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code-status-annotations-mimic

For 1174 MIMIC-III (Version: 1.4) [1] discharge summaries, the in-text mentions of patient's do-not-resuscitate and/or do-not-intubate status or full code status were annotated.

Background

Do-not-resuscitate (DNR) and do-not-intubate (DNI) code status during hospital stay are important predictors for several clinical outcomes like length of hospital stay, survival, and disease progression. The annotation work was part of a project aiming to assess the impact of using NLP tools while conducting an association study [3].

Methods

In a first round, both authors each annotated half of the 1174 discharge summaries. In a second round, both authors checked each other's annotations. Any disagreements were discussed and resolved. The annotations were performed using the freely available open source Brat annotation tool [2].

Data Description

The annotations consist of three labels:

FULL (indicating full code) DNR_DNI (indicating do-not-resuscitate and/or do-not-intubate) OTHER (any other code status mentions, e.g., comfort measures) The selection process of the 1174 discharge summaries is described in an arXiv article [3], and corresponds to a subset of the patients in the N2C2 NLP Challenge on extraction of social determinants of health [4].

Usage Notes

The BRAT annotation format was used (.ann files). An example (23327.ann) is:

T1 FULL 8163 8172 full code T2 DNR_DNI 8429 8436 DNR/DNI This format contains one annotated mention per row. Per row first an event id is given (for row 1: T1), then 4 spaces, then the annotated label (for row 1: FULL), then one space followed by the character index of the start of the annotated span (for row 1: 8163), then another space, followed by the end of the annotated span (for row 1: 8172), followed by another four spaces and the annotated text (for row 1: full code).

The actual discharge summaries are not in this repository. The file names correspond to the EVENTROWID of the MIMIC-III (Version: 1.4) NOTEEVENTS table, and can in this way be linked to the MIMIC-III discharge summaries (e.g., file 23327.ann corresponds to EVENTROWID 23327 in the NOTEEVENTS table).

When using these data, please cite the original publication:

Release Notes

Version 1 (initial upload).

Ethics

Due to the nature of the work, which involved the use of de-identified data obtained from a publicly available dataset, and the fact that the shared annotations do not contain identifiable information (the clinical notes are not included, only the labels) ethical review was not performed.

Acknowledgements

This research was funded by the Dutch Research Council, as part of the project “RAISE: Responsible AI Science Explorations” (Grant Number NWA.1418.22.008).

Conflicts of Interest

None declared

References

  1. Johnson AE, Pollard TJ, Shen L, Lehman LW, Feng M, Ghassemi M, Moody B, Szolovits P, Anthony Celi L, Mark RG. MIMIC-III, a freely accessible critical care database. Scientific data. 2016 May 24;3(1):1-9.
  2. Stenetorp P, Pyysalo S, Topić G, Ohta T, Ananiadou S, Tsujii JI. BRAT: a web-based tool for NLP-assisted text annotation. InProceedings of the Demonstrations at the 13th Conference of the European Chapter of the Association for Computational Linguistics 2012 Apr (pp. 102-107).
  3. Sushil M, Butte AJ, Schuit E, van Smeden M, Leeuwenberg AM. Cross-institution natural language processing for reliable clinical association studies: a methodological exploration. Journal of Clinical Epidemiology. 2024 Mar 1;167:111258.
  4. Lybarger K, Yetisgen M, Uzuner Ö. The 2022 n2c2/UW Shared Task on Extracting Social Determinants of Health. arXiv preprint arXiv:2301.05571. 2023 Jan 13.

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Code status annotations for 1174 MIMIC-III discharge summaries

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