In this study, we introduce a new network feature for detecting suicidal ideation from clinical texts and conduct various additional experiments to enrich the state of knowledge. We evaluate statistical features with and without stopwords, use lexical networks for feature extraction and classification, and compare the results with standard machine learning methods using a logistic classifier, a neural network, and a deep learning method. We utilize three text collections. The first two contain transcriptions of interviews conducted by experts with suicidal (n=161 patients that experienced severe ideation) and control subjects (n=153). The third collection consists of interviews conducted by experts with epilepsy patients, with a few of them admitting to experiencing suicidal ideation in the past (32 suicidal and 77 control). The selected methods detect suicidal ideation with an average area under the curve (AUC) score of 95% on the merged collection with high suicidal ideation, and the trained models generalize over the third collection with an average AUC score of 69%. Results reveal that lexical networks are promising for classification and feature extraction as successful as the deep learning model. We also observe that a logistic classifier’s performance was comparable with the deep learning method while promising explainability.
BACKGROUND Despite steady gains in life expectancy, individuals with cystic fibrosis (CF) lung disease still experience rapid pulmonary decline throughout their clinical course, which can ultimately end in respiratory failure. Point-of-care tools for accurate and timely information regarding the risk of rapid decline is essential for clinical decision support. OBJECTIVE This study aims to translate a novel algorithm for earlier, more accurate prediction of rapid lung function decline in patients with CF into an interactive web-based application that can be integrated within electronic health record systems, via collaborative development with clinicians. METHODS Longitudinal clinical history, lung function measurements, and time-invariant characteristics were obtained for 30,879 patients with CF who were followed in the US Cystic Fibrosis Foundation Patient Registry (2003-2015). We iteratively developed the application using the R Shiny framework and by conducting a qualitative study with care provider focus groups (N=17). RESULTS A clinical conceptual model and 4 themes were identified through coded feedback from application users: (1) ambiguity in rapid decline, (2) clinical utility, (3) clinical significance, and (4) specific suggested revisions. These themes were used to revise our application to the currently released version, available online for exploration. This study has advanced the application’s potential prognostic utility for monitoring individuals with CF lung disease. Further application development will incorporate additional clinical characteristics requested by the users and also a more modular layout that can be useful for care provider and family interactions. CONCLUSIONS Our framework for creating an interactive and visual analytics platform enables generalized development of applications to synthesize, model, and translate electronic health data, thereby enhancing clinical decision support and improving care and health outcomes for chronic diseases and disorders. A prospective implementation study is necessary to evaluate this tool’s effectiveness regarding increased communication, enhanced shared decision-making, and improved clinical outcomes for patients with CF.
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