好色先生

好色先生

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Abstract Details

A Retrospective Textual Analysis of Sexual and Reproductive Health Counseling for Adolescent and Young Adult Women with Epilepsy
Child Neurology and Developmental Neurology
P3 - Poster Session 3 (5:30 PM-6:30 PM)
4-011
To analyze documentation of pediatric neurologists’ counseling regarding sexual and reproductive healthcare (SRH) for adolescent women with epilepsy (WWE)
The 好色先生 (AAN) recommends annual SRH counseling for WWE beginning at menarche. Pediatric neurologists self-report discussing SRH concerns infrequently with adolescent WWE. Documentation of such counseling has not been defined.
We retrospectively studied outpatient pediatric neurology notes (n=3663) for WWE age 13-21 using natural language processing to investigate documentation of SRH counseling. Notes were segmented into 388,019 sentences and evaluated for references to SRH counseling regarding: menstruation, sexual activity, contraception, folic acid, teratogens, and pregnancy. We developed training sets in Watchful and utilized spaCy machine learning to identify additional counseling instances. We repeated this process iteratively until no new relevant sentences were identified. Two external reviewers assessed for validity (n=400 sentences, Cohen’s kappa for all categories >0.88); we then removed sentences reviewers disagreed on (n=13) and calculated kappa values between the model and reviewers (>0.98). We evaluated aggregated labeled texts for each patient per calendar year (n=2277 patient-years) with descriptive statistics and logistic regression (adjusting for race, age, and teratogen use).
Nearly half of patient-years had no mention of SRH counseling (49.1%). Among 971 WWE, 38.0% never had SRH counseling documented. Documentation was present regarding menstruation in 26.7% of patient-years, folic acid in 25.0%, contraception in 21.9%, pregnancy in 3.5%, teratogens in 3.0%, and sexual activity in 1.8%. Documentation regarding menstruation and contraception was associated with prescription of teratogens (OR=1.26, p=0.020; OR=1.27, p=0.028). Documentation regarding contraception, folic acid, and sexual activity was associated with older patients (OR=1.28, p=0.000; OR=1.26, p=0.000; OR=1.26, p=0.004). Documentation of sexual activity was decreased among patients identifying as White (OR=0.40, p=0.012).
Pediatric neurologists counsel WWE on SRH less frequently than recommended by the AAN based on chart documentation.
Authors/Disclosures
Elizabeth Harrison, MD (UPMC Children's Hospital of Pittsburgh)
PRESENTER 		Dr. Harrison has nothing to disclose.
Laura A. Kirkpatrick, MD (UPMC Children's Hospital of Pittsburgh) The institution of Dr. Kirkpatrick has received research support from American Epilepsy Society. The institution of Dr. Kirkpatrick has received research support from Child Neurologist Career Development Program. The institution of Dr. Kirkpatrick has received research support from Child Neurology Foundation. The institution of Dr. Kirkpatrick has received research support from Rosenau Family Research Foundation. The institution of Dr. Kirkpatrick has received research support from Society of Family Planning. The institution of Dr. Kirkpatrick has received research support from Pediatric Epilepsy Research Consortium. Dr. Kirkpatrick has received personal compensation in the range of $500-$4,999 for serving as a Meeting Attendee with One8 Foundation. Dr. Kirkpatrick has received personal compensation in the range of $500-$4,999 for serving as a Meeting Attendee with Brigham and Women's Hospital. Dr. Kirkpatrick has received personal compensation in the range of $0-$499 for serving as a Meeting Attendee with Pediatric Epilepsy Research Consortium. Dr. Kirkpatrick has received personal compensation in the range of $0-$499 for serving as a Grant reviewer with Society of Family Planning. Dr. Kirkpatrick has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Norton Children's Hospital. Dr. Kirkpatrick has a non-compensated relationship as a Board of Directors member with My Epilepsy Story that is relevant to AAN interests or activities.
No disclosure on file
Yoshimi Sogawa, MD (Montefiore Medical Center) Dr. Sogawa has nothing to disclose.
Traci Kazmerski The institution of Traci Kazmerski has received research support from Cystic Fibrosis Foundation. The institution of Traci Kazmerski has received research support from NIH.