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Feasibility of An Assisted Chart Review for Assessing the Development of Radiation Pneumonitis

Jordan McKenzie(1), Jinying Wu(2), Hua Shen(2), Shan Rajapakshe(3), Rasika Rajapakshe(4,5), Angela Lin(5,6) (1) Northern Medical Program, Faculty of Medicine, University of British Columbia; (2) Department of Mathematics & Statistics, University of Calgary; (3) Island Medical Program, Faculty of Medicine, University of British Columbia; (4) Medical Physics, BC Cancer Kelowna; (5) Department of Surgery, Faculty of Medicine, University of British Columbia; (6) Radiation Oncology, BC Cancer Kelowna.


(Sunday, 7/12/2020)   [Eastern Time (GMT-4)]

Room: AAPM ePoster Library

Manual chart review is a labour-intensive process requiring significant time investment for clinical researchers. Our project aims to evaluate the feasibility and accuracy of an assisted chart review program to identify patients who developed radiation pneumonitis (RP) after receiving curative radiation therapy (RT).

A retrospective chart review was completed for patients who received curative RT for stage II-III lung cancer from January 1, 2013 to December 31, 2015 at BC Cancer Kelowna. In the manual chart review, RP diagnosis and grading were recorded using Common Terminology Criteria for Adverse Events (CTCAE) v4.0. From the charts of 50 sample patients, a total of 1413 clinical documents were extracted for review from the Cancer Agency Information System (CAIS). The computer program was built using the Natural Language Toolkit (NLTK) Python platform. Python version 3.7.2. was used to run the computer algorithm. The output of the computer program is a list of the full sentences containing the key terms, the document ID’s and dates from which these sentences were extracted. The computer program and manual chart review results were then compared.

The algorithm was able to ascertain 23 out of 25 patients who developed RP = grade 1 (sensitivity = 0.92, 95%CI:0.74-0.99; specificity = 0.36, 95%CI:0.18-0.57), and all 9 patients with RP = grade 2 (sensitivity = 1.0, 95%CI: 0.66-1.0; specificity = 0.27, 95%CI:0.14-0.43). The utility of the algorithm would be avoiding unnecessary manual review of 11 non-RP patients, including their 198 (14% total) electronic documents.

This feasibility study showed that the computer program was able to assist with the identification of patients who developed RP after curative radiotherapy. This work has a potential to improve future clinical research, as the computer program can perform chart review in a more time efficient manner, compared to traditional manual chart review.


Computer Software, Data Acquisition


IM/TH- Informatics: Data archiving - Therapy

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