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Prediction of multiclass surgical outcomes in glaucoma using multimodal deep learning based on free-text operative notes and structured EHR data

J Am Med Inform Assoc. 2024 Jan 18;31(2):456-464. doi: 10.1093/jamia/ocad213.

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Michelle Hribar, Phd
Associate Professor of Ophthalmology and Informatics | NIH DATA Scholar
Oregon Health & Science University | National Eye Institute (NEI)
Wei-Chun Lin, MD, PhD
Senior Data Scientist
Oregon Health & Science University | Casey Eye Institute

Statement of Purpose

The integration of the vast available EHR data and artificial intelligence (AI) in healthcare management and clinical care has been a growing area in recent decades. In this study, we focused on predicting the outcomes of glaucoma surgery, where long-term outcomes are critical for effective postoperative care. Unlike previous models that primarily focused on binary outcomes using either structured pre-operative or post-operative data, our study introduces a comprehensive approach by predicting multiclass surgical outcomes. These multiclass predictions provide a nuanced understanding of potential postoperative scenarios, enabling tailored patient care.

With the rapid advancement of Natural Language Processing (NLP) development, there has been increasing attention on the utilization of free-text clinical data. We developed multimodal deep learning models that integrate both structured EHR data and the information contained in free-text operative notes. Additionally, we explored different methods for effectively extracting information from free-text notes, such as using a pre-trained Bio-Clinical BERT model and custom word embedding with a transformer block. Overall, our findings demonstrate that the integration of intraoperative details can enhance model performance, highlighting the untapped potential of operative notes in surgical outcome prediction. Furthermore, more nuanced predictions may assist in improving postoperative patient care.

Learning Outcomes

  1. Compare information extraction techniques using BioClinical BERT and custom word embeddings for specific types of clinical notes
  2. Explain the potential of using multimodal models in healthcare outcome prediction
  3. Describe the importance of multiclass surgical outcome prediction in postoperative care


  • 35-minute presentation by article author(s) considering salient features of the published study and its potential impact on practice
  • 25-minute discussion of questions submitted by listeners via the webinar tools and moderated by JAMIA Student Editorial Board members. 

CME Credit

The American Medical Informatics Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Medical Informatics Association designates this live activity for a maximum of 1.0 AMA PRA Category 1™ credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CNE Credit

The American Medical Informatics Association is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

  • Approved Contact Hours: 1.0 total
  • Nurse Planner: Jenna Thate, PhD, RN, CNE


Dates and Times: -
Type: Webinar
Course Format(s): Live Virtual
Price: Free
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