Adverse Events

When the nlp-insights service is configured to use ACD for NLP processing, the service will discover AdverseEvent FHIR resources.

Within the FHIR standard, an adverse event is the result of an intervention that caused unintentional harm to a specific subject or group of subjects.

The nlp-insights service will detect adverse events that are medication related, such as a drug interaction.

👉 The FHIR standard states that an AdverseEvent resource should not be used when a more specific resource exists. This means that the adverse event should not be discovered for an allergic reaction to a medication, since FHIR defines an AllergyIntolerance resource that is more specific. The differentiation of an adverse event from other FHIR concepts such as allergies requires an advanced NLP engine such as ACD, since more language awareness is required than simple pattern matching can provide.

🚧 Adverse events are characterized by the need to capture cause and effect, in addition to actuality, severity and outcome. The nlp-insights service currently limits discovery to the detection of medication related adverse events. There is no support for creating cause/effect/outcome relationships with other resources that represent characteristics of the event. Standard codes such as SNOMED CT and MedDRA are NOT included in the created AdverseEvent FHIR resource. While detection is a significant step forward, further contributions to this feature will be needed when more ACD support becomes available. 🚧

The capabilities of the nlp-insights service are best explained using an example.

✋ Before using the nlp-insights service, it must be started and configured for ACD.
If the nlp-insights service has not been started and configured to use ACD, follow the steps here.

Derive insights from a diagnostic report that describes an adverse event

Adverse Events are very challenging for NLP to recognize because they involve multiple concepts, temporal relationships and causality.

This example is typical; There is no single concept or span of text that indicates an Adverse Event happened. 

B64_REPORT_TEXT=$(echo "\
The patient's course was also complicated by mental status \
changes secondary to a combination of his narcotics and Neurontin, \
which had been given for his trigeminal neuralgia and chronic pain. \
The Neurontin was stopped and he received hemodialysis on consecutive days.\
" | base64 -w 0)

The diagnostic report is built and sent to the nlp-insights service for insight discovery. The returned resources are stored in a json file for future analysis. (The report text has alredy been converted to base64 encoding, so that it can be attached to a diagnostic report).

curl  -w "\n%{http_code}\n" -s -o /tmp/output.json -XPOST localhost:5000/discoverInsights  -H 'Content-Type: application/json; charset=utf-8' --data-binary @- << EOF
{
    "resourceType": "Bundle",
    "id": "abc",
    "type": "transaction",
    "entry": [
        {
            "resource": {
                "id": "abcefg-1234567890",
                "status": "final",
                "code": {
                    "text": "Chief complaint Narrative - Reported"
                },
                "presentedForm": [
                    {
                        "contentType": "text",
                        "language": "en",
                        "data": "$B64_REPORT_TEXT",
                        "title": "ER VISIT",
                        "creation": "2020-08-02T12:44:55+08:00"
                    }
                ],
                "resourceType": "DiagnosticReport"
            },
            "request": {
                "method": "POST",
                "url": "DiagnosticReport"
            }
        }
    ]
}
EOF

Adverse Event Resources

In addition to two conditions and a medication statement, the nlp-insights service has discovered adverse events associated with "narcotics" and "neurontin".

Resource Type Description
DiagnosticReport Chief complaint Narrative - Reported
Condition trigeminal neuralgia
Condition chronic pain
MedicationStatement Neurontin
AdverseEvent narcotics
AdverseEvent neurontin

The complete json for the two Adverse Events are included here, with the highlights being discussed in the next sections.

Adverse Event resource for "narcotics" 
{
  "meta": {
    "extension": [
      {
        "extension": [
          {
            "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-id",
            "valueIdentifier": {
              "system": "urn:alvearie.io/health_patterns/services/nlp_insights/acd",
              "value": "a129d489aea84c37b7377201e70cd416fe2b26ce3dc1d29f250fdfa1"
            }
          },
          {
            "url": "http://ibm.com/fhir/cdm/StructureDefinition/path",
            "valueString": "AdverseEvent"
          },
          {
            "extension": [
              {
                "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference",
                "valueReference": {
                  "reference": "urn:uuid:7fbcf71d-44fe-466e-b8d1-bc51cedf000b"
                }
              },
              {
                "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference-path",
                "valueString": "DiagnosticReport.presentedForm[0].data"
              },
              {
                "url": "http://ibm.com/fhir/cdm/StructureDefinition/evaluated-output",
                "valueAttachment": {
                  "contentType": "application/json",
                  "data": "{"attributeValues": [{"begin": 104, "end": 113, "coveredText": "narcotics", "negated": false, "preferredName": "narcotics", "values": [{"value": "narcotics"}], "source": "Clinical Insights - Attributes", "sourceVersion": "v1.0", "concept": {"uid": 8}, "name": "MedicationAdverseEvent", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "startedEvent": {"score": 0.982, "usage": {"explicitScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "doseChangedEvent": {"score": 0.001, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.001, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.999, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 1.0, "discussedScore": 0.0}}}}}, {"begin": 118, "end": 127, "coveredText": "Neurontin", "negated": false, "preferredName": "neurontin", "values": [{"value": "neurontin"}], "source": "Clinical Insights - Attributes", "sourceVersion": "v1.0", "concept": {"uid": 9}, "name": "MedicationAdverseEvent", "rxNormId": "196498", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "startedEvent": {"score": 0.998, "usage": {"explicitScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "doseChangedEvent": {"score": 0.002, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.891, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.678, "discussedScore": 0.0}}}}}, {"begin": 165, "end": 185, "coveredText": "trigeminal neuralgia", "negated": false, "preferredName": "trigeminal neuralgia", "values": [{"value": "trigeminal neuralgia"}], "source": "Clinical Insights - Attributes", "sourceVersion": "v1.0", "concept": {"uid": 10}, "name": "Diagnosis", "icd9Code": "350.1", "icd10Code": "G50.0", "snomedConceptId": "31681005", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 1.0, "patientReportedScore": 0.0, "discussedScore": 0.0}, "suspectedScore": 0.0, "symptomScore": 0.0, "traumaScore": 0.0, "familyHistoryScore": 0.003}}, "ccsCode": "95"}, {"begin": 190, "end": 202, "coveredText": "chronic pain", "negated": false, "preferredName": "chronic pain", "values": [{"value": "chronic pain"}], "source": "Clinical Insights - Attributes", "sourceVersion": "v1.0", "concept": {"uid": 11}, "name": "Diagnosis", "icd9Code": "338.29", "icd10Code": "R52.2,R52", "snomedConceptId": "82423001", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 1.0, "patientReportedScore": 0.0, "discussedScore": 0.0}, "suspectedScore": 0.0, "symptomScore": 0.021, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "ccsCode": "259"}], "concepts": [{"type": "umls.MentalOrBehavioralDysfunction", "begin": 52, "end": 73, "coveredText": "mental status changes", "negated": false, "cui": "C0856054", "preferredName": "Mental Status Change", "semanticType": "mobd", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C157435", "loincId": "LA7455-4", "vocabs": "CHV,LNC,NCI,NCI_CPTAC,MTHICD9"}, {"type": "umls.Finding", "begin": 89, "end": 100, "coveredText": "combination", "negated": false, "cui": "C3811910", "preferredName": "combination - answer to question", "semanticType": "fndg", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "loincId": "LA12701-1", "vocabs": "MTH,LNC"}, {"type": "umls.HazardousOrPoisonousSubstance", "begin": 104, "end": 113, "coveredText": "narcotics", "negated": false, "cui": "C0027415", "preferredName": "Narcotics", "semanticType": "hops", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C1506", "meshId": "M0014481", "loincId": "MTHU003470,LP18149-2", "vocabs": "LCH,LNC,MTH,CHV,CSP,MSH,MEDLINEPLUS,LCH_NW,NCI,NCI_NCI-GLOSS"}, {"type": "umls.PharmacologicSubstance", "uid": 2, "begin": 104, "end": 113, "coveredText": "narcotics", "negated": false, "cui": "C0027415", "preferredName": "Narcotics", "semanticType": "phsu", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C1506", "meshId": "M0014481", "loincId": "MTHU003470,LP18149-2", "vocabs": "LCH,LNC,MTH,CHV,CSP,MSH,MEDLINEPLUS,LCH_NW,NCI,NCI_NCI-GLOSS", "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "startedEvent": {"score": 0.982, "usage": {"explicitScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "doseChangedEvent": {"score": 0.001, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.001, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.999, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 1.0, "discussedScore": 0.0}}}}}, {"type": "umls.OrganicChemical", "uid": 6, "begin": 118, "end": 127, "coveredText": "Neurontin", "negated": false, "cui": "C0678176", "preferredName": "Neurontin", "semanticType": "orch", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C1108", "meshId": "M0119420", "rxNormId": "196498", "vocabs": "CHV,MSH,NCI,RXNORM,PDQ"}, {"type": "umls.PharmacologicSubstance", "uid": 3, "begin": 118, "end": 127, "coveredText": "Neurontin", "negated": false, "cui": "C0678176", "preferredName": "Neurontin", "semanticType": "phsu", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C1108", "meshId": "M0119420", "rxNormId": "196498", "vocabs": "CHV,MSH,NCI,RXNORM,PDQ", "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "startedEvent": {"score": 0.998, "usage": {"explicitScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "doseChangedEvent": {"score": 0.002, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.891, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.678, "discussedScore": 0.0}}}}}, {"type": "umls.HealthCareActivity", "begin": 146, "end": 156, "coveredText": "perscribed", "negated": false, "cui": "C0278329", "preferredName": "Prescribed", "semanticType": "hlca", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "vocabs": "MTH,CHV,LCH"}, {"type": "umls.DiseaseOrSyndrome", "uid": 4, "begin": 165, "end": 185, "coveredText": "trigeminal neuralgia", "negated": false, "cui": "C0040997", "preferredName": "Trigeminal Neuralgia", "semanticType": "dsyn", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "icd10Code": "B02.2,G50.0,G53.0", "snomedConceptId": "31681005", "meshId": "M0021966", "vocabs": "MTH,CSP,MSH,CST,HPO,OMIM,COSTAR,ICPC,CHV,MEDLINEPLUS,LCH_NW,QMR,ICD9CM,SNOMEDCT_US,DXP,MTHICD9", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 1.0, "patientReportedScore": 0.0, "discussedScore": 0.0}, "suspectedScore": 0.0, "symptomScore": 0.0, "traumaScore": 0.0, "familyHistoryScore": 0.003}}}, {"type": "umls.SignOrSymptom", "uid": 5, "begin": 190, "end": 202, "coveredText": "chronic pain", "negated": false, "cui": "C0150055", "preferredName": "Chronic pain", "semanticType": "sosy", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "icd9Code": "338.29", "icd10Code": "R52,R52.2", "nciCode": "C26940", "snomedConceptId": "82423001", "meshId": "M0549837", "loincId": "MTHU013382,LA22093-1", "vocabs": "LNC,MTH,NCI_NICHD,CSP,MSH,HPO,OMIM,NCI_NCI-GLOSS,CHV,MEDLINEPLUS,LCH_NW,NCI,ICD9CM,SNOMEDCT_US", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 1.0, "patientReportedScore": 0.0, "discussedScore": 0.0}, "suspectedScore": 0.0, "symptomScore": 0.021, "traumaScore": 0.0, "familyHistoryScore": 0.0}}}, {"type": "ICMedication", "begin": 104, "end": 113, "coveredText": "narcotics", "negated": false, "cui": "C0027415", "preferredName": "Narcotics", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "nciCode": "C1506", "meshId": "M0014481", "loincId": "MTHU003470,LP18149-2", "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "startedEvent": {"score": 0.982, "usage": {"explicitScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "doseChangedEvent": {"score": 0.001, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.001, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.999, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 1.0, "discussedScore": 0.0}}}}, "ruleId": "7861c024-ad1c-47e6-b40e-c90cb7b19e26", "derivedFrom": [{"uid": 2}]}, {"type": "ICNormality", "begin": 104, "end": 113, "coveredText": "narcotics", "negated": false, "cui": "C0027415", "preferredName": "Narcotics", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C1506", "meshId": "M0014481", "loincId": "MTHU003470,LP18149-2", "insightModelData": {}, "ruleId": "d004df62-a65d-4136-aa32-161a43eb9506", "derivedFrom": [{"uid": 2}]}, {"type": "ICMedication", "begin": 118, "end": 127, "coveredText": "Neurontin", "negated": false, "cui": "C0678176", "preferredName": "Neurontin", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "nciCode": "C1108", "meshId": "M0119420", "rxNormId": "196498", "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "startedEvent": {"score": 0.998, "usage": {"explicitScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "doseChangedEvent": {"score": 0.002, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.891, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.678, "discussedScore": 0.0}}}}, "ruleId": "7861c024-ad1c-47e6-b40e-c90cb7b19e26", "derivedFrom": [{"uid": 3}]}, {"type": "ICNormality", "begin": 118, "end": 127, "coveredText": "Neurontin", "negated": false, "cui": "C0678176", "preferredName": "Neurontin", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C1108", "meshId": "M0119420", "rxNormId": "196498", "insightModelData": {}, "ruleId": "d004df62-a65d-4136-aa32-161a43eb9506", "derivedFrom": [{"uid": 3}]}, {"type": "ICNormality", "begin": 118, "end": 127, "coveredText": "Neurontin", "negated": false, "cui": "C0678176", "preferredName": "Neurontin", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "NO_DECISION"}, "insightModelData": {}, "ruleId": "343e6158-2c30-4726-be71-33a570b28703", "derivedFrom": [{"uid": 6}]}, {"type": "ICDiagnosis", "begin": 165, "end": 185, "coveredText": "trigeminal neuralgia", "negated": false, "cui": "C0040997", "preferredName": "Trigeminal Neuralgia", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "icd10Code": "B02.2,G50.0,G53.0", "snomedConceptId": "31681005", "meshId": "M0021966", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 1.0, "patientReportedScore": 0.0, "discussedScore": 0.0}, "suspectedScore": 0.0, "symptomScore": 0.0, "traumaScore": 0.0, "familyHistoryScore": 0.003}}, "ruleId": "698f2b19-27b6-4dab-9150-7d7ef3b03a5c", "derivedFrom": [{"uid": 4}]}, {"type": "ICDiagnosis", "begin": 190, "end": 202, "coveredText": "chronic pain", "negated": false, "cui": "C0150055", "preferredName": "Chronic pain", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "icd9Code": "338.29", "icd10Code": "R52,R52.2", "nciCode": "C26940", "snomedConceptId": "82423001", "meshId": "M0549837", "loincId": "MTHU013382,LA22093-1", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 1.0, "patientReportedScore": 0.0, "discussedScore": 0.0}, "suspectedScore": 0.0, "symptomScore": 0.021, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "ruleId": "3cf38e29-77f0-47b3-9950-4a0292f64c93", "derivedFrom": [{"uid": 5}]}], "MedicationInd": [{"type": "aci.MedicationInd", "uid": 8, "begin": 104, "end": 113, "coveredText": "narcotics", "negated": false, "cui": "C0027415", "drug": [{"coveredText": "narcotics", "cui": "C0027415", "complex": "false", "end": 113, "type": "aci.Ind_Drug", "name1": [{"coveredText": "narcotics", "cui": "C0027415", "drugSurfaceForm": "narcotics", "drugNormalizedName": "narcotics", "end": 113, "type": "aci.DrugName", "begin": 104}], "begin": 104}], "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "startedEvent": {"score": 0.982, "usage": {"explicitScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "doseChangedEvent": {"score": 0.001, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.001, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.999, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 1.0, "discussedScore": 0.0}}}}, "disambiguationData": {"validity": "VALID", "comment": "marked VALID by clinical insight models."}}, {"type": "aci.MedicationInd", "uid": 9, "begin": 118, "end": 127, "coveredText": "Neurontin", "negated": false, "cui": "C0678176", "drug": [{"coveredText": "Neurontin", "cui": "C0678176", "complex": "false", "end": 127, "type": "aci.Ind_Drug", "name1": [{"rxNormID": "196498", "coveredText": "Neurontin", "cui": "C0678176", "drugSurfaceForm": "Neurontin", "drugNormalizedName": "neurontin", "end": 127, "type": "aci.DrugName", "begin": 118}], "begin": 118}], "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "startedEvent": {"score": 0.998, "usage": {"explicitScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "doseChangedEvent": {"score": 0.002, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.891, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.678, "discussedScore": 0.0}}}}, "disambiguationData": {"validity": "VALID", "comment": "marked VALID by clinical insight models."}}], "SymptomDiseaseInd": [{"type": "aci.SymptomDiseaseInd", "uid": 10, "begin": 165, "end": 185, "coveredText": "trigeminal neuralgia", "negated": false, "cui": "C0040997", "icd10Code": "G50.0", "modality": "potential", "symptomDiseaseSurfaceForm": "trigeminal neuralgia", "snomedConceptId": "31681005", "ccsCode": "95", "symptomDiseaseNormalizedName": "trigeminal neuralgia", "icd9Code": "350.1", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 1.0, "patientReportedScore": 0.0, "discussedScore": 0.0}, "suspectedScore": 0.0, "symptomScore": 0.0, "traumaScore": 0.0, "familyHistoryScore": 0.003}}}, {"type": "aci.SymptomDiseaseInd", "uid": 11, "begin": 190, "end": 202, "coveredText": "chronic pain", "negated": false, "cui": "C0150055", "icd10Code": "R52.2,R52", "modality": "potential", "symptomDiseaseSurfaceForm": "chronic pain", "snomedConceptId": "82423001", "ccsCode": "259", "symptomDiseaseNormalizedName": "chronic pain", "icd9Code": "338.29", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 1.0, "patientReportedScore": 0.0, "discussedScore": 0.0}, "suspectedScore": 0.0, "symptomScore": 0.021, "traumaScore": 0.0, "familyHistoryScore": 0.0}}}], "spellingCorrections": [{"begin": 146, "end": 156, "coveredText": "perscribed", "suggestions": [{"text": "prescribed", "confidence": 0.9, "applied": true}, {"text": "proscribed", "confidence": 0.803, "applied": false}, {"text": "described", "confidence": 0.802, "applied": false}, {"text": "prescribe", "confidence": 0.801, "applied": false}, {"text": "prescriber", "confidence": 0.8, "applied": false}]}], "spellCorrectedText": [{"correctedText": "The patient's course could have been complicated by mental status changes secondary to a combination of narcotics and Neurontin, which was almost prescribed for his trigeminal neuralgia and chronic pain. \n\n"}]}"
                }
              },
              {
                "extension": [
                  {
                    "extension": [
                      {
                        "url": "http://ibm.com/fhir/cdm/StructureDefinition/covered-text",
                        "valueString": "narcotics"
                      },
                      {
                        "url": "http://ibm.com/fhir/cdm/StructureDefinition/offset-begin",
                        "valueInteger": 104
                      },
                      {
                        "url": "http://ibm.com/fhir/cdm/StructureDefinition/offset-end",
                        "valueInteger": 113
                      },
                      {
                        "extension": [
                          {
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                                {
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            ],
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        ],
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    ]
  },
  "extension": [
    {
      "extension": [
        {
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          "valueIdentifier": {
            "system": "urn:alvearie.io/health_patterns/services/nlp_insights/acd",
            "value": "a129d489aea84c37b7377201e70cd416fe2b26ce3dc1d29f250fdfa1"
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        },
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              {
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  "actuality": "actual",
  "event": {
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      {
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        "system": "http://terminology.hl7.org/CodeSystem/umls"
      }
    ],
    "text": "narcotics"
  },
  "resourceType": "AdverseEvent"
}
Adverse Event for "neurontin" 
{
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"NO_DECISION"}, "insightModelData": {}, "ruleId": "343e6158-2c30-4726-be71-33a570b28703", "derivedFrom": [{"uid": 6}]}, {"type": "ICDiagnosis", "begin": 165, "end": 185, "coveredText": "trigeminal neuralgia", "negated": false, "cui": "C0040997", "preferredName": "Trigeminal Neuralgia", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "icd10Code": "B02.2,G50.0,G53.0", "snomedConceptId": "31681005", "meshId": "M0021966", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 1.0, "patientReportedScore": 0.0, "discussedScore": 0.0}, "suspectedScore": 0.0, "symptomScore": 0.0, "traumaScore": 0.0, "familyHistoryScore": 0.003}}, "ruleId": "698f2b19-27b6-4dab-9150-7d7ef3b03a5c", "derivedFrom": [{"uid": 4}]}, {"type": "ICDiagnosis", "begin": 190, "end": 202, "coveredText": "chronic pain", "negated": false, "cui": "C0150055", "preferredName": "Chronic pain", "source": "Clinical Insights - Derived Concepts", 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185, "coveredText": "trigeminal neuralgia", "negated": false, "cui": "C0040997", "icd10Code": "G50.0", "modality": "potential", "symptomDiseaseSurfaceForm": "trigeminal neuralgia", "snomedConceptId": "31681005", "ccsCode": "95", "symptomDiseaseNormalizedName": "trigeminal neuralgia", "icd9Code": "350.1", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 1.0, "patientReportedScore": 0.0, "discussedScore": 0.0}, "suspectedScore": 0.0, "symptomScore": 0.0, "traumaScore": 0.0, "familyHistoryScore": 0.003}}}, {"type": "aci.SymptomDiseaseInd", "uid": 11, "begin": 190, "end": 202, "coveredText": "chronic pain", "negated": false, "cui": "C0150055", "icd10Code": "R52.2,R52", "modality": "potential", "symptomDiseaseSurfaceForm": "chronic pain", "snomedConceptId": "82423001", "ccsCode": "259", "symptomDiseaseNormalizedName": "chronic pain", "icd9Code": "338.29", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": 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                }
              },
              {
                "extension": [
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                    "extension": [
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                        "url": "http://ibm.com/fhir/cdm/StructureDefinition/covered-text",
                        "valueString": "Neurontin"
                      },
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                            "url": "http://ibm.com/fhir/cdm/StructureDefinition/description",
                            "valueString": "Adverse Event Score"
                          }
                        ],
                        "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-confidence"
                      }
                    ],
                    "url": "http://ibm.com/fhir/cdm/StructureDefinition/span"
                  }
                ],
                "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-result"
              }
            ],
            "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-detail"
          }
        ],
        "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight"
      }
    ]
  },
  "extension": [
    {
      "extension": [
        {
          "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-id",
          "valueIdentifier": {
            "system": "urn:alvearie.io/health_patterns/services/nlp_insights/acd",
            "value": "1b32afb1d37b7a442c676f8f191800d89882c8d8163b6379d1c387f5"
          }
        },
        {
          "url": "http://ibm.com/fhir/cdm/StructureDefinition/category",
          "valueCodeableConcept": {
            "coding": [
              {
                "code": "natural-language-processing",
                "display": "NLP",
                "system": "http://ibm.com/fhir/cdm/CodeSystem/insight-category-code-system"
              }
            ],
            "text": "NLP"
          }
        }
      ],
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-summary"
    }
  ],
  "actuality": "actual",
  "event": {
    "coding": [
      {
        "code": "C0678176",
        "system": "http://terminology.hl7.org/CodeSystem/umls"
      }
    ],
    "text": "neurontin"
  },
  "resourceType": "AdverseEvent"
}

Codes

It's easy to see that each of our adverse event resources contains a single UMLS code for the event. These codes are associated with a surface form that caused the adverse event to be created.

🚧 A UMLS concept is not an ideal code for representing an Adverse Event. The FHIR standard recommends a SNOMED CT value set. Because adverse events often are of interest to regulators, MedDRA codes are also highly desirable. These coding systems are not yet provided by ACD, but we hope to add these codes if/when the NLP technology is available. 🚧

Adverse Event Text Code System
narcotics C0027415 http://terminology.hl7.org/CodeSystem/umls
neurontin C0678176 http://terminology.hl7.org/CodeSystem/umls

Actuality

While the FHIR standard distinguishes between potential (or near-miss) adverse events and actual events, the nlp-insights service creates adverse event resources as actual, and does not distinguish between actual and potential events.

It is possible that the problem could be solved (in some cases) with a code change to nlp-insights. For example, suppose the text passage was something similar to:

The patient's course could have been complicated by mental status \
changes secondary to a combination of narcotics and Neurontin, \
which was almost perscribed for his trigeminal neuralgia and chronic pain.

ACD would return confidences with a high value for the "considering" usage score: 

 "adverseEvent": {
    "score": 0.999,
    "allergyScore": 0,
    "usage": {
      "explicitScore": 0,
      "consideringScore": 1,
      "discussedScore": 0
    }
  },

This could be leveraged by nlp-insights to determine that the event did not actually happen.

In building the reference implementation, we did not have sufficient examples to determine if this approach would work well enough to be of value in practice, or what value of the consideringScore should be used as the decision boundary. Another consideration was that additional functionality might someday be added to ACD that solves this problem in a better way.

🚧 The determination of actuality is therefore still an area of research and further contribution. 🚧

Evidence

The available evidence is consistent with other derived resource types.

  • The span will cover the surface form used to construct the UMLS code for the event.
  • A confidence will be returned for the Adverse Event. No other confidences are returned at this time.