A Deep Learning Method to Detect Opioid Prescription and Opioid Use Disorder from Electronic Health Records

Kashyap, A.; Callison-Burch, C.; Boland, M. R.

Objective: As the opioid epidemic continues across the United States, methods are needed to accurately and quickly identify patients at risk for opioid use disorder (OUD). The purpose of this study is to develop two predictive algorithms: one to predict opioid prescription and one to predict OUD. Materials and Methods: We developed an informatics algorithm that trains two deep learning models over patient EHRs using the MIMIC-III database. We utilize both the structured and unstructured parts of the EHR and show that it is possible to predict both of these challenging outcomes. Results: Our deep learning models incorporate both structured and unstructured data elements from the EHRs to predict opioid prescription with an F1-score of 0.88 +/- 0.003 and an AUC-ROC of 0.93 +/- 0.002. We also constructed a model to predict OUD diagnosis achieving an F1-score of 0.82 +/- 0.05 and AUC-ROC of 0.94 +/- 0.008. Discussion: Our model for OUD prediction outperformed prior algorithms for specificity, F1 score and AUC-ROC while achieving equivalent sensitivity. This demonstrates the importance of a.) deep learning approaches in predicting OUD and b.) incorporating both structured and unstructured data for this prediction task. No prediction models for opioid prescription as an outcome were found in the literature and therefore this represents an important contribution of our work as opioid prescriptions are more common than OUDs. Conclusion: Algorithms such as those described in this paper will become increasingly important to understand the drivers underlying this national epidemic.