论文标题

肥厚性心肌病(HCM)患者的植入式心脏逆变器除颤器(ICD)的现实世界数据分析

Real-World Data Analysis of Implantable Cardioverter Defibrillator (ICD) in Patients with Hypertrophic Cardiomyopathy (HCM)

论文作者

Moon, Sungrim, Wen, Andrew, Scott, Christopher G., Ackerman, Michael J., Geske, Jeffrey B., Noseworthy, Peter A., Ommen, Steve R, Shellum, Jane L, Liu, Hongfang, Nishimura, Rick A.

论文摘要

背景:年轻人突然心脏死亡(SCD)的常见原因之一是肥厚性心肌病(HCM),而SCD的主要预防是植入式心脏逆转除颤器(ICD)。关于适当的ICD治疗的发生率以及与ICD植入和出院相关的并发症,植入ICD的患者受到密切监测,并通过临床咨询产生询问报告。方法:在这项研究中,我们比较了结构化设备数据和非结构化询问报告的性能,以提取ICD治疗和心律的信息。我们采样了687个报告,并通过手动图表审查生成了黄金标准。使用480个报告开发了基于规则的自然语言处理(NLP)系统,并为任务汇总了相应的设备数据中的信息。我们使用其余207个报告将NLP系统的性能与从结构化设备数据汇总的信息进行了比较。结果:基于规则的NLP系统的ICD治疗和心律达到0.92和0.98,而汇总设备数据的性能分别为0.78和0.45,汇总设备数据的性能显着降低。仅使用结构化设备数据的局限性包括实际事件与管理事件,数据可用性以及供应商和数据粒度的不同视角的限制,而使用询问报告需要克服非代表性的关键字/模式和上下文错误。结论:从现实世界中产生的数据中提取表型信息需要纳入医学知识。分析,比较和协调多个数据源以生成现实证据的生成至关重要。

Background: One of the common causes of sudden cardiac death (SCD) in young people is hypertrophic cardiomyopathy (HCM) and the primary prevention of SCD is with an implantable cardioverter defibrillators (ICD). Concerning the incidence of appropriate ICD therapy and the complications associated with ICD implantation and discharge, patients with implanted ICDs are closely monitored and interrogation reports are generated from clinical consultations. Methods: In this study, we compared the performance of structured device data and unstructured interrogation reports for extracting information of ICD therapy and heart rhythm. We sampled 687 reports with a gold standard generated through manual chart review. A rule-based natural language processing (NLP) system was developed using 480 reports and the information in the corresponding device data was aggregated for the task. We compared the performance of the NLP system with information aggregated from structured device data using the remaining 207 reports. Results: The rule-based NLP system achieved F-measure of 0.92 and 0.98 for ICD therapy and heart rhythm while the performance of aggregating device data was significantly lower with F-measure of 0.78 and 0.45 respectively. Limitations of using only structured device data include no differentiation of real events from management events, data availability, and disparate perspectives of vendor and data granularity while using interrogation reports needs to overcome non-representative keyword/pattern and contextual errors. Conclusions: Extracting phenotyping information from data generated in real-world requires the incorporation of medical knowledge. It is essential to analyze, compare, and harmonize multiple data sources for real-world evidence generation.

扫码加入交流群

加入微信交流群

微信交流群二维码

扫码加入学术交流群,获取更多资源