Document Detail


An automated technique for identifying associations between medications, laboratory results and problems.
MedLine Citation:
PMID:  20884377     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: The patient problem list is an important component of clinical medicine. The problem list enables decision support and quality measurement, and evidence suggests that patients with accurate and complete problem lists may have better outcomes. However, the problem list is often incomplete.
OBJECTIVE: To determine whether association rule mining, a data mining technique, has utility for identifying associations between medications, laboratory results and problems. Such associations may be useful for identifying probable gaps in the problem list.
DESIGN: Association rule mining was performed on structured electronic health record data for a sample of 100,000 patients receiving care at the Brigham and Women's Hospital, Boston, MA. The dataset included 272,749 coded problems, 442,658 medications and 11,801,068 laboratory results.
MEASUREMENTS: Candidate medication-problem and laboratory-problem associations were generated using support, confidence, chi square, interest, and conviction statistics. High-scoring candidate pairs were compared to a gold standard: the Lexi-Comp drug reference database for medications and Mosby's Diagnostic and Laboratory Test Reference for laboratory results.
RESULTS: We were able to successfully identify a large number of clinically accurate associations. A high proportion of high-scoring associations were adjudged clinically accurate when evaluated against the gold standard (89.2% for medications with the best-performing statistic, chi square, and 55.6% for laboratory results using interest).
CONCLUSION: Association rule mining appears to be a useful tool for identifying clinically accurate associations between medications, laboratory results and problems and has several important advantages over alternative knowledge-based approaches.
Authors:
Adam Wright; Elizabeth S Chen; Francine L Maloney
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-25
Journal Detail:
Title:  Journal of biomedical informatics     Volume:  43     ISSN:  1532-0480     ISO Abbreviation:  J Biomed Inform     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100970413     Medline TA:  J Biomed Inform     Country:  United States    
Other Details:
Languages:  eng     Pagination:  891-901     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Division of General Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA. awright5@partners.org
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