Combining Unsupervised, Supervised, and Rule-based Algorithms for Text Mining of Electronic Health Records - A Clinical Decision Support System for Identifying and Classifying Allergies of Concern for Anesthesia During Surgery

Undisclosed allergic reactions of patients are a major risk when undertaking surgeries in hospitals. We present our early experience and preliminary findings for a Clinical Decision Support System (CDSS) being developed in a Norwegian Hospital Trust. The system incorporates unsupervised and supervised machine learning algorithms in combination with rule-based algorithms to identify and classify allergies of concern for anesthesia during surgery. Our approach is novel in that it utilizes unsupervised machine learning to analyze large corpora of narratives to automatically build a clinical language model containing words and phrases of which meanings and relative meanings are also learnt. It further implements a semi-automatic annotation scheme for efficient and interactive machine-learning, which to a large extent eliminates the substantial manual annotation (of clinical narratives) effort necessary for the training of supervised algorithms. Validation of system performance was performed through comparing allergies identified by the CDSS with a manual reference standard

DrugExBERT for Pharmacovigilance – A Novel Approach for Detecting Drug Experiences from User-Generated Content

Pharmaceutical companies have to maintain drug safety through pharmacovigilance systems by monitoring various sources of information about adverse drug experiences. Recently, user-generated content (UGC) has emerged as a valuable source of real-world drug experiences, posing new challenges due to its high volume and variety. We present DrugExBERT, a novel approach to extract adverse drug experiences (adverse reaction, lack of effect) and supportive drug experiences (effectiveness, intervention, indication, and off-label use) from UGC. To be able to verify the extracted drug experiences, DrugExBERT additionally provides explications in the form of UGC phrases that were critical for the extraction. In our evaluation, we demonstrate that DrugExBERT outperforms state-of-the-art pharmacovigilance approaches as well as ChatGPT on several performance measures and that DrugExBERT is data- and drug-agnostic. Thus, our novel approach can help pharmaceutical companies meet their legal obligations and ethical responsibility while ensuring patient safety and monitoring drug effectiveness

Drug prescription support in dental clinics through drug corpus mining

The rapid increase in the volume and variety of data poses a challenge to safe drug prescription for the dentist. The increasing number of patients that take multiple drugs further exerts pressure on the dentist to make the right decision at point-of-care. Hence, a robust decision support system will enable dentists to make decisions on drug prescription quickly and accurately. Based on the assumption that similar drug pairs have a higher similarity ratio, this paper suggests an innovative approach to obtain the similarity ratio between the drug that the dentist is going to prescribe and the drug that the patient is currently taking. We conducted experiments to obtain the similarity ratios of both positive and negative drug pairs, by using feature vectors generated from term similarities and word embeddings of biomedical text corpus. This model can be easily adapted and implemented for use in a dental clinic to assist the dentist in deciding if a drug is suitable for prescription, taking into consideration the medical profile of the patients. Experimental evaluation of our model’s association of the similarity ratio between two drugs yielded a superior F score of 89%. Hence, such an approach, when integrated within the clinical work flow, will reduce prescription errors and thereby increase the health outcomes of patients

Drug prescription support in dental clinics through drug corpus mining

The rapid increase in the volume and variety of data poses a challenge to safe drug prescription for the dentist. The increasing number of patients that take multiple drugs further exerts pressure on the dentist to make the right decision at point-of-care. Hence, a robust decision support system will enable dentists to make decisions on drug prescription quickly and accurately. Based on the assumption that similar drug pairs have a higher similarity ratio, this paper suggests an innovative approach to obtain the similarity ratio between the drug that the dentist is going to prescribe and the drug that the patient is currently taking. We conducted experiments to obtain the similarity ratios of both positive and negative drug pairs, by using feature vectors generated from term similarities and word embeddings of biomedical text corpus. This model can be easily adapted and implemented for use in a dental clinic to assist the dentist in deciding if a drug is suitable for prescription, taking into consideration the medical profile of the patients. Experimental evaluation of our model’s association of the similarity ratio between two drugs yielded a superior F score of 89%. Hence, such an approach, when integrated within the clinical work flow, will reduce prescription errors and thereby increase the health outcomes of patients

Mining Frequency of Drug Side Effects Over a Large Twitter Dataset Using Apache Spark

Despite clinical trials by pharmaceutical companies as well as current FDA reporting systems, there are still drug side effects that have not been caught. To find a larger sample of reports, a possible way is to mine online social media. With its current widespread use, social media such as Twitter has given rise to massive amounts of data, which can be used as reports for drug side effects. To process these large datasets, Apache Spark has become popular for fast, distributed batch processing. In this work, we have improved on previous pipelines in sentimental analysis-based mining, processing, and extracting tweets with drug-caused side effects. We have also added a new ensemble classifier using a combination of sentiment analysis features to increase the accuracy of identifying drug-caused side effects. In addition, the frequency count for the side effects is also provided. Furthermore, we have also implemented the same pipeline in Apache Spark to improve the speed of processing of tweets by 2.5 times, as well as to support the process of large tweet datasets. As the frequency count of drug side effects opens a wide door for further analysis, we present a preliminary study on this issue, including the side effects of simultaneously using two drugs, and the potential danger of using less-common combination of drugs. We believe the pipeline design and the results present in this work would have great implication on studying drug side effects and on big data analysis in general

Challenges and opportunities for mining adverse drug reactions: perspectives from pharma, regulatory agencies, healthcare providers and consumers

Monitoring drug safety is a central concern throughout the drug life cycle. Information about toxicity and adverse events is generated at every stage of this life cycle, and stakeholders have a strong interest in applying text mining and artificial intelligence (AI) methods to manage the ever-increasing volume of this information. Recognizing the importance of these applications and the role of challenge evaluations to drive progress in text mining, the organizers of BioCreative VII (Critical Assessment of Information Extraction in Biology) convened a panel of experts to explore ‘Challenges in Mining Drug Adverse Reactions’. This article is an outgrowth of the panel; each panelist has highlighted specific text mining application(s), based on their research and their experiences in organizing text mining challenge evaluations. While these highlighted applications only sample the complexity of this problem space, they reveal both opportunities and challenges for text mining to aid in the complex process of drug discovery, testing, marketing and post-market surveillance. Stakeholders are eager to embrace natural language processing and AI tools to help in this process, provided that these tools can be demonstrated to add value to stakeholder workflows. This creates an opportunity for the BioCreative community to work in partnership with regulatory agencies, pharma and the text mining community to identify next steps for future challenge evaluations.M.K.: This work was supported in part through the collaboration between the Spanish Plan for the Advancement of Language Technology (Plan TL) and the Barcelona Supercomputing Center; we also acknowledge the 2020 Proyectos de I+D+i - RTI Tipo A (PID2020-119266RA-I00) for support. Ö.U.: This study was supported in part by the National Library of Medicine under Award Number R15LM013209 and R13LM013127.Peer ReviewedPostprint (published version

Mining drug properties for decision support in dental clinics

The rise of polypharmacy requires from health providers an awareness of a patient’s drug profile before prescribing. Existing methods to extract information on drug interactions do not integrate with the patient’s medical history. This paper describes state-of-the-art approaches in extracting the term frequencies of drug properties and combining this knowledge with consideration of the patient’s drug allergies and current medications to decide if a drug is suitable for prescription. Experimental evaluation of our models association of the similarity ratio between two drugs (based on each drug’s term frequencies) with the similarity between them yields a superior accuracy of 79%. Similarity to a drug the patient is allergic to or is currently taking are important considerations as to the suitability of a drug for prescription. Hence, such an approach, when integrated within the clinical workflow, will reduce prescription errors thereby increasing the health outcome of the patient

Ontology-based knowledge representation of experiment metadata in biological data mining

According to the PubMed resource from the U.S. National Library of Medicine, over 750,000 scientific articles have been published in the ~5000 biomedical journals worldwide in the year 2007 alone. The vast majority of these publications include results from hypothesis-driven experimentation in overlapping biomedical research domains. Unfortunately, the sheer volume of information being generated by the biomedical research enterprise has made it virtually impossible for investigators to stay aware of the latest findings in their domain of interest, let alone to be able to assimilate and mine data from related investigations for purposes of meta-analysis. While computers have the potential for assisting investigators in the extraction, management and analysis of these data, information contained in the traditional journal publication is still largely unstructured, free-text descriptions of study design, experimental application and results interpretation, making it difficult for computers to gain access to the content of what is being conveyed without significant manual intervention. In order to circumvent these roadblocks and make the most of the output from the biomedical research enterprise, a variety of related standards in knowledge representation are being developed, proposed and adopted in the biomedical community. In this chapter, we will explore the current status of efforts to develop minimum information standards for the representation of a biomedical experiment, ontologies composed of shared vocabularies assembled into subsumption hierarchical structures, and extensible relational data models that link the information components together in a machine-readable and human-useable framework for data mining purposes

Utilizing artificial intelligence in perioperative patient flow:systematic literature review

Abstract. The purpose of this thesis was to map the existing landscape of artificial intelligence (AI) applications used in secondary healthcare, with a focus on perioperative care. The goal was to find out what systems have been developed, and how capable they are at controlling perioperative patient flow. The review was guided by the following research question: How is AI currently utilized in patient flow management in the context of perioperative care? This systematic literature review examined the current evidence regarding the use of AI in perioperative patient flow. A comprehensive search was conducted in four databases, resulting in 33 articles meeting the inclusion criteria. Findings demonstrated that AI technologies, such as machine learning (ML) algorithms and predictive analytics tools, have shown somewhat promising outcomes in optimizing perioperative patient flow. Specifically, AI systems have proven effective in predicting surgical case durations, assessing risks, planning treatments, supporting diagnosis, improving bed utilization, reducing cancellations and delays, and enhancing communication and collaboration among healthcare providers. However, several challenges were identified, including the need for accurate and reliable data sources, ethical considerations, and the potential for biased algorithms. Further research is needed to validate and optimize the application of AI in perioperative patient flow. The contribution of this thesis is summarizing the current state of the characteristics of AI application in perioperative patient flow. This systematic literature review provides information about the features of perioperative patient flow and the clinical tasks of AI applications previously identified

Biomedical Information Extraction Pipelines for Public Health in the Age of Deep Learning

abstract: Unstructured texts containing biomedical information from sources such as electronic health records, scientific literature, discussion forums, and social media offer an opportunity to extract information for a wide range of applications in biomedical informatics. Building scalable and efficient pipelines for natural language processing and extraction of biomedical information plays an important role in the implementation and adoption of applications in areas such as public health. Advancements in machine learning and deep learning techniques have enabled rapid development of such pipelines. This dissertation presents entity extraction pipelines for two public health applications: virus phylogeography and pharmacovigilance. For virus phylogeography, geographical locations are extracted from biomedical scientific texts for metadata enrichment in the GenBank database containing 2.9 million virus nucleotide sequences. For pharmacovigilance, tools are developed to extract adverse drug reactions from social media posts to open avenues for post-market drug surveillance from non-traditional sources. Across these pipelines, high variance is observed in extraction performance among the entities of interest while using state-of-the-art neural network architectures. To explain the variation, linguistic measures are proposed to serve as indicators for entity extraction performance and to provide deeper insight into the domain complexity and the challenges associated with entity extraction. For both the phylogeography and pharmacovigilance pipelines presented in this work the annotated datasets and applications are open source and freely available to the public to foster further research in public health.Dissertation/ThesisDoctoral Dissertation Biomedical Informatics 201