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...
| Authors: | ; ; ; ; ; ; ; ; ; ; ; |
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| Format: | Article |
| Status: | Published version |
| Publication date: | 2022 |
| Country: | España |
| Institution: | Universitat Pompeu Fabra |
| Repository: | Repositorio Digital de la UPF |
| OAI Identifier: | oai:repositori.upf.edu:10230/54018 |
| Online Access: | http://hdl.handle.net/10230/54018 http://dx.doi.org/10.2196/39003 |
| Access Level: | Open access |
| Keyword: | Cancer Depression Electronic health records Natural language processing Text mining |
| _version_ | 1878729672413413376 |
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| author | Leis Machín, Angela 1974- |
| 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 |
| author_browse | Albanell Mestres, Joan Casadevall Aguilar, David Castells, Xavier Furlong, Laura I., 1971- Leis Machín, Angela 1974- Macià Guilà, Francesc Assís Martínez Roldán, Jordi Mayer, Miguel Ángel, 1960- Posso, Margarita Ramírez Anguita, Juan Manuel Ronzano, Francesco Sanz, Ferran |
| 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 |
| collection | Repositorio Digital de la UPF |
| 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_0ca6e9d2f16b4aaf8bb2f2e6d0bc445d |
| institution | Universitat Pompeu Fabra |
| instname_str | Universitat Pompeu Fabra |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:repositori.upf.edu:10230/54018 |
| publishDate | 2022 |
| publishDateSort | 2022 |
| publisher | JMIR Publications |
| publisherStr | JMIR Publications |
| reponame_str | Repositorio Digital de la UPF |
| spelling | Exploring the association of cancer and depression in electronic health records: combining encoded diagnosis and mining free-text clinical notes 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- Cancer Depression Electronic health records Natural language processing Text mining 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. 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 Publications http://hdl.handle.net/10230/54018 http://dx.doi.org/10.2196/39003 |
| 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 |
| status_str | publishedVersion |
| title | 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_short | 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 |
| topic | Cancer Depression Electronic health records Natural language processing Text mining |
| topic_facet | Cancer Depression Electronic health records Natural language processing Text mining |
| url | http://hdl.handle.net/10230/54018 http://dx.doi.org/10.2196/39003 |