Jennifer J. Liang

Giridhar Kaushik Ramachandran, Kevin Lybarger, Yaya Liu et al.

An accurate and detailed account of patient medications, including medication changes within the patient timeline, is essential for healthcare providers to provide appropriate patient care. Healthcare providers or the patients themselves may initiate changes to patient medication. Medication changes take many forms, including prescribed medication and associated dosage modification. These changes provide information about the overall health of the patient and the rationale that led to the current care. Future care can then build on the resulting state of the patient. This work explores the automatic extraction of medication change information from free-text clinical notes. The Contextual Medication Event Dataset (CMED) is a corpus of clinical notes with annotations that characterize medication changes through multiple change-related attributes, including the type of change (start, stop, increase, etc.), initiator of the change, temporality, change likelihood, and negation. Using CMED, we identify medication mentions in clinical text and propose three novel high-performing BERT-based systems that resolve the annotated medication change characteristics. We demonstrate that our proposed systems improve medication change classification performance over the initial work exploring CMED.

Diwakar Mahajan, Jennifer J. Liang, Ching-Huei Tsou

Medication timelines have been shown to be effective in helping physicians visualize complex patient medication information. A key feature in many such designs is a longitudinal representation of a medication's daily dosage and its changes over time. However, daily dosage as a discrete value is generally not provided and needs to be derived from free text instructions (Sig). Existing works in daily dosage extraction are narrow in scope, targeting dosage extraction for a single drug from clinical notes. Here, we present an automated approach to calculate daily dosage for all medications, combining deep learning-based named entity extractor with lexicon dictionaries and regular expressions, achieving 0.98 precision and 0.95 recall on an expert-generated dataset of 1,000 Sigs. We also analyze our expert-generated dataset, discuss the challenges in understanding the complex information contained in Sigs, and provide insights to guide future work in the general-purpose daily dosage calculation task.

Preethi Raghavan, Siddharth Patwardhan, Jennifer J. Liang et al.

Our research is in the relatively unexplored area of question answering technologies for patient-specific questions over their electronic health records. A large dataset of human expert curated question and answer pairs is an important pre-requisite for developing, training and evaluating any question answering system that is powered by machine learning. In this paper, we describe a process for creating such a dataset of questions and answers. Our methodology is replicable, can be conducted by medical students as annotators, and results in high inter-annotator agreement (0.71 Cohen's kappa). Over the course of 11 months, 11 medical students followed our annotation methodology, resulting in a question answering dataset of 5696 questions over 71 patient records, of which 1747 questions have corresponding answers generated by the medical students.