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Integrating structured and unstructured data for timely prediction of bloodstream infection among children.

Publication ,  Journal Article
Tabaie, A; Orenstein, EW; Kandaswamy, S; Kamaleswaran, R
Published in: Pediatr Res
March 2023

BACKGROUND: Hospitalized children with central venous lines (CVLs) are at higher risk of hospital-acquired infections. Information in electronic health records (EHRs) can be employed in training deep learning models to predict the onset of these infections. We incorporated clinical notes in addition to structured EHR data to predict serious bloodstream infections, defined as positive blood culture followed by at least 4 days of new antimicrobial agent administration, among hospitalized children with CVLs. METHODS: Structured EHR information and clinical notes were extracted for a retrospective cohort including all hospitalized patients with CVLs at a single tertiary care pediatric health system from 2013 to 2018. Deep learning models were trained to determine the added benefit of incorporating the information embedded in clinical notes in predicting serious bloodstream infection. RESULTS: A total of 24,351 patient encounters met inclusion criteria. The best-performing model restricted to structured EHR data had a specificity of 0.951 and positive predictive value (PPV) of 0.056 when the sensitivity was set to 0.85. The addition of contextualized word embeddings improved the specificity to 0.981 and PPV to 0.113. CONCLUSIONS: Integrating clinical notes with structured EHR data improved the prediction of serious bloodstream infections among pediatric patients with CVLs. IMPACT: Developed an advanced infection prediction model in pediatrics that integrates the structured and unstructured EHRs. Extracted information from clinical notes to do timely prediction in a clinical setting. Developed a deep learning model framework that can be employed in predicting rare events in a complex and dynamic environment.

Duke Scholars

Published In

Pediatr Res

DOI

EISSN

1530-0447

Publication Date

March 2023

Volume

93

Issue

4

Start / End Page

969 / 975

Location

United States

Related Subject Headings

  • Sepsis
  • Retrospective Studies
  • Pediatrics
  • Humans
  • Child
  • 3213 Paediatrics
  • 1117 Public Health and Health Services
  • 1114 Paediatrics and Reproductive Medicine
 

Citation

APA
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ICMJE
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Tabaie, A., Orenstein, E. W., Kandaswamy, S., & Kamaleswaran, R. (2023). Integrating structured and unstructured data for timely prediction of bloodstream infection among children. Pediatr Res, 93(4), 969–975. https://doi.org/10.1038/s41390-022-02116-6
Tabaie, Azade, Evan W. Orenstein, Swaminathan Kandaswamy, and Rishikesan Kamaleswaran. “Integrating structured and unstructured data for timely prediction of bloodstream infection among children.Pediatr Res 93, no. 4 (March 2023): 969–75. https://doi.org/10.1038/s41390-022-02116-6.
Tabaie A, Orenstein EW, Kandaswamy S, Kamaleswaran R. Integrating structured and unstructured data for timely prediction of bloodstream infection among children. Pediatr Res. 2023 Mar;93(4):969–75.
Tabaie, Azade, et al. “Integrating structured and unstructured data for timely prediction of bloodstream infection among children.Pediatr Res, vol. 93, no. 4, Mar. 2023, pp. 969–75. Pubmed, doi:10.1038/s41390-022-02116-6.
Tabaie A, Orenstein EW, Kandaswamy S, Kamaleswaran R. Integrating structured and unstructured data for timely prediction of bloodstream infection among children. Pediatr Res. 2023 Mar;93(4):969–975.

Published In

Pediatr Res

DOI

EISSN

1530-0447

Publication Date

March 2023

Volume

93

Issue

4

Start / End Page

969 / 975

Location

United States

Related Subject Headings

  • Sepsis
  • Retrospective Studies
  • Pediatrics
  • Humans
  • Child
  • 3213 Paediatrics
  • 1117 Public Health and Health Services
  • 1114 Paediatrics and Reproductive Medicine