Electronic interpretation of chest radiograph reports to detect central venous catheters

Infect Control Hosp Epidemiol. 2003 Dec;24(12):950-4. doi: 10.1086/502165.

Abstract

Objective: To evaluate whether a natural language processing system, SymText, was comparable to human interpretation of chest radiograph reports for identifying the mention of a central venous catheter (CVC), and whether use of SymText could detect patients who had a CVC.

Design: To identify patients who had a CVC, we performed two surveys of hospitalized patients. Then, we obtained available reports from 104 patients who had a CVC during one of two cross-sectional surveys (ie, case-patients) and 104 randomly selected patients who did not have a CVC (ie, control-patients).

Setting: A 600-bed public teaching hospital.

Results: Chest radiograph reports were available from 124 of the 208 participants. Compared with human interpretation, SymText had a sensitivity of 95.8% and a specificity of 98.7%. The use of SymText to identify case- and control-patients resulted in a sensitivity of 43% and a specificity of 98%. Successful application of SymText varied significantly by venous insertion site (eg, a sensitivity of 78% for subclavian and a sensitivity of 3.7% for femoral). Twenty-six percent of the case-patients had a femoral CVC.

Conclusions: Compared with human interpretation, SymText performed well in interpreting whether a report mentioned a CVC. In patient populations with less frequent CVC placement in femoral veins, the sensitivity for CVC detection likely would be higher. Applying a natural language processing system to chest radiograph reports may be a useful adjunct to other data sources to automate detection of patients who had a CVC.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / instrumentation
  • Catheterization, Central Venous / statistics & numerical data*
  • Catheters, Indwelling / microbiology
  • Catheters, Indwelling / statistics & numerical data*
  • Chicago / epidemiology
  • Cross Infection / epidemiology*
  • Cross Infection / etiology
  • Hospitals, Public
  • Hospitals, Teaching
  • Humans
  • Image Interpretation, Computer-Assisted*
  • Natural Language Processing*
  • Radiography, Thoracic*
  • Radiology / methods*
  • Radiology Information Systems
  • Sensitivity and Specificity
  • Sentinel Surveillance
  • Sepsis / epidemiology*
  • Sepsis / etiology