从电子病历中识别骨关节炎患者疼痛等级,辅助基层医疗决策。
PLeDO: Pain Level Detection for Osteoarthritis from EMR Data

- 基于同义词的文本分析与多源数据融合,识别病历中的疼痛表达。
- 在真实数据上验证,对轻度与中重度疼痛分类准确率显著提升。
- 适合临床研究者、医疗数据工程师参考,推动智能疼痛评估落地。
骨关节炎(OA)是一种进行性慢性关节疾病,因受损关节组织无法正常修复导致软骨和骨骼退化。本研究旨在通过初级保健电子病历(EMR)中的结构化数据和非结构化病程记录,结合信息提取、自然语言处理与机器学习技术,分析患者疼痛程度。提出SPaDe工具,利用同义词策略对病程记录中的疼痛描述进行分类,区分轻度与中重度疼痛。由于疼痛表达具有主观性且受文化背景与人口特征影响,研究进一步融合结构化病历中的用药信息及病程记录中的疼痛量表信息,构建集成式疼痛检测工具PLeDO。借助人工标注的黄金标准数据,证明SPaDe与PLeDO均能有效从EMR中识别疼痛等级,有助于分析诊断与治疗模式,并可能提升初级医疗质量。
原文摘要 · Abstract (English)
Osteoarthritis (OA) is a progressive chronic joint disease resulting in a breakdown of articular cartilage and bone when damaged joint tissues are not able to normally repair themselves. The aim of this pilot research study is to understand the pain severity for OA from patients' primary care Electronic Medical Records (EMR), both from the structured medical data and the unstructured chart note data using information extraction, natural language processing and machine learning techniques. We propose SPaDe, a Synonym-based Pain level Detection tool to categorize patients into having mild or moderate-to-severe pain to understand diagnosis and treatment methods based on only the pain related expressions in the unstructured chart note. Expressions are subjective, objective, and influenced by cultural background and demography which poses a difficult challenge. Therefore, we improve the model by incorporating the medication information from the structured EMR data and pain scale related information from the chart note to propose an integrated pain level detection tool for OA called PLeDO. With the help of human labeled gold standard data, we demonstrate that both SPaDe and PLeDO can detect mild and moderate-to-severe pain from the EMR data to analyze and potentially improve the quality of care in primary care setting.
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