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The reporting of ne...
The reporting of neuropsychiatric symptoms in electronic health records of individuals with Alzheimer’s disease : a natural language processing study
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- Eikelboom, Willem S. (författare)
- Erasmus University Medical Center
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- Singleton, Ellen H. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- van den Berg, Esther (författare)
- Erasmus University Medical Center
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- de Boer, Casper (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- Coesmans, Michiel (författare)
- Erasmus University Medical Center
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- Goudzwaard, Jeannette A. (författare)
- Erasmus University Medical Center
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- Vijverberg, Everard G.B. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- Pan, Michel (författare)
- Erasmus University Medical Center
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- Gouw, Cornalijn (författare)
- Erasmus University Medical Center
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- Mol, Merel O. (författare)
- Erasmus University Medical Center
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- Gillissen, Freek (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- Fieldhouse, Jay L.P. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- Pijnenburg, Yolande A.L. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- van der Flier, Wiesje M. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- van Swieten, John C. (författare)
- Erasmus University Medical Center
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- Ossenkoppele, Rik (författare)
- Lund University,Lunds universitet,Klinisk minnesforskning,Forskargrupper vid Lunds universitet,LU profilområde: Proaktivt åldrande,Lunds universitets profilområden,Clinical Memory Research,Lund University Research Groups,LU Profile Area: Proactive Ageing,Lund University Profile areas,Amsterdam UMC - Vrije Universiteit Amsterdam
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- Kors, Jan A. (författare)
- Erasmus University Medical Center
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- Papma, Janne M. (författare)
- Erasmus University Medical Center
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(creator_code:org_t)
- 2023
- 2023
- Engelska.
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Ingår i: Alzheimer's Research and Therapy. - 1758-9193. ; 15:1
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Background: Neuropsychiatric symptoms (NPS) are prevalent in the early clinical stages of Alzheimer’s disease (AD) according to proxy-based instruments. Little is known about which NPS clinicians report and whether their judgment aligns with proxy-based instruments. We used natural language processing (NLP) to classify NPS in electronic health records (EHRs) to estimate the reporting of NPS in symptomatic AD at the memory clinic according to clinicians. Next, we compared NPS as reported in EHRs and NPS reported by caregivers on the Neuropsychiatric Inventory (NPI). Methods: Two academic memory clinic cohorts were used: the Amsterdam UMC (n = 3001) and the Erasmus MC (n = 646). Patients included in these cohorts had MCI, AD dementia, or mixed AD/VaD dementia. Ten trained clinicians annotated 13 types of NPS in a randomly selected training set of n = 500 EHRs from the Amsterdam UMC cohort and in a test set of n = 250 EHRs from the Erasmus MC cohort. For each NPS, a generalized linear classifier was trained and internally and externally validated. Prevalence estimates of NPS were adjusted for the imperfect sensitivity and specificity of each classifier. Intra-individual comparison of the NPS classified in EHRs and NPS reported on the NPI were conducted in a subsample (59%). Results: Internal validation performance of the classifiers was excellent (AUC range: 0.81–0.91), but external validation performance decreased (AUC range: 0.51–0.93). NPS were prevalent in EHRs from the Amsterdam UMC, especially apathy (adjusted prevalence = 69.4%), anxiety (adjusted prevalence = 53.7%), aberrant motor behavior (adjusted prevalence = 47.5%), irritability (adjusted prevalence = 42.6%), and depression (adjusted prevalence = 38.5%). The ranking of NPS was similar for EHRs from the Erasmus MC, although not all classifiers obtained valid prevalence estimates due to low specificity. In both cohorts, there was minimal agreement between NPS classified in the EHRs and NPS reported on the NPI (all kappa coefficients < 0.28), with substantially more reports of NPS in EHRs than on NPI assessments. Conclusions: NLP classifiers performed well in detecting a wide range of NPS in EHRs of patients with symptomatic AD visiting the memory clinic and showed that clinicians frequently reported NPS in these EHRs. Clinicians generally reported more NPS in EHRs than caregivers reported on the NPI.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- Affective symptoms
- Alzheimer’s disease
- Apathy
- Diagnosis
- Machine learning
- Neuropsychiatric symptoms
- Prevalence
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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Eikelboom, Wille ...
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Singleton, Ellen ...
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van den Berg, Es ...
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de Boer, Casper
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Coesmans, Michie ...
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Goudzwaard, Jean ...
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Vijverberg, Ever ...
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Pan, Michel
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Gouw, Cornalijn
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Mol, Merel O.
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Gillissen, Freek
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Fieldhouse, Jay ...
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Pijnenburg, Yola ...
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van der Flier, W ...
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van Swieten, Joh ...
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Ossenkoppele, Ri ...
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Kors, Jan A.
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Papma, Janne M.
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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Alzheimer's Rese ...
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Lunds universitet