Abstract

Interventional cancer clinical trials are generally too restrictive, and some patients are often excluded on the basis of comorbidity, past or concomitant treatments, or the fact that they are over a certain age. The efficacy and safety of new treatments for patients with these characteristics are, therefore, not defined. In this work, we built a model to automatically predict whether short clinical statements were considered inclusion or exclusion criteria. We used protocols from cancer clinical trials that were available in public registries from the last 18 years to train word-embeddings, and we constructed a dataset of 6M short free-texts labeled as eligible or not eligible. A text classifier was trained using deep neural networks, with pre-trained word-embeddings as inputs, to predict whether or not short free-text statements describing clinical information were considered eligible. We additionally analyzed the semantic reasoning of the word-embedding representations obtained and were able to identify equivalent treatments for a type of tumor analogous with the drugs used to treat other tumors. We show that representation learning using deep neural networks can be successfully leveraged to extract the medical knowledge from clinical trial protocols for potentially assisting practitioners when prescribing treatments.

Highlights

  • Clinical trials (CTs) provide the evidence needed to determine the safety and effectiveness of new medical treatments

  • This signifies that the results obtained in CTs cannot be extrapolated to patients if their clinical profiles were excluded from the clinical trial protocols

  • After extracting bigrams and word-embeddings, we explored different state-of-the-art classification methods (FastText, Convolutional Neural Networks (CNN), Support Vector Machines (SVM), and k-Nearest

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Summary

Introduction

Clinical trials (CTs) provide the evidence needed to determine the safety and effectiveness of new medical treatments. These trials are the bases employed for clinical practice guidelines [1] and greatly assist clinicians in their daily practice when making decisions regarding treatment. Patients are often excluded on the basis of comorbidity, past or concomitant treatments, or the fact they are over a certain age, and those patients that are selected do not, mimic clinical practice This signifies that the results obtained in CTs cannot be extrapolated to patients if their clinical profiles were excluded from the clinical trial protocols. Given the clinical characteristics of particular patients, their type of cancer, and the intended treatment, discovering whether or not they are represented in the corpus of CTs that is available requires the manual review of numerous eligibility criteria, which is impracticable for clinicians on a daily basis

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