Supervised machine learning applied in nursing notes for identifying the need of childhood cancer patients for psychosocial support

IntroductionChildhood cancer survivors have a higher risk of mental health and adaptive problems compared with their siblings, for example. Assessing the need for psychosocial support is essential for prevention. This project aims to investigate the use of supervised machine learning in the form of...

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Main Authors: Akseli Reunamo, Hans Moen, Sanna Salanterä, Päivi M. Lähteenmäki
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Digital Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fdgth.2025.1585309/full
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author Akseli Reunamo
Hans Moen
Sanna Salanterä
Sanna Salanterä
Päivi M. Lähteenmäki
author_facet Akseli Reunamo
Hans Moen
Sanna Salanterä
Sanna Salanterä
Päivi M. Lähteenmäki
author_sort Akseli Reunamo
collection DOAJ
description IntroductionChildhood cancer survivors have a higher risk of mental health and adaptive problems compared with their siblings, for example. Assessing the need for psychosocial support is essential for prevention. This project aims to investigate the use of supervised machine learning in the form of text classification in identifying childhood cancer patients needing psychosocial support from nursing notes when at least 1 year had passed from their cancer diagnosis.MethodsWe evaluated three well-known machine learning–based models to recognize patients who had outpatient clinic reservations in the mental health–related care units from free-text nursing notes of 1,672 patients. For model training, the patients were children diagnosed with diabetes mellitus or cancer, while evaluation of the model was done on the patients diagnosed with cancer. A stratified fivefold nested cross-validation was used. We designed this as a binary classification task, with the following labels: no support (0) or psychosocial support (1) was needed. Patients with the latter label were identified by having an outpatient appointment reservation in a mental health–related care unit at least 1 year after their primary diagnosis.ResultsThe random forest classification model trained on both cancer and diabetes patients performed best for the cancer patient population in three-times repeated nested cross-validation with 0.798 mean area under the receiver operating characteristics curve and was better with 99% probability (credibility interval −0.2840 to −0.0422) than the neural network–based model using only cancer patients in training when comparing all classifiers pairwise by using the Bayesian correlated t-test.ConclusionsUsing machine learning to predict childhood cancer patients needing psychosocial support was possible using nursing notes with a good area under the receiver operating characteristics curve. The reported experiment indicates that machine learning may assist in identifying patients likely to need mental health–related support later in life.
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spelling doaj-art-8a176a59f73d43df988d40d1a771d0422025-08-20T03:40:46ZengFrontiers Media S.A.Frontiers in Digital Health2673-253X2025-08-01710.3389/fdgth.2025.15853091585309Supervised machine learning applied in nursing notes for identifying the need of childhood cancer patients for psychosocial supportAkseli Reunamo0Hans Moen1Sanna Salanterä2Sanna Salanterä3Päivi M. Lähteenmäki4Department of Computing, University of Turku, Turku, FinlandDepartment of Computer Science, Aalto University, Espoo, FinlandDepartment of Nursing Science, University of Turku, Turku, FinlandNursing Administration, Turku University Hospital, Turku, FinlandDepartment of Pediatric and Adolescent Medicine, Turku University Hospital, FICAN-WEST and University of Turku, Turku, FinlandIntroductionChildhood cancer survivors have a higher risk of mental health and adaptive problems compared with their siblings, for example. Assessing the need for psychosocial support is essential for prevention. This project aims to investigate the use of supervised machine learning in the form of text classification in identifying childhood cancer patients needing psychosocial support from nursing notes when at least 1 year had passed from their cancer diagnosis.MethodsWe evaluated three well-known machine learning–based models to recognize patients who had outpatient clinic reservations in the mental health–related care units from free-text nursing notes of 1,672 patients. For model training, the patients were children diagnosed with diabetes mellitus or cancer, while evaluation of the model was done on the patients diagnosed with cancer. A stratified fivefold nested cross-validation was used. We designed this as a binary classification task, with the following labels: no support (0) or psychosocial support (1) was needed. Patients with the latter label were identified by having an outpatient appointment reservation in a mental health–related care unit at least 1 year after their primary diagnosis.ResultsThe random forest classification model trained on both cancer and diabetes patients performed best for the cancer patient population in three-times repeated nested cross-validation with 0.798 mean area under the receiver operating characteristics curve and was better with 99% probability (credibility interval −0.2840 to −0.0422) than the neural network–based model using only cancer patients in training when comparing all classifiers pairwise by using the Bayesian correlated t-test.ConclusionsUsing machine learning to predict childhood cancer patients needing psychosocial support was possible using nursing notes with a good area under the receiver operating characteristics curve. The reported experiment indicates that machine learning may assist in identifying patients likely to need mental health–related support later in life.https://www.frontiersin.org/articles/10.3389/fdgth.2025.1585309/fullcancernursing notesmachine learningelectronic health recordspsychosocial support systemslate effects
spellingShingle Akseli Reunamo
Hans Moen
Sanna Salanterä
Sanna Salanterä
Päivi M. Lähteenmäki
Supervised machine learning applied in nursing notes for identifying the need of childhood cancer patients for psychosocial support
Frontiers in Digital Health
cancer
nursing notes
machine learning
electronic health records
psychosocial support systems
late effects
title Supervised machine learning applied in nursing notes for identifying the need of childhood cancer patients for psychosocial support
title_full Supervised machine learning applied in nursing notes for identifying the need of childhood cancer patients for psychosocial support
title_fullStr Supervised machine learning applied in nursing notes for identifying the need of childhood cancer patients for psychosocial support
title_full_unstemmed Supervised machine learning applied in nursing notes for identifying the need of childhood cancer patients for psychosocial support
title_short Supervised machine learning applied in nursing notes for identifying the need of childhood cancer patients for psychosocial support
title_sort supervised machine learning applied in nursing notes for identifying the need of childhood cancer patients for psychosocial support
topic cancer
nursing notes
machine learning
electronic health records
psychosocial support systems
late effects
url https://www.frontiersin.org/articles/10.3389/fdgth.2025.1585309/full
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