Table 1. Topic modelling across all clinical documents in patients with opioid misuse.
| Topic Number† | Top 10 medical terms (CUIs) within each topic (ordered highest to lowest probability within each topic)* |
Topic theme (annotated from CUIs)‡ |
|---|---|---|
| 1 | Kidney; Dialysis procedure; Kidney Failure, Acute; Kidney Failure; Hypertensive disease; Anemia; Pressure (finding); Chronic Kidney Diseases; Kidney Diseases; Amlodipine; Creatinine | Renal |
| 2 | Lorazepam; Thiamine; Vitamins; Vitamin B Complex; Folic Acid; Alcohol abuse; Ativan; Seizures; Multivitamin preparation; Alcohol withdrawal; Confusion | Alcohol Use Disorder intoxication/withdrawal |
| 3 | Cells; Neoplasms; Malignant neoplasms; Mass of body structure; Skeletal bone, Dilaudid; Morphine; Effusion; Biopsy; Pleural disease; Lymph node | Cancer Pain |
| 4 | Depressive disorder, Mood psychological function, Thinking function, Suicide, Axis, Suicidal, Mental State, Source, Insight, Affect (mental function) | Mental Health |
| 5 | Seizures; Magnetic Resonance Imaging; Cerebrovascular Accident; Cerebral hemisphere structure; Face; Brain; CAT scan of head; Mental state, Electroencephalography; Reflex action | Neurology (seizures) |
| 6 | Pancreatitis; Pancreas; Dilaudid; Nutrition function; Colon structure; Lipase; Nothing by mouth; Pelvis, Pantoprazole; Esophagogastroduodenoscopy | Gastrointestinal (pancreatitis) |
| 7 | Vancomycin; Microbial culture; Abscess; Blood culture; Antibiotics: Methicillin resistant Staphylococcus aureus infection; HIV infections; Bacteremia; Probe with amplification; Drainage | Infection |
| 8 | Vitamins; Warfarin; Vitamin D; Sulfate measurement; Sulfate Ion; Sulfates inorganic; Prednisone; Coumadin; Multivitamin; Calcium | Vitamin supplementation/therapy |
| 9 | Sitting position; Mobility as a finding; Independently able; Does stand; Rehabilitation therapy; Equilibrium; Physical therapy exercises; Range of motion exercises; Term birth; Supervision | Physical Therapy |
| 10 | Knee; Joint examination, Knee; Fracture; Hip structure; Procedure on Hip; Ankle; Femur; Leg; Bones of tibia; Foot | Lower extremity injury |
| 11 | Fracture; Trauma; Vertebral column; Laceration; Face; Pelvis; Skeletal bone; Neurosurgical procedures; Bone structure of rib; Hematoma | Trauma |
| 12 | Infusion procedures; Nebulizer; Vancomycin; Nutrition function; Inspiration function; Fentanyl; Albuterol; Plain Chest x-ray; Respiratory failure; Aspiration | Respiratory failure |
| 13 | Anesthesia procedure; Patient-controlled analgesia; Pyrrolidonecarboxylic Acid; Surgical incision; Drain procedure; Naloxone; Morphine; Acetaminophen; Surgical repair; Complication | Procedural pain management |
| 14 | Injury wounds; Hand; Thigh structure; Upper arm; Leg; Dressing; Dressing of wound; Body tissue; Forearm; Foot | Appendage injury |
| 15 | Liver; Hepatic; Liver cirrhosis; Ascites; Hepatitis; Transplanted tissue; Hepatoerythropoietic purpura; HEP tumour staging; Icterus; Dilated | Liver disease |
| 16 | Methadone; Heroin; Inspiration function; Asthma; Cocaine; Albuterol; Clonidine; Chronic Obstructive Airway Disease; Nebulizer solution; Hypertensive disease | Polysubstance use and inhalational complications |
| 17 | Hypertensive disease, Aspirin, Insulin, Transplanted tissue; Metoprolol; Coronary Artery Disease; Insulin Lispro; Lisinopril; Blood vessel; Lasix | Coronary artery disease |
| 18 | Integrity of skin; Impaired health; Goal achieved; Impaired skin integrity; Nursing diagnosis; Comfort alteration; At risk for falls; At risk of injury; Lack of knowledge; Impaired skin integrity | Nursing Assessment |
| 19 | Aorta; Heart ventricle; Heart atrium; Stenosis; Regurgitation; Tissue dissection; Arteries; Aortic valve structure; Veins; Kidney | Non-coronary heart |
| 20 | Human patch material; Patch-extended release; Miralax; Polyethylene; Glycol; Powder dose; Glycols; Docusate; Lidocaine; Sennosides; Fentanyl | Constipation with pain medications |
† The best fit was 20 topics (coherence = 0.51) across all clinical documents (n = 422,147) with 25,801 unique CUIs.
*All entity mentions have been mapped to standardized medical vocabulary using the National Library of Medicine Unified Medical Language System Metathesaurus. The mentions are the concept unique identifier (CUI) from the free text of all the clinical documents from the EHR.
‡Overall topic themes were finalized after consensus agreement for face validity between a clinical informatics and critical care specialist, psychiatrist, and addiction specialist.