Automating venous thromboembolism risk assessment: a dual-branch deep learning method using electronic medical records

Front Med (Lausanne). 2023 Aug 10:10:1237616. doi: 10.3389/fmed.2023.1237616. eCollection 2023.

Abstract

Background: Venous thromboembolism (VTE) is a prevalent cardiovascular disease. Although risk assessment and preventive measures are effective, manual assessment is inefficient and covers a small population in clinical practice. Hence, it is necessary to explore intelligent methods for VTE risk assessment.

Methods: The Padua scale has been widely used in VTE risk assessment, and we divided its assessment into disease category judgment and comprehensive clinical information judgment according to the characteristics of the Padua scale. We proposed a dual-branch deep learning (DB-DL) assessment method. First, in the disease category branch, we propose a deep learning-based Padua disease classification model (PDCM) for determining patients' Padua disease categories by considering patients' diagnosis, symptoms, and symptom weights. In the branch of comprehensive clinical information, we use the Chinese lexical analysis (LAC) word separation technique, combined with professional corpus and rules, to extract and judge the comprehensive clinical factors in the electronic medical record (EMR).

Results: We validated the accuracy of the method with the Padua assessment results of 7,690 Chinese clinical EMRs. First, our proposed method allows for a fully automated assessment, and the average time to assess one patient is only 0.37 s. Compared to the gold standard, our method has an Area Under Curve (AUC) value of 0.883, a specificity value of 0.957, and a sensitivity value of 0.816 for assessing the Padua risk patient class.

Conclusion: Our DB-DL assessment method automates VTE risk assessment, thereby addressing the challenges of time-consuming evaluation and limited population coverage. Thus, this method is highly clinically valuable.

Keywords: Padua; deep learning; electronic medical record; intelligent assessment; venous thromboembolism.

Grants and funding

This study has received funding from the National Natural Science Foundation of China, No. 82160347 and the Yunnan Key Laboratory of Smart City in Cyberspace Security, No. 202102AE090031.