Can antiepileptic drug efficacy be studied from electronic health records? A review of current approaches

As automated data extraction and natural language processing (NLP) are rapidly evolving, applicability to harness large data to improve healthcare delivery is garnering great interest. Assessing antiepileptic drug (AED) efficacy remains a barrier to improving epilepsy care. In this review, we examined automatic electronic health record (EHR) extraction methodologies pertinent to epilepsy examining AED efficacy. We also reviewed more generalizable NLP pipelines to extract other critical patient variables. Our review found varying reports of performance measures. Whereas automated data extraction pipelines are a crucial advancement, this review calls attention to standardizing NLP methodology and accuracy reporting for greater generalizability. Moreover, the use of crowdsourcing competitions to spur innovative NLP pipelines would further advance this field. HIGHLIGHTS ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Barbara Decker, MD receives funding from NIH T32-NS-061779. Pouya Khankhanian, MD receives finding from NIH T32-NS-091008. Chloe E Hill, MD, MS receives funding from NIH KL2TR002241. Steven Baldassano, MD receives funding from NIH T32-NS-091006-01. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This is a systematic review and is exempt from IRB approval. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.