Sungrim Moon

Sungrim Moon, Huan He, Hongfang Liu et al.

Background: Extractive question-answering (EQA) is a useful natural language processing (NLP) application for answering patient-specific questions by locating answers in their clinical notes. Realistic clinical EQA can have multiple answers to a single question and multiple focus points in one question, which are lacking in the existing datasets for development of artificial intelligence solutions. Objective: Create a dataset for developing and evaluating clinical EQA systems that can handle natural multi-answer and multi-focus questions. Methods: We leveraged the annotated relations from the 2018 National NLP Clinical Challenges (n2c2) corpus to generate an EQA dataset. Specifically, the 1-to-N, M-to-1, and M-to-N drug-reason relations were included to form the multi-answer and multi-focus QA entries, which represent more complex and natural challenges in addition to the basic one-drug-one-reason cases. A baseline solution was developed and tested on the dataset. Results: The derived RxWhyQA dataset contains 96,939 QA entries. Among the answerable questions, 25% require multiple answers, and 2% ask about multiple drugs within one question. There are frequent cues observed around the answers in the text, and 90% of the drug and reason terms occur within the same or an adjacent sentence. The baseline EQA solution achieved a best f1-measure of 0.72 on the entire dataset, and on specific subsets, it was: 0.93 on the unanswerable questions, 0.48 on single-drug questions versus 0.60 on multi-drug questions, 0.54 on the single-answer questions versus 0.43 on multi-answer questions. Discussion: The RxWhyQA dataset can be used to train and evaluate systems that need to handle multi-answer and multi-focus questions. Specifically, multi-answer EQA appears to be challenging and therefore warrants more investment in research.

Andrew Wen, Mohamed Y. Elwazir, Sungrim Moon et al.

Objectives: To adapt and evaluate a deep learning language model for answering why-questions based on patient-specific clinical text. Materials and Methods: Bidirectional encoder representations from transformers (BERT) models were trained with varying data sources to perform SQuAD 2.0 style why-question answering (why-QA) on clinical notes. The evaluation focused on: 1) comparing the merits from different training data, 2) error analysis. Results: The best model achieved an accuracy of 0.707 (or 0.760 by partial match). Training toward customization for the clinical language helped increase 6% in accuracy. Discussion: The error analysis suggested that the model did not really perform deep reasoning and that clinical why-QA might warrant more sophisticated solutions. Conclusion: The BERT model achieved moderate accuracy in clinical why-QA and should benefit from the rapidly evolving technology. Despite the identified limitations, it could serve as a competent proxy for question-driven clinical information extraction.

Sunyang Fu, David Chen, Huan He et al.

Background Concept extraction, a subdomain of natural language processing (NLP) with a focus on extracting concepts of interest, has been adopted to computationally extract clinical information from text for a wide range of applications ranging from clinical decision support to care quality improvement. Objectives In this literature review, we provide a methodology review of clinical concept extraction, aiming to catalog development processes, available methods and tools, and specific considerations when developing clinical concept extraction applications. Methods Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted for retrieving EHR-based information extraction articles written in English and published from January 2009 through June 2019 from Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Scopus, Web of Science, and the ACM Digital Library. Results A total of 6,686 publications were retrieved. After title and abstract screening, 228 publications were selected. The methods used for developing clinical concept extraction applications were discussed in this review.