Acquisition of temporal patterns from electronic health records: an application to multimorbid patients

Abstract

Background: The exponential growth of digital healthcare data is fueling the development of Knowledge Discovery in Databases (KDD). Extracting temporal relationships between medical events is essential to reveal hidden patterns that can help physicians find optimal treatments, diagnose illnesses, detect drug adverse reactions, and more. This paper presents an approach for the extraction of patient evolution patterns from electronic health records written in Catalan and/or Spanish. Methods: We propose a robust formulation for extracting Temporal Association Rules (TARs) that goes beyond simple rule extraction by considering the sequence of multiple visits. Our highly configurable algorithm leverages this formulation to extract Temporal Association Rules from sequences of medical instances. We can generate rules in the desired format, content, and temporal factors while accounting for different levels of abstraction of medical instances. To demonstrate the effectiveness of our methodology, we applied it to extract patient evolution patterns from clinical histories of multimorbid patients suffering from heart disease and stroke who visited Primary Care Centers (CAP) in Catalonia. Our main objective is to uncover complex rules with multiple temporal steps, that comprise a set of medical instances. Results: As we are working with real-world, error-prone data, we propose a process of validation of the results by expert practitioners in primary care. Despite our limited dataset, the high percentage of patterns deemed correct and relevant by the experts is promising. The insights gained from these patterns can inform preventive measures and help detect risk factors, ultimately leading to better treatments and outcomes for patients. Conclusion: Our algorithm successfully extracted a set of meaningful and relevant temporal patterns, especially for the specific type of multimorbid patients considered. These patterns were evaluated by experts and demonstrated the ability to predict risk factors that are commonly associated with certain diseases. Moreover, the average time gap between the occurrence of medical events provided critical insight into the term of these risk factors. This information holds significant value in the context of primary healthcare and preventive medicine, highlighting the potential of our method to serve as a valuable medical tool.