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Medical data and text mining 
Linking diseases, drugs, and 
adverse reactions 
Lars Juhl Jensen
structured data
Jensen et al., Nature Reviews Genetics, 2012
unstructured data
central registries
individual hospitals
opt-out
opt-in
Danish registries
civil registration system
CPR number
established in 1968
Jensen et al., Nature Reviews Genetics, 2012
national discharge registry
14 years
6.2 million patients
45 million admissions
68 million records
119 million diagnosis
ICD-10
Jensen et al., Nature Reviews Genetics, 2012
not research
reimbursement
diagnosis trajectories
naïve approach
comorbidity
Jensen et al., Nature Reviews Genetics, 2012
confounding factors
“known knowns”
gender
age
type of hospital encounter
Jensen et al., Nature Communications, 2014
“known unknowns”
smoking
diet
“unknown unknowns”
reporting biases
matched controls
temporal correlations
multiple testing
trajectories
Jensen et al., Nature Communications, 2014
trajectory networks
Jensen et al., Nature Communications, 2014
key diagnoses
Jensen et al., Nature Communications, 2014
direct medical implications
electronic health records
structured data
Jensen et al., Nature Reviews Genetics, 2012
unstructured data
free text
Danish
busy doctors
typos
psychiatric patients
text mining
comprehensive dictionary
drugs
adverse drug reactions
expansion rules
Clozapine
Clozapine 
clozapi 
n 
clossapi 
n 
klozapin 
e 
chlosapi 
n 
chlozapi 
chlosapi 
ne 
n 
chlozapi 
ne 
klossapi 
n 
closapin 
e 
klozapi 
klosapi n 
n
post-coordination rules
failure of kidney
renal failure
pharmacovigilance
clinical trials
spontaneous reports
underreporting
data mining
structured data
medication
semi-structured data
drug indications
known ADRs
unstructured data
adverse drug reactions
temporal correlations
hand-crafted rules
Drug introduction Adverse event Drug discontinuation 
Negative modifier Indication Pre-existing Adverse event 
Eriksson et al., Drug Safety, 2014 
condition 
Adverse drug reaction Possible 
adverse drug reaction 
ADR of 
additional drug
Drug introduction Identification star t Adverse event Drug discontinuation 
Negative modifier Indication Pre-existing Adverse event 
Eriksson et al., Drug Safety, 2014 
condition 
Adverse drug reaction Possible 
adverse drug reaction 
ADR of 
additional drug
Drug introduction Drug discontinuation 
Negative modifier Indication Pre-existing Adverse event 
Eriksson et al., Drug Safety, 2014 
condition 
Adverse drug reaction Possible 
adverse drug reaction 
Adverse event 
ADR of 
additional drug 
Identification star t
Drug introduction Drug discontinuation 
Negative modifier Indication Pre-existing Adverse event 
Eriksson et al., Drug Safety, 2014 
condition 
Adverse drug reaction Possible 
adverse drug reaction 
Adverse event 
ADR of 
additional drug 
Identification star t
recall known ADRs
estimate ADR frequencies
Eriksson et al., Drug Safety, 2014
discover new ADRs
Drug substance ADE p-value 
Chlordiazepoxide Nystagmus 4.0e-8 
Simvastatin Personality 
changes 
8.4e-8 
Dipyridamole Visual impairment 4.4e-4 
Citalopram Psychosis 8.8e-4 
Bendroflumethiazi 
Apoplexy 8.5e-3 
de 
Eriksson et al., Drug Safety, 2014
Acknowledgments 
Disease trajectories 
Anders Bøck Jensen 
Tudor Oprea 
Pope Moseley 
Søren Brunak 
Adverse drug reactions 
Robert Eriksson 
Thomas Werge 
Søren Brunak 
EHR text mining 
Peter Bjødstrup 
Jensen 
Robert Eriksson 
Henriette Schmock 
Francisco S. Roque 
Anders Juul 
Marlene Dalgaard 
Massimo Andreatta 
Sune Frankild 
Eva Roitmann 
Thomas Hansen 
Karen Søeby 
Søren Bredkjær 
Thomas Werge 
Søren Brunak

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