Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notes

Background: A cancer diagnosis is a source of psychological and emotional stress, which are often maintained for sustained periods of time that may lead to depressive disorders. Depression is one of the most common psychological conditions in patients with cancer. According to the Global Cancer Obse...

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Autores: Leis Machín, Angela 1974-, Casadevall Aguilar, David, Albanell Mestres, Joan, Posso, Margarita, Macià Guilà, Francesc Assís, Castells, Xavier, Ramírez Anguita, Juan Manuel, Martínez Roldán, Jordi, Furlong, Laura I., 1971-, Sanz, Ferran, Ronzano, Francesco, Mayer, Miguel Ángel, 1960-
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/54018
Acceso en línea:http://hdl.handle.net/10230/54018
http://dx.doi.org/10.2196/39003
Access Level:acceso abierto
Palabra clave:Cancer
Depression
Electronic health records
Natural language processing
Text mining
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network_name_str España
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dc.title.none.fl_str_mv Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notes
title Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notes
spellingShingle Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notes
Leis Machín, Angela 1974-
Cancer
Depression
Electronic health records
Natural language processing
Text mining
title_short Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notes
title_full Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notes
title_fullStr Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notes
title_full_unstemmed Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notes
title_sort Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notes
dc.creator.none.fl_str_mv Leis Machín, Angela 1974-
Casadevall Aguilar, David
Albanell Mestres, Joan
Posso, Margarita
Macià Guilà, Francesc Assís
Castells, Xavier
Ramírez Anguita, Juan Manuel
Martínez Roldán, Jordi
Furlong, Laura I., 1971-
Sanz, Ferran
Ronzano, Francesco
Mayer, Miguel Ángel, 1960-
author Leis Machín, Angela 1974-
author_facet Leis Machín, Angela 1974-
Casadevall Aguilar, David
Albanell Mestres, Joan
Posso, Margarita
Macià Guilà, Francesc Assís
Castells, Xavier
Ramírez Anguita, Juan Manuel
Martínez Roldán, Jordi
Furlong, Laura I., 1971-
Sanz, Ferran
Ronzano, Francesco
Mayer, Miguel Ángel, 1960-
author_role author
author2 Casadevall Aguilar, David
Albanell Mestres, Joan
Posso, Margarita
Macià Guilà, Francesc Assís
Castells, Xavier
Ramírez Anguita, Juan Manuel
Martínez Roldán, Jordi
Furlong, Laura I., 1971-
Sanz, Ferran
Ronzano, Francesco
Mayer, Miguel Ángel, 1960-
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cancer
Depression
Electronic health records
Natural language processing
Text mining
topic Cancer
Depression
Electronic health records
Natural language processing
Text mining
description Background: A cancer diagnosis is a source of psychological and emotional stress, which are often maintained for sustained periods of time that may lead to depressive disorders. Depression is one of the most common psychological conditions in patients with cancer. According to the Global Cancer Observatory, breast and colorectal cancers are the most prevalent cancers in both sexes and across all age groups in Spain. Objective: This study aimed to compare the prevalence of depression in patients before and after the diagnosis of breast or colorectal cancer, as well as to assess the usefulness of the analysis of free-text clinical notes in 2 languages (Spanish or Catalan) for detecting depression in combination with encoded diagnoses. Methods: We carried out an analysis of the electronic health records from a general hospital by considering the different sources of clinical information related to depression in patients with breast and colorectal cancer. This analysis included ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis codes and unstructured information extracted by mining free-text clinical notes via natural language processing tools based on Systematized Nomenclature of Medicine Clinical Terms that mentions symptoms and drugs used for the treatment of depression. Results: We observed that the percentage of patients diagnosed with depressive disorders significantly increased after cancer diagnosis in the 2 types of cancer considered-breast and colorectal cancers. We managed to identify a higher number of patients with depression by mining free-text clinical notes than the group selected exclusively on ICD-9-CM codes, increasing the number of patients diagnosed with depression by 34.8% (441/1269). In addition, the number of patients with depression who received chemotherapy was higher than those who did not receive this treatment, with significant differences (P<.001). Conclusions: This study provides new clinical evidence of the depression-cancer comorbidity and supports the use of natural language processing for extracting and analyzing free-text clinical notes from electronic health records, contributing to the identification of additional clinical data that complements those provided by coded data to improve the management of these patients.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/54018
http://dx.doi.org/10.2196/39003
url http://hdl.handle.net/10230/54018
http://dx.doi.org/10.2196/39003
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv JMIR Cancer. 2022 Jul 11;8(3):e39003
info:eu-repo/grantAgreement/EC/H2020/634143
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv JMIR Publications
publisher.none.fl_str_mv JMIR Publications
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
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spelling Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notesLeis Machín, Angela 1974-Casadevall Aguilar, DavidAlbanell Mestres, JoanPosso, MargaritaMacià Guilà, Francesc AssísCastells, XavierRamírez Anguita, Juan ManuelMartínez Roldán, JordiFurlong, Laura I., 1971-Sanz, FerranRonzano, FrancescoMayer, Miguel Ángel, 1960-CancerDepressionElectronic health recordsNatural language processingText miningBackground: A cancer diagnosis is a source of psychological and emotional stress, which are often maintained for sustained periods of time that may lead to depressive disorders. Depression is one of the most common psychological conditions in patients with cancer. According to the Global Cancer Observatory, breast and colorectal cancers are the most prevalent cancers in both sexes and across all age groups in Spain. Objective: This study aimed to compare the prevalence of depression in patients before and after the diagnosis of breast or colorectal cancer, as well as to assess the usefulness of the analysis of free-text clinical notes in 2 languages (Spanish or Catalan) for detecting depression in combination with encoded diagnoses. Methods: We carried out an analysis of the electronic health records from a general hospital by considering the different sources of clinical information related to depression in patients with breast and colorectal cancer. This analysis included ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis codes and unstructured information extracted by mining free-text clinical notes via natural language processing tools based on Systematized Nomenclature of Medicine Clinical Terms that mentions symptoms and drugs used for the treatment of depression. Results: We observed that the percentage of patients diagnosed with depressive disorders significantly increased after cancer diagnosis in the 2 types of cancer considered-breast and colorectal cancers. We managed to identify a higher number of patients with depression by mining free-text clinical notes than the group selected exclusively on ICD-9-CM codes, increasing the number of patients diagnosed with depression by 34.8% (441/1269). In addition, the number of patients with depression who received chemotherapy was higher than those who did not receive this treatment, with significant differences (P<.001). Conclusions: This study provides new clinical evidence of the depression-cancer comorbidity and supports the use of natural language processing for extracting and analyzing free-text clinical notes from electronic health records, contributing to the identification of additional clinical data that complements those provided by coded data to improve the management of these patients.This research was carried out under the framework of the project Creating medically-driven integrative bioinformatics applications focused on oncology, CNS disorders and their comorbidities (MedBioinformatics, H2020-EU; grant 634143); and partially funded by the Institute of Health Carlos III (project IMPaCT-Data; IMP/00019) and cofunded by the European Union, European Regional Development Fund (“A way to make Europe”); and the Clinical Knowledge Aggregation by Mining Medical Reports (CliKA-MinE; PI17/00230), which is funded by Institute of Health Carlos III and cofunded by the European Union.JMIR Publications202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/54018http://dx.doi.org/10.2196/39003reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésJMIR Cancer. 2022 Jul 11;8(3):e39003info:eu-repo/grantAgreement/EC/H2020/634143© Angela Leis, David Casadevall, Joan Albanell, Margarita Posso, Francesc Macià, Xavier Castells, Juan Manuel Ramírez-Anguita, Jordi Martínez Roldán, Laura I Furlong, Ferran Sanz, Francesco Ronzano, Miguel A Mayer. Originally published in JMIR Cancer (https://cancer.jmir.org), 11.07.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cancer, is properly cited. The complete bibliographic information, a link to the original publication on https://cancer.jmir.org/, as well as this copyright and license information must be included.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/540182026-06-12T07:21:37Z
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