Question answering systems for health professionals at the point of care -- a systematic review

Objective: Question answering (QA) systems have the potential to improve the quality of clinical care by providing health professionals with the latest and most relevant evidence. However, QA systems have not been widely adopted. This systematic review aims to characterize current medical QA systems, assess their suitability for healthcare, and identify areas of improvement. Materials and methods: We searched PubMed, IEEE Xplore, ACM Digital Library, ACL Anthology and forward and backward citations on 7th February 2023. We included peer-reviewed journal and conference papers describing the design and evaluation of biomedical QA systems. Two reviewers screened titles, abstracts, and full-text articles. We conducted a narrative synthesis and risk of bias assessment for each study. We assessed the utility of biomedical QA systems. Results: We included 79 studies and identified themes, including question realism, answer reliability, answer utility, clinical specialism, systems, usability, and evaluation methods. Clinicians' questions used to train and evaluate QA systems were restricted to certain sources, types and complexity levels. No system communicated confidence levels in the answers or sources. Many studies suffered from high risks of bias and applicability concerns. Only 8 studies completely satisfied any criterion for clinical utility, and only 7 reported user evaluations. Most systems were built with limited input from clinicians. Discussion: While machine learning methods have led to increased accuracy, most studies imperfectly reflected real-world healthcare information needs. Key research priorities include developing more realistic healthcare QA datasets and considering the reliability of answer sources, rather than merely focusing on accuracy.Comment: Accepted to the Journal of the American Medical Informatics Association (JAMIA

Question Answering System : A Review On Question Analysis, Document Processing, And Answer Extraction Techniques

Question Answering System could automatically provide an answer to a question posed by human in natural languages. This system consists of question analysis, document processing, and answer extraction module. Question Analysis module has task to translate query into a form that can be processed by document processing module. Document processing is a technique for identifying candidate documents, containing answer relevant to the user query. Furthermore, answer extraction module receives the set of passages from document processing module, then determine the best answers to user. Challenge to optimize Question Answering framework is to increase the performance of all modules in the framework. The performance of all modules that has not been optimized has led to the less accurate answer from question answering systems. Based on this issues, the objective of this study is to review the current state of question analysis, document processing, and answer extraction techniques. Result from this study reveals the potential research issues, namely morphology analysis, question classification, and term weighting algorithm for question classification

Comparing Attributional and Relational Similarity as a Means to Identify Clinically Relevant Drug-gene Relationships

In emerging domains, such as precision oncology, knowledge extracted from explicit assertions may be insufficient to identify relationships of interest. One solution to this problem involves drawing inference on the basis of similarity. Computational methods have been developed to estimate the semantic similarity and relatedness between terms and relationships that are distributed across corpora of literature such as Medline abstracts and other forms of human readable text. Most research on distributional similarity has focused on the notion of attributional similarity, which estimates the similarity between entities based on the contexts in which they occur across a large corpus. A relatively under-researched area concerns relational similarity, in which the similarity between pairs of entities is estimated from the contexts in which these entity pairs occur together. While it seems intuitive that models capturing the structure of the relationships between entities might mediate the identification of biologically important relationships, there is to date no comparison of the relative utility of attributional and relational models for this purpose. In this research, I compare the performance of a range of relational and attributional similarity methods, on the task of identifying drugs that may be therapeutically useful in the context of particular aberrant genes, as identified by a team of human experts. My hypothesis is that relational similarity will be of greater utility than attributional similarity as a means to identify biological relationships that may provide answers to clinical questions, (such as “which drugs INHIBIT gene x”?) in the context of rapidly evolving domains. My results show that models based on relational similarity outperformed models based on attributional similarity on this task. As the methods explained in this research can be applied to identify any sort of relationship for which cue pairs exist, my results suggest that relational similarity may be a suitable approach to apply to other biomedical problems. Furthermore, I found models based on neural word embeddings (NWE) to be particularly useful for this task, given their higher performance than Random Indexing-based models, and significantly less computational effort needed to create them. NWE methods (such as those produced by the popular word2vec tool) are a relatively recent development in the domain of distributional semantics, and are considered by many as the state-of-the-art when it comes to semantic language modeling. However, their application in identifying biologically important relationships from Medline in general, and specifically, in the domain of precision oncology has not been well studied. The results of this research can guide the design and implementation of biomedical question answering and other relationship extraction applications for precision medicine, precision oncology and other similar domains, where there is rapid emergence of novel knowledge. The methods developed and evaluated in this project can help NLP applications provide more accurate results by leveraging corpus based methods that are by design scalable and robust

Biomedical question answering using semantic relations

Background: The proliferation of the scientific literature in the field of biomedicine makes it difficult to keep abreast of current knowledge, even for domain experts. While general Web search engines and specialized information retrieval (IR) systems have made important strides in recent decades, the problem of accurate knowledge extraction from the biomedical literature is far from solved. Classical IR systems usually return a list of documents that have to be read by the user to extract relevant information. This tedious and time-consuming work can be lessened with automatic Question Answering (QA) systems, which aim to provide users with direct and precise answers to their questions. In this work we propose a novel methodology for QA based on semantic relations extracted from the biomedical literature. Results: We extracted semantic relations with the SemRep natural language processing system from 122,421,765 sentences, which came from 21,014,382 MEDLINE citations (i.e., the complete MEDLINE distribution up to the end of 2012). A total of 58,879,300 semantic relation instances were extracted and organized in a relational database. The QA process is implemented as a search in this database, which is accessed through a Web-based application, called SemBT (available at http://sembt.mf.uni-lj.si). We conducted an extensive evaluation of the proposed methodology in order to estimate the accuracy of extracting a particular semantic relation from a particular sentence. Evaluation was performed by 80 domain experts. In total 7,510 semantic relation instances belonging to 2,675 distinct relations were evaluated 12,083 times. The instances were evaluated as correct 8,228 times (68%). Conclusions: In this work we propose an innovative methodology for biomedical QA. The system is implemented as a Web-based application that is able to provide precise answers to a wide range of questions. A typical question is answered within a few seconds. The tool has some extensions that make it especially useful for interpretation of DNA microarray results