Detecting of a Patient's Condition From Clinical Narratives Using Natural Language Representation

Abstract

The rapid progress in clinical data management systems and artificial intelligence approaches enable the era of personalized medicine. Intensive care units (ICUs) are ideal clinical research environments for such development because they collect many clinical data and are highly computerized. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Goal:</i> We designed a retrospective clinical study on a prospective ICU database using clinical natural language to help in the early diagnosis of heart failure in critically ill children. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Methods:</i> The methodology consisted of empirical experiments of a learning algorithm to learn the hidden interpretation and presentation of the French clinical note data. This study included 1386 patients' clinical notes with 5444 single lines of notes. There were 1941 positive cases (36% of total) and 3503 negative cases classified by two independent physicians using a standardized approach. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Results:</i> The multilayer perceptron neural network outperforms other discriminative and generative classifiers. Consequently, the proposed framework yields an overall classification performance with 89% accuracy, 88% recall, and 89% precision. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Conclusions:</i> This study successfully applied learning representation and machine learning algorithms to detect heart failure in a single French institution from clinical natural language. Further work is needed to use the same methodology in other languages and institutions.