Enhancing Automatic ICD-9-CM Code Assignment for Medical Texts with PubMed

Assigning a standard ICD-9-CM code to disease symptoms in medical texts is an important task in the medical domain. Automating this process could greatly reduce the costs. However, the effectiveness of an automatic ICD-9-CM code classifier faces a serious problem, which can be triggered by unbalanced training data. Frequent diseases often have more training data, which helps its classification to perform better than that of an infrequent disease. However, a disease’s frequency does not necessarily reflect its importance. To resolve this training data shortage problem, we propose to strategically draw data from PubMed to enrich the training data when there is such need. We validate our method on the CMC dataset, and the evaluation results indicate that our method can significantly improve the code assignment classifiers' performance at the macro-averaging level

Domain-specific word embeddings for ICD-9-CM classification

In this work we evaluate domain-speci�c embedding models induced from textual resources in the medical domain. The International Classi�cation of Diseases (ICD) is a standard, broadly used classi�cation system, that codes a large number of speci�c diseases, symptoms, injuries and medical procedures into numerical classes. Assigning a code to a clinical case means classifying that case into one or more particular discrete class, hence allowing further statistics studies and automated calculations. The possibility to have a discrete code instead of a text in natural language is intuitively a great advantage for data processing systems. The use of such classi�cation is becoming increasingly important for, but not limited to, economic and policy-making purposes. Experiments show that domain-speci�c word embeddings, instead of a general one, improves classi�ers in terms of frequency similarities between words

Automated machine learning for healthcare and clinical notes analysis

Machine learning (ML) has been slowly entering every aspect of our lives and its positive impact has been astonishing. To accelerate embedding ML in more applications and incorporating it in real-world scenarios, automated machine learning (AutoML) is emerging. The main purpose of AutoML is to provide seamless integration of ML in various industries, which will facilitate better outcomes in everyday tasks. In healthcare, AutoML has been already applied to easier settings with structured data such as tabular lab data. However, there is still a need for applying AutoML for interpreting medical text, which is being generated at a tremendous rate. For this to happen, a promising method is AutoML for clinical notes analysis, which is an unexplored research area representing a gap in ML research. The main objective of this paper is to fill this gap and provide a comprehensive survey and analytical study towards AutoML for clinical notes. To that end, we first introduce the AutoML technology and review its various tools and techniques. We then survey the literature of AutoML in the healthcare industry and discuss the developments specific to clinical settings, as well as those using general AutoML tools for healthcare applications. With this background, we then discuss challenges of working with clinical notes and highlight the benefits of developing AutoML for medical notes processing. Next, we survey relevant ML research for clinical notes and analyze the literature and the field of AutoML in the healthcare industry. Furthermore, we propose future research directions and shed light on the challenges and opportunities this emerging field holds. With this, we aim to assist the community with the implementation of an AutoML platform for medical notes, which if realized can revolutionize patient outcomes

Machine learning for medical coding in health care surveys

This exploratory study evaluates the use of machine learning classifiers to perform automated medical coding for large statistical healthcare surveys

Extreme multi-label deep neural classification of Spanish health records according to the International Classification of Diseases

111 p.Este trabajo trata sobre la minería de textos clínicos, un campo del Procesamiento del Lenguaje Natural aplicado al dominio biomédico. El objetivo es automatizar la tarea de codificación médica. Los registros electrónicos de salud (EHR) son documentos que contienen información clínica sobre la salud de unpaciente. Los diagnósticos y procedimientos médicos plasmados en la Historia Clínica Electrónica están codificados con respecto a la Clasificación Internacional de Enfermedades (CIE). De hecho, la CIE es la base para identificar estadísticas de salud internacionales y el estándar para informar enfermedades y condiciones de salud. Desde la perspectiva del aprendizaje automático, el objetivo es resolver un problema extremo de clasificación de texto de múltiples etiquetas, ya que a cada registro de salud se le asignan múltiples códigos ICD de un conjunto de más de 70 000 términos de diagnóstico. Una cantidad importante de recursos se dedican a la codificación médica, una laboriosa tarea que actualmente se realiza de forma manual. Los EHR son narraciones extensas, y los codificadores médicos revisan los registros escritos por los médicos y asignan los códigos ICD correspondientes. Los textos son técnicos ya que los médicos emplean una jerga médica especializada, aunque rica en abreviaturas, acrónimos y errores ortográficos, ya que los médicos documentan los registros mientras realizan la práctica clínica real. Paraabordar la clasificación automática de registros de salud, investigamos y desarrollamos un conjunto de técnicas de clasificación de texto de aprendizaje profundo

Explainable Prediction of Medical Codes from Clinical Text

Clinical notes are text documents that are created by clinicians for each patient encounter. They are typically accompanied by medical codes, which describe the diagnosis and treatment. Annotating these codes is labor intensive and error prone; furthermore, the connection between the codes and the text is not annotated, obscuring the reasons and details behind specific diagnoses and treatments. We present an attentional convolutional network that predicts medical codes from clinical text. Our method aggregates information across the document using a convolutional neural network, and uses an attention mechanism to select the most relevant segments for each of the thousands of possible codes. The method is accurate, achieving precision@8 of 0.71 and a Micro-F1 of 0.54, which are both better than the prior state of the art. Furthermore, through an interpretability evaluation by a physician, we show that the attention mechanism identifies meaningful explanations for each code assignmentComment: NAACL 201

Deep Neural Networks for Multi-Label Text Classification: Application to Coding Electronic Medical Records

Coding Electronic Medical Records (EMRs) with diagnosis and procedure codes is an essential task for billing, secondary data analyses, and monitoring health trends. Both speed and accuracy of coding are critical. While coding errors could lead to more patient-side financial burden and misinterpretation of a patient’s well-being, timely coding is also needed to avoid backlogs and additional costs for the healthcare facility. Therefore, it is necessary to develop automated diagnosis and procedure code recommendation methods that can be used by professional medical coders. The main difficulty with developing automated EMR coding methods is the nature of the label space. The standardized vocabularies used for medical coding contain over 10 thousand codes. The label space is large, and the label distribution is extremely unbalanced - most codes occur very infrequently, with a few codes occurring several orders of magnitude more than others. A few codes never occur in training dataset at all. In this work, we present three methods to handle the large unbalanced label space. First, we study how to augment EMR training data with biomedical data (research articles indexed on PubMed) to improve the performance of standard neural networks for text classification. PubMed indexes more than 23 million citations. Many of the indexed articles contain relevant information about diagnosis and procedure codes. Therefore, we present a novel method of incorporating this unstructured data in PubMed using transfer learning. Second, we combine ideas from metric learning with recent advances in neural networks to form a novel neural architecture that better handles infrequent codes. And third, we present new methods to predict codes that have never appeared in the training dataset. Overall, our contributions constitute advances in neural multi-label text classification with potential consequences for improving EMR coding

Aportaciones de las técnicas de aprendizaje automático a la clasificación de partes de alta hospitalarios reales en castellano

Hospitals attached to the Spanish Ministry of Health are currently using the International Classification of Diseases 9 Clinical Modification (ICD9-CM) to classify health discharge records. Nowadays, this work is manually done by experts. This paper tackles the automatic classification of real Discharge Records in Spanish following the ICD9-CM standard. The challenge is that the Discharge Records are written in spontaneous language. We explore several machine learning techniques to deal with the classification problem. Random Forest resulted in the most competitive one, achieving an F-measure of 0.876.La red de hospitales que configuran el sistema español de sanidad utiliza la Clasificación Internacional de Enfermedades Modificación Clínica (ICD9-CM) para codificar partes de alta hospitalaria. Hoy en día, este trabajo lo realizan a mano los expertos. Este artículo aborda la problemática de clasificar automáticamente partes reales de alta hospitalaria escritos en español teniendo en cuenta el estándar ICD9-CM. El desafío radica en que los partes hospitalarios están escritos con lenguaje espontáneo. Hemos experimentado con varios sistemas de aprendizaje automático para solventar este problema de clasificación. El algoritmo Random Forest es el más competitivo de los probados, obtiene un F-measure de 0.876.This work was partially supported by the European Commission (SEP-210087649), the Spanish Ministry of Science and Innovation (TIN2012-38584-C06-02) and the Industry of the Basque Government (IT344-10)

Extracção de informação médica em português europeu

Doutoramento em Engenharia InformáticaThe electronic storage of medical patient data is becoming a daily experience in most of the practices and hospitals worldwide. However, much of the data available is in free-form text, a convenient way of expressing concepts and events, but especially challenging if one wants to perform automatic searches, summarization or statistical analysis. Information Extraction can relieve some of these problems by offering a semantically informed interpretation and abstraction of the texts. MedInX, the Medical Information eXtraction system presented in this document, is the first information extraction system developed to process textual clinical discharge records written in Portuguese. The main goal of the system is to improve access to the information locked up in unstructured text, and, consequently, the efficiency of the health care process, by allowing faster and reliable access to quality information on health, for both patient and health professionals. MedInX components are based on Natural Language Processing principles, and provide several mechanisms to read, process and utilize external resources, such as terminologies and ontologies, in the process of automatic mapping of free text reports onto a structured representation. However, the flexible and scalable architecture of the system, also allowed its application to the task of Named Entity Recognition on a shared evaluation contest focused on Portuguese general domain free-form texts. The evaluation of the system on a set of authentic hospital discharge letters indicates that the system performs with 95% F-measure, on the task of entity recognition, and 95% precision on the task of relation extraction. Example applications, demonstrating the use of MedInX capabilities in real applications in the hospital setting, are also presented in this document. These applications were designed to answer common clinical problems related with the automatic coding of diagnoses and other health-related conditions described in the documents, according to the international classification systems ICD-9-CM and ICF. The automatic review of the content and completeness of the documents is an example of another developed application, denominated MedInX Clinical Audit system.O armazenamento electrónico dos dados médicos do paciente é uma prática cada vez mais comum nos hospitais e clínicas médicas de todo o mundo. No entanto, a maior parte destes dados são disponibilizados sob a forma de texto livre, uma forma conveniente de expressar conceitos e termos mas particularmente desafiante quando se pretende realizar procuras, sumarização ou análise estatística de uma forma automática. As tecnologias de extracção automática de informação podem ajudar a solucionar alguns destes problemas através da interpretação semântica e da abstracção do conteúdo dos textos. O sistema de Extracção de Informação Médica apresentado neste documento, o MedInX, é o primeiro sistema desenvolvido para o processamento de cartas de alta hospitalar escritas em Português. O principal objectivo do sistema é a melhoria do acesso à informação trancada nos textos e, consequentemente, a melhoria da eficiência dos cuidados de saúde, através do acesso rápido e confiável à informação, quer relativa ao doente, quer aos profissionais de saúde. O MedInX utiliza diversas componentes, baseadas em princípios de processamento de linguagem natural, para a análise dos textos clínicos, e contém vários mecanismos para ler, processar e utilizar recursos externos, como terminologias e ontologias. Este recursos são utilizados, em particular, no mapeamento automático do texto livre para uma representação estruturada. No entanto, a arquitectura flexível e escalável do sistema permitiu, também, a sua aplicação na tarefa de Reconhecimento de Entidades Nomeadas numa avaliação conjunta relativa ao processamento de textos de domínio geral, escritos em Português. A avaliação do sistema num conjunto de cartas de alta hospitalar reais, indica que o sistema realiza a tarefa de extracção de informação com uma medida F de 95% e a tarefa de extracção de relações com uma precisão de 95%. A utilidade do sistema em aplicações reais é demonstrada através do desenvolvimento de um conjunto de projectos exemplificativos, que pretendem responder a problemas concretos e comuns em ambiente hospitalar. Estes problemas estão relacionados com a codificação automática de diagnósticos e de outras condições relacionadas com o estado de saúde do doente, seguindo as classificações internacionais, ICD-9-CM e ICF. A revisão automática do conteúdo dos documentos é outro exemplo das possíveis aplicações práticas do sistema. Esta última aplicação é representada pelo o sistema de auditoria do MedInX

Application of Semantics to Solve Problems in Life Sciences

Fecha de lectura de Tesis: 10 de diciembre de 2018La cantidad de información que se genera en la Web se ha incrementado en los últimos años. La mayor parte de esta información se encuentra accesible en texto, siendo el ser humano el principal usuario de la Web. Sin embargo, a pesar de todos los avances producidos en el área del procesamiento del lenguaje natural, los ordenadores tienen problemas para procesar esta información textual. En este cotexto, existen dominios de aplicación en los que se están publicando grandes cantidades de información disponible como datos estructurados como en el área de las Ciencias de la Vida. El análisis de estos datos es de vital importancia no sólo para el avance de la ciencia, sino para producir avances en el ámbito de la salud. Sin embargo, estos datos están localizados en diferentes repositorios y almacenados en diferentes formatos que hacen difícil su integración. En este contexto, el paradigma de los Datos Vinculados como una tecnología que incluye la aplicación de algunos estándares propuestos por la comunidad W3C tales como HTTP URIs, los estándares RDF y OWL. Haciendo uso de esta tecnología, se ha desarrollado esta tesis doctoral basada en cubrir los siguientes objetivos principales: 1) promover el uso de los datos vinculados por parte de la comunidad de usuarios del ámbito de las Ciencias de la Vida 2) facilitar el diseño de consultas SPARQL mediante el descubrimiento del modelo subyacente en los repositorios RDF 3) crear un entorno colaborativo que facilite el consumo de Datos Vinculados por usuarios finales, 4) desarrollar un algoritmo que, de forma automática, permita descubrir el modelo semántico en OWL de un repositorio RDF, 5) desarrollar una representación en OWL de ICD-10-CM llamada Dione que ofrezca una metodología automática para la clasificación de enfermedades de pacientes y su posterior validación haciendo uso de un razonador OWL