scholarly journals Extracting Family History Information From Electronic Health Records: Natural Language Processing Analysis (Preprint)

2020 ◽  
Author(s):  
Maciej Rybinski ◽  
Xiang Dai ◽  
Sonit Singh ◽  
Sarvnaz Karimi ◽  
Anthony Nguyen

BACKGROUND The prognosis, diagnosis, and treatment of many genetic disorders and familial diseases significantly improve if the family history (FH) of a patient is known. Such information is often written in the free text of clinical notes. OBJECTIVE The aim of this study is to develop automated methods that enable access to FH data through natural language processing. METHODS We performed information extraction by using transformers to extract disease mentions from notes. We also experimented with rule-based methods for extracting family member (FM) information from text and coreference resolution techniques. We evaluated different transfer learning strategies to improve the annotation of diseases. We provided a thorough error analysis of the contributing factors that affect such information extraction systems. RESULTS Our experiments showed that the combination of domain-adaptive pretraining and intermediate-task pretraining achieved an F1 score of 81.63% for the extraction of diseases and FMs from notes when it was tested on a public shared task data set from the National Natural Language Processing Clinical Challenges (N2C2), providing a statistically significant improvement over the baseline (<i>P</i><.001). In comparison, in the 2019 N2C2/Open Health Natural Language Processing Shared Task, the median F1 score of all 17 participating teams was 76.59%. CONCLUSIONS Our approach, which leverages a state-of-the-art named entity recognition model for disease mention detection coupled with a hybrid method for FM mention detection, achieved an effectiveness that was close to that of the top 3 systems participating in the 2019 N2C2 FH extraction challenge, with only the top system convincingly outperforming our approach in terms of precision.

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Craig H Ganoe ◽  
Weiyi Wu ◽  
Paul J Barr ◽  
William Haslett ◽  
Michelle D Dannenberg ◽  
...  

Abstract Objectives The objective of this study is to build and evaluate a natural language processing approach to identify medication mentions in primary care visit conversations between patients and physicians. Materials and Methods Eight clinicians contributed to a data set of 85 clinic visit transcripts, and 10 transcripts were randomly selected from this data set as a development set. Our approach utilizes Apache cTAKES and Unified Medical Language System controlled vocabulary to generate a list of medication candidates in the transcribed text and then performs multiple customized filters to exclude common false positives from this list while including some additional common mentions of the supplements and immunizations. Results Sixty-five transcripts with 1121 medication mentions were randomly selected as an evaluation set. Our proposed method achieved an F-score of 85.0% for identifying the medication mentions in the test set, significantly outperforming existing medication information extraction systems for medical records with F-scores ranging from 42.9% to 68.9% on the same test set. Discussion Our medication information extraction approach for primary care visit conversations showed promising results, extracting about 27% more medication mentions from our evaluation set while eliminating many false positives in comparison to existing baseline systems. We made our approach publicly available on the web as an open-source software. Conclusion Integration of our annotation system with clinical recording applications has the potential to improve patients’ understanding and recall of key information from their clinic visits, and, in turn, to positively impact health outcomes.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Zhongyu Anna Liu ◽  
Muhammad Mamdani ◽  
Richard Aviv ◽  
Chloe Pou-Prom ◽  
Amy Yu

Introduction: Diagnostic imaging reports contain important data for stroke surveillance and clinical research but converting a large amount of free-text data into structured data with manual chart abstraction is resource-intensive. We determined the accuracy of CHARTextract, a natural language processing (NLP) tool, to extract relevant stroke-related attributes from full reports of computed tomograms (CT), CT angiograms (CTA), and CT perfusion (CTP) performed at a tertiary stroke centre. Methods: We manually extracted data from full reports of 1,320 consecutive CT/CTA/CTP performed between October 2017 and January 2019 in patients presenting with acute stroke. Trained chart abstractors collected data on the presence of anterior proximal occlusion, basilar occlusion, distal intracranial occlusion, established ischemia, haemorrhage, the laterality of these lesions, and ASPECT scores, all of which were used as a reference standard. Reports were then randomly split into a training set (n= 921) and validation set (n= 399). We used CHARTextract to extract the same attributes by creating rule-based information extraction pipelines. The rules were human-defined and created through an iterative process in the training sample and then validated in the validation set. Results: The prevalence of anterior proximal occlusion was 12.3% in the dataset (n=86 left, n=72 right, and n=4 bilateral). In the training sample, CHARTextract identified this attribute with an overall accuracy of 97.3% (PPV 84.1% and NPV 99.4%, sensitivity 95.5% and specificity 97.5%). In the validation set, the overall accuracy was 95.2% (PPV 76.3% and NPV 98.5%, sensitivity 90.0% and specificity 96.0%). Conclusions: We showed that CHARTextract can identify the presence of anterior proximal vessel occlusion with high accuracy, suggesting that NLP can be used to automate the process of data collection for stroke research. We will present the accuracy of CHARTextract for the remaining neurological attributes at ISC 2020.


Author(s):  
Yanshan Wang ◽  
Sunyang Fu ◽  
Feichen Shen ◽  
Sam Henry ◽  
Ozlem Uzuner ◽  
...  

BACKGROUND Semantic textual similarity is a common task in the general English domain to assess the degree to which the underlying semantics of 2 text segments are equivalent to each other. Clinical Semantic Textual Similarity (ClinicalSTS) is the semantic textual similarity task in the clinical domain that attempts to measure the degree of semantic equivalence between 2 snippets of clinical text. Due to the frequent use of templates in the Electronic Health Record system, a large amount of redundant text exists in clinical notes, making ClinicalSTS crucial for the secondary use of clinical text in downstream clinical natural language processing applications, such as clinical text summarization, clinical semantics extraction, and clinical information retrieval. OBJECTIVE Our objective was to release ClinicalSTS data sets and to motivate natural language processing and biomedical informatics communities to tackle semantic text similarity tasks in the clinical domain. METHODS We organized the first BioCreative/OHNLP ClinicalSTS shared task in 2018 by making available a real-world ClinicalSTS data set. We continued the shared task in 2019 in collaboration with National NLP Clinical Challenges (n2c2) and the Open Health Natural Language Processing (OHNLP) consortium and organized the 2019 n2c2/OHNLP ClinicalSTS track. We released a larger ClinicalSTS data set comprising 1642 clinical sentence pairs, including 1068 pairs from the 2018 shared task and 1006 new pairs from 2 electronic health record systems, GE and Epic. We released 80% (1642/2054) of the data to participating teams to develop and fine-tune the semantic textual similarity systems and used the remaining 20% (412/2054) as blind testing to evaluate their systems. The workshop was held in conjunction with the American Medical Informatics Association 2019 Annual Symposium. RESULTS Of the 78 international teams that signed on to the n2c2/OHNLP ClinicalSTS shared task, 33 produced a total of 87 valid system submissions. The top 3 systems were generated by IBM Research, the National Center for Biotechnology Information, and the University of Florida, with Pearson correlations of <i>r</i>=.9010, <i>r</i>=.8967, and <i>r</i>=.8864, respectively. Most top-performing systems used state-of-the-art neural language models, such as BERT and XLNet, and state-of-the-art training schemas in deep learning, such as pretraining and fine-tuning schema, and multitask learning. Overall, the participating systems performed better on the Epic sentence pairs than on the GE sentence pairs, despite a much larger portion of the training data being GE sentence pairs. CONCLUSIONS The 2019 n2c2/OHNLP ClinicalSTS shared task focused on computing semantic similarity for clinical text sentences generated from clinical notes in the real world. It attracted a large number of international teams. The ClinicalSTS shared task could continue to serve as a venue for researchers in natural language processing and medical informatics communities to develop and improve semantic textual similarity techniques for clinical text.


2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Carla Abreu ◽  
Jorge Teixeira ◽  
Eugénio Oliveira

This work aims at defining and evaluating different techniques to automatically build temporal news sequences. The approach proposed is composed by three steps: (i) near duplicate documents detention; (ii) keywords extraction; (iii) news sequences creation. This approach is based on: Natural Language Processing, Information Extraction, Name Entity Recognition and supervised learning algorithms. The proposed methodology got a precision of 93.1% for news chains sequences creation.


2021 ◽  
Author(s):  
Dan W Joyce ◽  
Andrey Kormilitzin ◽  
Julia Hamer-Hunt ◽  
Anthony James ◽  
Alejo Nevado-Holgado ◽  
...  

ABSTRACTBackgroundAccessing specialist secondary mental health care in the NHS in England requires a referral, usually from primary or acute care. Community mental health teams triage these referrals deciding on the most appropriate team to meet patients’ needs. Referrals require resource-intensive review by clinicians and often, collation and review of the patient’s history with services captured in their electronic health records (EHR). Triage processes are, however, opaque and often result in patients not receiving appropriate and timely access to care that is a particular concern for some minority and under-represented groups. Our project, funded by the National Institute of Health Research (NIHR) will develop a clinical decision support tool (CDST) to deliver accurate, explainable and justified triage recommendations to assist clinicians and expedite access to secondary mental health care.MethodsOur proposed CDST will be trained on narrative free-text data combining referral documentation and historical EHR records for patients in the UK-CRIS database. This high-volume data set will enable training of end-to-end neural network natural language processing (NLP) to extract ‘signatures’ of patients who were (historically) triaged to different treatment teams. The resulting algorithm will be externally validated using data from different NHS trusts (Nottinghamshire Healthcare, Southern Health, West London and Oxford Health). We will use an explicit algorithmic fairness framework to mitigate risk of unintended harm evident in some artificial intelligence (AI) healthcare applications. Consequently, the performance of the CDST will be explicitly evaluated in simulated triage team scenarios where the tool augments clinician’s decision making, in contrast to traditional “human versus AI” performance metrics.DiscussionThe proposed CDST represents an important test-case for AI applied to real-world process improvement in mental health. The project leverages recent advances in NLP while emphasizing the risks and benefits for patients of AI-augmented clinical decision making. The project’s ambition is to deliver a CDST that is scalable and can be deployed to any mental health trust in England to assist with digital triage.


10.2196/23375 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e23375 ◽  
Author(s):  
Yanshan Wang ◽  
Sunyang Fu ◽  
Feichen Shen ◽  
Sam Henry ◽  
Ozlem Uzuner ◽  
...  

Background Semantic textual similarity is a common task in the general English domain to assess the degree to which the underlying semantics of 2 text segments are equivalent to each other. Clinical Semantic Textual Similarity (ClinicalSTS) is the semantic textual similarity task in the clinical domain that attempts to measure the degree of semantic equivalence between 2 snippets of clinical text. Due to the frequent use of templates in the Electronic Health Record system, a large amount of redundant text exists in clinical notes, making ClinicalSTS crucial for the secondary use of clinical text in downstream clinical natural language processing applications, such as clinical text summarization, clinical semantics extraction, and clinical information retrieval. Objective Our objective was to release ClinicalSTS data sets and to motivate natural language processing and biomedical informatics communities to tackle semantic text similarity tasks in the clinical domain. Methods We organized the first BioCreative/OHNLP ClinicalSTS shared task in 2018 by making available a real-world ClinicalSTS data set. We continued the shared task in 2019 in collaboration with National NLP Clinical Challenges (n2c2) and the Open Health Natural Language Processing (OHNLP) consortium and organized the 2019 n2c2/OHNLP ClinicalSTS track. We released a larger ClinicalSTS data set comprising 1642 clinical sentence pairs, including 1068 pairs from the 2018 shared task and 1006 new pairs from 2 electronic health record systems, GE and Epic. We released 80% (1642/2054) of the data to participating teams to develop and fine-tune the semantic textual similarity systems and used the remaining 20% (412/2054) as blind testing to evaluate their systems. The workshop was held in conjunction with the American Medical Informatics Association 2019 Annual Symposium. Results Of the 78 international teams that signed on to the n2c2/OHNLP ClinicalSTS shared task, 33 produced a total of 87 valid system submissions. The top 3 systems were generated by IBM Research, the National Center for Biotechnology Information, and the University of Florida, with Pearson correlations of r=.9010, r=.8967, and r=.8864, respectively. Most top-performing systems used state-of-the-art neural language models, such as BERT and XLNet, and state-of-the-art training schemas in deep learning, such as pretraining and fine-tuning schema, and multitask learning. Overall, the participating systems performed better on the Epic sentence pairs than on the GE sentence pairs, despite a much larger portion of the training data being GE sentence pairs. Conclusions The 2019 n2c2/OHNLP ClinicalSTS shared task focused on computing semantic similarity for clinical text sentences generated from clinical notes in the real world. It attracted a large number of international teams. The ClinicalSTS shared task could continue to serve as a venue for researchers in natural language processing and medical informatics communities to develop and improve semantic textual similarity techniques for clinical text.


2020 ◽  
Vol 27 (10) ◽  
pp. 1529-1537 ◽  
Author(s):  
Sam Henry ◽  
Yanshan Wang ◽  
Feichen Shen ◽  
Ozlem Uzuner

Abstract Objective The 2019 National Natural language processing (NLP) Clinical Challenges (n2c2)/Open Health NLP (OHNLP) shared task track 3, focused on medical concept normalization (MCN) in clinical records. This track aimed to assess the state of the art in identifying and matching salient medical concepts to a controlled vocabulary. In this paper, we describe the task, describe the data set used, compare the participating systems, present results, identify the strengths and limitations of the current state of the art, and identify directions for future research. Materials and Methods Participating teams were provided with narrative discharge summaries in which text spans corresponding to medical concepts were identified. This paper refers to these text spans as mentions. Teams were tasked with normalizing these mentions to concepts, represented by concept unique identifiers, within the Unified Medical Language System. Submitted systems represented 4 broad categories of approaches: cascading dictionary matching, cosine distance, deep learning, and retrieve-and-rank systems. Disambiguation modules were common across all approaches. Results A total of 33 teams participated in the MCN task. The best-performing team achieved an accuracy of 0.8526. The median and mean performances among all teams were 0.7733 and 0.7426, respectively. Conclusions Overall performance among the top 10 teams was high. However, several mention types were challenging for all teams. These included mentions requiring disambiguation of misspelled words, acronyms, abbreviations, and mentions with more than 1 possible semantic type. Also challenging were complex mentions of long, multi-word terms that may require new ways of extracting and representing mention meaning, the use of domain knowledge, parse trees, or hand-crafted rules.


2020 ◽  
pp. 3-17
Author(s):  
Peter Nabende

Natural Language Processing for under-resourced languages is now a mainstream research area. However, there are limited studies on Natural Language Processing applications for many indigenous East African languages. As a contribution to covering the current gap of knowledge, this paper focuses on evaluating the application of well-established machine translation methods for one heavily under-resourced indigenous East African language called Lumasaaba. Specifically, we review the most common machine translation methods in the context of Lumasaaba including both rule-based and data-driven methods. Then we apply a state of the art data-driven machine translation method to learn models for automating translation between Lumasaaba and English using a very limited data set of parallel sentences. Automatic evaluation results show that a transformer-based Neural Machine Translation model architecture leads to consistently better BLEU scores than the recurrent neural network-based models. Moreover, the automatically generated translations can be comprehended to a reasonable extent and are usually associated with the source language input.


Sign in / Sign up

Export Citation Format

Share Document