{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:14:05Z","timestamp":1789132445789,"version":"build-2803163510"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":520,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis AG","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Kaiser Permanente Northern California Community Benefit Program"},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Worsening heart failure (WHF) events occurring in non-inpatient settings are becoming increasingly recognized, with implications for prognostication. We evaluate the performance of a natural language processing (NLP)-based approach compared with traditional diagnostic coding for non-inpatient clinical encounters and left ventricular ejection fraction (LVEF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We compared characteristics for encounters that did vs. did not meet WHF criteria, stratified by care setting [i.e. emergency department (ED) and observation stay]. Overall, 8407 (22%) encounters met NLP-based criteria for WHF (3909 ED visits and 4498 observation stays). The use of an NLP-derived definition adjudicated 3983 (12%) of non-primary HF diagnoses as meeting consensus definitions for WHF. The most common diagnosis indicated in these encounters was dyspnoea. Results were primarily driven by observation stays, in which 2205 (23%) encounters with a secondary HF diagnosis met the WHF definition by NLP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of standard claims-based adjudication for primary diagnosis in the non-inpatient setting may lead to misclassification of WHF events in the ED and overestimate observation stays. Primary diagnoses alone may underestimate the burden of WHF in non-hospitalized settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14829","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T01:39:58Z","timestamp":1715650798000},"page":"2542-2545","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Applying Natural Language Processing to Identify Emergency Department and Observation Encounters for Worsening Heart Failure"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8539-4322","authenticated-orcid":false,"given":"Steven A.","family":"Hamilton","sequence":"first","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente San Francisco Medical Center , San Francisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Ambrosy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente San Francisco Medical Center , San Francisco, CA ,","place":["USA"]},{"name":"Division of Research, Kaiser Permanente Northern California , Pleasanton, CA ,","place":["USA"]},{"name":"Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine , Pasadena, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi V.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente San Francisco Medical Center , San Francisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thida C.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente San Francisco Medical Center , San Francisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse K.","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente Santa Clara Medical Center , Santa Clara, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshith R.","family":"Avula","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente Walnut Creek Medical Center , Walnut Creek, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander T.","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Division of Cardiology and the Cardiovascular Institute, Department of Medicine, Stanford University , Stanford, CA ,","place":["USA"]},{"name":"Palo Alto Veterans Affairs Healthcare System , Palo Alto, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy A.","family":"Ku","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente San Francisco Medical Center , San Francisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan S.","family":"Go","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California , Pleasanton, CA ,","place":["USA"]},{"name":"Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine , Pasadena, CA ,","place":["USA"]},{"name":"Department of Epidemiology, Biostatistics and Medicine, University of California, San Francisco , San Francisco, CA ,","place":["USA"]},{"name":"Department of Medicine, Stanford University , Palo Alto, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Sax","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kaiser Permanente Oakland Medical Center , Oakland, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankeet S.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente San Francisco Medical Center , San Francisco, CA ,","place":["USA"]},{"name":"Division of Research, Kaiser Permanente Northern California , Pleasanton, CA ,","place":["USA"]},{"name":"Department of Medicine, Stanford University School of Medicine , Palo Alto, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,13]]},"reference":[{"key":"2026012113144832500_ehf214829-bib-0001","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4563","article-title":"Hospital revisits within 30 days after discharge for medical conditions targeted by the Hospital Readmissions Reduction Program in the United States: National retrospective analysis","volume":"366","author":"Wadhera","year":"2019","journal-title":"BMJ"},{"key":"2026012113144832500_ehf214829-bib-0002","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.35152","article-title":"A natural language processing\u2013based approach for identifying hospitalizations for worsening heart failure within an integrated health care delivery system","volume":"4","author":"Ambrosy","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2026012113144832500_ehf214829-bib-0003","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/j.jacc.2022.04.045","article-title":"Analysis of worsening heart failure events in an integrated health care system","volume":"80","author":"Ambrosy","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026012113144832500_ehf214829-bib-0004","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1161\/CIRCULATIONAHA.117.033502","article-title":"2017 cardiovascular and stroke endpoint definitions for clinical trials","volume":"137","author":"Hicks","year":"2018","journal-title":"Circulation"},{"key":"2026012113144832500_ehf214829-bib-0005","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.jchf.2021.01.014","article-title":"Worsening heart failure episodes outside a hospital setting in heart failure with preserved ejection fraction","volume":"9","author":"Vaduganathan","year":"2021","journal-title":"J Am Coll Cardiol-Heart Fail"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/11\/5\/2542\/64514956\/eschf_11_5_2542.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/11\/5\/2542\/64514956\/eschf_11_5_2542.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T18:16:44Z","timestamp":1769019404000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/11\/5\/2542\/8271250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,13]]},"references-count":5,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,10,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.14829","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,10]]},"published":{"date-parts":[[2024,5,13]]},"assertion":[{"value":"2024-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}