Xiong Liu

Xiong Liu, Greg L. Hersch, Iya Khalil et al.

Natural language processing (NLP) of clinical trial documents can be useful in new trial design. Here we identify entity types relevant to clinical trial design and propose a framework called CT-BERT for information extraction from clinical trial text. We trained named entity recognition (NER) models to extract eligibility criteria entities by fine-tuning a set of pre-trained BERT models. We then compared the performance of CT-BERT with recent baseline methods including attention-based BiLSTM and Criteria2Query. The results demonstrate the superiority of CT-BERT in clinical trial NLP.

Xiong Liu, Cheng Shi, Uday Deore et al.

FDA has been promoting enrollment practices that could enhance the diversity of clinical trial populations, through broadening eligibility criteria. However, how to broaden eligibility remains a significant challenge. We propose an AI approach to Cohort Optimization (AICO) through transformer-based natural language processing of the eligibility criteria and evaluation of the criteria using real-world data. The method can extract common eligibility criteria variables from a large set of relevant trials and measure the generalizability of trial designs to real-world patients. It overcomes the scalability limits of existing manual methods and enables rapid simulation of eligibility criteria design for a disease of interest. A case study on breast cancer trial design demonstrates the utility of the method in improving trial generalizability.

Xiong Liu, Luca A. Finelli, Greg L. Hersch et al.

COVID-19 clinical trial design is a critical task in developing therapeutics for the prevention and treatment of COVID-19. In this study, we apply a deep learning approach to extract eligibility criteria variables from COVID-19 trials to enable quantitative analysis of trial design and optimization. Specifically, we train attention-based bidirectional Long Short-Term Memory (Att-BiLSTM) models and use the optimal model to extract entities (i.e., variables) from the eligibility criteria of COVID-19 trials. We compare the performance of Att-BiLSTM with traditional ontology-based method. The result on a benchmark dataset shows that Att-BiLSTM outperforms the ontology model. Att-BiLSTM achieves a precision of 0.942, recall of 0.810, and F1 of 0.871, while the ontology model only achieves a precision of 0.715, recall of 0.659, and F1 of 0.686. Our analyses demonstrate that Att-BiLSTM is an effective approach for characterizing patient populations in COVID-19 clinical trials.

Xiong Liu, Yu Chen, Jay Bae et al.

Heart failure hospitalization is a severe burden on healthcare. How to predict and therefore prevent readmission has been a significant challenge in outcomes research. To address this, we propose a deep learning approach to predict readmission from clinical notes. Unlike conventional methods that use structured data for prediction, we leverage the unstructured clinical notes to train deep learning models based on convolutional neural networks (CNN). We then use the trained models to classify and predict potentially high-risk admissions/patients. For evaluation, we trained CNNs using the discharge summary notes in the MIMIC III database. We also trained regular machine learning models based on random forest using the same datasets. The result shows that deep learning models outperform the regular models in prediction tasks. CNN method achieves a F1 score of 0.756 in general readmission prediction and 0.733 in 30-day readmission prediction, while random forest only achieves a F1 score of 0.674 and 0.656 respectively. We also propose a chi-square test based method to interpret key features associated with deep learning predicted readmissions. It reveals clinical insights about readmission embedded in the clinical notes. Collectively, our method can make the human evaluation process more efficient and potentially facilitate the reduction of readmission rates.