Electronic interpretation of chest radiograph reports to detect central venous catheters.
OBJECTIVE
To evaluate whether a natural language processing system, SymText, was comparable to human interpretation of chest radiograph reports for identifying the mention of a central venous catheter (CVC), and whether use of SymText could detect patients who had a CVC.


METHODS
To identify patients who had a CVC, we performed two surveys of hospitalized patients. Then, we obtained available reports from 104 patients who had a CVC during one of two cross-sectional surveys (ie, case-patients) and 104 randomly selected patients who did not have a CVC (ie, control-patients).


METHODS
A 600-bed public teaching hospital.


RESULTS
Chest radiograph reports were available from 124 of the 208 participants. Compared with human interpretation, SymText had a sensitivity of 95.8% and a specificity of 98.7%. The use of SymText to identify case- and control-patients resulted in a sensitivity of 43% and a specificity of 98%. Successful application of SymText varied significantly by venous insertion site (eg, a sensitivity of 78% for subclavian and a sensitivity of 3.7% for femoral). Twenty-six percent of the case-patients had a femoral CVC.


CONCLUSIONS
Compared with human interpretation, SymText performed well in interpreting whether a report mentioned a CVC. In patient populations with less frequent CVC placement in femoral veins, the sensitivity for CVC detection likely would be higher. Applying a natural language processing system to chest radiograph reports may be a useful adjunct to other data sources to automate detection of patients who had a CVC.
Trick
William E
WE
Health Outcomes Branch, Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia, USA.
Chapman
Wendy W
WW
Wisniewski
Mary F
MF
Peterson
Brian J
BJ
Solomon
Steven L
SL
Weinstein
Robert A
RA
D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data*; D002408:Catheters, Indwelling / Q000382:microbiology / Q000706:statistics & numerical data*; D002641:Chicago / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology; D006779:Hospitals, Public; D006784:Hospitals, Teaching; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D009323:Natural Language Processing; D013902:Radiography, Thoracic; D011871:Radiology / Q000379:methods*; D011873:Radiology Information Systems; D012680:Sensitivity and Specificity; D018571:Sentinel Surveillance; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology