{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:56:11Z","timestamp":1786978571971,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adrenal gland incidentalomas (AGIs) are found in up to 5% of cross\u2010sectional images. However, rates of guideline\u2010based workup for AGIs are notoriously low. We sought to determine if a natural language processing (NLP)\u2010informed AGI clinic could improve the rates of indicated biochemical evaluation and adrenal\u2010specific imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      An NLP algorithm was created to detect clinically significant adrenal nodules from radiology reports of cross\u2010sectional images at an academic institution. The NLP algorithm was applied to scans occurring between June 2020 and July 2021 to form a baseline cohort. The NLP algorithm was re\u2010applied to scans from August 2021 to February 2023 and identified patients were invited to join an outpatient clinic dedicated to AGIs. Patients evaluated in the clinic from March 2022 to February 2023 were included in the intervention cohort. Statistical analysis utilized chi\u2010square,\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test, and a multivariable logistic regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The baseline and intervention cohorts included 1784 and 322 unique patients, respectively. Patients in the intervention cohort were more likely to be female (59% vs. 51%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01), be younger (60\u00a0\u00b1\u00a013.1 vs. 64\u00a0\u00b1\u00a013.2\u00a0years,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), have smaller nodules (1.7\u00a0cm, IQR 1.4\u20132.1 vs. 1.8\u00a0cm, IQR 1.4\u20132.5\u00a0cm,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.017), have had biochemical workup (99% vs. 13%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and have had adrenal\u2010specific imaging (40% vs. 11%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). In a multivariable analysis, intervention cohort patients were significantly more likely to have had biochemical workup (odds ratio ,OR 1209, confidence interval ,CI 434\u20135117,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and adrenal\u2010specific imaging (OR 8.89, CI 6.42\u201312.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The implementation of an NLP\u2010informed AGI clinic was associated with a seven\u2010fold increase in biochemical workup and a three\u2010fold increase in adrenal\u2010specific imaging in participating patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.12346","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T23:29:06Z","timestamp":1726615746000},"page":"2907-2917","source":"Crossref","is-referenced-by-count":7,"title":["A natural language processing\u2010informed adrenal gland incidentaloma clinic improves guideline\u2010based care"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4323-0696","authenticated-orcid":false,"given":"C. 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Chandler","family":"McLeod","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Osborne","sequence":"additional","affiliation":[{"name":"Department of Computer Science University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micah","family":"Cochran","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics and Data Science University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haleigh","family":"Negrete","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srini","family":"Tridandipani","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Rothenberg","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gillis","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Fazendin","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenessa","family":"Lindeman","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03344099"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP.15.S1.1"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/M22\u20101619"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnaa008"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(20)30314\u20104"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10140\u2010023\u201002138\u20105"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2021.07.041"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2022.12.009"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2020.07.027"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2021.08.019"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.05.031"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE\u201016\u20100467"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.3544"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz284"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab512"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/M21\u20101737"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2019.11.03"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3402\/jchimp.v6.32913"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2021.06.015"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2021.03.038"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znac242.093"},{"key":"e_1_2_10_23_1","unstructured":"Adrenal Incidentaloma.Columbia Surgery. 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