ABSTRACT
Introduction: Uppsala Monitoring Centre (UMC) manage VigiBase;the largest global database of reports of suspected adverse events (side effects) to medicines, on behalf of the World Health organisation (WHO). Following the emergency rollout of the vaccines against COVID-19, combined with a global focus on monitoring their safety, UMC saw a sharp increase in the volume of reports of suspected side effects of the vaccines. UMC sometimes receives multiple reports corresponding to the same suspected adverse event. This can have undesirable effects when it comes to both statistical signal detection and manual review of cases. Duplicate detection of vaccines has historically been especially challenging, due to homogeneity of patients. However, the extreme quantity of COVID-19 vaccine reports has highlighted the necessity for automated duplicate detection to be performant for them. Detecting duplicate reports is a non-trivial problem. Since reports do not always contain the same level of detail, and data errors can lead to different values in corresponding fields for duplicate reports, reports cannot simply be compared field by field. Several methods have been proposed for detecting duplicates based on information provided in structured form (sex, age, date of onset etc) (1,2). In our study we additionally incorporate free text information into a duplicate detection model. Objective: To leverage the free text information in suspected adverse event reports to identify duplicate reports which are referring to the same adverse event. Methods: Our method ensembles state-of-the-art machine learning methods.Narratives are placed in a spacewhere a smaller distance between two narratives conveys higher semantic similarity. This is done with vector embeddings using the SapBERT model, fine-tuned on a set of known duplicate reports (3). Two reports are then compared using the cosine similarity between the vector embeddings for the two narratives. This similarity is combined with representations of the structured information used in othermethods in a gradient boosted decision tree model, calibrated by a logistic regression model to fine tune the probability output (4). These methods are evaluated on a set of curated datasets of COVID- 19 vaccine reports comprising 1239 pairs of known duplicates. We use random pairs of COVID-19 vaccine reports as examples of nonduplicates. Results: Our model successfully identifies 78.9% of known duplicate pairs. It achieved a false positive rate (the number of non-duplicates erroneously marked as duplicates) of 0.001%. The full results can be seen in table 1. Conclusion: Not Applicable.
ABSTRACT
Copy and paste (CPF) can be defined as the act of duplicating medical documentation from one section of the electronic medical record (EMR) and placing it verbatim in another section. The objective of this scoping review is to 1) describe the prevalence of copy and paste usage in EMR documentation, 2) detail the known measurable safety hazards associated with its use, and 3) identify potential solutions and/or strategies that can be used to mitigate the negative consequences of the CPF while preserving its essential role in documentation efficiency. The Joanna Briggs Institute guidelines were used to identify, screen, and assess the text of articles for final inclusion in CPF article review. The primary search strategy for copy-paste articles was developed in PubMed® and then translated to CINAHL®, ScienceDirect®, and IEEExplore® to extract additional articles. Identified copy-paste articles were imported into Covidence®. Two reviewers determined the final articles that were included in the review. The search retrieved 63 publications of which 17 were identified for final inclusion. The scoping review revealed CPF of medical text is a common occurrence that cuts across all clinician types (e.g., physicians and nurses). The scoping review revealed that automated methods for finding duplication in electronic documentation had emerged. A limited number of studies with quantifiable harms associated with CPF were found. Clinicians stated that CPF 1) had a negative impact on critical thinking, 2) led to medical complications being more likely to be overlooked, and 3) led to safety issues being missed with copy-paste content. A few different approaches were tested by researchers as alternatives to CPF. They included dictation systems, practice guidelines, note templates, highlighting of copied information, note splitting, and text insertion. CPF is long overdue for innovative approaches to minimizing patient risk and maximizing provider efficiency. https//doi.org/10.34105/j.kmel.2021.13.028