Evidence mapPaperPMID 41520124Full record

ArticleArthritis research & therapy2026

Development of a confidence-based Natural Language Processing tool to identify inflammatory arthritis from non-inflammatory conditions in Rheumatology medical notes.

Antonio Tonutti, Nicoletta Luciano, Benedetta Maizza, Antonio Papatolo, Alessandro Bellone, Sofia Svensson Di Giorgio, Gaia Tettamanzi, Maria Chiara Grondelli, Elisa Barone, Nicola Lambri and 2 more

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Article in Arthritis research & therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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12 authors.

Antonio TonuttiDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, 20072, Italy.
Nicoletta LucianoDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, 20072, Italy.
Benedetta MaizzaMEDTEC School, Humanitas University, Pieve Emanuele, Milan, 20072, Italy.
Antonio PapatoloMEDTEC School, Humanitas University, Pieve Emanuele, Milan, 20072, Italy.
Alessandro BelloneMEDTEC School, Humanitas University, Pieve Emanuele, Milan, 20072, Italy.
Sofia Svensson Di GiorgioMEDTEC School, Humanitas University, Pieve Emanuele, Milan, 20072, Italy.
Gaia TettamanziMEDTEC School, Humanitas University, Pieve Emanuele, Milan, 20072, Italy.
Maria Chiara GrondelliMEDTEC School, Humanitas University, Pieve Emanuele, Milan, 20072, Italy.
Elisa BaroneDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, 20072, Italy.
Nicola LambriScuola di Specializzazione di Fisica Medica, Università degli Studi di Milano, Milan, Italy.
Daniele LoiaconoDipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy.
Carlo SelmiDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, 20072, Italy. carlo.selmi@hunimed.eu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn chronic diseases the length and redundancy of medical records can hamper the accurate interpretation of the individual clinical history, and we hypothesize that Natural Language Processing (NLP) may be used to optimize information from unstructured texts in electronic health records (EHRs). We developed an NLP-based classifier to discriminate rheumatoid (RA) and psoriatic arthritis (PsA) versus non-inflammatory rheumatic diseases (NIRD), namely osteoarthritis and fibromyalgia, from notes in the rheumatology practice.

methodsA retrospective cross-sectional study was conducted on 1,372 anonymized EHRs from a single Italian rheumatology center, including 468 RA, 732 PsA, and 172 NIRD cases. After removing explicit diagnostic referrals, texts were embedded using five models and the resulting embeddings were used to train multiple classifiers. The best-performing embedding-classifier combination was selected, predictions were stratified into high-, moderate-, and low-certainty according to a confidence-based decision system, and explainability was assessed using LIME and SHAP.

resultsThe chosen model reached an overall accuracy of 85% in distinguishing between the three diagnostic groups. In detail, 74.5% of cases were classified with high certainty, reaching 94.6% accuracy, while only 1.5% were considered uncertain. No misclassifications occurred between RA and NIRD, though some overlap was seen between PsA and the other two conditions. Attempts to interpret the model’s decisions through dedicated algorithms provided partially meaningful insights, but results were inconsistent, especially when the clinical notes included complex or negated language.

conclusionsWe developed an NLP-based classifier to detect inflammatory arthritis from unstructured rheumatology notes. The model showed high confidence and accuracy, with low risk of missing patients with inflammatory disease. Although interpretability remains a limitation, external validation in multicenter and multilingual cohorts is warranted to confirm its generalizability.

Indexed as

Arthritis, PsoriaticArthritis, RheumatoidElectronic Health RecordsFibromyalgiaNatural Language ProcessingOsteoarthritisRheumatologyAgedCross-Sectional StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesArtificial intelligenceElectronic health recordsPsoriatic arthritisRheumatoid arthritis

Identifiers

PMID41520124
PMCPMC12882418

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