ExaCT: automatic extraction of clinical trial characteristics from journal publications

<p>Abstract</p> <p>Background</p> <p>Clinical trials are one of the most important sources of evidence for guiding evidence-based practice and the design of new trials. However, most of this information is available only in free text - e.g., in journal publications - which is labour intensive to process for systematic reviews, meta-analyses, and other evidence synthesis studies. This paper presents an automatic information extraction system, called ExaCT, that assists users with locating and extracting key trial characteristics (e.g., eligibility criteria, sample size, drug dosage, primary outcomes) from full-text journal articles reporting on randomized controlled trials (RCTs).</p> <p>Methods</p> <p>ExaCT consists of two parts: an information extraction (IE) engine that searches the article for text fragments that best describe the trial characteristics, and a web browser-based user interface that allows human reviewers to assess and modify the suggested selections. The IE engine uses a statistical text classifier to locate those sentences that have the highest probability of describing a trial characteristic. Then, the IE engine's second stage applies simple rules to these sentences to extract text fragments containing the target answer. The same approach is used for all 21 trial characteristics selected for this study.</p> <p>Results</p> <p>We evaluated ExaCT using 50 previously unseen articles describing RCTs. The text classifier (<it>first stage</it>) was able to recover 88% of relevant sentences among its top five candidates (top5 recall) with the topmost candidate being relevant in 80% of cases (top1 precision). Precision and recall of the extraction rules (<it>second stage</it>) were 93% and 91%, respectively. Together, the two stages of the extraction engine were able to provide (partially) correct solutions in 992 out of 1050 test tasks (94%), with a majority of these (696) representing fully correct and complete answers.</p> <p>Conclusions</p> <p>Our experiments confirmed the applicability and efficacy of ExaCT. Furthermore, they demonstrated that combining a statistical method with 'weak' extraction rules can identify a variety of study characteristics. The system is flexible and can be extended to handle other characteristics and document types (e.g., study protocols).</p

Automated Detection of Substance-Use Status and Related Information from Clinical Text

This study aims to develop and evaluate an automated system for extracting information related to patient substance use (smoking, alcohol, and drugs) from unstructured clinical text (medical discharge records). The authors propose a four-stage system for the extraction of the substance-use status and related attributes (type, frequency, amount, quit-time, and period). The first stage uses a keyword search technique to detect sentences related to substance use and to exclude unrelated records. In the second stage, an extension of the NegEx negation detection algorithm is developed and employed for detecting the negated records. The third stage involves identifying the temporal status of the substance use by applying windowing and chunking methodologies. Finally, in the fourth stage, regular expressions, syntactic patterns, and keyword search techniques are used in order to extract the substance-use attributes. The proposed system achieves an F1-score of up to 0.99 for identifying substance-use-related records, 0.98 for detecting the negation status, and 0.94 for identifying temporal status. Moreover, F1-scores of up to 0.98, 0.98, 1.00, 0.92, and 0.98 are achieved for the extraction of the amount, frequency, type, quit-time, and period attributes, respectively. Natural Language Processing (NLP) and rule-based techniques are employed efficiently for extracting substance-use status and attributes, with the proposed system being able to detect substance-use status and attributes over both sentence-level and document-level data. Results show that the proposed system outperforms the compared state-of-the-art substance-use identification system on an unseen dataset, demonstrating its generalisability

A national clinical decision support infrastructure to enable the widespread and consistent practice of genomic and personalized medicine

<p>Abstract</p> <p>Background</p> <p>In recent years, the completion of the Human Genome Project and other rapid advances in genomics have led to increasing anticipation of an era of genomic and personalized medicine, in which an individual's health is optimized through the use of all available patient data, including data on the individual's genome and its downstream products. Genomic and personalized medicine could transform healthcare systems and catalyze significant reductions in morbidity, mortality, and overall healthcare costs.</p> <p>Discussion</p> <p>Critical to the achievement of more efficient and effective healthcare enabled by genomics is the establishment of a robust, nationwide clinical decision support infrastructure that assists clinicians in their use of genomic assays to guide disease prevention, diagnosis, and therapy. Requisite components of this infrastructure include the standardized representation of genomic and non-genomic patient data across health information systems; centrally managed repositories of computer-processable medical knowledge; and standardized approaches for applying these knowledge resources against patient data to generate and deliver patient-specific care recommendations. Here, we provide recommendations for establishing a national decision support infrastructure for genomic and personalized medicine that fulfills these needs, leverages existing resources, and is aligned with the <it>Roadmap for National Action on Clinical Decision Support </it>commissioned by the U.S. Office of the National Coordinator for Health Information Technology. Critical to the establishment of this infrastructure will be strong leadership and substantial funding from the federal government.</p> <p>Summary</p> <p>A national clinical decision support infrastructure will be required for reaping the full benefits of genomic and personalized medicine. Essential components of this infrastructure include standards for data representation; centrally managed knowledge repositories; and standardized approaches for leveraging these knowledge repositories to generate patient-specific care recommendations at the point of care.</p

Safeguarding Privacy Through Deep Learning Techniques

Over the last few years, there has been a growing need to meet minimum security and privacy requirements. Both public and private companies have had to comply with increasingly stringent standards, such as the ISO 27000 family of standards, or the various laws governing the management of personal data. The huge amount of data to be managed has required a huge effort from the employees who, in the absence of automatic techniques, have had to work tirelessly to achieve the certification objectives. Unfortunately, due to the delicate information contained in the documentation relating to these problems, it is difficult if not impossible to obtain material for research and study purposes on which to experiment new ideas and techniques aimed at automating processes, perhaps exploiting what is in ferment in the scientific community and linked to the fields of ontologies and artificial intelligence for data management. In order to bypass this problem, it was decided to examine data related to the medical world, which, especially for important reasons related to the health of individuals, have gradually become more and more freely accessible over time, without affecting the generality of the proposed methods, which can be reapplied to the most diverse fields in which there is a need to manage privacy-sensitive information

SIFR BioPortal : Un portail ouvert et générique d’ontologies et de terminologies biomédicales françaises au service de l’annotation sémantique

National audienceContexte – Le volume de données en biomédecine ne cesse de croître. En dépit d'une large adoption de l'anglais, une quantité significative de ces données est en français. Dans le do-maine de l’intégration de données, les terminologies et les ontologies jouent un rôle central pour structurer les données biomédicales et les rendre interopérables. Cependant, outre l'existence de nombreuses ressources en anglais, il y a beaucoup moins d'ontologies en français et il manque crucialement d'outils et de services pour les exploiter. Cette lacune contraste avec le montant considérable de données biomédicales produites en français, par-ticulièrement dans le monde clinique (e.g., dossiers médicaux électroniques). Methode & Résultats – Dans cet article, nous présentons certains résultats du projet In-dexation sémantique de ressources biomédicales francophones (SIFR), en particulier le SIFR BioPortal, une plateforme ouverte et générique pour l’hébergement d’ontologies et de terminologies biomédicales françaises, basée sur la technologie du National Center for Biomedical Ontology. Le portail facilite l’usage et la diffusion des ontologies du domaine en offrant un ensemble de services (recherche, alignements, métadonnées, versionnement, vi-sualisation, recommandation) y inclus pour l’annotation sémantique. En effet, le SIFR An-notator est un outil d’annotation basé sur les ontologies pour traiter des données textuelles en français. Une évaluation préliminaire, montre que le service web obtient des résultats équivalents à ceux reportés précedement, tout en étant public, fonctionnel et tourné vers les standards du web sémantique. Nous présentons également de nouvelles fonctionnalités pour les services à base d’ontologies pour l’anglais et le français

Machine Learning and Clinical Text. Supporting Health Information Flow

Fluent health information flow is critical for clinical decision-making. However, a considerable part of this information is free-form text and inabilities to utilize it create risks to patient safety and cost-­effective hospital administration. Methods for automated processing of clinical text are emerging. The aim in this doctoral dissertation is to study machine learning and clinical text in order to support health information flow.First, by analyzing the content of authentic patient records, the aim is to specify clinical needs in order to guide the development of machine learning applications.The contributions are a model of the ideal information flow,a model of the problems and challenges in reality, and a road map for the technology development. Second, by developing applications for practical cases,the aim is to concretize ways to support health information flow. Altogether five machine learning applications for three practical cases are described: The first two applications are binary classification and regression related to the practical case of topic labeling and relevance ranking.The third and fourth application are supervised and unsupervised multi-class classification for the practical case of topic segmentation and labeling.These four applications are tested with Finnish intensive care patient records.The fifth application is multi-label classification for the practical task of diagnosis coding. It is tested with English radiology reports.The performance of all these applications is promising. Third, the aim is to study how the quality of machine learning applications can be reliably evaluated.The associations between performance evaluation measures and methods are addressed,and a new hold-out method is introduced.This method contributes not only to processing time but also to the evaluation diversity and quality. The main conclusion is that developing machine learning applications for text requires interdisciplinary, international collaboration. Practical cases are very different, and hence the development must begin from genuine user needs and domain expertise. The technological expertise must cover linguistics,machine learning, and information systems. Finally, the methods must be evaluated both statistically and through authentic user-feedback.Siirretty Doriast