论文标题

关于探索健康因素的社会决定因素的临床社会工作笔记的主题建模

Topic Modeling on Clinical Social Work Notes for Exploring Social Determinants of Health Factors

论文作者

Sun, Shenghuan, Zack, Travis, Sushil, Madhumita, Butte, Atul J.

论文摘要

大多数对健康的社会决定因素(SDOH)的研究都集中在电子病历(EMR)的医师笔记或结构化元素上。我们假设社会工作者的临床笔记是改善社会和经济因素的作用,可能会提供有关SDOH的更多数据来源。我们试图执行主题建模,以确定大量社会工作记录中的讨论的强大主题。我们在旧金山分校的181,644名患者中检索了来自181,644名患者的95万个临床社会工作记录的多样化的,具有95万个临床社会工作记录。我们使用单词频率分析和潜在的DIRICHLET分配(LDA)主题建模分析来表征该语料库并确定讨论的潜在主题。单词频率分析确定了与特定ICD10章节相关的医学和非医学术语。 LDA主题建模分析提取了与健康风险因素的社会决定因素有关的11个主题,包括财务状况,虐待历史,社会支持,死亡风险和心理健康。此外,主题建模方法捕获了不同类型的社会工作说明与不同类型疾病或疾病的患者之间的差异。我们证明,社会工作笔记包含有关个人SDOH的丰富,独特和其他无法获得的信息。

Most research studying social determinants of health (SDoH) has focused on physician notes or structured elements of the electronic medical record (EMR). We hypothesize that clinical notes from social workers, whose role is to ameliorate social and economic factors, might provide a richer source of data on SDoH. We sought to perform topic modeling to identify robust topics of discussion within a large cohort of social work notes. We retrieved a diverse, deidentified corpus of 0.95 million clinical social work notes from 181,644 patients at the University of California, San Francisco. We used word frequency analysis and Latent Dirichlet Allocation (LDA) topic modeling analysis to characterize this corpus and identify potential topics of discussion. Word frequency analysis identified both medical and non-medical terms associated with specific ICD10 chapters. The LDA topic modeling analysis extracted 11 topics related to social determinants of health risk factors including financial status, abuse history, social support, risk of death, and mental health. In addition, the topic modeling approach captured the variation between different types of social work notes and across patients with different types of diseases or conditions. We demonstrated that social work notes contain rich, unique, and otherwise unobtainable information on an individual's SDoH.

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