Using natural language processing (NLP) tools to identify veterans with metastatic prostate cancer (mPCa).

Authors

null

Patrick R. Alba

VA Salt Lake City Healthcare System, Salt Lake City, UT

Patrick R. Alba , Julie Ann Lynch , Anthony Gao , Kyung Min Lee , Tori Anglin-Foote , Brian Robison , Jeremy B. Shelton , Olga Efimova , Olga V Patterson , Scott L. DuVall

Organizations

VA Salt Lake City Healthcare System, Salt Lake City, UT, VA Salt Lake City Health Care System, Salt Lake City, UT, Bedford VA Medical Center, Bedford, MA, UCLA-David Geffen School of Medcn, Los Angeles, CA

Research Funding

Other Government Agency
Department of Veteran Affairs

Background: Veterans may benefit from promising innovations in treatments for mPCa. The Veterans Affairs (VA) and Prostate Cancer Foundation (PCF) leadership issued a challenge to identify, in real time, the national census of Veterans receiving care for mPCa. Administrative diagnostic and procedural coding do not accurately identify the risk status or disease state of prostate cancer (PCa). This study reports the development and validation of NLP tools deployed on clinical notes to identify risk status or disease state. Methods: Using diagnosis and histology codes, we queried the VA Corporate Data Warehouse to identify Veterans with prostate cancer. We included structured laboratory tests, medications, procedures, and surgeries related to prostate cancer diagnosis or treatment in the analysis. Using structured data, we identified 1000 likely mPCa cases and controls. Medical records were reviewed to confirm status and to extract term dictionaries related to cancer, anatomy, metastasis, and other diagnostic concepts. We went through several iterations of testing to refine and validate the NLP tool on a limited set of known cases and controls. We deployed the tool on all cancer, urology, pathology, and radiation oncology notes. Results: The NLP system was able to identify the patients' history of metastatic disease with 0.975 precision and 0.828 recall. Among the 1,081,137 Veterans with prostate cancer, NLP identified 63,222 (5.8%) with mPCa. There are 16,282 Veterans alive with mPCa. Mean age of diagnosis was 67 and 8,847 (54.3%) were diagnosed in the VA. Demographics were: White 9,756 (60%), Black 4,466 (27%), and other 2,060 (13%). Conclusions: NLP is a reliable tool for identifying Veterans who may benefit from novel innovations in mPCa diagnosis and treatment.

Validation MetricValueDetail
Precision0.975True Positive (TP) (159) / (TP (159) + False Positive (4))
Recall0.828TP (159) / (TP (159) + False Negative (33))

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Abstract Details

Meeting

2020 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer - Advanced,Prostate Cancer - Localized

Sub Track

Patient-Reported Outcomes and Real-World Evidence

Citation

J Clin Oncol 38, 2020 (suppl 6; abstr 60)

Abstract #

60

Poster Bd #

C4

Abstract Disclosures

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