Table_1_Connecting the use of innovative treatments and glucocorticoids with the multidisciplinary evaluation through rule-based natural-language processing: a real-world study on patients with rheumatoid arthritis, psoriatic arthritis, and psoriasis.docx

BackgroundThe impact of a multidisciplinary management of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and psoriasis on systemic glucocorticoids or innovative treatments remains unknown. Rule-based natural language processing and text extraction help to manage large datasets of unstructured information and provide insights into the profile of treatment choices.MethodsWe obtained structured information from text data of outpatient visits between 2017 and 2022 using regular expressions (RegEx) to define elastic search patterns and to consider only affirmative citation of diseases or prescribed therapy by detecting negations. Care processes were described by binary flags which express the presence of RA, PsA and psoriasis and the prescription of glucocorticoids and biologics or small molecules in each cases. Logistic regression analyses were used to train the classifier to predict outcomes using the number of visits and the other specialist visits as the main variables.ResultsWe identified 1743 patients with RA, 1359 with PsA and 2,287 with psoriasis, accounting for 5,677, 4,468 and 7,770 outpatient visits, respectively. Among these, 25% of RA, 32% of PsA and 25% of psoriasis cases received biologics or small molecules, while 49% of RA, 28% of PsA, and 40% of psoriasis cases received glucocorticoids. Patients evaluated also by other specialists were treated more frequently with glucocorticoids (70% vs. 49% for RA, 60% vs. 28% for PsA, 51% vs. 40% for psoriasis; p < 0.001) as well as with biologics/small molecules (49% vs. 25% for RA, 64% vs. 32% in PsA; 51% vs. 25% for psoriasis; p < 0.001) compared to cases seen only by the main specialist.ConclusionPatients with RA, PsA, or psoriasis undergoing multiple evaluations are more likely to receive innovative treatments or glucocorticoids, possibly reflecting more complex cases.

背景：关于类风湿关节炎（RA）、银屑病关节炎（PsA）和银屑病的多学科管理对系统性糖皮质激素或创新治疗的影响尚不清楚。基于规则的天然语言处理和文本提取有助于管理大量非结构化信息数据集，并为治疗选择概貌提供洞见。
方法：我们通过正则表达式（RegEx）定义弹性搜索模式，并仅通过检测否定来确定疾病的肯定引用，从而从2017年至2022年间的门诊访问文本数据中获取结构化信息。通过二元标志描述护理过程，这些标志表达RA、PsA和银屑病的存在，以及在每个案例中处方糖皮质激素和生物制剂或小分子的用药情况。逻辑回归分析用于训练分类器，通过访问次数和其他专科访问次数等主要变量预测结果。
结果：我们确定了1,743名患有RA的患者，1,359名患有PsA的患者和2,287名患有银屑病的患者，分别对应5,677、4,468和7,770次门诊访问。在这些患者中，25%的RA、32%的PsA和25%的银屑病病例接受了生物制剂或小分子治疗，而49%的RA、28%的PsA和40%的银屑病病例接受了糖皮质激素治疗。接受其他专科评估的患者更频繁地接受糖皮质激素治疗（RA中为70%对49%，PsA中为60%对28%，银屑病中为51%对40%；p < 0.001）以及生物制剂/小分子治疗（RA中为49%对25%，PsA中为64%对32%，银屑病中为51%对25%；p < 0.001），与仅由主要专科会诊的病例相比。
结论：经历多次评估的RA、PsA或银屑病患者更有可能接受创新治疗或糖皮质激素治疗，这或许反映了病例的复杂性。