David Talby

Ali Emre Varol, Veysel Kocaman, Hasham Ul Haq et al.

Being a global pandemic, the COVID-19 outbreak received global media attention. In this study, we analyze news publications from CNN and The Guardian - two of the world's most influential media organizations. The dataset includes more than 36,000 articles, analyzed using the clinical and biomedical Natural Language Processing (NLP) models from the Spark NLP for Healthcare library, which enables a deeper analysis of medical concepts than previously achieved. The analysis covers key entities and phrases, observed biases, and change over time in news coverage by correlating mined medical symptoms, procedures, drugs, and guidance with commonly mentioned demographic and occupational groups. Another analysis is of extracted Adverse Drug Events about drug and vaccine manufacturers, which when reported by major news outlets has an impact on vaccine hesitancy.

Andrei Marian Feier, Veysel Kocaman, Yigit Gul et al.

Large language models (LLMs) are increasingly deployed across healthcare, yet existing benchmarks fail to capture model behavior under adversarial or ethically complex conditions common in clinical practice. We developed a multi-domain red teaming framework evaluating eleven contemporary LLMs across 690 clinically grounded scenarios spanning nine domains and over 150 subcategories. Scenarios incorporated adversarial transformations, and responses were assessed using a seven-dimension rubric with LLM-assisted scoring and human-in-the-loop validation. Results revealed substantial performance variance, with mean scores ranging from 0.791 to 0.984. Critically, several high-performing systems produced complete failures in individual safety-critical scenarios, demonstrating that aggregate accuracy masks clinically meaningful risk. The highest-performing systems (X-BAI, GPT-5, Claude Opus 4.1) achieved scores above 0.97 with low variance, while performance varied significantly across domains. Equity-related tasks showed 10-20% error amplification with demographic modifications, and human reviewers identified clinically relevant failures missed by automated evaluation. Our findings demonstrate that performance variance and worst-case failures provide more clinically meaningful reliability indicators than mean accuracy alone, and that hybrid evaluation approaches combining automation with clinician oversight are essential for credible safety assessment.

Veysel Kocaman, Gursev Pirge, Yigit Gul et al.

Extracting detailed clinical information from free-text medical narratives remains a practical challenge for researchers and healthcare systems. Terminology for immune-mediated and infectious diseases is especially inconsistent across sources, which often limits the ability of general-purpose Natural Language Processing (NLP) systems to capture the relevant biomedical concepts with sufficient granularity. We developed a domain-specific Named Entity Recognition (NER) model tailored to identify disease-related entities occurring in immunology and infectious disease contexts. We assembled and manually annotated a dataset of 371 case reports in collaboration with two clinical specialists, defining twelve entity classes covering immune-mediated and infectious conditions as well as related symptoms and clinical descriptors. We evaluated several modeling strategies, including the MedicalNER architecture with multiple healthcare-specific embeddings, a BERT-based token classification model, and zero-shot NER systems. The strongest performance was obtained with a transformer-based model trained on clinical-domain embeddings, which reached an F1 score of 0.89, consistently outperforming baseline and zero-shot approaches. The combination of specialized embeddings and expert annotation proved particularly valuable for capturing nuanced disease terminology and improving generalization across heterogeneous biomedical text. The prompted LLM baseline achieved substantially lower performance under the same evaluation protocol, reflecting difficulties in producing span-consistent outputs for fine-grained entity boundaries despite detailed prompting. The resulting model provides a structured way to analyze case reports and can support downstream tasks such as cohort identification, disease monitoring, and clinical decision support.

Veysel Kocaman, David Talby

Named entity recognition (NER) is a widely applicable natural language processing task and building block of question answering, topic modeling, information retrieval, etc. In the medical domain, NER plays a crucial role by extracting meaningful chunks from clinical notes and reports, which are then fed to downstream tasks like assertion status detection, entity resolution, relation extraction, and de-identification. Reimplementing a Bi-LSTM-CNN-Char deep learning architecture on top of Apache Spark, we present a single trainable NER model that obtains new state-of-the-art results on seven public biomedical benchmarks without using heavy contextual embeddings like BERT. This includes improving BC4CHEMD to 93.72% (4.1% gain), Species800 to 80.91% (4.6% gain), and JNLPBA to 81.29% (5.2% gain). In addition, this model is freely available within a production-grade code base as part of the open-source Spark NLP library; can scale up for training and inference in any Spark cluster; has GPU support and libraries for popular programming languages such as Python, R, Scala and Java; and can be extended to support other human languages with no code changes.

Veysel Kocaman, Hasham Ul Haq, David Talby

Recent research advances achieve human-level accuracy for de-identifying free-text clinical notes on research datasets, but gaps remain in reproducing this in large real-world settings. This paper summarizes lessons learned from building a system used to de-identify over one billion real clinical notes, in a fully automated way, that was independently certified by multiple organizations for production use. A fully automated solution requires a very high level of accuracy that does not require manual review. A hybrid context-based model architecture is described, which outperforms a Named Entity Recogniton (NER) - only model by 10% on the i2b2-2014 benchmark. The proposed system makes 50%, 475%, and 575% fewer errors than the comparable AWS, Azure, and GCP services respectively while also outperforming ChatGPT by 33%. It exceeds 98% coverage of sensitive data across 7 European languages, without a need for fine tuning. A second set of described models enable data obfuscation -- replacing sensitive data with random surrogates -- while retaining name, date, gender, clinical, and format consistency. Both the practical need and the solution architecture that provides for reliable & linked anonymized documents are described.

Veysel Kocaman, Yigit Gul, M. Aytug Kaya et al.

Assertion status detection is a critical yet often overlooked component of clinical NLP, essential for accurately attributing extracted medical facts. Past studies have narrowly focused on negation detection, leading to underperforming commercial solutions such as AWS Medical Comprehend, Azure AI Text Analytics, and GPT-4o due to their limited domain adaptation. To address this gap, we developed state-of-the-art assertion detection models, including fine-tuned LLMs, transformer-based classifiers, few-shot classifiers, and deep learning (DL) approaches. We evaluated these models against cloud-based commercial API solutions, the legacy rule-based NegEx approach, and GPT-4o. Our fine-tuned LLM achieves the highest overall accuracy (0.962), outperforming GPT-4o (0.901) and commercial APIs by a notable margin, particularly excelling in Present (+4.2%), Absent (+8.4%), and Hypothetical (+23.4%) assertions. Our DL-based models surpass commercial solutions in Conditional (+5.3%) and Associated-with-Someone-Else (+10.1%) categories, while the few-shot classifier offers a lightweight yet highly competitive alternative (0.929), making it ideal for resource-constrained environments. Integrated within Spark NLP, our models consistently outperform black-box commercial solutions while enabling scalable inference and seamless integration with medical NER, Relation Extraction, and Terminology Resolution. These results reinforce the importance of domain-adapted, transparent, and customizable clinical NLP solutions over general-purpose LLMs and proprietary APIs.

Veysel Kocaman, Muhammed Santas, Yigit Gul et al.

We evaluate the performance of four leading solutions for de-identification of unstructured medical text - Azure Health Data Services, AWS Comprehend Medical, OpenAI GPT-4o, and John Snow Labs - on a ground truth dataset of 48 clinical documents annotated by medical experts. The analysis, conducted at both entity-level and token-level, suggests that John Snow Labs' Medical Language Models solution achieves the highest accuracy, with a 96% F1-score in protected health information (PHI) detection, outperforming Azure (91%), AWS (83%), and GPT-4o (79%). John Snow Labs is not only the only solution which achieves regulatory-grade accuracy (surpassing that of human experts) but is also the most cost-effective solution: It is over 80% cheaper compared to Azure and GPT-4o, and is the only solution not priced by token. Its fixed-cost local deployment model avoids the escalating per-request fees of cloud-based services, making it a scalable and economical choice.

Hasham Ul Haq, Veysel Kocaman, David Talby

Adverse drug reactions / events (ADR/ADE) have a major impact on patient health and health care costs. Detecting ADR's as early as possible and sharing them with regulators, pharma companies, and healthcare providers can prevent morbidity and save many lives. While most ADR's are not reported via formal channels, they are often documented in a variety of unstructured conversations such as social media posts by patients, customer support call transcripts, or CRM notes of meetings between healthcare providers and pharma sales reps. In this paper, we propose a natural language processing (NLP) solution that detects ADR's in such unstructured free-text conversations, which improves on previous work in three ways. First, a new Named Entity Recognition (NER) model obtains new state-of-the-art accuracy for ADR and Drug entity extraction on the ADE, CADEC, and SMM4H benchmark datasets (91.75%, 78.76%, and 83.41% F1 scores respectively). Second, two new Relation Extraction (RE) models are introduced - one based on BioBERT while the other utilizing crafted features over a Fully Connected Neural Network (FCNN) - are shown to perform on par with existing state-of-the-art models, and outperform them when trained with a supplementary clinician-annotated RE dataset. Third, a new text classification model, for deciding if a conversation includes an ADR, obtains new state-of-the-art accuracy on the CADEC dataset (86.69% F1 score). The complete solution is implemented as a unified NLP pipeline in a production-grade library built on top of Apache Spark, making it natively scalable and able to process millions of batch or streaming records on commodity clusters.

Hasham Ul Haq, Veysel Kocaman, David Talby

The surging amount of biomedical literature & digital clinical records presents a growing need for text mining techniques that can not only identify but also semantically relate entities in unstructured data. In this paper we propose a text mining framework comprising of Named Entity Recognition (NER) and Relation Extraction (RE) models, which expands on previous work in three main ways. First, we introduce two new RE model architectures -- an accuracy-optimized one based on BioBERT and a speed-optimized one utilizing crafted features over a Fully Connected Neural Network (FCNN). Second, we evaluate both models on public benchmark datasets and obtain new state-of-the-art F1 scores on the 2012 i2b2 Clinical Temporal Relations challenge (F1 of 73.6, +1.2% over the previous SOTA), the 2010 i2b2 Clinical Relations challenge (F1 of 69.1, +1.2%), the 2019 Phenotype-Gene Relations dataset (F1 of 87.9, +8.5%), the 2012 Adverse Drug Events Drug-Reaction dataset (F1 of 90.0, +6.3%), and the 2018 n2c2 Posology Relations dataset (F1 of 96.7, +0.6%). Third, we show two practical applications of this framework -- for building a biomedical knowledge graph and for improving the accuracy of mapping entities to clinical codes. The system is built using the Spark NLP library which provides a production-grade, natively scalable, hardware-optimized, trainable & tunable NLP framework.

Veysel Kocaman, David Talby

Spark NLP is a Natural Language Processing (NLP) library built on top of Apache Spark ML. It provides simple, performant and accurate NLP annotations for machine learning pipelines that can scale easily in a distributed environment. Spark NLP comes with 1100 pre trained pipelines and models in more than 192 languages. It supports nearly all the NLP tasks and modules that can be used seamlessly in a cluster. Downloaded more than 2.7 million times and experiencing nine times growth since January 2020, Spark NLP is used by 54% of healthcare organizations as the worlds most widely used NLP library in the enterprise.

Veysel Kocaman, David Talby

Following the global COVID-19 pandemic, the number of scientific papers studying the virus has grown massively, leading to increased interest in automated literate review. We present a clinical text mining system that improves on previous efforts in three ways. First, it can recognize over 100 different entity types including social determinants of health, anatomy, risk factors, and adverse events in addition to other commonly used clinical and biomedical entities. Second, the text processing pipeline includes assertion status detection, to distinguish between clinical facts that are present, absent, conditional, or about someone other than the patient. Third, the deep learning models used are more accurate than previously available, leveraging an integrated pipeline of state-of-the-art pretrained named entity recognition models, and improving on the previous best performing benchmarks for assertion status detection. We illustrate extracting trends and insights, e.g. most frequent disorders and symptoms, and most common vital signs and EKG findings, from the COVID-19 Open Research Dataset (CORD-19). The system is built using the Spark NLP library which natively supports scaling to use distributed clusters, leveraging GPUs, configurable and reusable NLP pipelines, healthcare specific embeddings, and the ability to train models to support new entity types or human languages with no code changes.