Machine Learning Approach to Inpatient Violence Risk Assessment Using Routinely Collected Clinical Notes in Electronic Health Records

Key Points Question To what extent can inpatient violence risk assessment be performed by applying machine learning techniques to clinical notes in patients’ electronic health records? Findings In this prognostic study, machine learning was used to analyze clinical notes recorded in electronic health records of 2 independent psychiatric health care institutions in the Netherlands to predict inpatient violence. Internal predictive validity was measured using areas under the curve, which were 0.797 for site 1 and 0.764 for site 2; however, applying pretrained models to data from other sites resulted in significantly lower areas under the curve. Meaning The findings suggest that inpatient violence risk assessment can be performed automatically using already available clinical notes without sacrificing predictive validity compared with existing violence risk assessment methods.