Major Depressive Disorder: 10/16/09

Courtesy Patience Gallagher

Minutes:

Collapsing terms

o   McLean admission à change to psych admission

o   List of terms that Jordan gave Margarita that we didn’t necessarily annotate, Margarita will add after.

o   Terms that have the same regular expression will be filtered at the end

o   Medication category: fga

• We annotated as IW bipolar, but last time we said was CW, which one is it?
• Sergey says right now doesn’t matter, because the computer will decide
• We will keep it labeled as IW

o   Li/vpa/lamtical à change to mood stablilizer

• Add term mood stabilizer(s)

o   Neuro/cognitive impairment includes

• Confused and disoriented
• Gross cognitive impairment
• Significant cognitive deficits
• dementia

o   Agitation includes

• Hyperactivity
• Hyper
• pacing

o   dx depression includes:

• depressive disorder
• dsythymia

o   bipolar disorder includes:

• dx bipolar disorder
• 296.0, .1, .4, .5, .6, .7
• • .2, .3 are MDD, so we cannot say 296.x = BPD

o   Inappropriate behavior category, leave in:

• Wanting to disrobe
• Inappropriate sexual contacts (do not put with excessive pleasurable activities)

o   Rapid cycling

• 4 or more per year

o   Mania will include

• Category now called “mania/manic”
• Category now called “manic episode”
• Cycling, cycles (not specified as rapid/less than 4 per year)

o   Typos will include variations on spellings of:

• Grandiose
• distractibility

o   “loose associations” will be its own category

o   Depressed episode à put with hx depression

o   “unable to read, study, concentrate” à put with distractibility

o   “tx bipolar disorder” à add in term “rx”

o   Hypomania will be own category

o   hyper mood à mood elevation

o   Delete:

§ Line 310: dx substance abuse, schizophreniaParanoid schizo-affected disorder

§ Out of control

Big group: 9:30-10:30

·       Protocol in the grant

• Are we doing what we said in the grant? For ex. Step #3
• • In grant, describes that classic way of doing NLP
  • You come up with list of terms from your head without looking at notes.
  • Then expand these terms, add regular expressions, negation
• Our method
• • Is a hybrid of the 2. We annotated notes, but we also came up with a list of terms
  • Annotate notes, generate list of terms, create regular expression, group, add in a priori terms, Tianxi goes through them and takes out terms that don’t matter (lasso), then feed to the computer
  • The IRB will not really care that this is slightly different.
• Which method is better?
• • Unknown
  • Classic model relies on what’s in your head, our method relies on # notes reviewed
  • We could try to compare, but it’s a little too late because our list of terms wasn’t blind to the notes
• Dr. Savova ) will be coming on boad as NLP team lead
• • Would be good for her to give mini lecture about NLP so we are prepared to present at conferences
  • Should consult with her about project
• Negation
• • So far Margarita has only added negation to some terms
  • Should modify algorithm so that every term also has corresponding negation term
  • Negation terms are very common in psych notes
  • Sergey to see if this can be done, although a lot of work
  • Would be useful for future i2b2 projects
  • Margarita explained that she plans on conducting a small validation study
  • • For a particular patient, she can provide an idea of how strong the diagnosis we assign (e.g. BP2) is by showing what are the arguments for/against placing a person in a particular class

·       Next steps:

o   Jordan, Vivian, Margarita, Sergey, Victor, Roy to meet on Tuesday, October 20^th 10:00 – 11:00 to finish collapsing term.