Background: The natural language processing (NLP) algorithm for predetermined asthma criteria (NLP-PAC) was successfully developed and validated for automatically ascertaining pediatric asthma from electronic health record (EHRs) systems. A scalable, efficient, and automated tool for ascertaining adult asthma status from EHRs remains nonexistent.
Objective: We validated NLP-PAC enabling ascertainment and early identification of adult asthma status in their EHRs.
Methods: We applied the validated NLP-PAC to EHRs of a convenient sample (adult cohorts who participated in our previous population-based studies) in which a reference standard (ie, asthma status defined by manual chart review) is available. The performance of NLP-PAC was assessed by determining criterion validity against manual chart review and construct validity before and after the new EHR (Epic) system was implemented in 2018.
Results: The cohort consisted of 1,898 subjects, with 43% male and a median age at time of last follow-up of 65 years (interquartile range, 55-76). Manual chart review and NLP-PAC identified 97 (5.1%) and 98 (5.1%) subjects with asthma, respectively, with 89 subjects commonly identified by both methods. The sensitivity, specificity, positive predictive value, and negative predictive value of NLP-PAC were 92%, 99%, 91%, and 99%, respectively, before the new EHR system was implement, which remained similar after introducing the system (95%, 88%, 96%, and 85%, respectively). The risk factors for asthma identified either by NLP-PAC or manual chart review were similar.
Conclusion: Automatic asthma ascertainment for adults based on EHR data is feasible with our NLP algorithm, offering immense scientific and clinical value for large-scale clinical research and population management for adult asthma care.
Keywords: Asthma; adult; algorithm; artificial intelligence; diagnosis; diagnosis management; electronic health record; natural language processing.
© 2025 The Author(s).