title: Coronary artery disease risk assessment from unstructured electronic health records using text mining.
abstract: Coronary artery disease (CAD) often leads to myocardial infarction, which may be fatal. Risk factors can be used to predict CAD, which may subsequently lead to prevention or early intervention. Patient data such as co-morbidities, medication history, social history and family history are required to determine the risk factors for a disease. However, risk factor data are usually embedded in unstructured clinical narratives if the data is not collected specifically for risk assessment purposes. Clinical text mining can be used to extract data related to risk factors from unstructured clinical notes. This study presents methods to extract Framingham risk factors from unstructured electronic health records using clinical text mining and to calculate 10-year coronary artery disease risk scores in a cohort of diabetic patients. We developed a rule-based system to extract risk factors: age, gender, total cholesterol, HDL-C, blood pressure, diabetes history and smoking history. The results showed that the output from the text mining system was reliable, but there was a significant amount of missing data to calculate the Framingham risk score. A systematic approach for understanding missing data was followed by implementation of imputation strategies. An analysis of the 10-year Framingham risk scores for coronary artery disease in this cohort has shown that the majority of the diabetic patients are at moderate risk of CAD.
authors: School of Public Health and Community Medicine, University of New South Wales, Australia; Asia-Pacific Ubiquitous Healthcare Research Centre, University of New South Wales, Australia; Prince of Wales Clinical School, University of New South Wales, Australia.
authors: Jitendra
authors: J
authors: Jonnagaddala
authors: School of Public Health and Community Medicine, University of New South Wales, Australia. Electronic address: siaw@unsw.edu.au.
authors: Siaw-Teng
authors: ST
authors: Liaw
authors: Asia-Pacific Ubiquitous Healthcare Research Centre, University of New South Wales, Australia.
authors: Pradeep
authors: P
authors: Ray
authors: Prince of Wales Clinical School, University of New South Wales, Australia.
authors: Manish
authors: M
authors: Kumar
authors: Institution of Information Science, Academia Sinica, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taiwan.
authors: Nai-Wen
authors: NW
authors: Chang
authors: Department of Computer Science and Information Engineering, National Taitung University, Taiwan. Electronic address: hjdai@nttu.edu.tw.
authors: Hong-Jie
authors: HJ
authors: Dai
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D016494:Computer Security; D003219:Confidentiality; D057225:Data Mining / Q000379:methods*; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology*; D057286:Electronic Health Records / Q000458:organization & administration*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D033262:Narration; D009323:Natural Language Processing; D009517:New South Wales / Q000453:epidemiology; D010363:Pattern Recognition, Automated / Q000379:methods; D018570:Risk Assessment / Q000379:methods; D018875:Vocabulary, Controlled
keywords: Coronary artery disease; EHR; Framingham risk score; Temporal data; Text mining