Today: Aug 29, 2025
RU / EN
Last update: Aug 28, 2025
The Data-Driven Definition of “Complication” in Medicine

The Data-Driven Definition of “Complication” in Medicine

Danilov G.V., Kotov A.A., Usachev D.Yu., Nazarenko A.G., Strunina Yu.V., Tsukanova T.V., Kotik K.B., Potapov A.A.
Key words: complication; definition of complication; natural language processing; word embeddings; tracking the safety of medical care; neurosurgery.
2025, volume 17, issue 4, page 19.

Full text

html pdf
14
12

The concept of “complication” is widely used in the medical domain to designate unfavorable events in the course of medical care. However, the medical community has not yet established a strict and generally accepted definition of “complication”. This makes it much harder to systematically track and ensure the safety of medical care, whether in an individual clinic or across the entire healthcare system.

This study aimed to define the concept of “complication” by identifying its generic concept and key distinguishing features using natural language processing.

Results. We conducted linguistic and statistical analysis of the term “complication” using a large corpus of medical texts from 90,688 completed neurosurgical cases in the digital archive of the N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of the Russian Federation, spanning 2000 to 2017. The corpus was tokenized and normalized to obtain a vocabulary of 40,121 lexemes. A total of 5853 lexemes were selected as the lexicon of adverse medical events (LAME), supposed to be found in the context of complications. Using n-gram vector representations trained on our corpus, we obtained vector representations of LAME words and selected 4416 words as the sub-LAME core based on their positive cosine similarity with the vector for “complication”. From the nouns, adjectives, and verbs in the sub-LAME, we extracted features that generalize, characterize, and classify complications. “Pathology” was identified as the generic concept for complication. The distinguishing features of complications were determined to be their novelty and emergence during observation of a primary phenomenon.

Thus, we propose the following definition of “complication” for medical care safety monitoring:

A complication (in medicine) is an intercurrent pathology detected during observation of an underlying disease, physiological process, or the result of intervention.

Our patented method presented in this paper enables the development of scientifically grounded definitions for unclear or poorly defined concepts.

  1. Helo S., Moulton C.E. Complications: acknowledging, managing, and coping with human error. Transl Androl Urol 2017; 6(4): 773–782, https://doi.org/10.21037/tau.2017.06.28.
  2. Amalberti R., Benhamou D., Auroy Y., Degos L. Adverse events in medicine: easy to count, complicated to understand, and complex to prevent. J Biomed Inform 2011; 44(3): 390–394, https://doi.org/10.1016/j.jbi.2009.06.004.
  3. E6(R2) Good Clinical Practice: Integrated Addendum to ICH E6(R1). Guidance for Industry. 2018. URL: https://database.ich.org/sites/default/files/E6_R2_Addendum.pdf.
  4. Gozal Y.M., Aktüre E., Ravindra V.M., Scoville J.P., Jensen R.L., Couldwell W.T., Taussky P. Defining a new neurosurgical complication classification: lessons learned from a monthly morbidity and mortality conference. J Neurosurg 2019; 132(1): 272–276, https://doi.org/10.3171/2018.9.JNS181004.
  5. Schiavolin S., Broggi M., Acerbi F., Brock S., Schiariti M., Cusin A., Visintini S., Leonardi M., Ferroli P. The impact of neurosurgical complications on patients’ health status: a comparison between different grades of complications. World Neurosurg 2015; 84(1): 36–40, https://doi.org/10.1016/j.wneu.2015.02.008.
  6. Brock S., Saleh C., Zekaj E., Servello D. How to compare clinical results of different neurosurgical centers? Is a classification of complications in neurosurgery necessary for this purpose? Surg Neurol Int 2016; 7(Suppl 20): S565–S569, https://doi.org/10.4103/2152-7806.188471.
  7. Rolston J.D., Han S.J., Lau C.Y., Berger M.S., Parsa A.T. Frequency and predictors of complications in neurological surgery: national trends from 2006 to 2011. J Neurosurg 2014; 120(3): 736–745, https://doi.org/10.3171/2013.10.JNS122419.
  8. Harper D. Online etymology dictionary. URL: https://www.etymonline.com/word/complication.
  9. WordNet. A lexical database for English. URL: https://wordnet.princeton.edu/.
  10. SNOMED CT Clinical Terms. URL: https://browser.ihtsdotools.org/.
  11. MyStem. URL: https://yandex.ru/dev/mystem/.
  12. Vector semantics and embeddings. In: Daniel J., Martin J.H. Speech and language processing. 2025. URL: https://web.stanford.edu/~jurafsky/slp3/6.pdf.
  13. Danilov G., Kotik K., Shifrin M., Strunina Y., Pronkina T., Tsukanova T., Ishankulov T., Shults M., Makashova E., Latyshev Y., Sufianov R., Sharipov O., Nazarenko A., Konovalov N., Potapov A. A comparison of word embeddings to study complications in neurosurgery. Stud Health Technol Inform 2022; 289: 5–8, https://doi.org/10.3233/SHTI210845.
  14. Danilov G., Shifrin M., Strunina U., Pronkina T., Potapov A. An information extraction algorithm for detecting adverse events in neurosurgery using documents written in a natural rich-in-morphology language. Stud Health Technol Inform 2019; 262: 194–197, https://doi.org/10.3233/SHTI190051.
  15. Levenshtein V.I. Binary codes capable of correcting deletions, insertions and reversals. Soviet Physics Doklady 1966; 10: 707–710.
  16. Pitskhelauri D., Bykanov A., Konovalov A., Danilov G., Buklina S., Sanikidze A., Sufianov R. Transsylvian insular glioma surgery: new classification system, clinical outcome in a consecutive series of 79 cases. Oper Neurosurg (Hagerstown) 2021; 20(6): 541–548, https://doi.org/10.1093/ons/opab051.
  17. Black P. What is a complication in neurosurgical surgery? A practical approach. In: Brain surgery: complication avoidance and management. Vol. I. Apuzzo M.L.J. (editor). New York: Churchill Livingston; 1993; p. XXV–XXVII.
  18. Lebude B., Yadla S., Albert T., Anderson D.G., Harrop J.S., Hilibrand A., Maltenfort M., Sharan A., Vaccaro A.R., Ratliff J.K. Defining “complications” in spine surgery: neurosurgery and orthopedic spine surgeons’ survey. J Spinal Disord Tech 2010; 23(8): 493–500, https://doi.org/10.1097/BSD.0b013e3181c11f89.
  19. Landriel Ibañez F.A., Hem S., Ajler P., Vecchi E., Ciraolo C., Baccanelli M., Tramontano R., Knezevich F., Carrizo A. A new classification of complications in neurosurgery. World Neurosurg 2011; 75(5–6): 709–611, https://doi.org/10.1016/j.wneu.2010.11.010.
  20. Dindo D., Demartines N., Clavien P.A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240(2): 205–213, https://doi.org/10.1097/01.sla.0000133083.54934.ae.
  21. Ferroli P., Brock S., Leonardi M., Schiavolin S., Acerbi F., Broggi M. Complications in neurosurgery: application of Landriel Ibañez classification and preliminary considerations on 1000 cases. World Neurosurg 2014; 82(3–4): e576–e577, https://doi.org/10.1016/j.wneu.2014.03.036.
  22. Likhterman L.B., Potapov A.A. Klassifikatsiya cherepno-mozgovoy travmy. V kn.: Klinicheskoe rukovodstvo po cherepno-mozgovoy travme. T. 1 [Classification of traumatic brain injury. In: Clinical guidelines for traumatic brain injury. Vol. 1]. Konovalov A.N., Likhterman L.B., Potapov A.A. (editors). Moscow: “ANTIDOR”; 1998; p. 47–128.
  23. Sokol D.K., Wilson J. What is a surgical complication? World J Surg 2008; 32(6): 942–944, https://doi.org/10.1007/s00268-008-9471-6.
  24. Wang Y., Wang L., Rastegar-Mojarad M., Moon S., Shen F., Afzal N., Liu S., Zeng Y., Mehrabi S., Sohn S., Liu H. Clinical information extraction applications: a literature review. J Biomed Inform 2018; 77: 34–49, https://doi.org/10.1016/j.jbi.2017.11.011.
  25. Sarker A., Gonzalez-Hernandez G. An unsupervised and customizable misspelling generator for mining noisy health-related text sources. J Biomed Inform 2018; 88: 98–107, https://doi.org/10.1016/j.jbi.2018.11.007.
  26. Yoo I.-H., Song M. Biomedical ontologies and text mining for biomedicine and healthcare: a survey. J Comput Sci Eng 2008; 2(2): 109–136, https://doi.org/10.5626/jcse.2008.2.2.109.
  27. Jabareen Y. Building a conceptual framework: philosophy, definitions, and procedure. International Journal of Qualitative Methods 2009; 8(4): 49–62, https://doi.org/10.1177/160940690900800406.
  28. Reason J. The contribution of latent human failures to the breakdown of complex systems. Philos Trans R Soc Lond B Biol Sci 1990; 327(1241): 475–484, https://doi.org/10.1098/rstb.1990.0090.
  29. Scott C.M., Lubritz R.R., Graham G.F. Adverse events. Dermatological Cryosurgery and Cryotherapy 2022; 221–223, https://doi.org/10.1007/978-1-4471-6765-5_47.
Danilov G.V., Kotov A.A., Usachev D.Yu., Nazarenko A.G., Strunina Yu.V., Tsukanova T.V., Kotik K.B., Potapov A.A. The Data-Driven Definition of “Complication” in Medicine. Sovremennye tehnologii v medicine 2025; 17(4): 19, https://doi.org/10.17691/stm2025.17.4.02


Journal in Databases

pubmed_logo.jpg

web_of_science.jpg

scopus.jpg

crossref.jpg

ebsco.jpg

embase.jpg

ulrich.jpg

cyberleninka.jpg

e-library.jpg

lan.jpg

ajd.jpg

SCImago Journal & Country Rank