A cascade of classifiers for extracting medication information from discharge summaries

<p>Abstract</p> <p>Background</p> <p>Extracting medication information from clinical records has many potential applications, and recently published research, systems, and competitions reflect an interest therein. Much of the early extraction work involved rules and lexicons, but more recently machine learning has been applied to the task.</p> <p>Methods</p> <p>We present a hybrid system consisting of two parts. The first part, field detection, uses a cascade of statistical classifiers to identify medication-related named entities. The second part uses simple heuristics to link those entities into medication events.</p> <p>Results</p> <p>The system achieved performance that is comparable to other approaches to the same task. This performance is further improved by adding features that reference external medication name lists.</p> <p>Conclusions</p> <p>This study demonstrates that our hybrid approach outperforms purely statistical or rule-based systems. The study also shows that a cascade of classifiers works better than a single classifier in extracting medication information. The system is available as is upon request from the first author.</p

Recognition of medication information from discharge summaries using ensembles of classifiers

BACKGROUND: Extraction of clinical information such as medications or problems from clinical text is an important task of clinical natural language processing (NLP). Rule-based methods are often used in clinical NLP systems because they are easy to adapt and customize. Recently, supervised machine learning methods have proven to be effective in clinical NLP as well. However, combining different classifiers to further improve the performance of clinical entity recognition systems has not been investigated extensively. Combining classifiers into an ensemble classifier presents both challenges and opportunities to improve performance in such NLP tasks. METHODS: We investigated ensemble classifiers that used different voting strategies to combine outputs from three individual classifiers: a rule-based system, a support vector machine (SVM) based system, and a conditional random field (CRF) based system. Three voting methods were proposed and evaluated using the annotated data sets from the 2009 i2b2 NLP challenge: simple majority, local SVM-based voting, and local CRF-based voting. RESULTS: Evaluation on 268 manually annotated discharge summaries from the i2b2 challenge showed that the local CRF-based voting method achieved the best F-score of 90.84% (94.11% Precision, 87.81% Recall) for 10-fold cross-validation. We then compared our systems with the first-ranked system in the challenge by using the same training and test sets. Our system based on majority voting achieved a better F-score of 89.65% (93.91% Precision, 85.76% Recall) than the previously reported F-score of 89.19% (93.78% Precision, 85.03% Recall) by the first-ranked system in the challenge. CONCLUSIONS: Our experimental results using the 2009 i2b2 challenge datasets showed that ensemble classifiers that combine individual classifiers into a voting system could achieve better performance than a single classifier in recognizing medication information from clinical text. It suggests that simple strategies that can be easily implemented such as majority voting could have the potential to significantly improve clinical entity recognition

The Hmong Medical Corpus: a biomedical corpus for a minority language

Biomedical communication is an area that increasingly benefits from natural language processing (NLP) work. Biomedical named entity recognition (NER) in particular provides a foundation for advanced NLP applications, such as automated medical question-answering and translation services. However, while a large body of biomedical documents are available in an array of languages, most work in biomedical NER remains in English, with the remainder in official national or regional languages. Minority languages so far remain an underexplored area. The Hmong language, a minority language with sizable populations in several countries and without official status anywhere, represents an exceptional challenge for effective communication in medical contexts. Taking advantage of the large number of government-produced medical information documents in Hmong, we have developed the first named entity-annotated biomedical corpus for a resource-poor minority language. The Hmong Medical Corpus contains 100,535 tokens with 4554 named entities (NEs) of three UMLS semantic types: diseases/syndromes, signs/symptoms, and body parts/organs/organ components. Furthermore, a subset of the corpus is annotated for word position and parts of speech, representing the first such gold-standard dataset publicly available for Hmong. The methodology presented provides a readily reproducible approach for the creation of biomedical NE-annotated corpora for other resource-poor languages

The Impact of Automatic Pre-annotation in Clinical Note Data Element Extraction - the CLEAN Tool

Objective. Annotation is expensive but essential for clinical note review and clinical natural language processing (cNLP). However, the extent to which computer-generated pre-annotation is beneficial to human annotation is still an open question. Our study introduces CLEAN (CLinical note rEview and ANnotation), a pre-annotation-based cNLP annotation system to improve clinical note annotation of data elements, and comprehensively compares CLEAN with the widely-used annotation system Brat Rapid Annotation Tool (BRAT). Materials and Methods. CLEAN includes an ensemble pipeline (CLEAN-EP) with a newly developed annotation tool (CLEAN-AT). A domain expert and a novice user/annotator participated in a comparative usability test by tagging 87 data elements related to Congestive Heart Failure (CHF) and Kawasaki Disease (KD) cohorts in 84 public notes. Results. CLEAN achieved higher note-level F1-score (0.896) over BRAT (0.820), with significant difference in correctness (P-value < 0.001), and the mostly related factor being system/software (P-value < 0.001). No significant difference (P-value 0.188) in annotation time was observed between CLEAN (7.262 minutes/note) and BRAT (8.286 minutes/note). The difference was mostly associated with note length (P-value < 0.001) and system/software (P-value 0.013). The expert reported CLEAN to be useful/satisfactory, while the novice reported slight improvements. Discussion. CLEAN improves the correctness of annotation and increases usefulness/satisfaction with the same level of efficiency. Limitations include untested impact of pre-annotation correctness rate, small sample size, small user size, and restrictedly validated gold standard. Conclusion. CLEAN with pre-annotation can be beneficial for an expert to deal with complex annotation tasks involving numerous and diverse target data elements

SemClinBr -- a multi institutional and multi specialty semantically annotated corpus for Portuguese clinical NLP tasks

The high volume of research focusing on extracting patient's information from electronic health records (EHR) has led to an increase in the demand for annotated corpora, which are a very valuable resource for both the development and evaluation of natural language processing (NLP) algorithms. The absence of a multi-purpose clinical corpus outside the scope of the English language, especially in Brazilian Portuguese, is glaring and severely impacts scientific progress in the biomedical NLP field. In this study, we developed a semantically annotated corpus using clinical texts from multiple medical specialties, document types, and institutions. We present the following: (1) a survey listing common aspects and lessons learned from previous research, (2) a fine-grained annotation schema which could be replicated and guide other annotation initiatives, (3) a web-based annotation tool focusing on an annotation suggestion feature, and (4) both intrinsic and extrinsic evaluation of the annotations. The result of this work is the SemClinBr, a corpus that has 1,000 clinical notes, labeled with 65,117 entities and 11,263 relations, and can support a variety of clinical NLP tasks and boost the EHR's secondary use for the Portuguese language

Doctor of Philosophy

dissertationManual annotation of clinical texts is often used as a method of generating reference standards that provide data for training and evaluation of Natural Language Processing (NLP) systems. Manually annotating clinical texts is time consuming, expensive, and requires considerable cognitive effort on the part of human reviewers. Furthermore, reference standards must be generated in ways that produce consistent and reliable data but must also be valid in order to adequately evaluate the performance of those systems. The amount of labeled data necessary varies depending on the level of analysis, the complexity of the clinical use case, and the methods that will be used to develop automated machine systems for information extraction and classification. Evaluating methods that potentially reduce cost, manual human workload, introduce task efficiencies, and reduce the amount of labeled data necessary to train NLP tools for specific clinical use cases are active areas of research inquiry in the clinical NLP domain. This dissertation integrates a mixed methods approach using methodologies from cognitive science and artificial intelligence with manual annotation of clinical texts. Aim 1 of this dissertation identifies factors that affect manual annotation of clinical texts. These factors are further explored by evaluating approaches that may introduce efficiencies into manual review tasks applied to two different NLP development areas - semantic annotation of clinical concepts and identification of information representing Protected Health Information (PHI) as defined by HIPAA. Both experiments integrate iv different priming mechanisms using noninteractive and machine-assisted methods. The main hypothesis for this research is that integrating pre-annotation or other machineassisted methods within manual annotation workflows will improve efficiency of manual annotation tasks without diminishing the quality of generated reference standards