QMAug 31, 2023
The Smart Data Extractor, a Clinician Friendly Solution to Accelerate and Improve the Data Collection During Clinical TrialsSophie Quennelle, Maxime Douillet, Lisa Friedlander et al.
In medical research, the traditional way to collect data, i.e. browsing patient files, has been proven to induce bias, errors, human labor and costs. We propose a semi-automated system able to extract every type of data, including notes. The Smart Data Extractor pre-populates clinic research forms by following rules. We performed a cross-testing experiment to compare semi-automated to manual data collection. 20 target items had to be collected for 79 patients. The average time to complete one form was 6'81'' for manual data collection and 3'22'' with the Smart Data Extractor. There were also more mistakes during manual data collection (163 for the whole cohort) than with the Smart Data Extractor (46 for the whole cohort). We present an easy to use, understandable and agile solution to fill out clinical research forms. It reduces human effort and provides higher quality data, avoiding data re-entry and fatigue induced errors.
CLMar 30
An Underexplored Frontier: Large Language Models for Rare Disease Patient Education and Communication -- A scoping reviewZaifu Zhan, Yu Hou, Kai Yu et al.
Rare diseases affect over 300 million people worldwide and are characterized by complex care pathways, limited clinical expertise, and substantial unmet communication needs throughout the long patient journey. Recent advances in large language models (LLMs) offer new opportunities to support patient education and communication, yet their application in rare diseases remains unclear. We conducted a scoping review of studies published between January 2022 and March 2026 across major databases, identifying 12 studies on LLM-based rare disease patient education and communication. Data were extracted on study characteristics, application scenarios, model usage, and evaluation methods, and synthesized using descriptive and qualitative analyses. The literature is highly recent and dominated by general-purpose models, particularly ChatGPT. Most studies focus on patient question answering using curated question sets, with limited use of real-world data or longitudinal communication scenarios. Evaluations are primarily centered on accuracy, with limited attention to patient-centered dimensions such as readability, empathy, and communication quality. Multilingual communication is rarely addressed. Overall, the field remains at an early stage. Future research should prioritize patient-centered design, domain-adapted methods, and real-world deployment to support safe, adaptive, and effective communication in rare diseases.
LGApr 30
Differentiable latent structure discovery for interpretable forecasting in clinical time seriesIvan Lerner, Jean Feydy, Alexandre Kalimouttou et al.
Background: Timely, uncertainty-aware forecasting from irregular electronic health records (EHR) can support critical-care decisions, yet most approaches either impute to a grid or sacrifice interpretability. We introduce StructGP, a continuous-time multi-task Gaussian process that couples process convolutions with differentiable structure learning to uncover a sparse, ordered directed acyclic graph (DAG) of inter-variable dependencies while preserving principled uncertainty. We further propose LP-StructGP, which augments StructGP with latent pathways-shared, temporally shifted trajectories inferred via subject-specific coupling filters and a softmax gating mechanism-to capture cross-patient progression patterns. Both models are trained under sparsity and acyclicity constraints (augmented Lagrangian, Adam) using scalable low-rank updates. Results: In simulations, the approach reliably recovers ground-truth graphs (Structural Hamming Distance approaching 0 as cohorts grow) and pathway assignments (high Adjusted Rand Index). On a MIMIC-IV septic shock cohort (n=1,008; norepinephrine, creatinine, mean arterial pressure), StructGP improves short-horizon (6 h) forecasting over independent-task baselines (average RMSE 0.68 [95%CI: 0.63--0.74] vs. 0.88 [0.83-0.94]) and, with 15 additional inputs, markedly outperforms unstructured kernels (0.63 [0.58-0.69] vs. 3.02 [2.85-3.18]) with superior calibration (coverage 0.96 vs. 0.84). On the PhysioNet Challenge (12k patients, 41 variables), StructGP attains competitive accuracy (MAE 3.72e-2) relative to a state-of-the-art graph neural model while maintaining calibrated uncertainty. Conclusion: These results show that structured process convolutions with latent pathways deliver interpretable, scalable, and well-calibrated forecasting for irregular clinical time series.
LGFeb 17, 2025
Spectral structure learning for clinical time seriesIvan Lerner, Anita Burgun, Francis Bach
We develop and evaluate a structure learning algorithm for clinical time series. Clinical time series are multivariate time series observed in multiple patients and irregularly sampled, challenging existing structure learning algorithms. We assume that our times series are realizations of StructGP, a k-dimensional multi-output or multi-task stationary Gaussian process (GP), with independent patients sharing the same covariance function. StructGP encodes ordered conditional relations between time series, represented in a directed acyclic graph. We implement an adapted NOTEARS algorithm, which based on a differentiable definition of acyclicity, recovers the graph by solving a series of continuous optimization problems. Simulation results show that up to mean degree 3 and 20 tasks, we reach a median recall of 0.93% [IQR, 0.86, 0.97] while keeping a median precision of 0.71% [0.57-0.84], for recovering directed edges. We further show that the regularization path is key to identifying the graph. With StructGP, we proposed a model of time series dependencies, that flexibly adapt to different time series regularity, while enabling us to learn these dependencies from observations.
CLApr 24, 2020
Learning the grammar of drug prescription: recurrent neural network grammars for medication information extraction in clinical textsIvan Lerner, Jordan Jouffroy, Anita Burgun et al.
In this study, we evaluated the RNNG, a neural top-down transition based parser, for medication information extraction in clinical texts. We evaluated this model on a French clinical corpus. The task was to extract the name of a drug (or a drug class), as well as attributes informing its administration: frequency, dosage, duration, condition and route of administration. We compared the RNNG model that jointly identifies entities, events and their relations with separate BiLSTMs models for entities, events and relations as baselines. We call seq-BiLSTMs the baseline models for relations extraction that takes as extra-input the output of the BiLSTMs for entities and events. Similarly, we evaluated seq-RNNG, a hybrid RNNG model that takes as extra-input the output of the BiLSTMs for entities and events. RNNG outperforms seq-BiLSTM for identifying complex relations, with on average 88.1 [84.4-91.6] % versus 69.9 [64.0-75.4] F-measure. However, RNNG tends to be weaker than the baseline BiLSTM on detecting entities, with on average 82.4 [80.8-83.8] versus 84.1 [82.7-85.6] % F- measure. RNNG trained only for detecting relations tends to be weaker than RNNG with the joint modelling objective, 87.4% [85.8-88.8] versus 88.5% [87.2-89.8]. Seq-RNNG is on par with BiLSTM for entities (84.0 [82.6-85.4] % F-measure) and with RNNG for relations (88.7 [87.4-90.0] % F-measure). The performance of RNNG on relations can be explained both by the model architecture, which provides inductive bias to capture the hierarchy in the targets, and the joint modeling objective which allows the RNNG to learn richer representations. RNNG is efficient for modeling relations between entities or/and events in medical texts and its performances are close to those of a BiLSTM for entity and event detection.
CLNov 23, 2018
Natural language understanding for task oriented dialog in the biomedical domain in a low resources contextAntoine Neuraz, Leonardo Campillos Llanos, Anita Burgun et al.
In the biomedical domain, the lack of sharable datasets often limit the possibility of developing natural language processing systems, especially dialogue applications and natural language understanding models. To overcome this issue, we explore data generation using templates and terminologies and data augmentation approaches. Namely, we report our experiments using paraphrasing and word representations learned on a large EHR corpus with Fasttext and ELMo, to learn a NLU model without any available dataset. We evaluate on a NLU task of natural language queries in EHRs divided in slot-filling and intent classification sub-tasks. On the slot-filling task, we obtain a F-score of 0.76 with the ELMo representation; and on the classification task, a mean F-score of 0.71. Our results show that this method could be used to develop a baseline system.
MLJul 25, 2018
Comparison of methods for early-readmission prediction in a high-dimensional heterogeneous covariates and time-to-event outcome frameworkSimon Bussy, Raphaël Veil, Vincent Looten et al.
Background: Choosing the most performing method in terms of outcome prediction or variables selection is a recurring problem in prognosis studies, leading to many publications on methods comparison. But some aspects have received little attention. First, most comparison studies treat prediction performance and variable selection aspects separately. Second, methods are either compared within a binary outcome setting (based on an arbitrarily chosen delay) or within a survival setting, but not both. In this paper, we propose a comparison methodology to weight up those different settings both in terms of prediction and variables selection, while incorporating advanced machine learning strategies. Methods: Using a high-dimensional case study on a sickle-cell disease (SCD) cohort, we compare 8 statistical methods. In the binary outcome setting, we consider logistic regression (LR), support vector machine (SVM), random forest (RF), gradient boosting (GB) and neural network (NN); while on the survival analysis setting, we consider the Cox Proportional Hazards (PH), the CURE and the C-mix models. We then compare performances of all methods both in terms of risk prediction and variable selection, with a focus on the use of Elastic-Net regularization technique. Results: Among all assessed statistical methods assessed, the C-mix model yields the better performances in both the two considered settings, as well as interesting interpretation aspects. There is some consistency in selected covariates across methods within a setting, but not much across the two settings. Conclusions: It appears that learning withing the survival setting first, and then going back to a binary prediction using the survival estimates significantly enhance binary predictions.