then employ a weakly supervised approach using all of our available data to build models for generating approximate interpretations of patient images. Finally, we demonstrate a more strictly supervised approach to detect the presence and absence of a number of frequent disease types, providing more specific interpretations of patient scans. A relatively small amount of data is used for this part, due to the challenge in gathering quality labels from large raw text data. Our work shows the feasibility of large-scale learning and prediction in electronic patient records available in most modern clinical institutions. It also demonstrates the trade-offs to consider in designing machine learning systems for analyzing large medical data.