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Pulmonary Hypertension

Annotation Guidelines: v0.2.1 Updated: May 20th, 2023

1: ICD Labels

SNOMED: 87837008, 88223008, 697915006, 70995007 ICD-9: 416, 416.0, 416.1, 416.2, 416.8, 416.9, ICD-10: I27.0, I27.1, I27.2, I27.20, I27.21, I27.22, I27.23, I27.24, I27.29, I27.81, I27.82, I27.83, I27.89, I27.9

2: NLP Labels

Current Positive

Explicit mention of “pulmonary hypertension” (or synonym) that refers to a currently ongoing condition. Definitive statement of presence of pulmonary hypertension

Current Positive Hedged

Explicit mention of a patient having “pulmonary hypertension” but with some hedging.

Examples Pt may have component of heart failure and/or pulmonary hypertension is suggestive of Pulm HTN

Current Negative

Definitive declaration of no pulmonary hypertension

Current Negative Hedged

Explicit mention of a patient not having “pulmonary hypertension” but with some hedging.

Current Hypothetical

Use of “pulmonary hypertension” to refer to a diagnosis that may happen, but hasn’t yet. PH might be suspected (e.g., in the case of ordering a test to rule in or out) but no results are available to draw a conclusion. This differs from hedging in that the clinician has not yet observed evidence that allows them to draw a preliminary conclusion.

Examples providing anesthesia to patients who have pulmonary hypertension. which may be seen in the setting of pulmonary hypertension We realize that sildenafil (Revatio) for pulmonary hypertension is approved by the FDA at a dose of 20 mg TID c/f possible heart failure and/or pulmonary hypertension TTE to rule out pulm HTN /RVH

Current Unclear

Conflicting inclusion criteria or statements of presence/absence of pulmonary hypertension. For example, “pulmonary hypertension” may occur in a list, but the list header is missing. This makes it difficult to predict if the mention is current or historical.

N/A

There is no explicit mention of pulmonary hypertension

NOTE: If multiple mentions are included (e.g., historical measurement values) label those as well. This can result in settings where both options (-RV and +RV) are tagged for a patient document.

PAP <25

Pulmonary Artery Pressure (PAP) <25 mmHg

PAP ≥25

Pulmonary Artery Pressure (PAP) ≥25 mmHg

RVSP <=45

Right Ventricular Systolic Pressure (RVSP) <= 45

RVSP >45

Right Ventricular Systolic Pressure (RVSP) > 45

-RV Dysfunction

No suggestion of RV Dysfunction

+RV Dysfunction

Any suggestion of RV Dysfunction

Historical Positive

Mention of “pulmonary hypertension” refers to a prior diagnosis. This can occur in the summary of past medical history or a statement of a prior diagnosis. Conditions denoted as chronic are by definition both current and historical.

Historical Negative

Mentions “pulmonary hypertension” being ruled out in the past.

OtherMeaning

Use of “pulmonary hypertension” as a modifier, adjective, or proper noun not reflecting a patient’s actual disease state. For example, we can have proper nouns (Stanford Pulmonary Hypertension Clinic) or adjectives for specialities (pulmonary hypertension fellow)

Examples pulmonary htn fellow

Follow Up Instructions Order Comments: Please call Stanford Pulmonary Hypertension clinic

in the pulmonary hypertension clinic