Textual analysis of clinical notes on pathology request forms to determine sensitivity and specificity of Hepatitis B and C virus infection status

TL;DR

This study evaluates how well clinical notes on pathology request forms can identify Hepatitis B and C infection status, finding moderate sensitivity but low specificity, thus limiting their usefulness for definitive diagnosis.

Contribution

It provides quantitative analysis of the diagnostic value of clinical notes for Hepatitis B and C, highlighting their limitations in specificity.

Findings

Clinical notes have 90% sensitivity for Hepatitis B.

Clinical notes have 86% sensitivity for Hepatitis C.

Specificity is low: 56% for Hepatitis B and 21% for Hepatitis C.

Abstract

Background: It is not established whether clinical notes provided on pathology request forms are useful as decision support data when assessing Hepatitis B and C viral infection status. Objective: To determine sensitivity, specificity, and predictive value of clinical notes for identifying infection status of Hepatitis B and C. Methods: The study comprises 179 cases and 166 cases tested for HBsAg and anti-HCV serological markers, respectively, and accompanied by a written description (clinical note) provided on pathology request forms by the clinician on duty. The clinical note sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated using serological HBsAg and anti-HCV tests as gold standards. Results: The sensitivity and specificity of clinical notes for Hepatitis B infection status were 90 percent and 56 percent, respectively. The sensitivity and specificity of clinical notes for Hepatitis C infection status were 86 percent and 21 percent, respectively. Conclusions: Clinical note information identifies moderate-to-high sensitivity with regards to Hepatitis B and C viral infection status, however, given low specificity in both groups, the clinical note is not favourable for ruling disease in, possibly due to high rate of false positives.