Abstract

BackgroundWith the improvements to text mining technology and the availability of large unstructured Electronic Healthcare Records (EHR) datasets, it is now possible to extract structured information from raw text contained within EHR at reasonably high accuracy. We describe a text mining system for classifying radiologists’ reports of CT and MRI brain scans, assigning labels indicating occurrence and type of stroke, as well as other observations. Our system, the Edinburgh Information Extraction for Radiology reports (EdIE-R) system, which we describe here, was developed and tested on a collection of radiology reports.The work reported in this paper is based on 1168 radiology reports from the Edinburgh Stroke Study (ESS), a hospital-based register of stroke and transient ischaemic attack patients. We manually created annotations for this data in parallel with developing the rule-based EdIE-R system to identify phenotype information related to stroke in radiology reports. This process was iterative and domain expert feedback was considered at each iteration to adapt and tune the EdIE-R text mining system which identifies entities, negation and relations between entities in each report and determines report-level labels (phenotypes).ResultsThe inter-annotator agreement (IAA) for all types of annotations is high at 96.96 for entities, 96.46 for negation, 95.84 for relations and 94.02 for labels. The equivalent system scores on the blind test set are equally high at 95.49 for entities, 94.41 for negation, 98.27 for relations and 96.39 for labels for the first annotator and 96.86, 96.01, 96.53 and 92.61, respectively for the second annotator.ConclusionAutomated reading of such EHR data at such high levels of accuracies opens up avenues for population health monitoring and audit, and can provide a resource for epidemiological studies. We are in the process of validating EdIE-R in separate larger cohorts in NHS England and Scotland. The manually annotated ESS corpus will be available for research purposes on application.

Highlights

  • With the improvements to text mining technology and the availability of large unstructured Electronic Healthcare Records (EHR) datasets, it is possible to extract structured information from raw text contained within electronic health records (EHRs) at reasonably high accuracy

  • The Extraction for Radiology reports (EdIE-R) system EdIE-R is a rule-based text mining system which we developed in tandem with manual data annotation in the form of correction of the system output

  • Note that inter-annotator agreement (IAA) represents an upper bound for system performance as an automatic method would not be expected to out-perform human capabilities

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Summary

Introduction

With the improvements to text mining technology and the availability of large unstructured Electronic Healthcare Records (EHR) datasets, it is possible to extract structured information from raw text contained within EHR at reasonably high accuracy. We manually created annotations for this data in parallel with developing the rule-based EdIE-R system to identify phenotype information related to stroke in radiology reports. This process was iterative and domain expert feedback was considered at each iteration to adapt and tune the EdIE-R text mining system which identifies entities, negation and relations between entities in each report and determines report-level labels (phenotypes). The goal of the EdIE-R system [1] is to label each report with an indication of what the radiologist was able to observe in the scan image, for example, small vessel disease, ischaemic stroke etc. Text mining systems typically apply Named Entity Recognition (NER), Relation Extraction (RE) and negation detection.

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