Roland Roller

Florian Borchert, Ignacio Llorca, Roland Roller et al.

Objective: To improve performance of medical entity normalization across many languages, especially when fewer language resources are available compared to English. Materials and Methods: We introduce xMEN, a modular system for cross-lingual medical entity normalization, which performs well in both low- and high-resource scenarios. When synonyms in the target language are scarce for a given terminology, we leverage English aliases via cross-lingual candidate generation. For candidate ranking, we incorporate a trainable cross-encoder model if annotations for the target task are available. We also evaluate cross-encoders trained in a weakly supervised manner based on machine-translated datasets from a high resource domain. Our system is publicly available as an extensible Python toolkit. Results: xMEN improves the state-of-the-art performance across a wide range of multilingual benchmark datasets. Weakly supervised cross-encoders are effective when no training data is available for the target task. Through the compatibility of xMEN with the BigBIO framework, it can be easily used with existing and prospective datasets. Discussion: Our experiments show the importance of balancing the output of general-purpose candidate generators with subsequent trainable re-rankers, which we achieve through a rank regularization term in the loss function of the cross-encoder. However, error analysis reveals that multi-word expressions and other complex entities are still challenging. Conclusion: xMEN exhibits strong performance for medical entity normalization in multiple languages, even when no labeled data and few terminology aliases for the target language are available. Its configuration system and evaluation modules enable reproducible benchmarks. Models and code are available online at the following URL: https://github.com/hpi-dhc/xmen

Roland Roller, Klemens Budde, Aljoscha Burchardt et al.

Scientific publications about machine learning in healthcare are often about implementing novel methods and boosting the performance - at least from a computer science perspective. However, beyond such often short-lived improvements, much more needs to be taken into consideration if we want to arrive at a sustainable progress in healthcare. What does it take to actually implement such a system, make it usable for the domain expert, and possibly bring it into practical usage? Targeted at Computer Scientists, this work presents a multidisciplinary view on machine learning in medical decision support systems and covers information technology, medical, as well as ethical aspects. Along with an implemented risk prediction system in nephrology, challenges and lessons learned in a pilot project are presented.

Roland Roller, Laura Seiffe, Ammer Ayach et al.

Background: In the information extraction and natural language processing domain, accessible datasets are crucial to reproduce and compare results. Publicly available implementations and tools can serve as benchmark and facilitate the development of more complex applications. However, in the context of clinical text processing the number of accessible datasets is scarce -- and so is the number of existing tools. One of the main reasons is the sensitivity of the data. This problem is even more evident for non-English languages. Approach: In order to address this situation, we introduce a workbench: a collection of German clinical text processing models. The models are trained on a de-identified corpus of German nephrology reports. Result: The presented models provide promising results on in-domain data. Moreover, we show that our models can be also successfully applied to other biomedical text in German. Our workbench is made publicly available so it can be used out of the box, as a benchmark or transferred to related problems.

Lisa Raithel, Philippe Thomas, Roland Roller et al.

In this work, we present the first corpus for German Adverse Drug Reaction (ADR) detection in patient-generated content. The data consists of 4,169 binary annotated documents from a German patient forum, where users talk about health issues and get advice from medical doctors. As is common in social media data in this domain, the class labels of the corpus are very imbalanced. This and a high topic imbalance make it a very challenging dataset, since often, the same symptom can have several causes and is not always related to a medication intake. We aim to encourage further multi-lingual efforts in the domain of ADR detection and provide preliminary experiments for binary classification using different methods of zero- and few-shot learning based on a multi-lingual model. When fine-tuning XLM-RoBERTa first on English patient forum data and then on the new German data, we achieve an F1-score of 37.52 for the positive class. We make the dataset and models publicly available for the community.

Iyadh Ben Cheikh Larbi, Aljoscha Burchardt, Roland Roller

Clinical text processing has gained more and more attention in recent years. The access to sensitive patient data, on the other hand, is still a big challenge, as text cannot be shared without legal hurdles and without removing personal information. There are many techniques to modify or remove patient related information, each with different strengths. This paper investigates the influence of different anonymization techniques on the performance of ML models using multiple datasets corresponding to five different NLP tasks. Several learnings and recommendations are presented. This work confirms that particularly stronger anonymization techniques lead to a significant drop of performance. In addition to that, most of the presented techniques are not secure against a re-identification attack based on similarity search.

Aditya Kumar, Simon Rauch, Mario Cypko et al.

We introduce Temporal Fusion Nexus (TFN), a multi-modal and task-agnostic embedding model to integrate irregular time series and unstructured clinical narratives. We analysed TFN in post-kidney transplant (KTx) care, with a retrospective cohort of 3382 patients, on three key outcomes: graft loss, graft rejection, and mortality. Compared to state-of-the-art model in post KTx care, TFN achieved higher performance for graft loss (AUC 0.96 vs. 0.94) and graft rejection (AUC 0.84 vs. 0.74). In mortality prediction, TFN yielded an AUC of 0.86. TFN outperformed unimodal baselines (approx 10% AUC improvement over time series only baseline, approx 5% AUC improvement over time series with static patient data). Integrating clinical text improved performance across all tasks. Disentanglement metrics confirmed robust and interpretable latent factors in the embedding space, and SHAP-based attributions confirmed alignment with clinical reasoning. TFN has potential application in clinical tasks beyond KTx, where heterogeneous data sources, irregular longitudinal data, and rich narrative documentation are available.

Mohammed Bin Sumait, Aleksandra Gabryszak, Leonhard Hennig et al.

Factuality can play an important role when automatically processing clinical text, as it makes a difference if particular symptoms are explicitly not present, possibly present, not mentioned, or affirmed. In most cases, a sufficient number of examples is necessary to handle such phenomena in a supervised machine learning setting. However, as clinical text might contain sensitive information, data cannot be easily shared. In the context of factuality detection, this work presents a simple solution using machine translation to translate English data to German to train a transformer-based factuality detection model.

Ibrahim Baroud, Christoph Otto, Vera Czehmann et al.

Accessing sensitive patient data for machine learning is challenging due to privacy concerns. Datasets with annotations of personally identifiable information are crucial for developing and testing anonymization systems to enable safe data sharing that complies with privacy regulations. Since accessing real patient data is a bottleneck, synthetic data offers an efficient solution for data scarcity, bypassing privacy regulations that apply to real data. Moreover, neural machine translation can help to create high-quality data for low-resource languages by translating validated real or synthetic data from a high-resource language. In this work, we create a multilingual anonymization benchmark in ten languages, using a machine translation methodology that preserves the original annotations and renders names of cities and people in a culturally and contextually appropriate form in each target language. Our evaluation study with medical professionals confirms the quality of the translations, both in general and with respect to the translation and adaptation of personal information. Our benchmark with over 2,500 annotations of personal information can be used in many applications, including training annotators, validating annotations across institutions without legal complications, and helping improve the performance of automatic personal information detection. We make our benchmark and annotation guidelines available for further research.

Johannes Kirschnick, Philippe Thomas, Roland Roller et al.

Recent years showed a strong increase in biomedical sciences and an inherent increase in publication volume. Extraction of specific information from these sources requires highly sophisticated text mining and information extraction tools. However, the integration of freely available tools into customized workflows is often cumbersome and difficult. We describe SIA (Scalable Interoperable Annotation Server), our contribution to the BeCalm-Technical interoperability and performance of annotation servers (BeCalm-TIPS) task, a scalable, extensible, and robust annotation service. The system currently covers six named entity types (i.e., Chemicals, Diseases, Genes, miRNA, Mutations, and Organisms) and is freely available under Apache 2.0 license at https://github.com/Erechtheus/sia.

Lisa Raithel, Hui-Syuan Yeh, Shuntaro Yada et al.

User-generated data sources have gained significance in uncovering Adverse Drug Reactions (ADRs), with an increasing number of discussions occurring in the digital world. However, the existing clinical corpora predominantly revolve around scientific articles in English. This work presents a multilingual corpus of texts concerning ADRs gathered from diverse sources, including patient fora, social media, and clinical reports in German, French, and Japanese. Our corpus contains annotations covering 12 entity types, four attribute types, and 13 relation types. It contributes to the development of real-world multilingual language models for healthcare. We provide statistics to highlight certain challenges associated with the corpus and conduct preliminary experiments resulting in strong baselines for extracting entities and relations between these entities, both within and across languages.

Ibrahim Baroud, Lisa Raithel, Sebastian Möller et al.

Sharing sensitive texts for scientific purposes requires appropriate techniques to protect the privacy of patients and healthcare personnel. Anonymizing textual data is particularly challenging due to the presence of diverse unstructured direct and indirect identifiers. To mitigate the risk of re-identification, this work introduces a schema of nine categories of indirect identifiers designed to account for different potential adversaries, including acquaintances, family members and medical staff. Using this schema, we annotate 100 MIMIC-III discharge summaries and propose baseline models for identifying indirect identifiers. We will release the annotation guidelines, annotation spans (6,199 annotations in total) and the corresponding MIMIC-III document IDs to support further research in this area.

Daniel Röder, Akhil Juneja, Roland Roller et al.

Web agents powered by large language models (LLMs) can autonomously perform complex, multistep tasks in dynamic web environments. However, current evaluations mostly focus on the overall success while overlooking intermediate errors. This limits insight into failure modes and hinders systematic improvement. This work analyzes existing benchmarks and highlights the lack of fine-grained diagnostic tools. To address this gap, we propose a modular evaluation framework that decomposes agent pipelines into interpretable stages for detailed error analysis. Using the SeeAct framework and the Mind2Web dataset as a case study, we show how this approach reveals actionable weaknesses missed by standard metrics - paving the way for more robust and generalizable web agents.

Iyadh Ben Cheikh Larbi, Ajay Madhavan Ravichandran, Aljoscha Burchardt et al.

Large language models (LLMs) excel at text generation, but their ability to handle clinical classification tasks involving structured data, such as time series, remains underexplored. In this work, we adapt instruction-tuned LLMs using DSPy-based prompt optimization to process clinical notes and structured EHR inputs jointly. Our results show that this approach achieves performance on par with specialized multimodal systems while requiring less complexity and offering greater adaptability across tasks.

Johann Frei, Nils Feldhus, Lisa Raithel et al.

For clinical data integration and healthcare services, the HL7 FHIR standard has established itself as a desirable format for interoperability between complex health data. Previous attempts at automating the translation from free-form clinical notes into structured FHIR resources rely on modular, rule-based systems or LLMs with instruction tuning and constrained decoding. Since they frequently suffer from limited generalizability and structural inconformity, we propose an end-to-end framework powered by LLM agents, code execution, and healthcare terminology database tools to address these issues. Our solution, called Infherno, is designed to adhere to the FHIR document schema and competes well with a human baseline in predicting FHIR resources from unstructured text. The implementation features a front end for custom and synthetic data and both local and proprietary models, supporting clinical data integration processes and interoperability across institutions.

Roland Roller, Michael Hahn, Ajay Madhavan Ravichandran et al.

Machine learning (ML) models are increasingly used to support clinical decision-making. However, real-world medical datasets are often noisy, incomplete, and imbalanced, leading to performance disparities across patient subgroups. These differences raise fairness concerns, particularly when they reinforce existing disadvantages for marginalized groups. In this work, we analyze several medical prediction tasks and demonstrate how model performance varies with patient characteristics. While ML models may demonstrate good overall performance, we argue that subgroup-level evaluation is essential before integrating them into clinical workflows. By conducting a performance analysis at the subgroup level, differences can be clearly identified-allowing, on the one hand, for performance disparities to be considered in clinical practice, and on the other hand, for these insights to inform the responsible development of more effective models. Thereby, our work contributes to a practical discussion around the subgroup-sensitive development and deployment of medical ML models and the interconnectedness of fairness and transparency.

Laura Seiffe, Oliver Marten, Michael Mikhailov et al.

Many people share information in social media or forums, like food they eat, sports activities they do or events which have been visited. This also applies to information about a person's health status. Information we share online unveils directly or indirectly information about our lifestyle and health situation and thus provides a valuable data resource. If we can make advantage of that data, applications can be created that enable e.g. the detection of possible risk factors of diseases or adverse drug reactions of medications. However, as most people are not medical experts, language used might be more descriptive rather than the precise medical expression as medics do. To detect and use those relevant information, laymen language has to be translated and/or linked to the corresponding medical concept. This work presents baseline data sources in order to address this challenge for German. We introduce a new data set which annotates medical laymen and technical expressions in a patient forum, along with a set of medical synonyms and definitions, and present first baseline results on the data.

Roland Roller, Madeleine Kittner, Dirk Weissenborn et al.

Biomedical concept normalization links concept mentions in texts to a semantically equivalent concept in a biomedical knowledge base. This task is challenging as concepts can have different expressions in natural languages, e.g. paraphrases, which are not necessarily all present in the knowledge base. Concept normalization of non-English biomedical text is even more challenging as non-English resources tend to be much smaller and contain less synonyms. To overcome the limitations of non-English terminologies we propose a cross-lingual candidate search for concept normalization using a character-based neural translation model trained on a multilingual biomedical terminology. Our model is trained with Spanish, French, Dutch and German versions of UMLS. The evaluation of our model is carried out on the French Quaero corpus, showing that it outperforms most teams of CLEF eHealth 2015 and 2016. Additionally, we compare performance to commercial translators on Spanish, French, Dutch and German versions of Mantra. Our model performs similarly well, but is free of charge and can be run locally. This is particularly important for clinical NLP applications as medical documents underlay strict privacy restrictions.

Viviana Cotik, Darío Filippo, Roland Roller et al.

This paper presents a new annotated corpus of 513 anonymized radiology reports written in Spanish. Reports were manually annotated with entities, negation and uncertainty terms and relations. The corpus was conceived as an evaluation resource for named entity recognition and relation extraction algorithms, and as input for the use of supervised methods. Biomedical annotated resources are scarce due to confidentiality issues and associated costs. This work provides some guidelines that could help other researchers to undertake similar tasks.

Roland Roller, Eneko Agirre, Aitor Soroa et al.

Distant supervision is a widely applied approach to automatic training of relation extraction systems and has the advantage that it can generate large amounts of labelled data with minimal effort. However, this data may contain errors and consequently systems trained using distant supervision tend not to perform as well as those based on manually labelled data. This work proposes a novel method for detecting potential false negative training examples using a knowledge inference method. Results show that our approach improves the performance of relation extraction systems trained using distantly supervised data.