Abstract BackgroundWhile most health-care providers now use electronic health records (EHRs) to document clinical care, many still treat them as digital versions of paper records. As a result, documentation often remains unstructured, with free-text entries in progress notes. This limits the potential for secondary use and analysis, as machine-learning and data analysis algorithms are more effective with structured data. ObjectiveThis study aims to use advanced artificial intelligence (AI) and natural language processing (NLP) techniques to improve diagnostic information extraction from clinical notes in a periodontal use case. By automating this process, the study seeks to reduce missing data in dental records and minimize the need for extensive manual annotation, a long-standing barrier to widespread NLP deployment in dental data extraction. Materials and MethodsThis research utilizes large language models (LLMs), specifically Generative Pretrained Transformer 4, to generate synthetic medical notes for fine-tuning a RoBERTa model. This model was trained to better interpret and process dental language, with particular attention to periodontal diagnoses. Model performance was evaluated by manually reviewing 360 clinical notes randomly selected from each of the participating site’s dataset. ResultsThe results demonstrated high accuracy of periodontal diagnosis data extraction, with the sites 1 and 2 achieving a weighted average score of 0.97-0.98. This performance held for all dimensions of periodontal diagnosis in terms of stage, grade, and extent. DiscussionSynthetic data effectively reduced manual annotation needs while preserving model quality. Generalizability across institutions suggests viability for broader adoption, though future work is needed to improve contextual understanding. ConclusionThe study highlights the potential transformative impact of AI and NLP on health-care research. Most clinical documentation (40%-80%) is free text. Scaling our method could enhance clinical data reuse.
more »
« less
Identify diabetic retinopathy-related clinical concepts and their attributes using transformer-based natural language processing methods
Abstract Background Diabetic retinopathy (DR) is a leading cause of blindness in American adults. If detected, DR can be treated to prevent further damage causing blindness. There is an increasing interest in developing artificial intelligence (AI) technologies to help detect DR using electronic health records. The lesion-related information documented in fundus image reports is a valuable resource that could help diagnoses of DR in clinical decision support systems. However, most studies for AI-based DR diagnoses are mainly based on medical images; there is limited studies to explore the lesion-related information captured in the free text image reports. Methods In this study, we examined two state-of-the-art transformer-based natural language processing (NLP) models, including BERT and RoBERTa, compared them with a recurrent neural network implemented using Long short-term memory (LSTM) to extract DR-related concepts from clinical narratives. We identified four different categories of DR-related clinical concepts including lesions, eye parts, laterality, and severity, developed annotation guidelines, annotated a DR-corpus of 536 image reports, and developed transformer-based NLP models for clinical concept extraction and relation extraction. We also examined the relation extraction under two settings including ‘gold-standard’ setting—where gold-standard concepts were used–and end-to-end setting. Results For concept extraction, the BERT model pretrained with the MIMIC III dataset achieve the best performance (0.9503 and 0.9645 for strict/lenient evaluation). For relation extraction, BERT model pretrained using general English text achieved the best strict/lenient F1-score of 0.9316. The end-to-end system, BERT_general_e2e, achieved the best strict/lenient F1-score of 0.8578 and 0.8881, respectively. Another end-to-end system based on the RoBERTa architecture, RoBERTa_general_e2e, also achieved the same performance as BERT_general_e2e in strict scores. Conclusions This study demonstrated the efficiency of transformer-based NLP models for clinical concept extraction and relation extraction. Our results show that it’s necessary to pretrain transformer models using clinical text to optimize the performance for clinical concept extraction. Whereas, for relation extraction, transformers pretrained using general English text perform better.
more »
« less
- Award ID(s):
- 1908299
- PAR ID:
- 10358246
- Date Published:
- Journal Name:
- BMC Medical Informatics and Decision Making
- Volume:
- 22
- Issue:
- S3
- ISSN:
- 1472-6947
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
More Like this
-
-
null (Ed.)Multilingual pre-trained Transformers, such as mBERT (Devlin et al., 2019) and XLM-RoBERTa (Conneau et al., 2020a), have been shown to enable effective cross-lingual zero-shot transfer. However, their performance on Arabic information extraction (IE) tasks is not very well studied. In this paper, we pre-train a customized bilingual BERT, dubbed GigaBERT, that is designed specifically for Arabic NLP and English-to-Arabic zero-shot transfer learning. We study GigaBERT’s effectiveness on zero-short transfer across four IE tasks: named entity recognition, part-of-speech tagging, argument role labeling, and relation extraction. Our best model significantly outperforms mBERT, XLM-RoBERTa, and AraBERT (Antoun et al., 2020) in both the supervised and zero-shot transfer settings. We have made our pre-trained models publicly available at: https://github.com/lanwuwei/GigaBERT.more » « less
-
null (Ed.)We investigate the extent to which individual attention heads in pretrained transformer language models, such as BERT and RoBERTa, implicitly capture syntactic dependency relations. We employ two methods---taking the maximum attention weight and computing the maximum spanning tree---to extract implicit dependency relations from the attention weights of each layer/head, and compare them to the ground-truth Universal Dependency (UD) trees. We show that, for some UD relation types, there exist heads that can recover the dependency type significantly better than baselines on parsed English text, suggesting that some self-attention heads act as a proxy for syntactic structure. We also analyze BERT fine-tuned on two datasets---the syntax-oriented CoLA and the semantics-oriented MNLI---to investigate whether fine-tuning affects the patterns of their self-attention, but we do not observe substantial differences in the overall dependency relations extracted using our methods. Our results suggest that these models have some specialist attention heads that track individual dependency types, but no generalist head that performs holistic parsing significantly better than a trivial baseline, and that analyzing attention weights directly may not reveal much of the syntactic knowledge that BERT-style models are known to learn.more » « less
-
Domain modeling is a central component in education technologies as it represents the target domain students are supposed to train on and eventually master. Automatically generating domain models can lead to substantial cost and scalability benefits. Automatically extracting key concepts or knowledge components from, for instance, textbooks can enable the development of automatic or semi-automatic processes for creating domain models. We explore in this work the use of transformer based pre-trained models for the task of keyphrase extraction. Specifically, we investigate and evaluate four different variants of BERT, a pre-trained transformer based architecture, that vary in terms of training data, training objective, or training strategy to extract knowledge components from textbooks for the domain of intro-to-programming. We report results obtained using the following BERT-based models: BERT, CodeBERT, SciBERT and RoBERTa.more » « less
-
Antonija Mitrovic and Nigel Bosch (Ed.)Domain modeling is a central component in education technologies as it represents the target domain students are supposed to train on and eventually master. Automatically generating domain models can lead to substantial cost and scalability benefits. Automatically extracting key concepts or knowledge components from, for instance, textbooks can enable the development of automatic or semi-automatic processes for creating domain models. We explore in this work the use of transformer based pre-trained models for the task of keyphrase extraction. Specifically, we investigate and evaluate four different variants of BERT, a pre-trained transformer based architecture, that vary in terms of training data, training objective, or training strategy to extract knowledge components from textbooks for the domain of intro-to-programming. We report results obtained using the following BERT-based models: BERT, CodeBERT, SciBERT and RoBERTa.more » « less
An official website of the United States government

