Exploiting natural language processing in the clinical domain requires de-identification, i.e., anonymization of personal information in texts. However, current research considers de-identification and downstream tasks, such as concept extraction, only in isolation and does not study the effects of de-identification on other tasks. In this paper, we close this gap by reporting concept extraction performance on automatically anonymized data and investigating joint models for de-identification and concept extraction. In particular, we propose a stacked model with restricted access to privacy-sensitive information and a multitask model. We set the new state of the art on benchmark datasets in English (96.1% F1 for de-identification and 88.9% F1 for concept extraction) and Spanish (91.4% F1 for concept extraction).
We introduce BlaBla, an open-source Python library for extracting linguistic features with proven clinical relevance to neurological and psychiatric diseases across many languages. BlaBla is a unifying framework for accelerating and simplifying clinical linguistic research. The library is built on state-of-the-art NLP frameworks and supports multithreaded/GPU-enabled feature extraction via both native Python calls and a command line interface. We describe BlaBla's architecture and clinical validation of its features across 12 diseases. We further demonstrate the application of BlaBla to a task…
University of California, Los Angeles（加利福尼亚大学洛杉矶分校）
Clinical case reports are written descriptions of the unique aspects of a particular clinical case, playing an essential role in sharing clinical experiences about atypical disease phenotypes and new therapies. However, to our knowledge, there has been no attempt to develop an end-to-end system to annotate, index, or otherwise curate these reports. In this paper, we propose a novel computational resource platform, CREATe, for extracting, indexing, and querying the contents of clinical case reports. CREATe fosters an environment of sustainable resource support and discovery, enabling researcher…
Bosch Center for Artificial Intelligence（博世人工智能中心）；Saarland University（萨尔大学）；University of Sydney（悉尼大学）
The recognition and normalization of clinical information, such as tumor morphology mentions, is an important, but complex process consisting of multiple subtasks. In this paper, we describe our system for the CANTEMIST shared task, which is able to extract, normalize and rank ICD codes from Spanish electronic health records using neural sequence labeling and parsing approaches with context-aware embeddings. Our best system achieves 85.3 F1, 76.7 F1, and 77.0 MAP for the three tasks, respectively.
Coronavirus disease 2019 (COVID-19) is a global pandemic. Although much has been learned about the novel coronavirus since its emergence, there are many open questions related to tracking its spread, describing symptomology, predicting the severity of infection, and forecasting healthcare utilization. Free-text clinical notes contain critical information for resolving these questions. Data-driven, automatic information extraction models are needed to use this text-encoded information in large-scale studies. This work presents a new clinical corpus, referred to as the COVID-19 Annotated Clinica…
University of California, Los Angeles（加州大学洛杉矶分校）；University of Southern California（南加州大学）
There has been a steady need in the medical community to precisely extract the temporal relations between clinical events. In particular, temporal information can facilitate a variety of downstream applications such as case report retrieval and medical question answering. Existing methods either require expensive feature engineering or are incapable of modeling the global relational dependencies among the events. In this paper, we propose a novel method, Clinical Temporal ReLation Exaction with Probabilistic Soft Logic Regularization and Global Inference (CTRL-PG) to tackle the problem at the …
Clinical notes contain an abundance of important but not-readily accessible information about patients. Systems to automatically extract this information rely on large amounts of training data for which their exists limited resources to create. Furthermore, they are developed dis-jointly; meaning that no information can be shared amongst task-specific systems. This bottle-neck unnecessarily complicates practical application, reduces the performance capabilities of each individual solution and associates the engineering debt of managing multiple information extraction systems. We address these …
Indian Institute of Technology Patna（印度理工学院巴特那分校）；ezDI, INC（ezDI公司）
Owing to the exponential rise in the electronic medical records, information extraction in this domain is becoming an important area of research in recent years. Relation extraction between the medical concepts such as medical problem, treatment, and test etc. is also one of the most important tasks in this area. In this paper, we present an efficient relation extraction system based on the shortest dependency path (SDP) generated from the dependency parsed tree of the sentence. Instead of relying on many handcrafted features and the whole sequence of tokens present in a sentence, our system r…
Data Science and AI, Novartis（诺华数据科学与人工智能部门）；Global Drug Development, Novartis Pharma AG（诺华制药全球药物开发部）
Natural language processing (NLP) of clinical trial documents can be useful in new trial design. Here we identify entity types relevant to clinical trial design and propose a framework called CT-BERT for information extraction from clinical trial text. We trained named entity recognition (NER) models to extract eligibility criteria entities by fine-tuning a set of pre-trained BERT models. We then compared the performance of CT-BERT with recent baseline methods including attention-based BiLSTM and Criteria2Query. The results demonstrate the superiority of CT-BERT in clinical trial NLP.
University of Florida（佛罗里达大学）；University of Florida Health Cancer Center（佛罗里达大学健康癌症中心）
The newly emerged transformer technology has a tremendous impact on NLP research. In the general English domain, transformer-based models have achieved state-of-the-art performances on various NLP benchmarks. In the clinical domain, researchers also have investigated transformer models for clinical applications. The goal of this study is to systematically explore three widely used transformer-based models (i.e., BERT, RoBERTa, and XLNet) for clinical relation extraction and develop an open-source package with clinical pre-trained transformer-based models to facilitate information extraction in…
We report an implementation of a clinical information extraction tool that leverages deep neural network to annotate event spans and their attributes from raw clinical notes and pathology reports. Our approach uses context words and their part-of-speech tags and shape information as features. Then we hire temporal (1D) convolutional neural network to learn hidden feature representations. Finally, we use Multilayer Perceptron (MLP) to predict event spans. The empirical evaluation demonstrates that our approach significantly outperforms baselines.
Boston University（波士顿大学）；Philips Research North America（飞利浦北美研究院）
Automatic extraction of clinical concepts is an essential step for turning the unstructured data within a clinical note into structured and actionable information. In this work, we propose a clinical concept extraction model for automatic annotation of clinical problems, treatments, and tests in clinical notes utilizing domain-specific contextual word embedding. A contextual word embedding model is first trained on a corpus with a mixture of clinical reports and relevant Wikipedia pages in the clinical domain. Next, a bidirectional LSTM-CRF model is trained for clinical concept extraction usin…
Massachusetts Institute of Technology（麻省理工学院）；Massachusetts General Hospital（麻省总医院）
Clinical studies often require understanding elements of a patient's narrative that exist only in free text clinical notes. To transform notes into structured data for downstream use, these elements are commonly extracted and normalized to medical vocabularies. In this work, we audit the performance of and indicate areas of improvement for state-of-the-art systems. We find that high task accuracies for clinical entity normalization systems on the 2019 n2c2 Shared Task are misleading, and underlying performance is still brittle. Normalization accuracy is high for common concepts (95.3%), but mu…
University of Sydney（悉尼大学）；Capital Markets CRC（资本市场合作研究中心）；University of Technology Sydney（悉尼科技大学）
Automated extraction of concepts from patient clinical records is an essential facilitator of clinical research. For this reason, the 2010 i2b2/VA Natural Language Processing Challenges for Clinical Records introduced a concept extraction task aimed at identifying and classifying concepts into predefined categories (i.e., treatments, tests and problems). State-of-the-art concept extraction approaches heavily rely on handcrafted features and domain-specific resources which are hard to collect and define. For this reason, this paper proposes an alternative, streamlined approach: a recurrent neur…
Current approaches for clinical information extraction are inefficient in terms of computational costs and memory consumption, hindering their application to process large-scale electronic health records (EHRs). We propose an efficient end-to-end model, the Joint-NER-RE-Fourier (JNRF), to jointly learn the tasks of named entity recognition and relation extraction for documents of variable length. The architecture uses positional encoding and unitary batch sizes to process variable length documents and uses a weight-shared Fourier network layer for low-complexity token mixing. Finally, we reach…
McLean Hospital（麦克莱恩医院）；Harvard Medical School（哈佛医学院）；Brandeis University（布兰迪斯大学）
Predicting which patients are more likely to be readmitted to a hospital within 30 days after discharge is a valuable piece of information in clinical decision-making. Building a successful readmission risk classifier based on the content of Electronic Health Records (EHRs) has proved, however, to be a challenging task. Previously explored features include mainly structured information, such as sociodemographic data, comorbidity codes and physiological variables. In this paper we assess incorporating additional clinically interpretable NLP-based features such as topic extraction and clinical s…
Georgia Institute of Technology（佐治亚理工学院）；Google Inc（谷歌公司）；Sutter Health（萨特医疗中心）
The text of clinical notes can be a valuable source of patient information and clinical assessments. Historically, the primary approach for exploiting clinical notes has been information extraction: linking spans of text to concepts in a detailed domain ontology. However, recent work has demonstrated the potential of supervised machine learning to extract document-level codes directly from the raw text of clinical notes. We propose to bridge the gap between the two approaches with two novel syntheses: (1) treating extracted concepts as features, which are used to supplement or replace the text…
Bosch Center for Artificial Intelligence, Robert Bosch GmbH（罗伯特·博世有限公司博世人工智能中心）；Saarland University（萨尔兰大学）
The field of natural language processing (NLP) has recently seen a large change towards using pre-trained language models for solving almost any task. Despite showing great improvements in benchmark datasets for various tasks, these models often perform sub-optimal in non-standard domains like the clinical domain where a large gap between pre-training documents and target documents is observed. In this paper, we aim at closing this gap with domain-specific training of the language model and we investigate its effect on a diverse set of downstream tasks and settings. We introduce the pre-traine…
University of Sydney（悉尼大学）；Capital Markets CRC（资本市场合作研究中心）；University of Technology Sydney（悉尼科技大学）
Extraction of concepts present in patient clinical records is an essential step in clinical research. The 2010 i2b2/VA Workshop on Natural Language Processing Challenges for clinical records presented concept extraction (CE) task, with aim to identify concepts (such as treatments, tests, problems) and classify them into predefined categories. State-of-the-art CE approaches heavily rely on hand crafted features and domain specific resources which are hard to collect and tune. For this reason, this paper employs bidirectional LSTM with CRF decoding initialized with general purpose off-the-shelf …
School of Biomedical Informatics（生物医学信息学院）；The University of Texas Health Science Center at Houston（德克萨斯大学休斯顿健康科学中心）
Neural network-based representations ("embeddings") have dramatically advanced natural language processing (NLP) tasks, including clinical NLP tasks such as concept extraction. Recently, however, more advanced embedding methods and representations (e.g., ELMo, BERT) have further pushed the state-of-the-art in NLP, yet there are no common best practices for how to integrate these representations into clinical tasks. The purpose of this study, then, is to explore the space of possible options in utilizing these new models for clinical concept extraction, including comparing these to traditional …
Clinical trials predicate subject eligibility on a diversity of criteria ranging from patient demographics to food allergies. Trials post their requirements as semantically complex, unstructured free-text. Formalizing trial criteria to a computer-interpretable syntax would facilitate eligibility determination. In this paper, we investigate an information extraction (IE) approach for grounding criteria from trials in ClinicalTrials(dot)gov to a shared knowledge base. We frame the problem as a novel knowledge base population task, and implement a solution combining machine learning and context f…
We submitted two systems to the SemEval-2016 Task 12: Clinical TempEval challenge, participating in Phase 1, where we identified text spans of time and event expressions in clinical notes and Phase 2, where we predicted a relation between an event and its parent document creation time. For temporal entity extraction, we find that a joint inference-based approach using structured prediction outperforms a vanilla recurrent neural network that incorporates word embeddings trained on a variety of large clinical document sets. For document creation time relations, we find that a combination of date…
MIT CSAIL（麻省理工学院计算机科学与人工智能实验室）；UMass Lowell（马萨诸塞大学洛厄尔分校）
Clinical notes often describe important aspects of a patient's stay and are therefore critical to medical research. Clinical concept extraction (CCE) of named entities - such as problems, tests, and treatments - aids in forming an understanding of notes and provides a foundation for many downstream clinical decision-making tasks. Historically, this task has been posed as a standard named entity recognition (NER) sequence tagging problem, and solved with feature-based methods using handengineered domain knowledge. Recent advances, however, have demonstrated the efficacy of LSTM-based models for…
University of Washington（华盛顿大学）；George Mason University（乔治梅森大学）
Symptom information is primarily documented in free-text clinical notes and is not directly accessible for downstream applications. To address this challenge, information extraction approaches that can handle clinical language variation across different institutions and specialties are needed. In this paper, we present domain generalization for symptom extraction using pretraining and fine-tuning data that differs from the target domain in terms of institution and/or specialty and patient population. We extract symptom events using a transformer-based joint entity and relation extraction metho…
Mayo Clinic（梅奥诊所）；University of Minnesota – Twin Cities（明尼苏达大学双城分校）
Background Concept extraction, a subdomain of natural language processing (NLP) with a focus on extracting concepts of interest, has been adopted to computationally extract clinical information from text for a wide range of applications ranging from clinical decision support to care quality improvement. Objectives In this literature review, we provide a methodology review of clinical concept extraction, aiming to catalog development processes, available methods and tools, and specific considerations when developing clinical concept extraction applications. Methods Based on the Preferred Report…
Clinical information extraction for Low-resource languages with Few-shot learning using Pre-trained language models and Prompting
Klaus Tschira Institute for Integrative Computational Cardiology（克劳斯·齐拉整合计算心脏病学研究所）；Heidelberg University（海德堡大学）；University Hospital Heidelberg（海德堡大学医院）；German Center for Cardiovascular Research - Partner site Heidelberg/Mannheim（德国心血管研究中心海德堡/曼海姆合作站点）；Informatics for Life（生命信息学机构）
In recent years extracting relevant information from biomedical and clinical texts such as research articles, discharge summaries, or electronic health records have been a subject of many research efforts and shared challenges. Relation extraction is the process of detecting and classifying the semantic relation among entities in a given piece of texts. Existing models for this task in biomedical domain use either manually engineered features or kernel methods to create feature vector. These features are then fed to classifier for the prediction of the correct class. It turns out that the resu…
Analysing zero-shot temporal relation extraction on clinical notes using temporal consistency
Faculty of Computer Science, University of Vienna（维也纳大学计算机科学学院）；UniVie Doctoral School Computer Science（维也纳大学计算机博士学院）；Aarhus University（奥胡斯大学）；Faculty of Philological and Cultural Studies, University of Vienna（维也纳大学语言与文化学院）
The surging amount of biomedical literature & digital clinical records presents a growing need for text mining techniques that can not only identify but also semantically relate entities in unstructured data. In this paper we propose a text mining framework comprising of Named Entity Recognition (NER) and Relation Extraction (RE) models, which expands on previous work in three main ways. First, we introduce two new RE model architectures -- an accuracy-optimized one based on BioBERT and a speed-optimized one utilizing crafted features over a Fully Connected Neural Network (FCNN). Second, we ev…
To minimize the accelerating amount of time invested in the biomedical literature search, numerous approaches for automated knowledge extraction have been proposed. Relation extraction is one such task where semantic relations between the entities are identified from the free text. In the biomedical domain, extraction of regulatory pathways, metabolic processes, adverse drug reaction or disease models necessitates knowledge from the individual relations, for example, physical or regulatory interactions between genes, proteins, drugs, chemical, disease or phenotype. In this paper, we study the …
Arizona State University（亚利桑那州立大学）；The University of Texas Health Science Center（德克萨斯大学健康科学中心）
Background: Identifying relationships between clinical events and temporal expressions is a key challenge in meaningfully analyzing clinical text for use in advanced AI applications. While previous studies exist, the state-of-the-art performance has significant room for improvement. Methods: We studied several variants of BERT (Bidirectional Encoder Representations using Transformers) some involving clinical domain customization and the others involving improved architecture and/or training strategies. We evaluated these methods using a direct temporal relations dataset which is a semantically…
Keyword-optimized Template Insertion for Clinical Information Extraction via Prompt-based Learning
Mount Sinai（西奈山）；Hasso Plattner Institute for Digital Health at Mount Sinai（西奈山哈索·普拉特纳数字健康研究所）；Icahn School of Medicine at Mount Sinai（西奈山伊坎医学院）；Institute for Personalized Medicine（个性化医学研究所）
Istituto di Scienza e Tecnologie dell’Informazione, Consiglio Nazionale delle Ricerche（意大利国家研究委员会信息科学与技术研究所）；Qatar Computing Research Institute, Qatar Foundation（卡塔尔基金会卡塔尔计算研究所）；Consiglio Nazionale delle Ricerche（意大利国家研究委员会）
In the last five years there has been a flurry of work on information extraction from clinical documents, i.e., on algorithms capable of extracting, from the informal and unstructured texts that are generated during everyday clinical practice, mentions of concepts relevant to such practice. Most of this literature is about methods based on supervised learning, i.e., methods for training an information extraction system from manually annotated examples. While a lot of work has been devoted to devising learning methods that generate more and more accurate information extractors, no work has been…
Radiology reports contain a diverse and rich set of clinical abnormalities documented by radiologists during their interpretation of the images. Comprehensive semantic representations of radiological findings would enable a wide range of secondary use applications to support diagnosis, triage, outcomes prediction, and clinical research. In this paper, we present a new corpus of radiology reports annotated with clinical findings. Our annotation schema captures detailed representations of pathologic findings that are observable on imaging ("lesions") and other types of clinical problems ("medica…
The Clinical E-Science Framework (CLEF) project was used to extract important information from medical texts by building a system for the purpose of clinical research, evidence-based healthcare and genotype-meets-phenotype informatics. The system is divided into two parts, one part concerns with the identification of relationships between clinically important entities in the text. The full parses and domain-specific grammars had been used to apply many approaches to extract the relationship. In the second part of the system, statistical machine learning (ML) approaches are applied to extract r…
MIT CSAIL（麻省理工学院计算机科学与人工智能实验室）；University of Münster（明斯特大学）
A long-running goal of the clinical NLP community is the extraction of important variables trapped in clinical notes. However, roadblocks have included dataset shift from the general domain and a lack of public clinical corpora and annotations. In this work, we show that large language models, such as InstructGPT, perform well at zero- and few-shot information extraction from clinical text despite not being trained specifically for the clinical domain. Whereas text classification and generation performance have already been studied extensively in such models, here we additionally demonstrate h…
Northwestern University Feinberg School of Medicine（西北大学范伯格医学院）
To reduce the large amount of time spent screening, identifying, and recruiting patients into clinical trials, we need prescreening systems that are able to automate the data extraction and decision-making tasks that are typically relegated to clinical research study coordinators. However, a major obstacle is the vast amount of patient data available as unstructured free-form text in electronic health records. Here we propose an information extraction-based approach that first automatically converts unstructured text into a structured form. The structured data are then compared against a list …
Nanjing Medical University（南京医科大学）；the First Affiliated Hospital（第一附属医院）
Event extraction is an important work of medical text processing. According to the complex characteristics of medical text annotation, we use the end-to-end event extraction model to enhance the output formatting information of events. Through pre training and fine-tuning, we can extract the attributes of the four dimensions of medical text: anatomical position, subject word, description word and occurrence state. On the test set, the accuracy rate was 0.4511, the recall rate was 0.3928, and the F1 value was 0.42. The method of this model is simple, and it has won the second place in the task …
Negative medical findings are prevalent in clinical reports, yet discriminating them from positive findings remains a challenging task for information extraction. Most of the existing systems treat this task as a pipeline of two separate tasks, i.e., named entity recognition (NER) and rule-based negation detection. We consider this as a multi-task problem and present a novel end-to-end neural model to jointly extract entities and negations. We extend a standard hierarchical encoder-decoder NER model and first adopt a shared encoder followed by separate decoders for the two tasks. This architec…
Crucial information about the practice of healthcare is recorded only in free-form text, which creates an enormous opportunity for high-impact NLP. However, annotated healthcare datasets tend to be small and expensive to obtain, which raises the question of how to make maximally efficient uses of the available data. To this end, we develop an LSTM-CRF model for combining unsupervised word representations and hand-built feature representations derived from publicly available healthcare ontologies. We show that this combined model yields superior performance on five datasets of diverse kinds of …
Goergen Institute for Data Science（格根数据科学研究所）；University of Rochester（罗切斯特大学）
Clinical concept extraction often begins with clinical Named Entity Recognition (NER). Often trained on annotated clinical notes, clinical NER models tend to struggle with tagging clinical entities in user queries because of the structural differences between clinical notes and user queries. User queries, unlike clinical notes, are often ungrammatical and incoherent. In many cases, user queries are compounded of multiple clinical entities, without comma or conjunction words separating them. By using as dataset a mixture of annotated clinical notes and synthesized user queries, we adapt a clini…
HwaMei Hospital, University of Chinese Academy of Sciences（中国科学院大学华美医院）；Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences（中国科学院大学宁波生命与健康产业研究院）
Medical information extraction consists of a group of natural language processing (NLP) tasks, which collaboratively convert clinical text to pre-defined structured formats. Current state-of-the-art (SOTA) NLP models are highly integrated with deep learning techniques and thus require massive annotated linguistic data. This study presents an engineering framework of medical entity recognition, relation extraction and attribute extraction, which are unified in annotation, modeling and evaluation. Specifically, the annotation scheme is comprehensive, and compatible between tasks, especially for …
Social determinants of health (SDOH) affect health outcomes, and knowledge of SDOH can inform clinical decision-making. Automatically extracting SDOH information from clinical text requires data-driven information extraction models trained on annotated corpora that are heterogeneous and frequently include critical SDOH. This work presents a new corpus with SDOH annotations, a novel active learning framework, and the first extraction results on the new corpus. The Social History Annotation Corpus (SHAC) includes 4,480 social history sections with detailed annotation for 12 SDOH characterizing t…
Making sense of words often requires to simultaneously examine the surrounding context of a term as well as the global themes characterizing the overall corpus. Several topic models have already exploited word embeddings to recognize local context, however, it has been weakly combined with the global context during the topic inference. This paper proposes to extract topical phrases corroborating the word embedding information with the global context detected by Latent Semantic Analysis, and then combine them by means of the Pólya urn model. To highlight the effectiveness of this combined appro…
University of Illinois at Urbana-Champaign（伊利诺伊大学厄巴纳-香槟分校）；IUPUI（印第安纳大学与普渡大学印第安纳波利斯联合分校）；Carmel High School（卡梅尔高中）；DePauw University（德堡大学）
Various deep learning algorithms have been developed to analyze different types of clinical data including clinical text classification and extracting information from 'free text' and so on. However, automate the keyword extraction from the clinical notes is still challenging. The challenges include dealing with noisy clinical notes which contain various abbreviations, possible typos, and unstructured sentences. The objective of this research is to investigate the attention-based deep learning models to classify the de-identified clinical progress notes extracted from a real-world EHR system. …
Clinical QA 2.0: Multi-Task Learning for Answer Extraction and Categorization
University of Washington（华盛顿大学）；New York University（纽约大学）；Liverpool John Moores University（利物浦约翰·摩尔斯大学）；Birla Institute of Technology Pilani（比拉理工学院帕利尼分校）；Columbia University（哥伦比亚大学）
German Research Center for Artificial Intelligence (DFKI)（德国人工智能研究中心）；Charité – Universitätsmedizin Berlin（柏林夏里特医学院）；Berlin Institute of Health（柏林健康研究所）
Background: In the information extraction and natural language processing domain, accessible datasets are crucial to reproduce and compare results. Publicly available implementations and tools can serve as benchmark and facilitate the development of more complex applications. However, in the context of clinical text processing the number of accessible datasets is scarce -- and so is the number of existing tools. One of the main reasons is the sensitivity of the data. This problem is even more evident for non-English languages. Approach: In order to address this situation, we introduce a workbe…
University of Bristol（布里斯托大学）；University of Sussex（萨塞克斯大学）
This research on data extraction methods applies recent advances in natural language processing to evidence synthesis based on medical texts. Texts of interest include abstracts of clinical trials in English and in multilingual contexts. The main focus is on information characterized via the Population, Intervention, Comparator, and Outcome (PICO) framework, but data extraction is not limited to these fields. Recent neural network architectures based on transformers show capacities for transfer learning and increased performance on downstream natural language processing tasks such as universal…
