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V-Model: a new perspective for EHR-based phenotyping.

ABSTRACT: Narrative resources in electronic health records make clinical phenotyping study difficult to achieve. If a narrative patient history can be represented in a timeline, this would greatly enhance the efficiency of information-based studies. However, current timeline representations have limitations in visualizing narrative events. In this paper, we propose a temporal model named the 'V-Model' which visualizes clinical narratives into a timeline.We developed the V-Model which models temporal clinical events in v-like graphical structure. It visualizes patient history on a timeline in an intuitive way. For the design, the representation, reasoning, and visualization (readability) aspects were considered. Furthermore, the unique graphical notation helps to find hidden patterns of a specific patient group. For evaluation, we verified our distinctive solutions, and surveyed usability. The experiments were carried out between the V-Model and a conventional timeline model group. Eighty medical students and physicians participated in this evaluation.The V-Model was proven to be superior in representing narrative medical events, provide sufficient information for temporal reasoning, and outperform in readability compared to a conventional timeline model. The usability of the V-Model was assessed as positive.The V-Model successfully resolves visualization issues of clinical documents, and provides better usability compared to a conventional timeline model.

SUBMITTER: Park H

PROVIDER: S-EPMC4283133 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

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V-Model: a new perspective for EHR-based phenotyping.

Park Heekyong H Choi Jinwook J

BMC medical informatics and decision making 20141023

<h4>Background</h4>Narrative resources in electronic health records make clinical phenotyping study difficult to achieve. If a narrative patient history can be represented in a timeline, this would greatly enhance the efficiency of information-based studies. However, current timeline representations have limitations in visualizing narrative events. In this paper, we propose a temporal model named the 'V-Model' which visualizes clinical narratives into a timeline.<h4>Methods</h4>We developed the ...[more]

PMID: 25341558

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Project description:Juvenile idiopathic arthritis is the most common rheumatic disease in children. Chronic uveitis is a common and serious comorbid condition of juvenile idiopathic arthritis, with insidious presentation and potential to cause blindness. Knowledge of clinical associations will improve risk stratification. Based on clinical observation, we hypothesized that allergic conditions are associated with chronic uveitis in juvenile idiopathic arthritis patients.This study is a retrospective cohort study using Stanford's clinical data warehouse containing data from Lucile Packard Children's Hospital from 2000-2011 to analyze patient characteristics associated with chronic uveitis in a large juvenile idiopathic arthritis cohort. Clinical notes in patients under 16 years of age were processed via a validated text analytics pipeline. Bivariate-associated variables were used in a multivariate logistic regression adjusted for age, gender, and race. Previously reported associations were evaluated to validate our methods. The main outcome measure was presence of terms indicating allergy or allergy medications use overrepresented in juvenile idiopathic arthritis patients with chronic uveitis. Residual text features were then used in unsupervised hierarchical clustering to compare clinical text similarity between patients with and without uveitis.Previously reported associations with uveitis in juvenile idiopathic arthritis patients (earlier age at arthritis diagnosis, oligoarticular-onset disease, antinuclear antibody status, history of psoriasis) were reproduced in our study. Use of allergy medications and terms describing allergic conditions were independently associated with chronic uveitis. The association with allergy drugs when adjusted for known associations remained significant (OR 2.54, 95% CI 1.22-5.4).This study shows the potential of using a validated text analytics pipeline on clinical data warehouses to examine practice-based evidence for evaluating hypotheses formed during patient care. Our study reproduces four known associations with uveitis development in juvenile idiopathic arthritis patients, and reports a new association between allergic conditions and chronic uveitis in juvenile idiopathic arthritis patients.

Dataset Information

V-Model: a new perspective for EHR-based phenotyping.

Publications

V-Model: a new perspective for EHR-based phenotyping.

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