Medical data and text miningLinking diseases, drugs, and

adverse reactions

Lars Juhl Jensen

structured data

Jensen et al., Nature Reviews Genetics, 2012

central registries

unstructured data

individual hospitals

opt-out

opt-in

diagnosis trajectories

Danish registries

civil registration system

established in 1968

Jensen et al., Nature Reviews Genetics, 2012

national discharge registry

14 years

6.2 million patients

45 million admissions

68 million records

119 million diagnosis

ICD-10

Jensen et al., Nature Reviews Genetics, 2012

not research

reimbursement

comorbidity

naïve approach

contingency table

Jensen et al., Nature Reviews Genetics, 2012

confounding factors

“known knowns”

gender

age

type of hospital encounter

Jensen et al., Nature Communications, 2014

“known unknowns”

smoking

diet

“unknown unknowns”

reporting biases

matched controls

proxy diagnoses

temporal correlations

diagnosis trajectories

Jensen et al., Nature Communications, 2014

trajectory networks

Jensen et al., Nature Communications, 2014

key diagnoses

Jensen et al., Nature Communications, 2014

direct medical implications

pharmacovigilance

clinical trials

spontaneous reports

underreporting

data mining

structured data

Jensen et al., Nature Reviews Genetics, 2012

unstructured data

free text

Danish

busy doctors

typos

psychiatric patients

text mining

computer

as smart as a dog

teach it specific tricks

comprehensive dictionary

adverse drug reactions

drugs

Clozapine

Clozapineclozapi

n

clossapin

klozapine

chlosapin

chlosapine

chlozapin

chlozapine

klossapin

closapine

klozapinklosapi

n

temporal correlations

hand-crafted rules

Eriksson et al., Drug Safety, 2014

Drug introduction Drug discontinuationAdverse event

Adverse eventNegative modifier Indication Pre-existingcondition

Adverse drug reaction Possibleadverse drug reaction

ADR ofadditional drug

Eriksson et al., Drug Safety, 2014

Drug introduction Drug discontinuationAdverse eventIdentification start

Adverse eventNegative modifier Indication Pre-existingcondition

Adverse drug reaction Possibleadverse drug reaction

ADR ofadditional drug

Eriksson et al., Drug Safety, 2014

Drug introduction Drug discontinuation

Adverse eventNegative modifier Indication Pre-existingcondition

Adverse drug reaction Possibleadverse drug reaction

Adverse event

ADR ofadditional drug

Identification start

Eriksson et al., Drug Safety, 2014

Drug introduction Drug discontinuation

Adverse eventNegative modifier Indication Pre-existingcondition

Adverse drug reaction Possibleadverse drug reaction

Adverse event

ADR ofadditional drug

Identification start

recall known ADRs

discover new ADRs

estimate ADR frequencies

AcknowledgmentsDisease trajectoriesAnders Bøck JensenTudor OpreaPope MoseleySøren Brunak

Adverse drug reactionsRobert ErikssonThomas WergeSøren Brunak

EHR text miningPeter Bjødstrup

JensenRobert Eriksson

Henriette SchmockFrancisco S. Roque

Anders JuulMarlene Dalgaard

Massimo AndreattaSune FrankildEva Roitmann

Thomas HansenKaren Søeby

Søren BredkjærThomas Werge

Søren Brunak

ありがとうございます