Complementary and Integrative Health Information in the literature: its lexicon and named entity recognition.

OBJECTIVE: To construct an exhaustive Complementary and Integrative Health (CIH) Lexicon (CIHLex) to help better represent the often underrepresented physical and psychological CIH approaches in standard terminologies, and to also apply state-of-the-art natural language processing (NLP) techniques to help recognize them in the biomedical literature. MATERIALS AND METHODS: We constructed the CIHLex by integrating various resources, compiling and integrating data from biomedical literature and relevant sources of knowledge. The Lexicon encompasses 724 unique concepts with 885 corresponding unique terms. We matched these concepts to the Unified Medical Language System (UMLS), and we developed and utilized BERT models comparing their efficiency in CIH named entity recognition to well-established models including MetaMap and CLAMP, as well as the large language model GPT3.5-turbo. RESULTS: Of the 724 unique concepts in CIHLex, 27.2% could be matched to at least one term in the UMLS. About 74.9% of the mapped UMLS Concept Unique Identifiers were categorized as "Therapeutic or Preventive Procedure." Among the models applied to CIH named entity recognition, BLUEBERT delivered the highest macro-average F1-score of 0.91, surpassing other models. CONCLUSION: Our CIHLex significantly augments representation of CIH approaches in biomedical literature. Demonstrating the utility of advanced NLP models, BERT notably excelled in CIH entity recognition. These results highlight promising strategies for enhancing standardization and recognition of CIH terminology in biomedical contexts.

Documentation of Complementary and Integrative Health Therapies in the Electronic Health Record: A Scoping Review.

Introduction: Complementary and integrative health (CIH) therapies refers to massage therapy, acupuncture, aromatherapy, and guided imagery. These therapies have gained increased attention in recent years, particularly for their potential to help manage chronic pain and other conditions. National organizations not only recommend the use of CIH therapies but also the documentation of these therapies within electronic health records (EHRs). Yet, how CIH therapies are documented in the EHR is not well understood. The purpose of this scoping review of the literature was to examine and describe research that focused on CIH therapy clinical documentation in the EHR. Methods: The authors conducted a literature search using six electronic databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ovid MEDLINE, Scopus, Google Scholar, Embase, and PubMed. Predefined search terms included "informatics," "documentation," "complementary and integrative health therapies," "non-pharmacological approaches," and "electronic health records" using AND/OR statements. No restrictions were placed on publication date. The inclusion criteria were as follows: (1) Original peer-reviewed full article in English, (2) focus on CIH therapies, and (3) CIH therapy documentation practice used in the research. Results: The authors identified 1684 articles, of which 33 met the criteria for a full review. A majority of the studies were conducted in the United States (20) and hospitals (19). The most common study design was retrospective (9), and 26 studies used EHR data as a data source for analysis. Documentation practices varied widely across all studies, ranging from the feasibility of documenting integrative therapies (i.e., homeopathy) to create changes in the EHR to support documentation (i.e., flowsheet). Discussion: This scoping review identified varying EHR clinical documentation trends for CIH therapies. Pain was the most frequent reason for use of CIH therapies across all included studies and a broad range of CIH therapies were used. Data standards and templates were suggested as informatics methods to support CIH documentation. A systems approach is needed to enhance and support the current technology infrastructure that will enable consistent CIH therapy documentation in EHRs.

Evaluating Systemized Nomenclature of Medicine Clinical Terms Coverage of Complementary and Integrative Health Therapy Approaches Used Within Integrative Nursing, Health, and Medicine.

The use of complementary and integrative health therapy strategies for a wide variety of health conditions is increasing and is rapidly becoming mainstream. However, little is known about how or if complementary and integrative health therapies are represented in the EHR. Standardized terminologies provide an organizing structure for health information that enable EHR representation and support shareable and comparable data; which may contribute to increased understanding of which therapies are being used for whom and for what purposes. Use of standardized terminologies is recommended for interoperable clinical data to support sharable, comparable data to enable the use of complementary and integrative health therapies and to enable research on outcomes. In this study, complementary and integrative health therapy terms were extracted from multiple sources and organized using the National Center for Complementary and Integrative Health and former National Center for Complementary and Alternative Medicine classification structures. A total of 1209 complementary and integrative health therapy terms were extracted. After removing duplicates, the final term list was generated via expert consensus. The final list included 578 terms, and these terms were mapped to Systemized Nomenclature of Medicine Clinical Terms. Of the 578, approximately half (48.1%) were found within Systemized Nomenclature of Medicine Clinical Terms. Levels of specificity of terms differed between National Center for Complementary and Integrative Health and National Center for Complementary and Alternative Medicine classification structures and Systemized Nomenclature of Medicine Clinical Terms. Future studies should focus on the terms not mapped to Systemized Nomenclature of Medicine Clinical Terms (51.9%), to formally submit terms for inclusion in Systemized Nomenclature of Medicine Clinical Terms, toward leveraging the data generated by use of these terms to determine associations among treatments and outcomes.