The attached query was developed to track medication refill encounters in emergency departments in ESSENCE during evacuations or extended mass gathering events. The query was initially developed for use with the chief complaint, triage note, and discharge diagnosis code (ICD-10 CM).
Comprehensive medical syndrome definitions are critical for outbreak investigation, disease trend monitoring, and public health surveillance. However, because current definitions are based on keyword string-matching, they may miss important distributional information in free text and medical codes that could be used to build a more general classifier. Here, we explore the idea that individual ICD codes can be categorized by examining their contextual relationships across all other ICD codes. We extend previous work in representation learning with medical data by generating dense vector embeddings of these ICD codes found in emergency department (ED) visit records. The resulting representations capture information about disease co-occurrence that would typically require SME involvement and support the development of more robust syndrome definitions.
Objective:
To better define and automate biosurveillance syndrome categorization using modern unsupervised vector embedding techniques.
Standard syndrome definitions for ED visits in ESSENCE rely on chief complaints. Visits with more words in the chief complaint field are more likely to match syndrome definitions. While using ESSENCE, we observed geographic differences in chief complaint length, apparently related to differences in electronic health record (EHR) systems, which resulted in disparate syndrome matching across Idaho regions. We hypothesized that chief complaint and diagnosis code co-occurrence among ED visits to facilities with long chief complaints could help identify terms that would improve syndrome match among facilities with short chief complaints.
Objective:
We sought to use free text mining tools to improve emergency department (ED) chief complaint and discharge diagnosis data syndrome definition matching across facilities with differing robustness of data in the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) application in Idahoâs syndromic surveillance system.