Syntactic methods for negation detection in radiology reports in Spanish

Identification of the certainty of events is an important text mining problem. In particular, biomedical texts report medical conditions or findings that might be factual, hedged or negated. Identification of negation and its scope over a term of interest determines whether a finding is reported and is a challenging task. Not much work has been performed for Spanish in this domain. In this work we introduce different algorithms developed to determine if a term of interest is under the scope of negation in radiology reports written in Spanish. The methods include syntactic techniques based in rules derived from PoS tagging patterns, constituent tree patterns and dependency tree patterns, and an adaption of NegEx, a well known rule-based negation detection algorithm (Chapman et al., 2001a). All methods outperform a simple dictionary lookup algorithm developed as baseline. NegEx and the PoS tagging pattern method obtain the best results with 0.92 F1.Peer ReviewedPostprint (published version

Negation detection in Swedish clinical text: An adaption of NegEx to Swedish

<p>Abstract</p> <p>Background</p> <p>Most methods for negation detection in clinical text have been developed for English text, and there is a need for evaluating the feasibility of adapting these methods to other languages. A Swedish adaption of the English rule-based negation detection system NegEx, which detects negations through the use of trigger phrases, was therefore evaluated.</p> <p>Results</p> <p>The Swedish adaption of NegEx showed a precision of 75.2% and a recall of 81.9%, when evaluated on 558 manually classified sentences containing negation triggers, and a negative predictive value of 96.5% when evaluated on 342 sentences not containing negation triggers.</p> <p>Conclusions</p> <p>The precision was significantly lower for the Swedish adaptation than published results for the English version, but since many negated propositions were identified through a limited set of trigger phrases, it could nevertheless be concluded that the same trigger phrase approach is possible in a Swedish context, even though it needs to be further developed.</p> <p>Availability</p> <p>The triggers used for the evaluation of the Swedish adaption of NegEx are available at <url>http://people.dsv.su.se/~mariask/resources/triggers.txt</url> and can be used together with the original NegEx program for negation detection in Swedish clinical text.</p

Evaluation of Negation and Uncertainty Detection and its Impact on Precision and Recall in Search

Radiology reports contain information that can be mined using a search engine for teaching, research, and quality assurance purposes. Current search engines look for exact matches to the search term, but they do not differentiate between reports in which the search term appears in a positive context (i.e., being present) from those in which the search term appears in the context of negation and uncertainty. We describe RadReportMiner, a context-aware search engine, and compare its retrieval performance with a generic search engine, Google Desktop. We created a corpus of 464 radiology reports which described at least one of five findings (appendicitis, hydronephrosis, fracture, optic neuritis, and pneumonia). Each report was classified by a radiologist as positive (finding described to be present) or negative (finding described to be absent or uncertain). The same reports were then classified by RadReportMiner and Google Desktop. RadReportMiner achieved a higher precision (81%), compared with Google Desktop (27%; p < 0.0001). RadReportMiner had a lower recall (72%) compared with Google Desktop (87%; p = 0.006). We conclude that adding negation and uncertainty identification to a word-based radiology report search engine improves the precision of search results over a search engine that does not take this information into account. Our approach may be useful to adopt into current report retrieval systems to help radiologists to more accurately search for radiology reports

A Review of Negation in Clinical Texts

Negation is commonly seen in clinical documents [Chapman et al., 2001a] ”In clinical reports the presence of a term does not necessarily indicate the presence of the clinical condition represented by that term. In fact, many of the most frequently described findings and diseases in discharge summaries, radiology reports, history and physical exams, and other transcribed reports are denied in the patient” [Chapman et al., 2001b, page. 301]

ContextD: An algorithm to identify contextual properties of medical terms in a dutch clinical corpus

Background: In order to extract meaningful information from electronic medical records, such as signs and symptoms, diagnoses, and treatments, it is important to take into account the contextual properties of the identified information: negation, temporality, and experiencer. Most work on automatic identification of these contextual properties has been done on English clinical text. This study presents ContextD, an adaptation of the English ConText algorithm to the Dutch language, and a Dutch clinical corpus. Results: The ContextD algorithm utilized 41 unique triggers to identify the contextual properties in the clinical corpus. For the negation property, the algorithm obtained an F-score from 87% to 93% for the different document types. For the experiencer property, the F-score was 99% to 100%. For the historical and hypothetical values of the temporality property, F-scores ranged from 26% to 54% and from 13% to 44%, respectively. Conclusions: The ContextD showed good performance in identifying negation and experiencer property values across all Dutch clinical document types. Accurate identification of the temporality property proved to be difficult and requires further work. The anonymized and annotated Dutch clinical corpus can serve as a useful resource for further algorithm development

Knowledge-based best of breed approach for automated detection of clinical events based on German free text digital hospital discharge letters

OBJECTIVES: The secondary use of medical data contained in electronic medical records, such as hospital discharge letters, is a valuable resource for the improvement of clinical care (e.g. in terms of medication safety) or for research purposes. However, the automated processing and analysis of medical free text still poses a huge challenge to available natural language processing (NLP) systems. The aim of this study was to implement a knowledge-based best of breed approach, combining a terminology server with integrated ontology, a NLP pipeline and a rules engine. METHODS: We tested the performance of this approach in a use case. The clinical event of interest was the particular drug-disease interaction "proton-pump inhibitor [PPI] use and osteoporosis". Cases were to be identified based on free text digital discharge letters as source of information. Automated detection was validated against a gold standard. RESULTS: Precision of recognition of osteoporosis was 94.19%, and recall was 97.45%. PPIs were detected with 100% precision and 97.97% recall. The F-score for the detection of the given drug-disease-interaction was 96,13%. CONCLUSION: We could show that our approach of combining a NLP pipeline, a terminology server, and a rules engine for the purpose of automated detection of clinical events such as drug-disease interactions from free text digital hospital discharge letters was effective. There is huge potential for the implementation in clinical and research contexts, as this approach enables analyses of very high numbers of medical free text documents within a short time period

Negation Scope Delimitation in Clinical Text Using Three Approaches: NegEx, PyConTextNLP and SynNeg

ABSTRACT Negation detection is a key component in clinical information extraction systems, as health record text contains reasonings in which the physician excludes different diagnoses by negating them. Many systems for negation detection rely on negation cues (e.g. not), but only few studies have investigated if the syntactic structure of the sentences can be used for determining the scope of these cues. We have in this paper compared three different systems for negation detection in Swedish clinical text (NegEx, PyConTextNLP and SynNeg), which have different approaches for determining the scope of negation cues. NegEx uses the distance between the cue and the disease, PyConTextNLP relies on a list of conjunctions limiting the scope of a cue, and in SynNeg the boundaries of the sentence units, provided by a syntactic parser, limit the scope of the cues. The three systems produced similar results, detecting negation with an F-score of around 80%, but using a parser had advantages when handling longer, complex sentences or short sentences with contradictory statements

BIOMEDICAL LANGUAGE UNDERSTANDING AND EXTRACTION (BLUE-TEXT): A MINIMAL SYNTACTIC, SEMANTIC METHOD

Clinical text understanding (CTU) is of interest to health informatics because critical clinical information frequently represented as unconstrained text in electronic health records are extensively used by human experts to guide clinical practice, decision making, and to document delivery of care, but are largely unusable by information systems for queries and computations. Recent initiatives advocating for translational research call for generation of technologies that can integrate structured clinical data with unstructured data, provide a unified interface to all data, and contextualize clinical information for reuse in multidisciplinary and collaborative environment envisioned by CTSA program. This implies that technologies for the processing and interpretation of clinical text should be evaluated not only in terms of their validity and reliability in their intended environment, but also in light of their interoperability, and ability to support information integration and contextualization in a distributed and dynamic environment. This vision adds a new layer of information representation requirements that needs to be accounted for when conceptualizing implementation or acquisition of clinical text processing tools and technologies for multidisciplinary research. On the other hand, electronic health records frequently contain unconstrained clinical text with high variability in use of terms and documentation practices, and without commitmentto grammatical or syntactic structure of the language (e.g. Triage notes, physician and nurse notes, chief complaints, etc). This hinders performance of natural language processing technologies which typically rely heavily on the syntax of language and grammatical structure of the text. This document introduces our method to transform unconstrained clinical text found in electronic health information systems to a formal (computationally understandable) representation that is suitable for querying, integration, contextualization and reuse, and is resilient to the grammatical and syntactic irregularities of the clinical text. We present our design rationale, method, and results of evaluation in processing chief complaints and triage notes from 8 different emergency departments in Houston Texas. At the end, we will discuss significance of our contribution in enabling use of clinical text in a practical bio-surveillance setting