Table A.
ADRD construct definitions, frequency, and NLP performance (N=1,762,034 notes)
| Domain / Construct | Definition | Frequency of notes detected by NLP algorithm | Frequency of notes confirmed by human review | Precision |
|---|---|---|---|---|
| Domain: ADRD disease names | ||||
| Mentions of ADRD | Presence of language indicative of ADRD disease names, including “Alzheimer’s disease”, “Dementia”, “senile”, etc. | 673 | 30/30 | 1 |
| Domain: Symptoms | ||||
| Memory loss | Presence of language indicative of long term or short term memory problems, such as regularly forgetting recent events, names and faces, recognizing faces or family members | 1717 | 30/30 | 1 |
| Unspecified cognitive deficits | Presence of language indicative of general cognitive deficits, such as cognitive impairment | 275 | 30/30 | 1 |
| Communication problems | Any difficulty in communication, such as impaired speech, spouse answers all the questions | 252 | 29/30 | 0.97 |
| Motor issues (motor hyperactivity, motor slowness and other motor issues) | Presence of language indicative of motor issues, such as slowness, hyperactivity (e.g., tremor or shaking), falls, etc. | 839 | 27/30 | 0.9 |
| Physically/verbally aggressive | Presence of language indicative of verbal or physical aggression | 810 | 29/30 | 0.97 |
| Poor sleep | Presence of language indicative of sleep problems (e.g., insomnia) | 322 | 29/30 | 0.97 |
| Wandering | Presence of language indicative of wandering | 34 | 26/30 | 0.86 |
| Disorientation | Presence of language indicative of disorientation to place or person | 101 | 27/30 | 0.9 |
| Hoarding and clutter | Presence of language indicative of clutter or hoarding in the patient’s apartment | 316 | 29/30 | 0.97 |
| Uncooperative/refusal/non-compliance | Presence of language indicative of noncompliance (e.g., not taking medications, refusal of care, uncooperative) | 1152 | 30/30 | 1 |
| Depression/apathy | Presence of language indicative of depressive symptoms or depression diagnosis | 2178 | 30/30 | 1 |
| Anxiety | Presence of language indicative of anxious and restless behaviors | 3215 | 30/30 | 1 |
| Delusions/hallucinations | Presence of language indicative of visual or hearing hallucinations or delusions | 102 | 28/30 | 0.93 |
| Agitation | Presence of language indicative of agitation | 407 | 29/30 | 0.97 |
| Confusion | Presence of language indicative of confusion and related symptoms | 682 | 28/30 | 0.93 |
| Bladder/bowel incontinence | Presence of language indicative of bladder/bowel incontinence | 555 | 29/30 | 0.97 |
| Weight loss | Presence of language indicative of loss of weight (e.g., cachexia, anorexia) | 449 | 29/30 | 0.97 |
| Poor/increased appetite | Presence of language indicative of appetite issues | 325 | 28/30 | 0.93 |
| Trouble eating or swallowing | Presence of language indicative of problems with eating or swallowing | 121 | 30/30 | 1 |
| Executive function problems | Presence of language indicative of variety of issues, including problems with: verbal reasoning, problem-solving, planning, the ability to maintain sustained attention, resistance to interference, multitasking, cognitive flexibility, etc. | 142 | 24/30 | 0.8 |
| Functional issues (ADL/IADL function issue) | Presence of language indicative of functional issues such as: problems with choosing clothing, needing clues and reminders in the bathroom and kitchen, leaving the stove on, problems with bathroom hygiene routines, etc. | 103 | 23/30 | 0.76 |
| Hearing loss | Presence of language indicative of mentions of hearing loss, hearing aids use | 117 | 29/30 | 0.97 |
| Caregiver stress | Presence of language indicative of increased needs of caregiver, such as increased caregiver strain and burden | 44 | 26/30 | 0.86 |
| Domain: Interventions | ||||
| Addressing unmet service needs | Presence of language indicative of addressing unmet service needs, e.g. referral to social work or psychiatry, teaching family about medication, increased home health aide hours | 37 | 27/30 | 0.9 |
| Referrals for end-of-life care | Presence of language indicative of referral for hospice care, advanced directives, end of life care, DNR | 474 | 28/30 | 0.93 |
| ADRD-specific medications | Presence of language indicative of specific medications that are often given to patients with ADRD-like symptoms, such as Donepezil, Galantamine, Memantine, Rivastigmine, etc. | 414 | 30/30 | 1 |
| Home safety interventions | Presence of language indicative of presence of assistive device, referral to superintendent in the building, safety hazards at home, hand rails, grab bars in the shower, door locks/alarms, GPS/tracking, safe return bracelet, etc. | 10713 | 30/30 | 1 |
| Overall precision | 0.945 |