Does the integration of pre-coded information with narratives improve in-hospital falls’ surveillance?

Abstract

To evaluate the value added by information reported in narratives (extracted through text mining techniques) in enhancing the characterization of falls patterns. Data on falls notified to the Risk Management Service of a Local Health Authority in Italy were considered in the analysis. Each record reported detailed pre-coded information about patient and fall’s characteristics, together with a narrative description of the fall. At first, multiple correspondence analysis (MCA) was performed on pre-coded information only. Then, it was re-run on the pre-coded data augmented with a variable representing the output analysis of the narrative records. This second analysis required a pre-processing of the narratives followed by text mining. Finally, a Hierarchical Clustering on the two MCA was carried out to identify distinct fall patterns. The dataset included 202 falls’ records. Three clusters corresponding to three distinct profiles of falls were identified through the Hierarchical Clustering performed using only pre-coded information. Hierarchical Clustering with the topic variable provided overlapping results. The present findings showed that the cluster analysis is effective in characterizing fall patterns; however, they do not sustain the hypothesis that the analysis of free-text information improves our understanding of such phenomenon.