Annotating patient clinical records with syntactic chunks and named entities: the Harvey corpus

The free text notes typed by physicians during patient consultations contain valuable information for the study of disease and treatment. These notes are difficult to process by existing natural language analysis tools since they are highly telegraphic (omitting many words), and contain many spelling mistakes, inconsistencies in punctuation, and non-standard word order. To support information extraction and classification tasks over such text, we describe a de-identified corpus of free text notes, a shallow syntactic and named entity annotation scheme for this kind of text, and an approach to training domain specialists with no linguistic background to annotate the text. Finally, we present a statistical chunking system for such clinical text with a stable learning rate and good accuracy, indicating that the manual annotation is consistent and that the annotation scheme is tractable for machine learning

Domain-specific language models and lexicons for tagging

AbstractAccurate and reliable part-of-speech tagging is useful for many Natural Language Processing (NLP) tasks that form the foundation of NLP-based approaches to information retrieval and data mining. In general, large annotated corpora are necessary to achieve desired part-of-speech tagger accuracy. We show that a large annotated general-English corpus is not sufficient for building a part-of-speech tagger model adequate for tagging documents from the medical domain. However, adding a quite small domain-specific corpus to a large general-English one boosts performance to over 92% accuracy from 87% in our studies. We also suggest a number of characteristics to quantify the similarities between a training corpus and the test data. These results give guidance for creating an appropriate corpus for building a part-of-speech tagger model that gives satisfactory accuracy results on a new domain at a relatively small cost

Unsupervised Biomedical Named Entity Recognition

Named entity recognition (NER) from text is an important task for several applications, including in the biomedical domain. Supervised machine learning based systems have been the most successful on NER task, however, they require correct annotations in large quantities for training. Annotating text manually is very labor intensive and also needs domain expertise. The purpose of this research is to reduce human annotation effort and to decrease cost of annotation for building NER systems in the biomedical domain. The method developed in this work is based on leveraging the availability of resources like UMLS (Unified Medical Language System), that contain a list of biomedical entities and a large unannotated corpus to build an unsupervised NER system that does not require any manual annotations. The method that we developed in this research has two phases. In the first phase, a biomedical corpus is automatically annotated with some named entities using UMLS through unambiguous exact matching which we call weakly-labeled data. In this data, positive examples are the entities in the text that exactly match in UMLS and have only one semantic type which belongs to the desired entity class to be extracted (for example, diseases and disorders). Negative examples are the entities in the text that exactly match in UMLS but are of semantic types other than those that belong to the desired entity class. These examples are then used to train a machine learning classifier using features that represent the contexts in which they appeared in the text. The trained classifier is applied back to the text to gather more examples iteratively through the process of self-training. The trained classifier is then capable of classifying mentions in an unseen text as of the desired entity class or not from the contexts in which they appear. Although the trained named entity detector is good at detecting the presence of entities of the desired class in text, it cannot determine their correct boundaries. In the second phase of our method, called “Boundary Expansion”, the correct boundaries of the entities are determined. This method is based on a novel idea that utilizes machine learning and UMLS. Training examples for boundary expansion are gathered directly from UMLS and do not require any manual annotations. We also developed a new WordNet based approach for boundary expansion. Our developed method was evaluated on three datasets - SemEval 2014 Task 7 dataset that has diseases and disorders as the desired entity class, GENIA dataset that has proteins, DNAs, RNAs, cell types, and cell lines as the desired entity classes, and i2b2 dataset that has problems, tests, and treatments as the desired entity classes. Our method performed well and obtained performance close to supervised methods on the SemEval dataset. On the other datasets, it outperformed an existing unsupervised method on most entity classes. Availability of a list of entity names with their semantic types and a large unannotated corpus are the only requirements of our method to work well. Given these, our method generalizes across different types of entities and different types of biomedical text. Being unsupervised, the method can be easily applied to new NER tasks without needing costly annotations

Classification of semantic relations in different syntactic structures in medical text using the MeSH hierarchy

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2005.Includes bibliographical references (leaf 38).Two different classification algorithms are evaluated in recognizing semantic relationships of different syntactic compounds. The compounds, which include noun- noun, adjective-noun, noun-adjective, noun-verb, and verb-noun, were extracted from a set of doctors' notes using a part of speech tagger and a parser. Each compound was labeled with a semantic relationship, and each word in the compound was mapped to its corresponding entry in the MeSH hierarchy. MeSH includes only medical terminology so it was extended to include everyday, non-medical terms. The two classification algorithms, neural networks and a classification tree, were trained and tested on the data set for each type of syntactic compound. Models representing different levels of MeSH were generated and fed into the neural networks. Both algorithms performed better than random guessing, and the classification tree performed better than the neural networks in predicting the semantic relationship between phrases from their syntactic structure.by Neha Bhooshan.M.Eng

Mining and Representing Unstructured Nicotine Use Data in a Structured Format for Secondary Use

The objective of this study was to use rules, NLP and machine learning for addressing the problem of clinical data interoperability across healthcare providers. Addressing this problem has the potential to make clinical data comparable, retrievable and exchangeable between healthcare providers. Our focus was in giving structure to unstructured patient smoking information. We collected our data from the MIMIC-III database. We wrote rules for annotating the data, then trained a CRF sequence classifier. We obtained an f-measure of 86%, 72%, 69%, 80%, and 12% for substance smoked, frequency, amount, temporal, and duration respectively. Amount smoked yielded a small value due to scarcity of related data. Then for smoking status we obtained an f-measure of 94.8% for non-smoker class, 83.0% for current-smoker, and 65.7% for past-smoker. We created a FHIR profile for mapping the extracted data based on openEHR reference models, however in future we will explore mapping to CIMI models

Large-scale evaluation of automated clinical note de-identification and its impact on information extraction

Objective: (1) To evaluate a state-of-the-art natural language processing (NLP)-based approach to automatically de-identify a large set of diverse clinical notes. (2) To measure the impact of de-identification on the performance of information extraction algorithms on the de-identified documents. Material and methods A cross-sectional study that included 3503 stratified, randomly selected clinical notes (over 22 note types) from five million documents produced at one of the largest US pediatric hospitals. Sensitivity, precision, F value of two automated de-identification systems for removing all 18 HIPAA-defined protected health information elements were computed. Performance was assessed against a manually generated ‘gold standard’. Statistical significance was tested. The automated de-identification performance was also compared with that of two humans on a 10% subsample of the gold standard. The effect of de-identification on the performance of subsequent medication extraction was measured. Results: The gold standard included 30 815 protected health information elements and more than one million tokens. The most accurate NLP method had 91.92% sensitivity (R) and 95.08% precision (P) overall. The performance of the system was indistinguishable from that of human annotators (annotators' performance was 92.15%(R)/93.95%(P) and 94.55%(R)/88.45%(P) overall while the best system obtained 92.91%(R)/95.73%(P) on same text). The impact of automated de-identification was minimal on the utility of the narrative notes for subsequent information extraction as measured by the sensitivity and precision of medication name extraction. Discussion and conclusion NLP-based de-identification shows excellent performance that rivals the performance of human annotators. Furthermore, unlike manual de-identification, the automated approach scales up to millions of documents quickly and inexpensively

Free text phrase encoding and information extraction from medical notes

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2005.Includes bibliographical references (p. 87-90).The Laboratory for Computational Physiology is collecting a large database of patient signals and clinical data from critically ill patients in hospital intensive care units (ICUs). The data will be used as a research resource to support the development of an advanced patient monitoring system for ICUs. Important pathophysiologic events in the patient data streams must be recognized and annotated by expert clinicians in order to create a "gold standard" database for training and evaluating automated monitoring systems. Annotating the database requires, among other things, analyzing and extracting important clinical information from textual patient data such as nursing admission and progress notes, and using the data to define and document important clinical events during the patient's ICU stay. Two major text-related annotation issues are addressed in this research. First, the documented clinical events must be described in a standardized vocabulary suitable for machine analysis. Second, an advanced monitoring system would need an automated way to extract meaning from the nursing notes, as part of its decision-making process. The thesis presents and evaluates methods to code significant clinical events into standardized terminology and to automatically extract significant information from free-text medical notes.by Jennifer Shu.M.Eng

Automatic de-identification of textual documents in the electronic health record: a review of recent research

<p>Abstract</p> <p>Background</p> <p>In the United States, the Health Insurance Portability and Accountability Act (HIPAA) protects the confidentiality of patient data and requires the informed consent of the patient and approval of the Internal Review Board to use data for research purposes, but these requirements can be waived if data is de-identified. For clinical data to be considered de-identified, the HIPAA "Safe Harbor" technique requires 18 data elements (called PHI: Protected Health Information) to be removed. The de-identification of narrative text documents is often realized manually, and requires significant resources. Well aware of these issues, several authors have investigated automated de-identification of narrative text documents from the electronic health record, and a review of recent research in this domain is presented here.</p> <p>Methods</p> <p>This review focuses on recently published research (after 1995), and includes relevant publications from bibliographic queries in PubMed, conference proceedings, the ACM Digital Library, and interesting publications referenced in already included papers.</p> <p>Results</p> <p>The literature search returned more than 200 publications. The majority focused only on structured data de-identification instead of narrative text, on image de-identification, or described manual de-identification, and were therefore excluded. Finally, 18 publications describing automated text de-identification were selected for detailed analysis of the architecture and methods used, the types of PHI detected and removed, the external resources used, and the types of clinical documents targeted. All text de-identification systems aimed to identify and remove person names, and many included other types of PHI. Most systems used only one or two specific clinical document types, and were mostly based on two different groups of methodologies: pattern matching and machine learning. Many systems combined both approaches for different types of PHI, but the majority relied only on pattern matching, rules, and dictionaries.</p> <p>Conclusions</p> <p>In general, methods based on dictionaries performed better with PHI that is rarely mentioned in clinical text, but are more difficult to generalize. Methods based on machine learning tend to perform better, especially with PHI that is not mentioned in the dictionaries used. Finally, the issues of anonymization, sufficient performance, and "over-scrubbing" are discussed in this publication.</p