Automated pancreatic cyst screening using natural language processing: a new tool in the early detection of pancreatic cancer.

INTRODUCTION: As many as 3% of computed tomography (CT) scans detect pancreatic cysts. Because pancreatic cysts are incidental, ubiquitous and poorly understood, follow-up is often not performed. Pancreatic cysts may have a significant malignant potential and their identification represents a 'window of opportunity' for the early detection of pancreatic cancer. The purpose of this study was to implement an automated Natural Language Processing (NLP)-based pancreatic cyst identification system. METHOD: A multidisciplinary team was assembled. NLP-based identification algorithms were developed based on key words commonly used by physicians to describe pancreatic cysts and programmed for automated search of electronic medical records. A pilot study was conducted prospectively in a single institution. RESULTS: From March to September 2013, 566,233 reports belonging to 50,669 patients were analysed. The mean number of patients reported with a pancreatic cyst was 88/month (range 78-98). The mean sensitivity and specificity were 99.9% and 98.8%, respectively. CONCLUSION: NLP is an effective tool to automatically identify patients with pancreatic cysts based on electronic medical records (EMR). This highly accurate system can help capture patients 'at-risk' of pancreatic cancer in a registry.

Influence of visual and haptic cues on podokinetic after-rotation.

Active countercircling on a rotating platform for 15 min causes individuals to involuntarily circle in the same direction when they step in place on firm ground. This is referred to as podokinetic after-rotation (PKAR). It is unclear how interjecting brief periods of visual or haptic inputs for a stable orientation reference affects PKAR. The authors studied this issue in 16 healthy individuals who participated in three sessions each. Following active countercircling, participants attempted to step in place for 30 min on firm ground. In two of three sessions, participants received full visual input or made fingertip contact with a stationary object for 30 s during 30 min of ongoing PKAR. All participants slowed or stopped rotating during the presence of visual or haptic inputs and resumed PKAR after removal of these inputs. Exponential functions fitted to angular trunk velocity versus time plots revealed no significant differences across conditions (p > .05). The preservation of PKAR after brief exposure to a visual or haptic reference is consistent with a slowly decaying velocity storage that is not reset or dumped after exposure to conflicting visual or haptic cues.