A context-blocks model for identifying clinical relationships in patient records

Clinical named entity recognition and relation extraction using natural language processing of medical free text: A systematic review

BACKGROUND

Natural Language Processing (NLP) applications have developed over the past years in various fields including its application to clinical free text for named entity recognition and relation extraction. However, there has been rapid developments the last few years that there's currently no overview of it. Moreover, it is unclear how these models and tools have been translated into clinical practice. We aim to synthesize and review these developments.

METHODS

We reviewed literature from 2010 to date, searching PubMed, Scopus, the Association of Computational Linguistics (ACL), and Association of Computer Machinery (ACM) libraries for studies of NLP systems performing general-purpose (i.e., not disease- or treatment-specific) information extraction and relation extraction tasks in unstructured clinical text (e.g., discharge summaries).

RESULTS

We included in the review 94 studies with 30 studies published in the last three years. Machine learning methods were used in 68 studies, rule-based in 5 studies, and both in 22 studies. 63 studies focused on Named Entity Recognition, 13 on Relation Extraction and 18 performed both. The most frequently extracted entities were "problem", "test" and "treatment". 72 studies used public datasets and 22 studies used proprietary datasets alone. Only 14 studies defined clearly a clinical or information task to be addressed by the system and just three studies reported its use outside the experimental setting. Only 7 studies shared a pre-trained model and only 8 an available software tool.

DISCUSSION

Machine learning-based methods have dominated the NLP field on information extraction tasks. More recently, Transformer-based language models are taking the lead and showing the strongest performance. However, these developments are mostly based on a few datasets and generic annotations, with very few real-world use cases. This may raise questions about the generalizability of findings, translation into practice and highlights the need for robust clinical evaluation.

Annotation and detection of drug effects in text for pharmacovigilance

Pharmacovigilance (PV) databases record the benefits and risks of different drugs, as a means to ensure their safe and effective use. Creating and maintaining such resources can be complex, since a particular medication may have divergent effects in different individuals, due to specific patient characteristics and/or interactions with other drugs being administered. Textual information from various sources can provide important evidence to curators of PV databases about the usage and effects of drug targets in different medical subjects. However, the efficient identification of relevant evidence can be challenging, due to the increasing volume of textual data. Text mining (TM) techniques can support curators by automatically detecting complex information, such as interactions between drugs, diseases and adverse effects. This semantic information supports the quick identification of documents containing information of interest (e.g., the different types of patients in which a given adverse drug reaction has been observed to occur). TM tools are typically adapted to different domains by applying machine learning methods to corpora that are manually labelled by domain experts using annotation guidelines to ensure consistency. We present a semantically annotated corpus of 597 MEDLINE abstracts, PHAEDRA, encoding rich information on drug effects and their interactions, whose quality is assured through the use of detailed annotation guidelines and the demonstration of high levels of inter-annotator agreement (e.g., 92.6% F-Score for identifying named entities and 78.4% F-Score for identifying complex events, when relaxed matching criteria are applied). To our knowledge, the corpus is unique in the domain of PV, according to the level of detail of its annotations. To illustrate the utility of the corpus, we have trained TM tools based on its rich labels to recognise drug effects in text automatically. The corpus and annotation guidelines are available at: http://www.nactem.ac.uk/PHAEDRA/ .

Adverse Drug Reaction Identification and Extraction in Social Media: A Scoping Review

BACKGROUND

The underreporting of adverse drug reactions (ADRs) through traditional reporting channels is a limitation in the efficiency of the current pharmacovigilance system. Patients' experiences with drugs that they report on social media represent a new source of data that may have some value in postmarketing safety surveillance.

OBJECTIVE

A scoping review was undertaken to explore the breadth of evidence about the use of social media as a new source of knowledge for pharmacovigilance.

METHODS

Daubt et al's recommendations for scoping reviews were followed. The research questions were as follows: How can social media be used as a data source for postmarketing drug surveillance? What are the available methods for extracting data? What are the different ways to use these data? We queried PubMed, Embase, and Google Scholar to extract relevant articles that were published before June 2014 and with no lower date limit. Two pairs of reviewers independently screened the selected studies and proposed two themes of review: manual ADR identification (theme 1) and automated ADR extraction from social media (theme 2). Descriptive characteristics were collected from the publications to create a database for themes 1 and 2.

RESULTS

Of the 1032 citations from PubMed and Embase, 11 were relevant to the research question. An additional 13 citations were added after further research on the Internet and in reference lists. Themes 1 and 2 explored 11 and 13 articles, respectively. Ways of approaching the use of social media as a pharmacovigilance data source were identified.

CONCLUSIONS

This scoping review noted multiple methods for identifying target data, extracting them, and evaluating the quality of medical information from social media. It also showed some remaining gaps in the field. Studies related to the identification theme usually failed to accurately assess the completeness, quality, and reliability of the data that were analyzed from social media. Regarding extraction, no study proposed a generic approach to easily adding a new site or data source. Additional studies are required to precisely determine the role of social media in the pharmacovigilance system.

SimConcept: a hybrid approach for simplifying composite named entities in biomedical text

One particular challenge in biomedical named entity recognition (NER) and normalization is the identification and resolution of composite named entities, where a single span refers to more than one concept (e.g., BRCA1/2). Previous NER and normalization studies have either ignored composite mentions, used simple ad hoc rules, or only handled coordination ellipsis, making a robust approach for handling multitype composite mentions greatly needed. To this end, we propose a hybrid method integrating a machine-learning model with a pattern identification strategy to identify the individual components of each composite mention. Our method, which we have named SimConcept, is the first to systematically handle many types of composite mentions. The technique achieves high performance in identifying and resolving composite mentions for three key biological entities: genes (90.42% in F-measure), diseases (86.47% in F-measure), and chemicals (86.05% in F-measure). Furthermore, our results show that using our SimConcept method can subsequently improve the performance of gene and disease concept recognition and normalization. SimConcept is available for download at: http://www.ncbi.nlm.nih.gov/CBBresearch/Lu/Demo/SimConcept/.

Crowdsourcing in biomedicine: challenges and opportunities

The use of crowdsourcing to solve important but complex problems in biomedical and clinical sciences is growing and encompasses a wide variety of approaches. The crowd is diverse and includes online marketplace workers, health information seekers, science enthusiasts and domain experts. In this article, we review and highlight recent studies that use crowdsourcing to advance biomedicine. We classify these studies into two broad categories: (i) mining big data generated from a crowd (e.g. search logs) and (ii) active crowdsourcing via specific technical platforms, e.g. labor markets, wikis, scientific games and community challenges. Through describing each study in detail, we demonstrate the applicability of different methods in a variety of domains in biomedical research, including genomics, biocuration and clinical research. Furthermore, we discuss and highlight the strengths and limitations of different crowdsourcing platforms. Finally, we identify important emerging trends, opportunities and remaining challenges for future crowdsourcing research in biomedicine.

tmBioC: improving interoperability of text-mining tools with BioC

The lack of interoperability among biomedical text-mining tools is a major bottleneck in creating more complex applications. Despite the availability of numerous methods and techniques for various text-mining tasks, combining different tools requires substantial efforts and time owing to heterogeneity and variety in data formats. In response, BioC is a recent proposal that offers a minimalistic approach to tool interoperability by stipulating minimal changes to existing tools and applications. BioC is a family of XML formats that define how to present text documents and annotations, and also provides easy-to-use functions to read/write documents in the BioC format. In this study, we introduce our text-mining toolkit, which is designed to perform several challenging and significant tasks in the biomedical domain, and repackage the toolkit into BioC to enhance its interoperability. Our toolkit consists of six state-of-the-art tools for named-entity recognition, normalization and annotation (PubTator) of genes (GenNorm), diseases (DNorm), mutations (tmVar), species (SR4GN) and chemicals (tmChem). Although developed within the same group, each tool is designed to process input articles and output annotations in a different format. We modify these tools and enable them to read/write data in the proposed BioC format. We find that, using the BioC family of formats and functions, only minimal changes were required to build the newer versions of the tools. The resulting BioC wrapped toolkit, which we have named tmBioC, consists of our tools in BioC, an annotated full-text corpus in BioC, and a format detection and conversion tool. Furthermore, through participation in the 2013 BioCreative IV Interoperability Track, we empirically demonstrate that the tools in tmBioC can be more efficiently integrated with each other as well as with external tools: Our experimental results show that using BioC reduces >60% in lines of code for text-mining tool integration. The tmBioC toolkit is publicly available at http://www.ncbi.nlm.nih.gov/CBBresearch/Lu/Demo/tmTools/. Database URL: http://www.ncbi.nlm.nih.gov/CBBresearch/Lu/Demo/tmTools/.

Knowledge-based extraction of adverse drug events from biomedical text

Background

Many biomedical relation extraction systems are machine-learning based and have to be trained on large annotated corpora that are expensive and cumbersome to construct. We developed a knowledge-based relation extraction system that requires minimal training data, and applied the system for the extraction of adverse drug events from biomedical text. The system consists of a concept recognition module that identifies drugs and adverse effects in sentences, and a knowledge-base module that establishes whether a relation exists between the recognized concepts. The knowledge base was filled with information from the Unified Medical Language System. The performance of the system was evaluated on the ADE corpus, consisting of 1644 abstracts with manually annotated adverse drug events. Fifty abstracts were used for training, the remaining abstracts were used for testing.

Results

The knowledge-based system obtained an F-score of 50.5%, which was 34.4 percentage points better than the co-occurrence baseline. Increasing the training set to 400 abstracts improved the F-score to 54.3%. When the system was compared with a machine-learning system, jSRE, on a subset of the sentences in the ADE corpus, our knowledge-based system achieved an F-score that is 7 percentage points higher than the F-score of jSRE trained on 50 abstracts, and still 2 percentage points higher than jSRE trained on 90% of the corpus.

Conclusion

A knowledge-based approach can be successfully used to extract adverse drug events from biomedical text without need for a large training set. Whether use of a knowledge base is equally advantageous for other biomedical relation-extraction tasks remains to be investigated.

NCBI disease corpus: a resource for disease name recognition and concept normalization

Information encoded in natural language in biomedical literature publications is only useful if efficient and reliable ways of accessing and analyzing that information are available. Natural language processing and text mining tools are therefore essential for extracting valuable information, however, the development of powerful, highly effective tools to automatically detect central biomedical concepts such as diseases is conditional on the availability of annotated corpora. This paper presents the disease name and concept annotations of the NCBI disease corpus, a collection of 793 PubMed abstracts fully annotated at the mention and concept level to serve as a research resource for the biomedical natural language processing community. Each PubMed abstract was manually annotated by two annotators with disease mentions and their corresponding concepts in Medical Subject Headings (MeSH®) or Online Mendelian Inheritance in Man (OMIM®). Manual curation was performed using PubTator, which allowed the use of pre-annotations as a pre-step to manual annotations. Fourteen annotators were randomly paired and differing annotations were discussed for reaching a consensus in two annotation phases. In this setting, a high inter-annotator agreement was observed. Finally, all results were checked against annotations of the rest of the corpus to assure corpus-wide consistency. The public release of the NCBI disease corpus contains 6892 disease mentions, which are mapped to 790 unique disease concepts. Of these, 88% link to a MeSH identifier, while the rest contain an OMIM identifier. We were able to link 91% of the mentions to a single disease concept, while the rest are described as a combination of concepts. In order to help researchers use the corpus to design and test disease identification methods, we have prepared the corpus as training, testing and development sets. To demonstrate its utility, we conducted a benchmarking experiment where we compared three different knowledge-based disease normalization methods with a best performance in F-measure of 63.7%. These results show that the NCBI disease corpus has the potential to significantly improve the state-of-the-art in disease name recognition and normalization research, by providing a high-quality gold standard thus enabling the development of machine-learning based approaches for such tasks. The NCBI disease corpus, guidelines and other associated resources are available at: http://www.ncbi.nlm.nih.gov/CBBresearch/Dogan/DISEASE/.

SimConcept: A Hybrid Approach for Simplifying Composite Named Entities in Biomedicine

Many text-mining studies have focused on the issue of named entity recognition and normalization, especially in the field of biomedical natural language processing. However, entity recognition is a complicated and difficult task in biomedical text. One particular challenge is to identify and resolve composite named entities, where a single span refers to more than one concept(e.g., BRCA1/2). Most bioconcept recognition and normalization studies have either ignored this issue, used simple ad-hoc rules, or only handled coordination ellipsis, which is only one of the many types of composite mentions studied in this work. No systematic methods for simplifying composite mentions have been previously reported, making a robust approach greatly needed. To this end, we propose a hybrid approach by integrating a machine learning model with a pattern identification strategy to identify the antecedent and conjuncts regions of a concept mention, and then reassemble the composite mention using those identified regions. Our method, which we have named SimConcept, is the first method to systematically handle most types of composite mentions. Our method achieves high performance in identifying and resolving composite mentions for three fundamental biological entities: genes (89.29% in F-measure), diseases (85.52% in F-measure) and chemicals (84.04% in F-measure). Furthermore, our results show that, using our SimConcept method can subsequently help improve the performance of gene and disease concept recognition and normalization.

Joint segmentation and named entity recognition using dual decomposition in Chinese discharge summaries

OBJECTIVE

In this paper, we focus on three aspects: (1) to annotate a set of standard corpus in Chinese discharge summaries; (2) to perform word segmentation and named entity recognition in the above corpus; (3) to build a joint model that performs word segmentation and named entity recognition.

DESIGN

Two independent systems of word segmentation and named entity recognition were built based on conditional random field models. In the field of natural language processing, while most approaches use a single model to predict outputs, many works have proved that performance of many tasks can be improved by exploiting combined techniques. Therefore, in this paper, we proposed a joint model using dual decomposition to perform both the two tasks in order to exploit correlations between the two tasks. Three sets of features were designed to demonstrate the advantage of the joint model we proposed, compared with independent models, incremental models and a joint model trained on combined labels.

MEASUREMENTS

Micro-averaged precision (P), recall (R), and F-measure (F) were used to evaluate results.

RESULTS

The gold standard corpus is created using 336 Chinese discharge summaries of 71 355 words. The framework using dual decomposition achieved 0.2% improvement for segmentation and 1% improvement for recognition, compared with each of the two tasks alone.

CONCLUSIONS

The joint model is efficient and effective in both segmentation and recognition compared with the two individual tasks. The model achieved encouraging results, demonstrating the feasibility of the two tasks.

Mining the pharmacogenomics literature--a survey of the state of the art

This article surveys efforts on text mining of the pharmacogenomics literature, mainly from the period 2008 to 2011. Pharmacogenomics (or pharmacogenetics) is the field that studies how human genetic variation impacts drug response. Therefore, publications span the intersection of research in genotypes, phenotypes and pharmacology, a topic that has increasingly become a focus of active research in recent years. This survey covers efforts dealing with the automatic recognition of relevant named entities (e.g. genes, gene variants and proteins, diseases and other pathological phenomena, drugs and other chemicals relevant for medical treatment), as well as various forms of relations between them. A wide range of text genres is considered, such as scientific publications (abstracts, as well as full texts), patent texts and clinical narratives. We also discuss infrastructure and resources needed for advanced text analytics, e.g. document corpora annotated with corresponding semantic metadata (gold standards and training data), biomedical terminologies and ontologies providing domain-specific background knowledge at different levels of formality and specificity, software architectures for building complex and scalable text analytics pipelines and Web services grounded to them, as well as comprehensive ways to disseminate and interact with the typically huge amounts of semiformal knowledge structures extracted by text mining tools. Finally, we consider some of the novel applications that have already been developed in the field of pharmacogenomic text mining and point out perspectives for future research.