Abstract
Background: Electronic Health Records (EHRs) are a rich source of clinical information used for patient monitoring, disease progression analysis, and treatment outcome assessment. However, their large-scale, heterogeneity, and temporal characteristics make them difficult to analyze. Topic modeling has emerged as an effective method to extract latent structures, detect disease characteristics, and trace patient trajectories in EHRs. Recent neural and transformer-based approaches such as BERTopic has significantly improved coherence, scalability, and domain adaptability compared to earlier probabilistic models. Methods: This Systematic Literature Review (SLR) examines topic modeling and its variants applied to EHR data over the past decade. We follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to identify, screen, and select relevant studies. The reviewed techniques span traditional probabilistic models, neural embedding-based methods, and temporal extensions designed for pathway and sequence modeling in clinical data. Results: The synthesis covers trends in publication patterns, dataset usage, application domains, and methodological contributions. The reviewed literature demonstrates strengths across different modeling families, while also highlighting challenges related to scalability, interpretability, temporal complexity, and privacy when analyzing large-scale EHRs. Conclusions: Topic modeling continues to play a central role in understanding temporal patterns and latent structures in EHRs. This review also outlines future possibilities for integrating topic modeling with Agentic AI and large language models to enhance clinical decision-making. Overall, this SLR provides researchers and practitioners with a consolidated foundation on temporal topic modeling in EHRs and its potential to advance data-driven healthcare.