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Extracting information from free-text electronic patient records to identify practice-based evidence of the performance of coronary stents.


ABSTRACT:

Background and objective

Percutaneous coronary intervention (PCI) using drug-eluting stents (DES) is an indispensable treatment for coronary artery disease. However, to evaluate the performance of various types of stents for PCI, numerous resources are required. We extracted clinical information from free-text records and, using practice-based evidence, compared the efficacy of various DES.

Materials and methods

We developed a text mining tool based on regular expression and applied it to PCI reports stored in the electronic health records (EHRs) of Ajou University Hospital from 2010-2014. The PCI data were extracted from EHRs with a sensitivity of 0.996, a specificity of 1.000, and an F-measure of 0.995 when compared with a sample of 200 reports. Using these data, we compared the performance of stents by Kaplan-Meier analysis and the Cox hazard proportional regression.

Results

In the self-validation analysis comparing the first-generation to the second-generation DES, the second-generation DES was superior to the first-generation DES (hazard ratio [HR]: 0.423, 95% confidence interval [CI]: 0.284-0.630) in terms of target vessel revascularization (TVR), showing similar findings to the established results of previous studies. Among the second-generation DES, the biodegradable-polymer DES tended to be superior, with a risk of TVR (HR: 0.568, 95% CI: 0.281-1.147) falling below than that for the durable-polymer DES approximately 1 year after the index procedure. The Endeavor stent had the highest TVR risk among the newer generation DES (HR: 2.576, 95% CI: 1.273-5.210).

Conclusions

In this study, we demonstrated how to construct a PCI data warehouse of PCI-related parameters obtained from free-text electronic records with high accuracy for use in the post surveillance of coronary stents in a time- and cost effective manner. Post surveillance of the practice based evidence in the PCI data warehouse indicated that the biodegradable-polymer DES might have a lower risk of TVR than the durable-polymer DES.

SUBMITTER: Kim YS 

PROVIDER: S-EPMC5553787 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Extracting information from free-text electronic patient records to identify practice-based evidence of the performance of coronary stents.

Kim Yoon Seob YS   Yoon Dukyong D   Byun JungHyun J   Park Hojun H   Lee Ahram A   Kim Il Hyun IH   Lee Sukhoon S   Lim Hong-Seok HS   Park Rae Woong RW  

PloS one 20170811 8


<h4>Background and objective</h4>Percutaneous coronary intervention (PCI) using drug-eluting stents (DES) is an indispensable treatment for coronary artery disease. However, to evaluate the performance of various types of stents for PCI, numerous resources are required. We extracted clinical information from free-text records and, using practice-based evidence, compared the efficacy of various DES.<h4>Materials and methods</h4>We developed a text mining tool based on regular expression and appli  ...[more]

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