Article Figures & Data
Figures
- Figure 1.
Study flowchart for clinical text note selection.
CFEM = clinical feature extraction model; CTN = clinical text note; PC = primary care.
- Figure 2.
The outcome distribution in the cross-validated data set.
CXR = chest x-ray; CRP = C-reactive protein; ICD-10 = International Classification of Diseases, 10th Revision; J00 = common cold; J15 =bacterial pneumonia; J20 = acute bronchitis; J44 = chronic obstructive pulmonary disease; J45 = asthma.
Notes: (A-E) bars represent 95% CIs. (F) shaded area represents 95% CIs.
- Figure 3.
The outcome distribution in test set 1.
CXR = chest x-ray; CRP = C-reactive protein; dL= deciliter; ED = emergency department; ICD-10 = International Classification of Diseases, 10th revision; J00 = common cold; J15 = bacterial pneumonia; J20 = acute bronchitis; J44 = chronic obstructive pulmonary disease; J45 = asthma; mg = milligram; PC = primary care.
Notes: (B) bars represent 95% CIs. (F) shaded area represents 95% CIs.
- Figure 4.
The outcome distribution in test set 2.
CXR = chest x-ray; CRP = C-reactive protein; dL= deciliter; ICD-10 = International Classification of Diseases, 10th revision; mg = milligram; PC = primary care.
Notes: (B) bars represent 95% CIs. (F) shaded area represents 95% CIs. ICD-10 code distribution in test set 2 was not examined for these symptomatically similar patients.
Tables
Variable Training Set Test Set 1 Test Set 2 Demographics Patients, No. 1,500 500 664 Age, mean (range), y 54
(18-93)55
(19-91)45
(18-92)Sex, female, % 66.1 62.6 61.1 ICD-10 codes, % J00 20.2 19.2 0.0 J15 0.4 0.2 0.0 J20 46.5 48.2 0.0 J44 11.1 9.8 0.0 J45 21.8 22.6 0.0 J10 0.0 0.0 0.8 J11 0.0 0.0 99.2 Patient outcomes CRP value, mean (range), mg /dL 20.7
(3-183)18.8
(3-84)28.2
(3-178)Antibiotics prescribed, % 49.0 50.8 15.5 CXRs ordered, % 6.6 6.8 3.5 CXR signs of pneumonia, % 12.6 9.6 9.1 CXR incidentaloma, % 1.6 3.2 4.3 PC re-evaluation, % 8.2 6.8 10.0 ED re-evaluation, % 0.2 0.6 0.8 CRP = C-reactive protein; CXR = chest x-ray; ED = emergency department; ICD-10 = International Classification of Diseases, 10th Revision; J00 = common cold; J11 = influenza; J12 = viral pneumonia; J15 = bacterial pneumonia; J20 = acute bronchitis; J44 = chronic obstructive pulmonary disease; ; J45 = asthma; PC = primary care.
- Table 2.
Comparison of Outcome Rates in the Test Sets Between Low-Risk and High-Risk Groups
Outcomesa Low-Risk Group High-Risk Group Sensitivity Specificity PPV NPV P Value Test set 1 Mean CRP values 7.9 23.0 … … … … <.05 Antibiotics prescribed 66 (40%) 188 (56.1%) 0.74 0.40 0.56 0.60 <.005 PC re-evaluation 9 (5.4%) 36 (10.7%) 0.80 0.34 0.11 0.95 .07 ED re-evaluation 1 (0.6%) 3 (0.89%) 0.50 0.33 0.01 0.98 .67 CXRs ordered 6 (3.6%) 25 (7.4%) 0.81 0.34 0.075 0.96 .07 Positive CXRsb 0 (0.0%) 3 (0.89%) 1.00 0.33 0.01 1.00 .30 Test set 2 Mean CRP values 29.4 27.4 … … … … 1.00 Antibiotics prescribed 33 (10.9%) 68 (18.7%) 0.67 0.48 0.19 0.89 <.05 PC re-evaluation 30 (9.9%) 35 (9.6%) 0.54 0.45 0.10 0.90 .90 ED re-evaluation 1 (0.3%) 4 (1.2%) 0.80 0.46 0.01 1.00 .38 CXRs ordered 8 (2.7%) 15 (4.1%) 0.65 0.46 0.04 0.97 .40 Positive CXRsb 0 (0.0%) 2 (0.6%) 1.00 0.45 0.01 1.00 .50 CRP = C-reactive protein; CXR = chest x-ray; ED = emergency department; NPV = negative predictive value; PC = primary care; PPV = positive predictive value.
Note: Test set 1 had 165 patients in low-risk group and 335 in high risk group; Test set 2 had 301 patients in low-risk group and 363 in high-risk group.
↵a Mean CRP values reported for groups in mg/dL. Other outcomes reported for groups as number of patients (percentage).
↵b Positive CXRs included those with signs of pneumonia only, incidentalomas were excluded.
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