Improving Syntactic Parsing of Clinical Text Using Domain Knowledge

Syntactic parsing is one of the fundamental tasks of Natural Language Processing (NLP). However, few studies have explored syntactic parsing in the medical domain. This dissertation systematically investigated different methods to improve the performance of syntactic parsing of clinical text, including (1) Constructing two clinical treebanks of discharge summaries and progress notes by developing annotation guidelines that handle missing elements in clinical sentences; (2) Retraining four state-of-the-art parsers, including the Stanford parser, Berkeley parser, Charniak parser, and Bikel parser, using clinical treebanks, and comparing their performance to identify better parsing approaches; and (3) Developing new methods to reduce syntactic ambiguity caused by Prepositional Phrase (PP) attachment and coordination using semantic information. Our evaluation showed that clinical treebanks greatly improved the performance of existing parsers. The Berkeley parser achieved the best F-1 score of 86.39% on the MiPACQ treebank. For PP attachment, our proposed methods improved the accuracies of PP attachment by 2.35% on the MiPACQ corpus and 1.77% on the I2b2 corpus. For coordination, our method achieved a precision of 94.9% and a precision of 90.3% for the MiPACQ and i2b2 corpus, respectively. To further demonstrate the effectiveness of the improved parsing approaches, we applied outputs of our parsers to two external NLP tasks: semantic role labeling and temporal relation extraction. The experimental results showed that performance of both tasks’ was improved by using the parse tree information from our optimized parsers, with an improvement of 3.26% in F-measure for semantic role labelling and an improvement of 1.5% in F-measure for temporal relation extraction

Doctor of Philosophy

dissertationDomain adaptation of natural language processing systems is challenging because it requires human expertise. While manual e ort is e ective in creating a high quality knowledge base, it is expensive and time consuming. Clinical text adds another layer of complexity to the task due to privacy and con dentiality restrictions that hinder the ability to share training corpora among di erent research groups. Semantic ambiguity is a major barrier for e ective and accurate concept recognition by natural language processing systems. In my research I propose an automated domain adaptation method that utilizes sublanguage semantic schema for all-word word sense disambiguation of clinical narrative. According to the sublanguage theory developed by Zellig Harris, domain-speci c language is characterized by a relatively small set of semantic classes that combine into a small number of sentence types. Previous research relied on manual analysis to create language models that could be used for more e ective natural language processing. Building on previous semantic type disambiguation research, I propose a method of resolving semantic ambiguity utilizing automatically acquired semantic type disambiguation rules applied on clinical text ambiguously mapped to a standard set of concepts. This research aims to provide an automatic method to acquire Sublanguage Semantic Schema (S3) and apply this model to disambiguate terms that map to more than one concept with di erent semantic types. The research is conducted using unmodi ed MetaMap version 2009, a concept recognition system provided by the National Library of Medicine, applied on a large set of clinical text. The project includes creating and comparing models, which are based on unambiguous concept mappings found in seventeen clinical note types. The e ectiveness of the nal application was validated through a manual review of a subset of processed clinical notes using recall, precision and F-score metrics

Mining the Medical and Patent Literature to Support Healthcare and Pharmacovigilance

Recent advancements in healthcare practices and the increasing use of information technology in the medical domain has lead to the rapid generation of free-text data in forms of scientific articles, e-health records, patents, and document inventories. This has urged the development of sophisticated information retrieval and information extraction technologies. A fundamental requirement for the automatic processing of biomedical text is the identification of information carrying units such as the concepts or named entities. In this context, this work focuses on the identification of medical disorders (such as diseases and adverse effects) which denote an important category of concepts in the medical text. Two methodologies were investigated in this regard and they are dictionary-based and machine learning-based approaches. Futhermore, the capabilities of the concept recognition techniques were systematically exploited to build a semantic search platform for the retrieval of e-health records and patents. The system facilitates conventional text search as well as semantic and ontological searches. Performance of the adapted retrieval platform for e-health records and patents was evaluated within open assessment challenges (i.e. TRECMED and TRECCHEM respectively) wherein the system was best rated in comparison to several other competing information retrieval platforms. Finally, from the medico-pharma perspective, a strategy for the identification of adverse drug events from medical case reports was developed. Qualitative evaluation as well as an expert validation of the developed system's performance showed robust results. In conclusion, this thesis presents approaches for efficient information retrieval and information extraction from various biomedical literature sources in the support of healthcare and pharmacovigilance. The applied strategies have potential to enhance the literature-searches performed by biomedical, healthcare, and patent professionals. The applied strategies have potential to enhance the literature-searches performed by biomedical, healthcare, and patent professionals. This can promote the literature-based knowledge discovery, improve the safety and effectiveness of medical practices, and drive the research and development in medical and healthcare arena

Application of information extraction techniques to pharmacological domain : extracting drug-drug interactions

Una interacción farmacológica ocurre cuando los efectos de un fármaco se modifican por la presencia de otro. Las consecuencias pueden ser perjudiciales si la interacción causa un aumento de la toxicidad del fármaco o la disminución de su efecto, pudiendo provocar incluso la muerte del paciente en los peores casos. Las interacciones farmacológicas no sólo suponen un grave problema para la seguridad del paciente, sino que además también conllevan un importante incremento en el gasto médico. En la actualidad, el personal sanitario tiene a su disposición diversas bases de datos sobre interacciones que permiten evitar posibles interacciones a la hora de prescribir un determinado tratamiento, sin embargo, estas bases de datos no están completas. Por este motivo, médicos y farmacéuticos se ven obligados a revisar una gran cantidad de artículos científicos e informes sobre seguridad de medicamentos para estar al día de todo lo publicado en relación al tema. Desgraciadamente, el gran volumen de información al respecto hace que estos profesionales estén desbordados ante tal avalancha. El desarrollo de métodos automáticos que permitan recopilar, mantener e interpretar toda esta información es crucial a la hora de conseguir una mejora real en la detección temprana de las interacciones entre fármacos. Por tanto, la extracción de información podría reducir el tiempo empleado por el personal médico en la revisión de la literatura médica. Sin embargo, la extracción de interacciones farmacológicas a partir textos biomédicos no ha sido dirigida hasta el momento. Motivados por estos aspectos, en esta tesis hemos realizado un estudio detallado sobre diversas técnicas de extracción de información aplicadas al dominio farmacológico. Basándonos en este estudio, hemos propuesto dos aproximaciones distintas para la extracción de interacciones farmacológicas de los textos. Nuestra primera aproximación propone un enfoque híbrido, que combina análisis sintáctico superficial y la aplicación de patrones léxicos definidos por un farmacéutico. La segunda aproximación se aborda mediante aprendizaje supervisado, concretamente, el uso de métodos kernels. Además, se han desarrollado las siguientes tareas auxiliares: (1) el análisis de los textos utilizando la herramienta UMLS MetaMap Transfer (MMTx), que proporciona información sintáctica y semántica, (2) un proceso para identificar y clasificar los nombres de fármacos que ocurren en los textos, y (3) un proceso para reconoger las expresiones anafóricas que se refieren a fármacos. Un prototipo ha sido desarrollado para integrar y combinar las distintas técnicas propuestas en esta tesis. Para la evaluación de las dos propuestas, con la ayuda de un farmacéutico desarrollamos y anotamos un corpus con interacciones farmacológicas. El corpus DrugDDI es una de las principales aportaciones de la tesis, ya que es el primer corpus en el dominio biomédico anotado con este tipo de información y porque creemos que puede alentar la investigación sobre extracción de información en el dominio farmacológico. Los experimentos realizados demuestran que el enfoque basado en kernels consigue mejores resultados que los reportados por el enfoque que utiliza información sintáctica y patrones léxicos. Además, los kernels consiguen resultados comparables a los obtenidos en dominios similares como son las interacciones entre proteínas. Esta tesis se ha llevado a cabo en el marco del consorcio de investigación MAVIRCM (Mejorando el acceso y visibilidad de la información multilingüe en red para la Comunidad de Madrid, www.mavir.net) dentro del Programa de Actividades de I+D en Tecnologías 2005-2008 de la Comunidad de Madrid (S-0505/TIC-0267) así como en el proyecto de investigación BRAVO: ”Búsqueda de Respuestas Avanzada Multimodal y Multilingüe” (TIN2007-67407-C03-01).----------------------------------------------------------------------------------------A drug-drug interaction occurs when one drug influences the level or activity of another drug. The detection of drug interactions is an important research area in patient safety since these interactions can become very dangerous and increase health care costs. Although there are different databases supporting health care professionals in the detection of drug interactions, this kind of resource is rarely complete. Drug interactions are frequently reported in journals of clinical pharmacology, making medical literature the most effective source for the detection of drug interactions. However, the increasing volume of the literature overwhelms health care professionals trying to keep an up-to-date collection of all reported drug-drug interactions. The development of automatic methods for collecting, maintaining and interpreting this information is crucial for achieving a real improvement in their early detection. Information Extraction (IE) techniques can provide an interesting way of reducing the time spent by health care professionals on reviewing the literature. Nevertheless, no approach has been carried out to extract drug-drug interactions from biomedical texts. In this thesis, we have conducted a detailed study on various IE techniques applied to biomedical domain. Based on this study, we have proposed two different approximations for the extraction of drug-drug interactions from texts. The first approximation proposes a hybrid approach, which combines shallow parsing and pattern matching to extract relations between drugs from biomedical texts. The second approximation is based on a supervised machine learning approach, in particular, kernel methods. In addition, we have created and annotated the first corpus, DrugDDI, annotated with drug-drug interactions, which allow us to evaluate and compare both approximations. To the best of our knowledge, the DrugDDI corpus is the only available corpus annotated for drug-drug interactions and this thesis is the first work which addresses the problem of extracting drug-drug interactions from biomedical texts. We believe the DrugDDI corpus is an important contribution because it could encourage other research groups to research into this problem. We have also defined three auxiliary processes to provide crucial information, which will be used by the aforementioned approximations. These auxiliary tasks are as follows: (1) a process for text analysis based on the UMLS MetaMap Transfer tool (MMTx) to provide shallow syntactic and semantic information from texts, (2) a process for drug name recognition and classification, and (3) a process for drug anaphora resolution. Finally, we have developed a pipeline prototype which integrates the different auxiliary processes. The pipeline architecture allows us to easily integrate these modules with each of the approaches proposed in this thesis: pattern-matching or kernels. Several experiments were performed on the DrugDDI corpus. They show that while the first approximation based on pattern matching achieves low performance, the approach based on kernel-methods achieves a performance comparable to those obtained by approaches which carry out a similar task such as the extraction of protein-protein interactions. This work has been partially supported by the Spanish research projects: MAVIR consortium (S-0505/TIC-0267, www.mavir.net), a network of excellence funded by the Madrid Regional Government and TIN2007-67407-C03-01 (BRAVO: Advanced Multimodal and Multilingual Question Answering)

Automatic Population of Structured Reports from Narrative Pathology Reports

There are a number of advantages for the use of structured pathology reports: they can ensure the accuracy and completeness of pathology reporting; it is easier for the referring doctors to glean pertinent information from them. The goal of this thesis is to extract pertinent information from free-text pathology reports and automatically populate structured reports for cancer diseases and identify the commonalities and differences in processing principles to obtain maximum accuracy. Three pathology corpora were annotated with entities and relationships between the entities in this study, namely the melanoma corpus, the colorectal cancer corpus and the lymphoma corpus. A supervised machine-learning based-approach, utilising conditional random fields learners, was developed to recognise medical entities from the corpora. By feature engineering, the best feature configurations were attained, which boosted the F-scores significantly from 4.2% to 6.8% on the training sets. Without proper negation and uncertainty detection, the quality of the structured reports will be diminished. The negation and uncertainty detection modules were built to handle this problem. The modules obtained overall F-scores ranging from 76.6% to 91.0% on the test sets. A relation extraction system was presented to extract four relations from the lymphoma corpus. The system achieved very good performance on the training set, with 100% F-score obtained by the rule-based module and 97.2% F-score attained by the support vector machines classifier. Rule-based approaches were used to generate the structured outputs and populate them to predefined templates. The rule-based system attained over 97% F-scores on the training sets. A pipeline system was implemented with an assembly of all the components described above. It achieved promising results in the end-to-end evaluations, with 86.5%, 84.2% and 78.9% F-scores on the melanoma, colorectal cancer and lymphoma test sets respectively