Richard Tobin

Beatrice Alex, Claire Grover, Arlene Casey et al.

We present GS-BrainText, a curated dataset of 8,511 brain radiology reports from the Generation Scotland cohort, of which 2,431 are annotated for 24 brain disease phenotypes. This multi-site dataset spans five Scottish NHS health boards and includes broad age representation (mean age 58, median age 53), making it uniquely valuable for developing and evaluating generalisable clinical natural language processing (NLP) algorithms and tools. Expert annotations were performed by a multidisciplinary clinical team using an annotation schema, with 10-100% double annotation per NHS health board and rigorous quality assurance. Benchmark evaluation using EdIE-R, an existing rule-based NLP system developed in conjunction with the annotation schema, revealed some performance variation across health boards (F1: 86.13-98.13), phenotypes (F1: 22.22-100) and age groups (F1: 87.01-98.13), highlighting critical challenges in generalisation of NLP tools. The GS-BrainText dataset addresses a significant gap in available UK clinical text resources and provides a valuable resource for the study of linguistic variation, diagnostic uncertainty expression and the impact of data characteristics on NLP system performance.

Arlene Casey, Emma Davidson, Michael Poon et al.

NLP has a significant role in advancing healthcare and has been found to be key in extracting structured information from radiology reports. Understanding recent developments in NLP application to radiology is of significance but recent reviews on this are limited. This study systematically assesses recent literature in NLP applied to radiology reports. Our automated literature search yields 4,799 results using automated filtering, metadata enriching steps and citation search combined with manual review. Our analysis is based on 21 variables including radiology characteristics, NLP methodology, performance, study, and clinical application characteristics. We present a comprehensive analysis of the 164 publications retrieved with each categorised into one of 6 clinical application categories. Deep learning use increases but conventional machine learning approaches are still prevalent. Deep learning remains challenged when data is scarce and there is little evidence of adoption into clinical practice. Despite 17% of studies reporting greater than 0.85 F1 scores, it is hard to comparatively evaluate these approaches given that most of them use different datasets. Only 14 studies made their data and 15 their code available with 10 externally validating results. Automated understanding of clinical narratives of the radiology reports has the potential to enhance the healthcare process but reproducibility and explainability of models are important if the domain is to move applications into clinical use. More could be done to share code enabling validation of methods on different institutional data and to reduce heterogeneity in reporting of study properties allowing inter-study comparisons. Our results have significance for researchers providing a systematic synthesis of existing work to build on, identify gaps, opportunities for collaboration and avoid duplication.

Arlene Casey, Mike Bennett, Richard Tobin et al.

The design of models that govern diseases in population is commonly built on information and data gathered from past outbreaks. However, epidemic outbreaks are never captured in statistical data alone but are communicated by narratives, supported by empirical observations. Outbreak reports discuss correlations between populations, locations and the disease to infer insights into causes, vectors and potential interventions. The problem with these narratives is usually the lack of consistent structure or strong conventions, which prohibit their formal analysis in larger corpora. Our interdisciplinary research investigates more than 100 reports from the third plague pandemic (1894-1952) evaluating ways of building a corpus to extract and structure this narrative information through text mining and manual annotation. In this paper we discuss the progress of our ongoing exploratory project, how we enhance optical character recognition (OCR) methods to improve text capture, our approach to structure the narratives and identify relevant entities in the reports. The structured corpus is made available via Solr enabling search and analysis across the whole collection for future research dedicated, for example, to the identification of concepts. We show preliminary visualisations of the characteristics of causation and differences with respect to gender as a result of syntactic-category-dependent corpus statistics. Our goal is to develop structured accounts of some of the most significant concepts that were used to understand the epidemiology of the third plague pandemic around the globe. The corpus enables researchers to analyse the reports collectively allowing for deep insights into the global epidemiological consideration of plague in the early twentieth century.

Philip John Gorinski, Honghan Wu, Claire Grover et al.

This work investigates multiple approaches to Named Entity Recognition (NER) for text in Electronic Health Record (EHR) data. In particular, we look into the application of (i) rule-based, (ii) deep learning and (iii) transfer learning systems for the task of NER on brain imaging reports with a focus on records from patients with stroke. We explore the strengths and weaknesses of each approach, develop rules and train on a common dataset, and evaluate each system's performance on common test sets of Scottish radiology reports from two sources (brain imaging reports in ESS -- Edinburgh Stroke Study data collected by NHS Lothian as well as radiology reports created in NHS Tayside). Our comparison shows that a hand-crafted system is the most accurate way to automatically label EHR, but machine learning approaches can provide a feasible alternative where resources for a manual system are not readily available.