Evidence mapPaperPMID 39601443Full record

ArticleJournal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing2025

Applying natural language processing to understand symptoms among older adult home healthcare patients with urinary incontinence.

Danielle Scharp, Jiyoun Song, Mollie Hobensack, Mary Happel Palmer, Veronica Barcelona, Maxim Topaz

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Article in Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Danielle ScharpColumbia University School of Nursing, New York, New York, USA.ORCID 0000-0002-3265-6667
Jiyoun SongDepartment of Biobehavioral Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-0362-0670
Mollie HobensackDepartment of Geriatrics and Palliative Care, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Mary Happel PalmerUniversity of North Carolina School of Nursing, Chapel Hill, North Carolina, USA.
Veronica BarcelonaColumbia University School of Nursing, New York, New York, USA.ORCID 0000-0003-3070-1716
Maxim TopazColumbia University School of Nursing, New York, New York, USA.

Funding

Reducing Health Disparities Through InformaticsT32NR007969 · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2002 to 2025
$1.2M
Research Training for the Care of Vulnerable Older Adults with Alzheimer's Disease and Related Dementias and Other Chronic ConditionsT32AG066598 · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2025 to 2025
$404k
AHRQ HHS R01 HS027742NHLBI NIH HHS K99 HL169940NIA NIH HHS T32 AG066598NINR NIH HHS T32 NR007969
6 · The paper itself

Abstract

introductionLittle is known about the range and frequency of symptoms among older adult home healthcare patients with urinary incontinence, as this information is predominantly contained in clinical notes. Natural language processing can uncover symptom information among older adults with urinary incontinence to promote holistic, equitable care.

designWe conducted a secondary analysis of cross-sectional data collected between January 1, 2015, and December 31, 2017, from the largest HHC agency in the Northeastern United States. We aimed to develop and test a natural language processing algorithm to extract symptom information from clinical notes for older adults with urinary incontinence and analyze differences in symptom documentation by race or ethnicity.

methodsSymptoms were identified through expert clinician-driven Delphi survey rounds. We developed a natural language processing algorithm for symptom identification in clinical notes, examined symptom documentation frequencies, and analyzed differences in symptom documentation by race or ethnicity using chi-squared tests and logistic regression models.

resultsIn total, 39,179 home healthcare episodes containing 1,098,419 clinical notes for 29,981 distinct patients were included. Nearly 40% of the sample represented racially or ethnically minoritized groups (i.e., 18% Black, 14% Hispanic, 7% Asian/Pacific Islander, 0.3% multi-racial, and 0.2% Native American). Based on expert clinician-driven Delphi survey rounds, the following symptoms were identified: anxiety, dizziness, constipation, syncope, tachycardia, urinary frequency/urgency, urinary hesitancy/retention, and vision impairment/blurred vision. The natural language processing algorithm achieved excellent performance (average precision of 0.92). Approximately 29% of home healthcare episodes had symptom information documented. Compared to home healthcare episodes for White patients, home healthcare episodes for Asian/Pacific Islander (odds ratio = 0.74, 95% confidence interval [0.67-0.80], p < 0.001), Black (odds ratio = 0.69, 95% confidence interval [0.64-0.73], p < 0.001), and Hispanic (odds ratio = 0.91, 95% confidence interval [0.85-0.97], p < 0.01) patients were less likely to have any symptoms documented in clinical notes.

conclusionWe found multidimensional symptoms and differences in symptom documentation among a diverse cohort of older adults with urinary incontinence, underscoring the need for comprehensive assessments by clinicians. Future research should apply natural language processing to other data sources and investigate symptom clusters to inform holistic care strategies for diverse populations. CLINICAL RELEVANCE: Knowledge of symptoms of older adult home healthcare patients with urinary incontinence can facilitate comprehensive assessments, health equity, and improved outcomes.

Indexed as

Home Care ServicesNatural Language ProcessingUrinary IncontinenceAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMalehealthcare disparitieshome healthcarenatural language processingnursing informaticsolder adultssymptom burdenurinary incontinence

Identifiers

PMID39601443
PMCPMC11772115

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.