Using RxNorm and NDF-RT to classify medication data extracted from electronic health records: experiences from the Rochester Epidemiology Project.
(2/10)
RxNorm and NDF-RT published by the National Library of Medicine (NLM) and Veterans Affairs (VA), respectively, are two publicly available federal medication terminologies. In this study, we evaluate the applicability of RxNorm and National Drug File-Reference Terminology (NDF-RT) for extraction and classification of medication data retrieved using structured querying and natural language processing techniques from electronic health records at two different medical centers within the Rochester Epidemiology Project (REP). Specifically, we explore how mappings between RxNorm concept codes and NDF-RT drug classes can be leveraged for hierarchical organization and grouping of REP medication data, identify gaps and coverage issues, and analyze the recently released NLM's NDF-RT Web service API. Our study concludes that RxNorm and NDF-RT can be applied together for classification of medication extracted from multiple EHR systems, although several issues and challenges remain to be addressed. We further conclude that the Web service APIs developed by the NLM provide useful functionalities for such activities. (+info)
An approximate matching method for clinical drug names.
(3/10)
OBJECTIVE: To develop an approximate matching method for finding the closest drug names within existing RxNorm content for drug name variants found in local drug formularies. METHODS: We used a drug-centric algorithm to determine the closest strings between the RxNorm data set and local variants which failed the exact and normalized string matching searches. Aggressive measures such as token splitting, drug name expansion and spelling correction are used to try and resolve drug names. The algorithm is evaluated against three sets containing a total of 17,164 drug name variants. RESULTS: Mapping of the local variant drug names to the targeted concept descriptions ranged from 83.8% to 92.8% in three test sets. The algorithm identified the appropriate RxNorm concepts as the top candidate in 76.8%, 67.9% and 84.8% of the cases in the three test sets and among the top three candidates in 90-96% of the cases. CONCLUSION: Using a drug-centric token matching approach with aggressive measures to resolve unknown names provides effective mappings to clinical drug names and has the potential of facilitating the work of drug terminology experts in mapping local formularies to reference terminologies. (+info)
Using RxNorm for cross-institutional formulary data normalization within a distributed grid-computing environment.
(4/10)
Within the CTSA (Clinical Translational Sciences Awards) program, academic medical centers are tasked with the storage of clinical formulary data within an Integrated Data Repository (IDR) and the subsequent exposure of that data over grid computing environments for hypothesis generation and cohort selection. Formulary data collected over long periods of time across multiple institutions requires normalization of terms before those data sets can be aggregated and compared. This paper sets forth a solution to the challenge of generating derived aggregated normalized views from large, distributed data sets of clinical formulary data intended for re-use within clinical translational research. (+info)
Using Medical Text Extraction, Reasoning and Mapping System (MTERMS) to process medication information in outpatient clinical notes.
(5/10)
Clinical information is often coded using different terminologies, and therefore is not interoperable. Our goal is to develop a general natural language processing (NLP) system, called Medical Text Extraction, Reasoning and Mapping System (MTERMS), which encodes clinical text using different terminologies and simultaneously establishes dynamic mappings between them. MTERMS applies a modular, pipeline approach flowing from a preprocessor, semantic tagger, terminology mapper, context analyzer, and parser to structure inputted clinical notes. Evaluators manually reviewed 30 free-text and 10 structured outpatient clinical notes compared to MTERMS output. MTERMS achieved an overall F-measure of 90.6 and 94.0 for free-text and structured notes respectively for medication and temporal information. The local medication terminology had 83.0% coverage compared to RxNorm's 98.0% coverage for free-text notes. 61.6% of mappings between the terminologies are exact match. Capture of duration was significantly improved (91.7% vs. 52.5%) from systems in the third i2b2 challenge. (+info)
Utilizing RxNorm to support practical computing applications: capturing medication history in live electronic health records.
(6/10)
Issues in creating and maintaining value sets for clinical quality measures.
(7/10)
OBJECTIVE: To develop methods for assessing the validity, consistency and currency of value sets for clinical quality measures, in order to support the developers of quality measures in which such value sets are used. METHODS: We assessed the well-formedness of the codes (in a given code system), the existence and currency of the codes in the corresponding code system, using the UMLS and RxNorm terminology services. We also investigated the overlap among value sets using the Jaccard similarity measure. RESULTS: We extracted 163,788 codes (76,062 unique codes) from 1463 unique value sets in the 113 quality measures published by the National Quality Forum (NQF) in December 2011. Overall, 5% of the codes are invalid (4% of the unique codes). We also found 67 duplicate value sets and 10 pairs of value sets exhibiting a high degree of similarity (Jaccard > .9). CONCLUSION: Invalid codes affect a large proportion of the value sets (19%). 79% of the quality Measures have at least one value set exhibiting errors. However, 50% of the quality measures exhibit errors in less than 10 % of their value sets. The existence of duplicate and highly-similar value sets suggests the need for an authoritative repository of value sets and related tooling in order to support the development of quality measures. (+info)
Extracting drug indication information from structured product labels using natural language processing.
(8/10)