Antidepressant Use in the Elderly Is Associated With an Increased Risk of Dementia.

A retrospective cohort study was conducted including 3688 patients age 60 years or older without dementia enrolled in a depression screening study in primary care clinics. Information on antidepressant use and incident dementia during follow-up was retrieved from electronic medical records. The Cox proportional hazard models were used to compare the risk for incident dementia among 5 participant groups: selective serotonin re-uptake inhibitors (SSRI) only, non-SSRI only (non-SSRI), mixed group of SSRI and non-SSRI, not on antidepressants but depressed, and not on antidepressants and not depressed.

Identification of Patients with Family History of Pancreatic Cancer--Investigation of an NLP System Portability.

In this study we have developed a rule-based natural language processing (NLP) system to identify patients with family history of pancreatic cancer. The algorithm was developed in a Unstructured Information Management Architecture (UIMA) framework and consisted of section segmentation, relation discovery, and negation detection. The system was evaluated on data from two institutions.

DEEPEN: A negation detection system for clinical text incorporating dependency relation into NegEx.

In Electronic Health Records (EHRs), much of valuable information regarding patients' conditions is embedded in free text format. Natural language processing (NLP) techniques have been developed to extract clinical information from free text. One challenge faced in clinical NLP is that the meaning of clinical entities is heavily affected by modifiers such as negation.

Redefined blood pressure variability measure and its association with mortality in elderly primary care patients.

Visit-to-visit blood pressure (BP) variability has received considerable attention recently. The objective of our study is to define a variability measure that is independent of change over time and determine the association between longitudinal summary measures of BP measurements and mortality risk. Data for the study came from a prospective cohort of 2906 adults, aged ≥60 years, in an urban primary care system with ≤15 years of follow-up.

An efficient pancreatic cyst identification methodology using natural language processing.

Pancreatic cancer is one of the deadliest cancers, mostly diagnosed at late stages. Patients with pancreatic cysts are at higher risk of developing cancer and their surveillance can help to diagnose the disease in earlier stages. In this retrospective study we collected a corpus of 1064 records from 44 patients at Indiana University Hospital from 1990 to 2012.

Natural language processing to extract follow-up provider information from hospital discharge summaries.

Objective: We evaluate the performance of a Natural Language Processing (NLP) application designed to extract follow-up provider information from free-text discharge summaries at two hospitals.

Evaluation: We compare performance by the NLP application, called the Regenstrief EXtracion tool (REX), to performance by three physician reviewers at extracting follow-up provider names, phone/fax numbers and location information. Precision, recall, and F-measures are reported, with 95% CI for pairwise comparisons.

Comparing methods for identifying pancreatic cancer patients using electronic data sources.

We sought to determine the accuracy of two electronic methods of identifying pancreatic cancer in a cohort of pancreatic cyst patients, and to examine the reasons for identification failure. We used the International Classification of Diseases, 9(th) Edition (ICD-9) codes and natural language processing (NLP) technology to identify pancreatic cancer in these patients. We compared both methods to a human-validated gold-standard surgical database.

Natural language processing for the development of a clinical registry: a validation study in intraductal papillary mucinous neoplasms.

Background: Medical natural language processing (NLP) systems have been developed to identify, extract and encode information within clinical narrative text. However, the role of NLP in clinical research and patient care remains limited. Pancreatic cysts are common.

Adequacy of hospital discharge summaries in documenting tests with pending results and outpatient follow-up providers.

Background: Poor communication of tests whose results are pending at hospital discharge can lead to medical errors.

Objective: To determine the adequacy with which hospital discharge summaries document tests with pending results and the appropriate follow-up providers.

Design: Retrospective study of a randomly selected sample

Patients: Six hundred ninety-six patients discharged from two large academic medical centers, who had test results identified as pending at discharge through queries of electronic medical records.

Which observations from the complete blood cell count predict mortality for hospitalized patients?

Background: Information on the prognostic utility of the admission complete blood count (CBC) and differential count is lacking.

Objective: To identify independent predictors of mortality from the varied number and morphology of cells in the complete blood count defined as a hemogram, automated five cell differential count and manual differential count.

Design: Retrospective cohort study and chart review.

Patients with elevated liver enzymes are not at higher risk for statin hepatotoxicity.

Background & Aims: Studies that evaluate the risk of hepatotoxicity from statins in hyperlipidemic subjects with elevated baseline serum transaminases are lacking. We conducted a study to test the hypothesis that patients with elevated baseline liver enzymes have higher risk of statin hepatotoxicity.

Methods: Our study consisted of the following 3 cohorts of patients seen between January 1, 1998 and June 31, 2002: Cohort 1: 342 hyperlipidemic patients with elevated baseline enzymes (AST >40 IU/L or ALT >35 IU/L) who were prescribed a statin; cohort 2: 1437 hyperlipidemic patients with normal transaminases who were prescribed a statin; and cohort 3: 2245 patients with elevated liver enzymes but who were not prescribed a statin.