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Applying a Text-Search Algorithm to Radiology Reports Can Find More Patients With Pulmonary Nodules Than Radiology Coding Alone.

Applying a Text-Search Algorithm to Radiology Reports Can Find More Patients With Pulmonary Nodules Than Radiology Coding Alone.

Authors :
Sanchez R
Bailey G
Kaboli PJ
Zeliadt SB
Lang JA
Hoffman RM
Source :
Federal practitioner : for the health care professionals of the VA, DoD, and PHS [Fed Pract] 2020 May; Vol. 37 (Suppl 2), pp. S32-S37.
Publication Year :
2020

Abstract

Introduction: Chest imaging often incidentally finds indeterminate nodules that need to be monitored to ensure early detection of lung cancers. Health care systems need effective approaches for identifying these lung nodules. We compared the diagnostic performance of 2 approaches for identifying patients with lung nodules on imaging studies (chest/abdomen): (1) relying on radiologists to code imaging studies with lung nodules; and (2) applying a text search algorithm to identify references to lung nodules in radiology reports.<br />Methods: We assessed all radiology studies performed between January 1, 2016 and November 30, 2016 in a single Veterans Health Administration hospital. We first identified imaging reports with a diagnostic code for a pulmonary nodule. We then applied a text search algorithm to identify imaging reports with key words associated with lung nodules. We reviewed medical records for all patients with a suspicious radiology report based on either search strategy to confirm the presence of a lung nodule. We calculated the yield and the positive predictive value (PPV) of each search strategy for finding pulmonary nodules.<br />Results: We identified 12,983 imaging studies with a potential lung nodule. Chart review confirmed 8,516 imaging studies with lung nodules, representing 2,912 unique patients. The text search algorithm identified all the patients with lung nodules identified by the radiology coding (n = 1,251) as well as an additional 1,661 patients. The PPV of the text search was 72% (2,912/4,071) and the PPV of the radiology code was 92% (1,251/1,363). Among the patients with nodules missed by radiology coding but identified by the text search algorithm, 130 had lung nodules > 8 mm in diameter.<br />Conclusions: The text search algorithm can identify additional patients with lung nodules compared to the radiology coding; however, this strategy requires substantial clinical review time to confirm nodules. Health care systems adopting nodule-tracking approaches should recognize that relying only on radiology coding might miss clinically important nodules.<br />Competing Interests: Author disclosures The authors report no actual or potential conflicts of interest with regard to the article.<br /> (Copyright © 2020 Frontline Medical Communications Inc., Parsippany, NJ, USA.)

Details

Language :
English
ISSN :
1078-4497
Volume :
37
Issue :
Suppl 2
Database :
MEDLINE
Journal :
Federal practitioner : for the health care professionals of the VA, DoD, and PHS
Publication Type :
Academic Journal
Accession number :
32952385