Leveraging Electronic Dental Record Data to Classify Patients Based on Their Smoking Intensity

J. Patel; Z. Siddiqui; A. Krishnan; T. P. Thyvalikakath

doi:10.1055/s-0039-1681088

Methods of Information in Medicine, Table of Contents

Methods Inf Med 2018; 57(05/06): 253-260
DOI: 10.1055/s-0039-1681088

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Leveraging Electronic Dental Record Data to Classify Patients Based on Their Smoking Intensity

Authors

J. Patel

¹Dental Informatics Core Division, Department of Cariology, Operative Dentistry, and Dental Public Health, Indiana University School of Dentistry, Indiana University – Purdue University Indianapolis, Indianapolis, Indiana, United States

²Department of Bio-Health Informatics, School of Informatics and Computing, Indiana University – Purdue University Indianapolis, Indianapolis, Indiana, United States
Z. Siddiqui

¹Dental Informatics Core Division, Department of Cariology, Operative Dentistry, and Dental Public Health, Indiana University School of Dentistry, Indiana University – Purdue University Indianapolis, Indianapolis, Indiana, United States
A. Krishnan

¹Dental Informatics Core Division, Department of Cariology, Operative Dentistry, and Dental Public Health, Indiana University School of Dentistry, Indiana University – Purdue University Indianapolis, Indianapolis, Indiana, United States
T. P. Thyvalikakath

¹Dental Informatics Core Division, Department of Cariology, Operative Dentistry, and Dental Public Health, Indiana University School of Dentistry, Indiana University – Purdue University Indianapolis, Indianapolis, Indiana, United States

²Department of Bio-Health Informatics, School of Informatics and Computing, Indiana University – Purdue University Indianapolis, Indianapolis, Indiana, United States

³Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, United States

Abstract

Background Smoking is an established risk factor for oral diseases and, therefore, dental clinicians routinely assess and record their patients' detailed smoking status. Researchers have successfully extracted smoking history from electronic health records (EHRs) using text mining methods. However, they could not retrieve patients' smoking intensity due to its limited availability in the EHR. The presence of detailed smoking information in the electronic dental record (EDR) often under a separate section allows retrieving this information with less preprocessing.

Objective To determine patients' detailed smoking status based on smoking intensity from the EDR.

Methods First, the authors created a reference standard of 3,296 unique patients’ smoking histories from the EDR that classified patients based on their smoking intensity. Next, they trained three machine learning classifiers (support vector machine, random forest, and naïve Bayes) using the training set (2,176) and evaluated performances on test set (1,120) using precision (P), recall (R), and F-measure (F). Finally, they applied the best classifier to classify smoking status from an additional 3,114 patients’ smoking histories.

Results Support vector machine performed best to classify patients into smokers, nonsmokers, and unknowns (P, R, F: 98%); intermittent smoker (P: 95%, R: 98%, F: 96%); past smoker (P, R, F: 89%); light smoker (P, R, F: 87%); smokers with unknown intensity (P: 76%, R: 86%, F: 81%), and intermediate smoker (P: 90%, R: 88%, F: 89%). It performed moderately to differentiate heavy smokers (P: 90%, R: 44%, F: 60%). EDR could be a valuable source for obtaining patients’ detailed smoking information.

Conclusion EDR data could serve as a valuable source for obtaining patients' detailed smoking information based on their smoking intensity that may not be readily available in the EHR.

Keywords

electronic dental record - smoking intensity - information extraction - electronic health record - dental informatics - machine learning classifiers

Full Text

References

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