Identifying Abdominal Aortic Aneurysm Cases and Controls using Natural Language Processing of Radiology Reports

Prevalence of abdominal aortic aneurysm (AAA) is increasing due to longer life expectancy and implementation of screening programs. Patient-specific longitudinal measurements of AAA are important to understand pathophysiology of disease development and modifiers of abdominal aortic size. In this paper, we applied natural language processing (NLP) techniques to process radiology reports and developed a rule-based algorithm to identify AAA patients and also extract the corresponding aneurysm size with the examination date. AAA patient cohorts were determined by a hierarchical approach that: 1) selected potential AAA reports using keywords; 2) classified reports into AAA-case vs. non-case using rules; and 3) determined the AAA patient cohort based on a report-level classification. Our system was built in an Unstructured Information Management Architecture framework that allows efficient use of existing NLP components. Our system produced an F-score of 0.961 for AAA-case report classification with an accuracy of 0.984 for aneurysm size extraction.

[1]  Sunghwan Sohn,et al.  Mayo clinical Text Analysis and Knowledge Extraction System (cTAKES): architecture, component evaluation and applications , 2010, J. Am. Medical Informatics Assoc..

[2]  Stacey L. Sheridan,et al.  Time to rethink screening for abdominal aortic aneurysm? , 2012, Archives of internal medicine.

[3]  Zhi-Yong Li,et al.  Association Between Aneurysm Shoulder Stress and Abdominal Aortic Aneurysm Expansion: A Longitudinal Follow-Up Study , 2010, Circulation.

[4]  H. Stefánsson,et al.  The same sequence variant on 9p21 associates with myocardial infarction, abdominal aortic aneurysm and intracranial aneurysm , 2008, Nature Genetics.

[5]  Clement J. McDonald,et al.  What can natural language processing do for clinical decision support? , 2009, J. Biomed. Informatics.

[6]  Sunghwan Sohn,et al.  Mayo Clinic Smoking Status Classification System: Extensions and Improvements , 2009, AMIA.

[7]  D. Mozaffarian,et al.  Executive summary: heart disease and stroke statistics--2012 update: a report from the American Heart Association. , 2012, Circulation.

[8]  D. Mozaffarian,et al.  Executive summary: heart disease and stroke statistics--2010 update: a report from the American Heart Association. , 2010, Circulation.

[9]  Jonathan H. Gillard,et al.  Association Between Aneurysm Shoulder Stress and Abdominal Aortic Aneurysm Expansion: A Longitudinal Follow-Up Study , 2010, Circulation.

[10]  H. Kuivaniemi,et al.  The lifetime prevalence of abdominal aortic aneurysms among siblings of aneurysm patients is eightfold higher than among siblings of spouses: an analysis of 187 aneurysm families in Nova Scotia, Canada. , 2005, Journal of vascular surgery.

[11]  Siddhartha R. Jonnalagadda,et al.  Feasibility of pooling annotated corpora for clinical concept extraction , 2012, AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science.

[12]  Peter R Hoskins,et al.  The relationship between aortic wall distensibility and rupture of infrarenal abdominal aortic aneurysm. , 2003, Journal of vascular surgery.

[13]  Peter J. Haug,et al.  Combining decision support methodologies to diagnose pneumonia , 2001, AMIA.

[14]  Tracy A Wolff,et al.  Screening for abdominal aortic aneurism. , 2005, American family physician.

[15]  P. Magnusson,et al.  Genetic and environmental contributions to abdominal aortic aneurysm development in a twin population. , 2009, Journal of vascular surgery.

[16]  Simon C. Potter,et al.  Abdominal aortic aneurysm is associated with a variant in low-density lipoprotein receptor-related protein 1. , 2011, American journal of human genetics.

[17]  Manabu Torii,et al.  A Hybrid Approach to Sentiment Sentence Classification in Suicide Notes , 2012, Biomedical informatics insights.

[18]  Christopher G. Chute,et al.  A Genome-Wide Association Study of Red Blood Cell Traits Using the Electronic Medical Record , 2010, PloS one.

[19]  Jin Fan,et al.  Leveraging informatics for genetic studies: use of the electronic medical record to enable a genome-wide association study of peripheral arterial disease , 2010, J. Am. Medical Informatics Assoc..

[20]  Gary R Johnson,et al.  Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. , 2002, JAMA.

[21]  Gerard Tromp,et al.  Genome-wide association study identifies a sequence variant within the DAB2IP gene conferring susceptibility to abdominal aortic aneurysm , 2010, Nature Genetics.

[22]  F. Lederle,et al.  Ultrasonographic Screening for Abdominal Aortic Aneurysms , 2003, Annals of Internal Medicine.

[23]  B. Jacobsen,et al.  Diameter of the infrarenal aorta as a risk factor for abdominal aortic aneurysm: the Tromsø Study, 1994-2001. , 2010, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[24]  Sunghwan Sohn,et al.  Drug side effect extraction from clinical narratives of psychiatry and psychology patients , 2011, J. Am. Medical Informatics Assoc..

[25]  Wendy A. Wolf,et al.  The eMERGE Network: A consortium of biorepositories linked to electronic medical records data for conducting genomic studies , 2011, BMC Medical Genomics.