Towards new information resources for public health: From WordNet to MedicalWordNet

In the last two decades, WORDNET has evolved as the most comprehensive computational lexicon of general English. In this article, we discuss its potential for supporting the creation of an entirely new kind of information resource for public health, viz. MEDICAL WORDNET. This resource is not to be conceived merely as a lexical extension of the original WORDNET to medical terminology; indeed, there is already a considerable degree of overlap between WORDNET and the vocabulary of medicine. Instead, we propose a new type of repository, consisting of three large collections of (1) medically relevant word forms, structured along the lines of the existing Princeton WORDNET; (2) medically validated propositions, referred to here as medical facts, which will constitute what we shall call MEDICAL FACTNET; and (3) propositions reflecting laypersons’ medical beliefs, which will constitute what we shall call the MEDICAL BELIEFNET. We introduce a methodology for setting up the MEDICAL WORDNET. We then turn to the discussion of research challenges that have to be met in order to build this new type of information resource

The potential for automated question answering in the context of genomic medicine: an assessment of existing resources and properties of answers

Knowledge gained in studies of genetic disorders is reported in a growing body of biomedical literature containing reports of genetic variation in individuals that map to medical conditions and/or response to therapy. These scientific discoveries need to be translated into practical applications to optimize patient care. Translating research into practice can be facilitated by supplying clinicians with research evidence. We assessed the role of existing tools in extracting answers to translational research questions in the area of genomic medicine. We: evaluate the coverage of translational research terms in the Unified Medical Language Systems (UMLS) Metathesaurus; determine where answers are most often found in full-text articles; and determine common answer patterns. Findings suggest that we will be able to leverage the UMLS in development of natural language processing algorithms for automated extraction of answers to translational research questions from biomedical text in the area of genomic medicine

Knowledge-based biomedical word sense disambiguation: comparison of approaches

<p>Abstract</p> <p>Background</p> <p>Word sense disambiguation (WSD) algorithms attempt to select the proper sense of ambiguous terms in text. Resources like the UMLS provide a reference thesaurus to be used to annotate the biomedical literature. Statistical learning approaches have produced good results, but the size of the UMLS makes the production of training data infeasible to cover all the domain.</p> <p>Methods</p> <p>We present research on existing WSD approaches based on knowledge bases, which complement the studies performed on statistical learning. We compare four approaches which rely on the UMLS Metathesaurus as the source of knowledge. The first approach compares the overlap of the context of the ambiguous word to the candidate senses based on a representation built out of the definitions, synonyms and related terms. The second approach collects training data for each of the candidate senses to perform WSD based on queries built using monosemous synonyms and related terms. These queries are used to retrieve MEDLINE citations. Then, a machine learning approach is trained on this corpus. The third approach is a graph-based method which exploits the structure of the Metathesaurus network of relations to perform unsupervised WSD. This approach ranks nodes in the graph according to their relative structural importance. The last approach uses the semantic types assigned to the concepts in the Metathesaurus to perform WSD. The context of the ambiguous word and semantic types of the candidate concepts are mapped to Journal Descriptors. These mappings are compared to decide among the candidate concepts. Results are provided estimating accuracy of the different methods on the WSD test collection available from the NLM.</p> <p>Conclusions</p> <p>We have found that the last approach achieves better results compared to the other methods. The graph-based approach, using the structure of the Metathesaurus network to estimate the relevance of the Metathesaurus concepts, does not perform well compared to the first two methods. In addition, the combination of methods improves the performance over the individual approaches. On the other hand, the performance is still below statistical learning trained on manually produced data and below the maximum frequency sense baseline. Finally, we propose several directions to improve the existing methods and to improve the Metathesaurus to be more effective in WSD.</p

Developing techniques for enhancing comprehensibility of controlled medical terminologies

A controlled medical terminology (CMT) is a collection of concepts (or terms) that are used in the medical domain. Typically, a CMT also contains attributes of those concepts and/or relationships between those concepts. Electronic CMTs are extremely useful and important for communication between and integration of independent information systems in healthcare, because data in this area is highly fragmented. A single query in this area might involve several databases, e.g., a clinical database, a pharmacy database, a radiology database, and a lab test database. Unfortunately, the extensive sizes of CMTs, often containing tens of thousands of concepts and hundreds of thousands of relationships between pairs of those concepts, impose steep learning curves for new users of such CMTs. In this dissertation, we address the problem of helping a user to orient himself in an existing large CMT. In order to help a user comprehend a large, complex CMT, we need to provide abstract views of the CMT. However, at this time, no tools exist for providing a user with such abstract views. One reason for the lack of tools is the absence of a good theory on how to partition an overwhelming CMT into manageable pieces. In this dissertation, we try to overcome the described problem by using a threepronged approach. (1) We use the power of Object-Oriented Databases to design a schema extraction process for large, complex CMTs. The schema resulting from this process provides an excellent, compact representation of the CMT. (2) We develop a theory and a methodology for partitioning a large OODI3 schema, modeled as a graph, into small meaningful units. The methodology relies on the interaction between a human and a computer, making optimal use of the human\u27s semantic knowledge and the computer\u27s speed. Furthermore, the theory and methodology developed for the scbemalevel partitioning are also adapted to the object-level of a CMT. (3) We use purely structural similarities for partitioning CMTs, eliminating the need for a human expert in the partitioning methodology mentioned above. Two large medical terminologies are used as our test beds, the Medical Entities Dictionary (MED) and the Unified Medical Language System (UMLS), which itself contains a number of terminologies

Information extraction from medication leaflets

Tese de mestrado integrado. Engenharia Informática e Computação. Faculdade de Engenharia. Universidade do Porto. 201

Using structural and semantic methodologies to enhance biomedical terminologies

Biomedical terminologies and ontologies underlie various Health Information Systems (HISs), Electronic Health Record (EHR) Systems, Health Information Exchanges (HIEs) and health administrative systems. Moreover, the proliferation of interdisciplinary research efforts in the biomedical field is fueling the need to overcome terminological barriers when integrating knowledge from different fields into a unified research project. Therefore well-developed and well-maintained terminologies are in high demand. Most of the biomedical terminologies are large and complex, which makes it impossible for human experts to manually detect and correct all errors and inconsistencies. Automated and semi-automated Quality Assurance methodologies that focus on areas that are more likely to contain errors and inconsistencies are therefore important. In this dissertation, structural and semantic methodologies are used to enhance biomedical terminologies. The dissertation work is divided into three major parts. The first part consists of structural auditing techniques for the Semantic Network of the Unified Medical Language System (UMLS), which serves as a vocabulary knowledge base for biomedical research in various applications. Research techniques are presented on how to automatically identify and prevent erroneous semantic type assignments to concepts. The Web-based adviseEditor system is introduced to help UMLS editors to make correct multiple semantic type assignments to concepts. It is made available to the National Library of Medicine for future use in maintaining the UMLS. The second part of this dissertation is on how to enhance the conceptual content of SNOMED CT by methods of semantic harmonization. By 2015, SNOMED will become the standard terminology for EH R encoding of diagnoses and problem lists. In order to enrich the semantics and coverage of SNOMED CT for clinical and research applications, the problem of semantic harmonization between SNOMED CT and six reference terminologies is approached by 1) comparing the vertical density of SNOM ED CT with the reference terminologies to find potential concepts for export and import; and 2) categorizing the relationships between structurally congruent concepts from pairs of terminologies, with SNOMED CT being one terminology in the pair. Six kinds of configurations are observed, e.g., alternative classifications, and suggested synonyms. For each configuration, a corresponding solution is presented for enhancing one or both of the terminologies. The third part applies Quality Assurance techniques based on “Abstraction Networks” to biomedical ontologies in BioPortal. The National Center for Biomedical Ontology provides B ioPortal as a repository of over 350 biomedical ontologies covering a wide range of domains. It is extremely difficult to design a new Quality Assurance methodology for each ontology in BioPortal. Fortunately, groups of ontologies in BioPortal share common structural features. Thus, they can be grouped into families based on combinations of these features. A uniform Quality Assurance methodology design for each family will achieve improved efficiency, which is critical with the limited Quality Assurance resources available to most ontology curators. In this dissertation, a family-based framework covering 186 BioPortal ontologies and accompanying Quality Assurance methods based on abstraction networks are presented to tackle this problem

Unsupervised grammar induction of clinical report sublanguage

BACKGROUND: Clinical reports are written using a subset of natural language while employing many domain-specific terms; such a language is also known as a sublanguage for a scientific or a technical domain. Different genres of clinical reports use different sublaguages, and in addition, different medical facilities use different medical language conventions. This makes supervised training of a parser for clinical sentences very difficult as it would require expensive annotation effort to adapt to every type of clinical text. METHODS: In this paper, we present an unsupervised method which automatically induces a grammar and a parser for the sublanguage of a given genre of clinical reports from a corpus with no annotations. In order to capture sentence structures specific to clinical domains, the grammar is induced in terms of semantic classes of clinical terms in addition to part-of-speech tags. Our method induces grammar by minimizing the combined encoding cost of the grammar and the corresponding sentence derivations. The probabilities for the productions of the induced grammar are then learned from the unannotated corpus using an instance of the expectation-maximization algorithm. RESULTS: Our experiments show that the induced grammar is able to parse novel sentences. Using a dataset of discharge summary sentences with no annotations, our method obtains 60.5% F-measure for parse-bracketing on sentences of maximum length 10. By varying a parameter, the method can induce a range of grammars, from very specific to very general, and obtains the best performance in between the two extremes

Knowledge-based Biomedical Data Science 2019

Knowledge-based biomedical data science (KBDS) involves the design and implementation of computer systems that act as if they knew about biomedicine. Such systems depend on formally represented knowledge in computer systems, often in the form of knowledge graphs. Here we survey the progress in the last year in systems that use formally represented knowledge to address data science problems in both clinical and biological domains, as well as on approaches for creating knowledge graphs. Major themes include the relationships between knowledge graphs and machine learning, the use of natural language processing, and the expansion of knowledge-based approaches to novel domains, such as Chinese Traditional Medicine and biodiversity.Comment: Manuscript 43 pages with 3 tables; Supplemental material 43 pages with 3 table

Utilizing Consumer Health Posts for Pharmacovigilance: Identifying Underlying Factors Associated with Patients’ Attitudes Towards Antidepressants

Non-adherence to antidepressants is a major obstacle to antidepressants therapeutic benefits, resulting in increased risk of relapse, emergency visits, and significant burden on individuals and the healthcare system. Several studies showed that non-adherence is weakly associated with personal and clinical variables, but strongly associated with patients’ beliefs and attitudes towards medications. The traditional methods for identifying the key dimensions of patients’ attitudes towards antidepressants are associated with some methodological limitations, such as concern about confidentiality of personal information. In this study, attempts have been made to address the limitations by utilizing patients’ self report experiences in online healthcare forums to identify underlying factors affecting patients attitudes towards antidepressants. The data source of the study was a healthcare forum called “askapatients.com”. 892 patients’ reviews were randomly collected from the forum for the four most commonly prescribed antidepressants including Sertraline (Zoloft) and Escitalopram (Lexapro) from SSRI class, and Venlafaxine (Effexor) and duloxetine (Cymbalta) from SNRI class. Methodology of this study is composed of two main phases: I) generating structured data from unstructured patients’ drug reviews and testing hypotheses concerning attitude, II) identification and normalization of Adverse Drug Reactions (ADRs), Withdrawal Symptoms (WDs) and Drug Indications (DIs) from the posts, and mapping them to both The UMLS and SNOMED CT concepts. Phase II also includes testing the association between ADRs and attitude. The result of the first phase of this study showed that “experience of adverse drug reactions”, “perceived distress received from ADRs”, “lack of knowledge about medication’s mechanism”, “withdrawal experience”, “duration of usage”, and “drug effectiveness” are strongly associated with patients attitudes. However, demographic variables including “age” and “gender” are not associated with attitude. Analysis of the data in second phase of the study showed that from 6,534 identified entities, 73% are ADRs, 12% are WDs, and 15 % are drug indications. In addition, psychological and cognitive expressions have higher variability than physiological expressions. All three types of entities were mapped to 811 UMLS and SNOMED CT concepts. Testing the association between ADRs and attitude showed that from twenty-one physiological ADRs specified in the ASEC questionnaire, “dry mouth”, “increased appetite”, “disorientation”, “yawning”, “weight gain”, and “problem with sexual dysfunction” are associated with attitude. A set of psychological and cognitive ADRs, such as “emotional indifference” and “memory problem were also tested that showed significance association between these types of ADRs and attitude. The findings of this study have important implications for designing clinical interventions aiming to improve patients\u27 adherence towards antidepressants. In addition, the dataset generated in this study has significant implications for improving performance of text-mining algorithms aiming to identify health related information from consumer health posts. Moreover, the dataset can be used for generating and testing hypotheses related to ADRs associated with psychiatric mediations, and identifying factors associated with discontinuation of antidepressants. The dataset and guidelines of this study are available at https://sites.google.com/view/pharmacovigilanceinpsychiatry/hom