{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T15:17:53Z","timestamp":1773760673160,"version":"3.50.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1","funder":[{"name":"Department of Veterans Affairs Office of Suicide Prevention"},{"DOI":"10.13039\/100000738","name":"Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["T32 HL07741"],"award-info":[{"award-number":["T32 HL07741"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["R01DK115629"],"award-info":[{"award-number":["R01DK115629"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"AHRQ","doi-asserted-by":"publisher","award":["P30HS029744"],"award-info":[{"award-number":["P30HS029744"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007217","name":"VA HSR&D","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Centers for Disease Control and Prevention Office of Forecasting and Analysis"},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["K23HL166783"],"award-info":[{"award-number":["K23HL166783"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Minnesota Medical School and Clinical and Translational Science Institute"},{"DOI":"10.13039\/100000054","name":"NCI","doi-asserted-by":"publisher","award":["R01CA287413"],"award-info":[{"award-number":["R01CA287413"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"NIA","doi-asserted-by":"publisher","award":["R01AG078154"],"award-info":[{"award-number":["R01AG078154"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008460","name":"NCCIH","doi-asserted-by":"publisher","award":["R01AT009457"],"award-info":[{"award-number":["R01AT009457"]}],"id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHMD","award":["R21MD019134"],"award-info":[{"award-number":["R21MD019134"]}]},{"name":"NIHMD","award":["2R01AT009457"],"award-info":[{"award-number":["2R01AT009457"]}]},{"name":"NIHMD","award":["1R01AG078154"],"award-info":[{"award-number":["1R01AG078154"]}]},{"name":"NIHMD","award":["1R01CA287413"],"award-info":[{"award-number":["1R01CA287413"]}]},{"name":"Career Development","award":["#1IK2HX002861-01A2"],"award-info":[{"award-number":["#1IK2HX002861-01A2"]}]},{"DOI":"10.13039\/100000738","name":"Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health Services Research and Development Service"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Access to firearms is associated with increased suicide risk. Our aim was to develop a natural language processing approach to characterizing firearm access in clinical records.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We used clinical notes from 36\u00a0685 Veterans Health Administration (VHA) patients between April 10, 2023 and April 10, 2024. We expanded preexisting firearm term sets using subject matter experts and generated 250-character snippets around each firearm term appearing in notes. Annotators labeled 3000 snippets into three classes. Using these annotated snippets, we compared four nonneural machine learning models (random forest, bagging, gradient boosting, logistic regression with ridge penalization) and two versions of Bidirectional Encoder Representations from Transformers, or BERT (specifically, BioBERT and Bio-ClinicalBERT) for classifying firearm access as \u201cdefinite access\u201d, \u201cdefinitely no access\u201d, or \u201cother\u201d.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Firearm terms were identified in 36\u00a0685 patient records (41.3%), 33.7% of snippets were categorized as definite access, 9.0% as definitely no access, and 57.2% as \u201cother\u201d. Among models classifying firearm access, five of six had acceptable performance, with BioBERT and Bio-ClinicalBERT performing best, with F1s of 0.876 (95% confidence interval, 0.874-0.879) and 0.896 (95% confidence interval, 0.894-0.899), respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and Conclusion<\/jats:title>\n                  <jats:p>Firearm-related terminology is common in the clinical records of VHA patients. The ability to use text to identify and characterize patients\u2019 firearm access could enhance suicide prevention efforts, and five of our six models could be used to identify patients for clinical interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocae169","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T14:07:20Z","timestamp":1731420440000},"page":"113-118","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of six natural language processing approaches to assessing firearm access in Veterans Health Administration electronic health records"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0882-463X","authenticated-orcid":false,"given":"Joshua","family":"Trujeque","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota Medical School , Minneapolis, MN 55455,","place":["United States"]}]},{"given":"R Adams","family":"Dudley","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota Medical School , Minneapolis, MN 55455,","place":["United States"]},{"name":"Center for Care Delivery and Outcomes Research (CCDOR), Veterans Affairs (VA) Minneapolis Healthcare System , Minneapolis, MN 55417,","place":["United States"]},{"name":"Institute for Health Informatics, University of Minnesota , Minneapolis, MN 55455,","place":["United States"]},{"name":"School of Public Health, University of Minnesota , Minneapolis, MN 55455,","place":["United States"]}]},{"given":"Nathan","family":"Mesfin","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota Medical School , Minneapolis, MN 55455,","place":["United States"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0292-0594","authenticated-orcid":false,"given":"Nicholas E","family":"Ingraham","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota Medical School , Minneapolis, MN 55455,","place":["United States"]}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0407-2559","authenticated-orcid":false,"given":"Isai","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Medical School, University of Minnesota , Minneapolis, MN 55455,","place":["United States"]}]},{"given":"Ann","family":"Bangerter","sequence":"additional","affiliation":[{"name":"Center for Care Delivery and Outcomes Research (CCDOR), Veterans Affairs (VA) Minneapolis Healthcare System , Minneapolis, MN 55417,","place":["United States"]}]},{"given":"Anjan","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Center for Care Delivery and Outcomes Research (CCDOR), Veterans Affairs (VA) Minneapolis Healthcare System , Minneapolis, MN 55417,","place":["United States"]}]},{"given":"Dalton","family":"Schutte","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Minnesota , Minneapolis, MN 55455,","place":["United States"]}]},{"given":"Jeremy","family":"Yeung","sequence":"additional","affiliation":[{"name":"Institute for Health Informatics, University of Minnesota , Minneapolis, MN 55455,","place":["United States"]}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Minnesota , Minneapolis, MN 55455,","place":["United States"]}]},{"given":"Alicia","family":"Woodward-Abel","sequence":"additional","affiliation":[{"name":"Center for Care Delivery and Outcomes Research (CCDOR), Veterans Affairs (VA) Minneapolis Healthcare System , Minneapolis, MN 55417,","place":["United States"]}]},{"given":"Emma","family":"Bromley","sequence":"additional","affiliation":[{"name":"Center for Care Delivery and Outcomes Research (CCDOR), Veterans Affairs (VA) Minneapolis Healthcare System , Minneapolis, MN 55417,","place":["United States"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8258-3585","authenticated-orcid":false,"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Minnesota , Minneapolis, MN 55455,","place":["United States"]}]},{"given":"Lisa A","family":"Brenner","sequence":"additional","affiliation":[{"name":"Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Rocky Mountain Regional VAMC (RMR VAMC) , Aurora, CO 80045,","place":["United States"]},{"name":"Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz School of Medicine , Aurora, CO 80045,","place":["United States"]},{"name":"Department of Neurology, University of Colorado Anschutz School of Medicine , Aurora, CO 80045,","place":["United States"]},{"name":"Department of Psychiatry, University of Colorado Anschutz School of Medicine , Aurora, CO 80045,","place":["United States"]}]},{"given":"Joseph A","family":"Simonetti","sequence":"additional","affiliation":[{"name":"Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Rocky Mountain Regional VAMC (RMR VAMC) , Aurora, CO 80045,","place":["United States"]},{"name":"Firearm Injury Prevention Initiative, University of Colorado Anschutz School of Medicine , Aurora, CO 80045,","place":["United States"]}]}],"member":"286","published-online":{"date-parts":[[2024,11,12]]},"reference":[{"key":"2024121616111166200_ocae169-B1"},{"key":"2024121616111166200_ocae169-B2","author":"U.S. Department of Veterans Affairs, Office of Mental Health and Suicide 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