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.

Angelo Ziletti, Christoph Berns, Oliver Treichel et al.

Millions of unsolicited medical inquiries are received by pharmaceutical companies every year. It has been hypothesized that these inquiries represent a treasure trove of information, potentially giving insight into matters regarding medicinal products and the associated medical treatments. However, due to the large volume and specialized nature of the inquiries, it is difficult to perform timely, recurrent, and comprehensive analyses. Here, we propose a machine learning approach based on natural language processing and unsupervised learning to automatically discover key topics in real-world medical inquiries from customers. This approach does not require ontologies nor annotations. The discovered topics are meaningful and medically relevant, as judged by medical information specialists, thus demonstrating that unsolicited medical inquiries are a source of valuable customer insights. Our work paves the way for the machine-learning-driven analysis of medical inquiries in the pharmaceutical industry, which ultimately aims at improving patient care.

Diwakar Mahajan, Jennifer J Liang, Ching-Huei Tsou

Understanding medication events in clinical narratives is essential to achieving a complete picture of a patient's medication history. While prior research has explored classification of medication changes from clinical notes, studies to date have not considered the necessary clinical context needed for their use in real-world applications, such as medication timeline generation and medication reconciliation. In this paper, we present the Contextualized Medication Event Dataset (CMED), a dataset for capturing relevant context of medication changes documented in clinical notes, which was developed using a novel conceptual framework that organizes context for clinical events into various orthogonal dimensions. In this process, we define specific contextual aspects pertinent to medication change events, characterize the dataset, and report the results of preliminary experiments. CMED consists of 9,013 medication mentions annotated over 500 clinical notes, and will be released to the community as a shared task in 2021.

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.

Anusri Pampari, Preethi Raghavan, Jennifer Liang et al.

We propose a novel methodology to generate domain-specific large-scale question answering (QA) datasets by re-purposing existing annotations for other NLP tasks. We demonstrate an instance of this methodology in generating a large-scale QA dataset for electronic medical records by leveraging existing expert annotations on clinical notes for various NLP tasks from the community shared i2b2 datasets. The resulting corpus (emrQA) has 1 million question-logical form and 400,000+ question-answer evidence pairs. We characterize the dataset and explore its learning potential by training baseline models for question to logical form and question to answer mapping.

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.