Advanced Care Planning Content Encoding with Natural Language Processing

Benjamin C. Knoll, Melissa Gunderson, Geetanjali Rajamani, Elizabeth C. Wick, Alexis Colley, Elizabeth Lindemann, Rubina Rizvi, Molly Diethelm, Gretchen Hultman, Logan Pierce, Rui Zhang, Genevieve B. Melton

Research output: Chapter in Book/Report/Conference proceedingConference contribution


While advanced care planning (ACP) is an essential practice for ensuring patient-centered care, its adoption remains poor and the completeness of its documentation variable. Natural language processing (NLP) approaches hold promise for supporting ACP, including its use for decision support to improve ACP gaps at the point of care. ACP themes were annotated on palliative care notes across four annotators (Fleiss kappa = 0.753) and supervised models trained (Huggingface models bert-base-uncased and Bio-ClinicalBERT) using 5-fold cross validation (F1=0.8, precision=0.75, recall=0.86, any theme). When applied across the full note corpus of 12,711 notes, we observed variability in documentation of ACP information. Our findings demonstrate the promise of NLP approaches for informatics-based approaches for ACP and patient-centered care.

Original languageEnglish (US)
Title of host publicationMEDINFO 2023 - The Future is Accessible
Subtitle of host publicationProceedings of the 19th World Congress on Medical and Health Informatics
EditorsJen Bichel-Findlay, Paula Otero, Philip Scott, Elaine Huesing
PublisherIOS Press BV
Number of pages5
ISBN (Electronic)9781643684567
StatePublished - Jan 25 2024
Event19th World Congress on Medical and Health Informatics, MedInfo 2023 - Sydney, Australia
Duration: Jul 8 2023Jul 12 2023

Publication series

NameStudies in Health Technology and Informatics
ISSN (Print)0926-9630
ISSN (Electronic)1879-8365


Conference19th World Congress on Medical and Health Informatics, MedInfo 2023

Bibliographical note

Publisher Copyright:
© 2024 International Medical Informatics Association (IMIA) and IOS Press.


  • Advanced care planning
  • decision support
  • natural language processing
  • palliative care
  • patient-centered care


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