9,128 research outputs found
Extraction of Information Related to Adverse Drug Events from Electronic Health Record Notes: Design of an End-to-End Model Based on Deep Learning
BACKGROUND: Pharmacovigilance and drug-safety surveillance are crucial for monitoring adverse drug events (ADEs), but the main ADE-reporting systems such as Food and Drug Administration Adverse Event Reporting System face challenges such as underreporting. Therefore, as complementary surveillance, data on ADEs are extracted from electronic health record (EHR) notes via natural language processing (NLP). As NLP develops, many up-to-date machine-learning techniques are introduced in this field, such as deep learning and multi-task learning (MTL). However, only a few studies have focused on employing such techniques to extract ADEs.
OBJECTIVE: We aimed to design a deep learning model for extracting ADEs and related information such as medications and indications. Since extraction of ADE-related information includes two steps-named entity recognition and relation extraction-our second objective was to improve the deep learning model using multi-task learning between the two steps.
METHODS: We employed the dataset from the Medication, Indication and Adverse Drug Events (MADE) 1.0 challenge to train and test our models. This dataset consists of 1089 EHR notes of cancer patients and includes 9 entity types such as Medication, Indication, and ADE and 7 types of relations between these entities. To extract information from the dataset, we proposed a deep-learning model that uses a bidirectional long short-term memory (BiLSTM) conditional random field network to recognize entities and a BiLSTM-Attention network to extract relations. To further improve the deep-learning model, we employed three typical MTL methods, namely, hard parameter sharing, parameter regularization, and task relation learning, to build three MTL models, called HardMTL, RegMTL, and LearnMTL, respectively.
RESULTS: Since extraction of ADE-related information is a two-step task, the result of the second step (ie, relation extraction) was used to compare all models. We used microaveraged precision, recall, and F1 as evaluation metrics. Our deep learning model achieved state-of-the-art results (F1=65.9%), which is significantly higher than that (F1=61.7%) of the best system in the MADE1.0 challenge. HardMTL further improved the F1 by 0.8%, boosting the F1 to 66.7%, whereas RegMTL and LearnMTL failed to boost the performance.
CONCLUSIONS: Deep learning models can significantly improve the performance of ADE-related information extraction. MTL may be effective for named entity recognition and relation extraction, but it depends on the methods, data, and other factors. Our results can facilitate research on ADE detection, NLP, and machine learning
Clinical Relation Extraction Toward Drug Safety Surveillance Using Electronic Health Record Narratives: Classical Learning Versus Deep Learning
BACKGROUND: Medication and adverse drug event (ADE) information extracted from electronic health record (EHR) notes can be a rich resource for drug safety surveillance. Existing observational studies have mainly relied on structured EHR data to obtain ADE information; however, ADEs are often buried in the EHR narratives and not recorded in structured data.
OBJECTIVE: To unlock ADE-related information from EHR narratives, there is a need to extract relevant entities and identify relations among them. In this study, we focus on relation identification. This study aimed to evaluate natural language processing and machine learning approaches using the expert-annotated medical entities and relations in the context of drug safety surveillance, and investigate how different learning approaches perform under different configurations.
METHODS: We have manually annotated 791 EHR notes with 9 named entities (eg, medication, indication, severity, and ADEs) and 7 different types of relations (eg, medication-dosage, medication-ADE, and severity-ADE). Then, we explored 3 supervised machine learning systems for relation identification: (1) a support vector machines (SVM) system, (2) an end-to-end deep neural network system, and (3) a supervised descriptive rule induction baseline system. For the neural network system, we exploited the state-of-the-art recurrent neural network (RNN) and attention models. We report the performance by macro-averaged precision, recall, and F1-score across the relation types.
RESULTS: Our results show that the SVM model achieved the best average F1-score of 89.1% on test data, outperforming the long short-term memory (LSTM) model with attention (F1-score of 65.72%) as well as the rule induction baseline system (F1-score of 7.47%) by a large margin. The bidirectional LSTM model with attention achieved the best performance among different RNN models. With the inclusion of additional features in the LSTM model, its performance can be boosted to an average F1-score of 77.35%.
CONCLUSIONS: It shows that classical learning models (SVM) remains advantageous over deep learning models (RNN variants) for clinical relation identification, especially for long-distance intersentential relations. However, RNNs demonstrate a great potential of significant improvement if more training data become available. Our work is an important step toward mining EHRs to improve the efficacy of drug safety surveillance. Most importantly, the annotated data used in this study will be made publicly available, which will further promote drug safety research in the community
Named Entity Recognition in Electronic Health Records Using Transfer Learning Bootstrapped Neural Networks
Neural networks (NNs) have become the state of the art in many machine
learning applications, especially in image and sound processing [1]. The same,
although to a lesser extent [2,3], could be said in natural language processing
(NLP) tasks, such as named entity recognition. However, the success of NNs
remains dependent on the availability of large labelled datasets, which is a
significant hurdle in many important applications. One such case are electronic
health records (EHRs), which are arguably the largest source of medical data,
most of which lies hidden in natural text [4,5]. Data access is difficult due
to data privacy concerns, and therefore annotated datasets are scarce. With
scarce data, NNs will likely not be able to extract this hidden information
with practical accuracy. In our study, we develop an approach that solves these
problems for named entity recognition, obtaining 94.6 F1 score in I2B2 2009
Medical Extraction Challenge [6], 4.3 above the architecture that won the
competition. Beyond the official I2B2 challenge, we further achieve 82.4 F1 on
extracting relationships between medical terms. To reach this state-of-the-art
accuracy, our approach applies transfer learning to leverage on datasets
annotated for other I2B2 tasks, and designs and trains embeddings that
specially benefit from such transfer.Comment: 11 pages, 4 figures, 8 table
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
Processing of Electronic Health Records using Deep Learning: A review
Availability of large amount of clinical data is opening up new research
avenues in a number of fields. An exciting field in this respect is healthcare,
where secondary use of healthcare data is beginning to revolutionize
healthcare. Except for availability of Big Data, both medical data from
healthcare institutions (such as EMR data) and data generated from health and
wellbeing devices (such as personal trackers), a significant contribution to
this trend is also being made by recent advances on machine learning,
specifically deep learning algorithms
GNTeam at 2018 n2c2:Feature-augmented BiLSTM-CRF for drug-related entity recognition in hospital discharge summaries
Monitoring the administration of drugs and adverse drug reactions are key
parts of pharmacovigilance. In this paper, we explore the extraction of drug
mentions and drug-related information (reason for taking a drug, route,
frequency, dosage, strength, form, duration, and adverse events) from hospital
discharge summaries through deep learning that relies on various
representations for clinical named entity recognition. This work was officially
part of the 2018 n2c2 shared task, and we use the data supplied as part of the
task. We developed two deep learning architecture based on recurrent neural
networks and pre-trained language models. We also explore the effect of
augmenting word representations with semantic features for clinical named
entity recognition. Our feature-augmented BiLSTM-CRF model performed with
F1-score of 92.67% and ranked 4th for entity extraction sub-task among
submitted systems to n2c2 challenge. The recurrent neural networks that use the
pre-trained domain-specific word embeddings and a CRF layer for label
optimization perform drug, adverse event and related entities extraction with
micro-averaged F1-score of over 91%. The augmentation of word vectors with
semantic features extracted using available clinical NLP toolkits can further
improve the performance. Word embeddings that are pre-trained on a large
unannotated corpus of relevant documents and further fine-tuned to the task
perform rather well. However, the augmentation of word embeddings with semantic
features can help improve the performance (primarily by boosting precision) of
drug-related named entity recognition from electronic health records
- …