• Using Natural Language Process...

Treffer: Using Natural Language Processing to Characterize Early Steps in the Kidney Transplant Evaluation Process Documented in the National Veterans Affairs Electronic Health Record.

Title:
Using Natural Language Processing to Characterize Early Steps in the Kidney Transplant Evaluation Process Documented in the National Veterans Affairs Electronic Health Record.
Authors:
Eyre H; Seattle-Denver Health Systems Research Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA., Prince DK; Division of Nephrology, Department of Medicine and the Kidney Research Institute, University of Washington, Seattle, Washington, USA., Abrahamson S; Nephrology Section, Hospital and Specialty Medicine, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA., Blankenhorn RK; Seattle-Denver Health Systems Research Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Eastern Colorado Health Care System, Denver, Colorado, USA., Carey EP; Department of Biostatistics & Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA., Laundry RJ; Seattle-Denver Health Systems Research Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA., Showalter W; Seattle-Denver Health Systems Research Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA., Todd-Stenberg J; Seattle-Denver Health Systems Research Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA., O'Hare AM; Seattle-Denver Health Systems Research Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.; Division of Nephrology, Department of Medicine and the Kidney Research Institute, University of Washington, Seattle, Washington, USA.; Nephrology Section, Hospital and Specialty Medicine, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA., Butler CR; Seattle-Denver Health Systems Research Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.; Division of Nephrology, Department of Medicine and the Kidney Research Institute, University of Washington, Seattle, Washington, USA.; Nephrology Section, Hospital and Specialty Medicine, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.
Source:
Clinical transplantation [Clin Transplant] 2026 Jan; Vol. 40 (1), pp. e70441.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Munksgaard Country of Publication: Denmark NLM ID: 8710240 Publication Model: Print Cited Medium: Internet ISSN: 1399-0012 (Electronic) Linking ISSN: 09020063 NLM ISO Abbreviation: Clin Transplant Subsets: MEDLINE
Imprint Name(s):
Original Publication: Copenhagen : Munksgaard,
MeSH Terms:
Kidney Transplantation*/statistics & numerical data , Natural Language Processing* , Electronic Health Records*/statistics & numerical data , Kidney Failure, Chronic*/surgery , Veterans*/statistics & numerical data, Humans ; Male ; Female ; United States ; Middle Aged ; Aged ; Follow-Up Studies ; United States Department of Veterans Affairs/statistics & numerical data ; Prognosis ; Aged, 80 and over ; Glomerular Filtration Rate ; Registries
References:
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Clin J Am Soc Nephrol. 2021 Jun;16(6):926-936. (PMID: 34039566)
JAMA Intern Med. 2025 Feb 01;185(2):186-194. (PMID: 39680376)
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JAMA Intern Med. 2022 Jul 1;182(7):710-719. (PMID: 35576068)
Clin Transplant. 2026 Jan;40(1):e70441. (PMID: 41533291)
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Healthcare (Basel). 2022 Nov 12;10(11):. (PMID: 36421593)
Grant Information:
I01 HX002682 United States HX HSRD VA; K23 DK129777 United States DK NIDDK NIH HHS; 5I01HX002682 Veterans Affairs; DK129777 United States DK NIDDK NIH HHS
Contributed Indexing:
Keywords: US Veterans Affairs; electronic health record; kidney transplant; natural language processing
Entry Date(s):
Date Created: 20260114 Date Completed: 20260114 Latest Revision: 20260117
Update Code:
20260117
PubMed Central ID:
PMC12802815
DOI:
10.1111/ctr.70441
PMID:
41533291
Database:
MEDLINE

Weitere Informationen

Background: Efforts to identify barriers and improve access to kidney transplantation in the United States are limited by a lack of population-level data on early steps in the transplant evaluation process.
Methods: We used a rule-based natural language processing (NLP) approach with clinical notes in the US Veterans Affairs Healthcare System (VA) electronic health record (EHR) and linkage with the United States Renal Data System registry to characterize sequential steps in the kidney transplant evaluation process. Adults with advanced kidney disease (estimated glomerular filtration rate ≤20 mL/min/1.73m <sup>2</sup> ) from 1/1/2012-12/31/2019 who were receiving care within the VA were followed through 12/31/2021.
Results: Among 45,174 cohort members, the median age was 71 (IQR 64, 80) years, and 97.2% were men. There was documentation of kidney transplant being mentioned as a treatment option for 46.3% of cohort members, 28.2% engaged in some type of evaluation for transplant, and 8.4% were referred to and 5.4% evaluated at a VA kidney transplant center. 6.9% of cohort members were added to the national deceased donor waitlist and 3.1% received a kidney transplant. Compared with events identified through EHR chart search and manual review by two clinicians, NLP identified events within 90 days with a precision of 0.82-0.94 and recall of 0.56-0.89.
Conclusion: These results illuminate the substantial proportion of patients who engage in early steps in the kidney transplant evaluation process. The work also demonstrates that NLP can accurately identify these key steps in the process as documented in patients' EHRs.
(© 2026 The Author(s). Clinical Transplantation published by Wiley Periodicals LLC.)