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SAGE Publications, Health Informatics Journal, 1(29), p. 146045822211156, 2023

DOI: 10.1177/14604582221115667

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Using ICD-9 diagnostic codes for external validation of topic models derived from primary care electronic medical record clinical text data

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Data provided by SHERPA/RoMEO

Abstract

Background/Objectives: Unsupervised topic models are often used to facilitate improved understanding of large unstructured clinical text datasets. In this study we investigated how ICD-9 diagnostic codes, collected alongside clinical text data, could be used to establish concurrent-, convergent- and discriminant-validity of learned topic models. Design/Setting: Retrospective open cohort design. Data were collected from primary care clinics located in Toronto, Canada between 01/01/2017 through 12/31/2020. Methods: We fit a non-negative matrix factorization topic model, with K = 50 latent topics/themes, to our input document term matrix (DTM). We estimated the magnitude of association between each Boolean-valued ICD-9 diagnostic code and each continuous latent topical vector. We identified ICD-9 diagnostic codes most strongly associated with each latent topical vector; and qualitatively interpreted how these codes could be used for external validation of the learned topic model. Results: The DTM consisted of 382,666 documents and 2210 words/tokens. We correlated concurrently assigned ICD-9 diagnostic codes with learned topical vectors, and observed semantic agreement for a subset of latent constructs (e.g. conditions of the breast, disorders of the female genital tract, respiratory disease, viral infection, eye/ear/nose/throat conditions, conditions of the urinary system, and dermatological conditions, etc.). Conclusions: When fitting topic models to clinical text corpora, researchers can leverage contemporaneously collected electronic medical record data to investigate the external validity of fitted latent variable models.