Table 5.

Discrepancy Analysis

Patient Case	Risk			Notes
	NLP	Manual Review (gold standard)	Clinical Review
1	Intermediate	Low	Intermediate	Discrepancy in Gleason score and PSA; manual review used OSH pathology Gleason (3 + 3 = 6), which was upgraded at VUMC to 3 + 4 = 7
2	Intermediate	Low	Intermediate	Discrepancy in Gleason score; manual review used OSH pathology Gleason (3 + 3 = 6), which was upgraded at VUMC to 3 + 4 = 7
3	High	Low	Low	Discrepancy in Gleason score; pathology note details why this patient case should be treated as 3 + 3 = 6 as opposed to 4 + 4 = 8; NLP algorithm parsed 4 + 4 = 8 from this discussion
4	Intermediate	Low	Intermediate	Discrepancy in PSA; clinical note: “prebiopsy PSA of 20 but then decreased to 5”
5	Low	Intermediate	Low	Discrepancy in Gleason score; manual review used OSH pathology Gleason score (4 + 3 = 7), which was downgraded at VUMC to 3 + 3 = 6
6	Low	Intermediate	Low	Discrepancy in Gleason score; manual review used OSH pathology Gleason score (3 + 4 = 7), which was downgraded at VUMC to 3 + 3 = 6
7	High	Intermediate	High	Discrepancy in Gleason score; manual review used OSH pathology Gleason (4 + 3 = 7), which was upgraded at VUMC to 4 + 4 = 8
8	High	High	High	Inconsequential discrepancy in Gleason score; VUMC pathology: 3 + 5 = 8; OSH pathology: 4 + 3 = 7
9	Intermediate	High	High	Discrepancy in Gleason score; NLP erroneously pulled 4+3=7 instead of 3+5=8
10	Intermediate	High	High	Discrepancy in clinical T stage; clinical note mentioned “some bilateral induration of the prostate and a little bit of nodularity … impression: stage T2c carcinoma of the prostate,” but clinical staging form recorded T1c, which is what NLP extracted

Abbreviations: NLP, natural language processing; OSH, outside hospital; PSA, prostate-specific antigen; VUMC, Vanderbilt University Medical Center.