Clinical Named Entity Recognition Research Articles

Medical Named Entity Recognition Model Based on Knowledge Graph Enhancement

To improve the recognition ability of clinical named entity recognition (CNER) in a limited number of Chinese electronic medical records, it provides meaningful support for clinical advanced knowledge extraction. In this paper, using CCKS2019 Chinese electronic medical record as an experimental data source, a fusion model enhanced by knowledge graph (KG) is proposed, and the model is applied to specific Chinese CNER tasks. This study consists of three main parts: single-mode model construction and comparison experiment, KG enhancement experiment, and model fusion experiment. The model has achieved good performance in CNER from the results. The accuracy rate, recall rate, and F1 value are 83.825%, 84.705%, and 84.263%, respectively, which is the global optimal, which proves the effectiveness of the model. This provides a good help for further research of medical information.

Automatic quantitative stroke severity assessment based on Chinese clinical named entity recognition with domain-adaptive pre-trained large language model

Background:Stroke is a prevalent disease with a significant global impact. Effective assessment of stroke severity is vital for an accurate diagnosis, appropriate treatment, and optimal clinical outcomes. The National Institutes of Health Stroke Scale (NIHSS) is a widely used scale for quantitatively assessing stroke severity. However, the current manual scoring of NIHSS is labor-intensive, time-consuming, and sometimes unreliable. Applying artificial intelligence (AI) techniques to automate the quantitative assessment of stroke on vast amounts of electronic health records (EHRs) has attracted much interest. Objective:This study aims to develop an automatic, quantitative stroke severity assessment framework through automating the entire NIHSS scoring process on Chinese clinical EHRs. Methods:Our approach consists of two major parts: Chinese clinical named entity recognition (CNER) with a domain-adaptive pre-trained large language model (LLM) and automated NIHSS scoring. To build a high-performing CNER model, we first construct a stroke-specific, densely annotated dataset “Chinese Stroke Clinical Records” (CSCR) from EHRs provided by our partner hospital, based on a stroke ontology that defines semantically related entities for stroke assessment. We then pre-train a Chinese clinical LLM coined “CliRoberta” through domain-adaptive transfer learning and construct a deep learning-based CNER model that can accurately extract entities directly from Chinese EHRs. Finally, an automated, end-to-end NIHSS scoring pipeline is proposed by mapping the extracted entities to relevant NIHSS items and values, to quantitatively assess the stroke severity. Results:Results obtained on a benchmark dataset CCKS2019 and our newly created CSCR dataset demonstrate the superior performance of our domain-adaptive pre-trained LLM and the CNER model, compared with the existing benchmark LLMs and CNER models. The high F1 score of 0.990 ensures the reliability of our model in accurately extracting the entities for the subsequent automatic NIHSS scoring. Subsequently, our automated, end-to-end NIHSS scoring approach achieved excellent inter-rater agreement (0.823) and intraclass consistency (0.986) with the ground truth and significantly reduced the processing time from minutes to a few seconds. Conclusion:Our proposed automatic and quantitative framework for assessing stroke severity demonstrates exceptional performance and reliability through directly scoring the NIHSS from diagnostic notes in Chinese clinical EHRs. Moreover, this study also contributes a new clinical dataset, a pre-trained clinical LLM, and an effective deep learning-based CNER model. The deployment of these advanced algorithms can improve the accuracy and efficiency of clinical assessment, and help improve the quality, affordability and productivity of healthcare services.

Improving large language models for clinical named entity recognition via prompt engineering.

The study highlights the potential of large language models, specifically GPT-3.5 and GPT-4, in processing complex clinical data and extracting meaningful information with minimal training data. By developing and refining prompt-based strategies, we can significantly enhance the models' performance, making them viable tools for clinical NER tasks and possibly reducing the reliance on extensive annotated datasets. This study quantifies the capabilities of GPT-3.5 and GPT-4 for clinical named entity recognition (NER) tasks and proposes task-specific prompts to improve their performance. We evaluated these models on 2 clinical NER tasks: (1) to extract medical problems, treatments, and tests from clinical notes in the MTSamples corpus, following the 2010 i2b2 concept extraction shared task, and (2) to identify nervous system disorder-related adverse events from safety reports in the vaccine adverse event reporting system (VAERS). To improve the GPT models' performance, we developed a clinical task-specific prompt framework that includes (1) baseline prompts with task description and format specification, (2) annotation guideline-based prompts, (3) error analysis-based instructions, and (4) annotated samples for few-shot learning. We assessed each prompt's effectiveness and compared the models to BioClinicalBERT. Using baseline prompts, GPT-3.5 and GPT-4 achieved relaxed F1 scores of 0.634, 0.804 for MTSamples and 0.301, 0.593 for VAERS. Additional prompt components consistently improved model performance. When all 4 components were used, GPT-3.5 and GPT-4 achieved relaxed F1 socres of 0.794, 0.861 for MTSamples and 0.676, 0.736 for VAERS, demonstrating the effectiveness of our prompt framework. Although these results trail BioClinicalBERT (F1 of 0.901 for the MTSamples dataset and 0.802 for the VAERS), it is very promising considering few training samples are needed. The study's findings suggest a promising direction in leveraging LLMs for clinical NER tasks. However, while the performance of GPT models improved with task-specific prompts, there's a need for further development and refinement. LLMs like GPT-4 show potential in achieving close performance to state-of-the-art models like BioClinicalBERT, but they still require careful prompt engineering and understanding of task-specific knowledge. The study also underscores the importance of evaluation schemas that accurately reflect the capabilities and performance of LLMs in clinical settings. While direct application of GPT models to clinical NER tasks falls short of optimal performance, our task-specific prompt framework, incorporating medical knowledge and training samples, significantly enhances GPT models' feasibility for potential clinical applications.

Chinese EMR Named Entity Recognition Using Fused Label Relations Based on Machine Reading Comprehension Framework.

Chinese electronic medical records (EMR) presents significant challenges for named entity recognition (NER) due to their specialized nature, unique language features, and diverse expressions. Traditionally, NER is treated as a sequence labeling task, where each token is assigned a label. Recent research has reframed NER within the machine reading comprehension (MRC) framework, extracting entities in a question-answer format, achieving state-of-the-art performance. However, these MRC-based methods have a significant limitation: they extract entities of various types independently, ignoring their interrelations. To address this, we introduce the Fusion Label Relations with MRC (FLR-MRC) model, which enhances the MRC model by implicitly capturing dependencies among entity types. FLR-MRC models interrelations between labels using graph attention networks, integrating these with textual data to identify entities. On the benchmark CMeEE and CCKS2017-CNER datasets, FLR-MRC achieves F1-scores of 0.6652 and 0.9101, respectively, outperforming existing clinical NER methods.

Language inference-based learning for Low-Resource Chinese clinical named entity recognition using language model

Electronic health records (EHRs) have been widely used and are gradually replacing paper records. Therefore, extracting valuable information from EHRs has become the focus and hotspot of current research. Clinical named entity recognition (CNER) is an important task in information extraction. Most current research methods used standard supervised learning approaches to fine-tune pre-trained language models (PLMs), which require a large amount of annotated data for model training. However, in realistic medical scenarios, annotated data are scarce, especially in the healthcare field. The process of annotating data in real clinical settings is time-consuming and labour-intensive. In this paper, a language inference-based learning method (LANGIL) is proposed to study clinical NER tasks with limited annotated samples, i.e., in low-resource clinical scenarios. A method based on prompt learning is designed to reformulate the entity recognition task into a language inference-based task. Differing from the standard fine-tuning method, the approach introduced in this paper does not design the additional network layers that train from scratch. This alleviates the gap between pre-training tasks and downstream tasks, allowing the comprehension capabilities of PLMs to be leveraged under the condition of limited training samples. The experiments on four Chinese clinical named entity recognition datasets showed that LANGIL achieves significant improvements in F1-score compared to the former method.

Incorporating dynamic attention gating mechanism and pre-trained embedding for Chinese clinical named entity recognition

Clinical Named Entity Recognition (CNER) serves as a cornerstone in clinical research and healthcare informatics, with its primary goal being the discernment and categorization of clinical terminologies present within Electronic Medical Records (EMRs). While deep learning has significantly improved CNER's performance, these models still face challenges in identifying rare or unseen entities. Our study unveils an innovative DAGM-BiLSTM-CRF model that seamlessly integrates data-driven deep learning strategies with human knowledge to surmount this limitation. The distinctive features of this model lie in its integration of a pre-trained character embedding layer, adept at encapsulating nuanced semantic variations at the granularity of individual characters. Furthermore, it incorporates a bidirectional Long Short-Term Memory (BiLSTM) layer, proficient in deriving contextually relevant information by traversing the sequence from both endpoints. The most noteworthy aspect of our model is the inclusion of a Dynamic Attention Gating Mechanism (DAGM) that dynamically recalibrates attention weights based on the traits of the input sequence and a Conditional Random Fields (CRF) layer that considers interdependencies among output labels within a sequence. The evaluation was carried out on the CCKS-2017 CNER benchmark dataset to underscore the superiority of our model over existing cutting-edge methods, thereby validating its proficiency in deciphering the intricacies of Chinese electronic medical records.

Transformers for extracting breast cancer information from Spanish clinical narratives

The wide adoption of electronic health records (EHRs) offers immense potential as a source of support for clinical research. However, previous studies focused on extracting only a limited set of medical concepts to support information extraction in the cancer domain for the Spanish language. Building on the success of deep learning for processing natural language texts, this paper proposes a transformer-based approach to extract named entities from breast cancer clinical notes written in Spanish and compares several language models. To facilitate this approach, a schema for annotating clinical notes with breast cancer concepts is presented, and a corpus for breast cancer is developed. Results indicate that both BERT-based and RoBERTa-based language models demonstrate competitive performance in clinical Named Entity Recognition (NER). Specifically, BETO and multilingual BERT achieve F-scores of 93.71% and 94.63%, respectively. Additionally, RoBERTa Biomedical attains an F-score of 95.01%, while RoBERTa BNE achieves an F-score of 94.54%. The findings suggest that transformers can feasibly extract information in the clinical domain in the Spanish language, with the use of models trained on biomedical texts contributing to enhanced results. The proposed approach takes advantage of transfer learning techniques by fine-tuning language models to automatically represent text features and avoiding the time-consuming feature engineering process.

Active learning with feature matching for clinical named entity recognition

Active learning (AL) methods for Named Entity Recognition (NER) perform best when train and test data are drawn from the same distribution. However, only limited research in active learning has considered how to leverage the similarity between train and test data distributions. This is especially critical for clinical NER due to the rare concept (e.g., Symptoms) issue. Therefore, in this paper we present a novel AL method for clinical NER that selects the most beneficial instances for training by comparing train and test data distributions via low computational cost similarity metrics. When using GloVe embeddings, our method outperforms baseline AL methods by up to 11% in terms of reduction of training data required to reach the best performance of a target NER model. In addition, our method outperforms the baselines by a high margin in the first 20 iterations. The average margin exceeds 10% on both ShARe/CLEF 2013 and i2b2/VA 2010. When using BioBERT embeddings, our method outperforms baseline AL methods by up to 6% in terms of reduction of training data required to reach the target NER model performance.

Chinese Clinical Named Entity Recognition From Electronic Medical Records Based on Multisemantic Features by Using Robustly Optimized Bidirectional Encoder Representation From Transformers Pretraining Approach Whole Word Masking and Convolutional Neural Networks: Model Development and Validation

Clinical electronic medical records (EMRs) contain important information on patients' anatomy, symptoms, examinations, diagnoses, and medications. Large-scale mining of rich medical information from EMRs will provide notable reference value for medical research. With the complexity of Chinese grammar and blurred boundaries of Chinese words, Chinese clinical named entity recognition (CNER) remains a notable challenge. Follow-up tasks such as medical entity structuring, medical entity standardization, medical entity relationship extraction, and medical knowledge graph construction largely depend on medical named entity recognition effects. A promising CNER result would provide reliable support for building domain knowledge graphs, knowledge bases, and knowledge retrieval systems. Furthermore, it would provide research ideas for scientists and medical decision-making references for doctors and even guide patients on disease and health management. Therefore, obtaining excellent CNER results is essential. We aimed to propose a Chinese CNER method to learn semantics-enriched representations for comprehensively enhancing machines to understand deep semantic information of EMRs by using multisemantic features, which makes medical information more readable and understandable. First, we used Robustly Optimized Bidirectional Encoder Representation from Transformers Pretraining Approach Whole Word Masking (RoBERTa-wwm) with dynamic fusion and Chinese character features, including 5-stroke code, Zheng code, phonological code, and stroke code, extracted by 1-dimensional convolutional neural networks (CNNs) to obtain fine-grained semantic features of Chinese characters. Subsequently, we converted Chinese characters into square images to obtain Chinese character image features from another modality by using a 2-dimensional CNN. Finally, we input multisemantic features into Bidirectional Long Short-Term Memory with Conditional Random Fields to achieve Chinese CNER. The effectiveness of our model was compared with that of the baseline and existing research models, and the features involved in the model were ablated and analyzed to verify the model's effectiveness. We collected 1379 Yidu-S4K EMRs containing 23,655 entities in 6 categories and 2007 self-annotated EMRs containing 118,643 entities in 7 categories. The experiments showed that our model outperformed the comparison experiments, with F1-scores of 89.28% and 84.61% on the Yidu-S4K and self-annotated data sets, respectively. The results of the ablation analysis demonstrated that each feature and method we used could improve the entity recognition ability. Our proposed CNER method would mine the richer deep semantic information in EMRs by multisemantic embedding using RoBERTa-wwm and CNNs, enhancing the semantic recognition of characters at different granularity levels and improving the generalization capability of the method by achieving information complementarity among different semantic features, thus making the machine semantically understand EMRs and improving the CNER task accuracy.

Critical assessment of transformer-based AI models for German clinical notes

Healthcare data such as clinical notes are primarily recorded in an unstructured manner. If adequately translated into structured data, they can be utilized for health economics and set the groundwork for better individualized patient care. To structure clinical notes, deep-learning methods, particularly transformer-based models like Bidirectional Encoder Representations from Transformers (BERT), have recently received much attention. Currently, biomedical applications are primarily focused on the English language. While general-purpose German-language models such as GermanBERT and GottBERT have been published, adaptations for biomedical data are unavailable. This study evaluated the suitability of existing and novel transformer-based models for the German biomedical and clinical domain. We used 8 transformer-based models and pre-trained 3 new models on a newly generated biomedical corpus, and systematically compared them with each other. We annotated a new dataset of clinical notes and used it with 4 other corpora (BRONCO150, CLEF eHealth 2019 Task 1, GGPONC, and JSynCC) to perform named entity recognition (NER) and document classification tasks. General-purpose language models can be used effectively for biomedical and clinical natural language processing (NLP) tasks, still, our newly trained BioGottBERT model outperformed GottBERT on both clinical NER tasks. However, training new biomedical models from scratch proved ineffective. The domain-adaptation strategy's potential is currently limited due to a lack of pre-training data. Since general-purpose language models are only marginally inferior to domain-specific models, both options are suitable for developing German-language biomedical applications. General-purpose language models perform remarkably well on biomedical and clinical NLP tasks. If larger corpora become available in the future, domain-adapting these models may improve performances.

Accurate Clinical and Biomedical Named Entity Recognition at Scale

We introduce an agile, production-grade clinical and biomedical Named entity recognition (NER) algorithm based on a modified BiLSTM-CNN-Char DL architecture built on top of Apache Spark. Our NER implementation establishes new state-of-the-art accuracy on 7 of 8 well-known biomedical NER benchmarks and 3 clinical concept extraction challenges: 2010 i2b2/VA clinical concept extraction, 2014 n2c2 de-identification, and 2018 n2c2 medication extraction. Moreover, clinical NER models trained using this implementation outperform the accuracy of commercial entity extraction solutions, AWS Medical Comprehend and Google Cloud Healthcare API by a large margin (8.9% and 6.7% respectively), without using memory-intensive language models.

A multi-layer soft lattice based model for Chinese clinical named entity recognition

ObjectiveNamed entity recognition (NER) is a key and fundamental part of many medical and clinical tasks, including the establishment of a medical knowledge graph, decision-making support, and question answering systems. When extracting entities from electronic health records (EHRs), NER models mostly apply long short-term memory (LSTM) and have surprising performance in clinical NER. However, increasing the depth of the network is often required by these LSTM-based models to capture long-distance dependencies. Therefore, these LSTM-based models that have achieved high accuracy generally require long training times and extensive training data, which has obstructed the adoption of LSTM-based models in clinical scenarios with limited training time.MethodInspired by Transformer, we combine Transformer with Soft Term Position Lattice to form soft lattice structure Transformer, which models long-distance dependencies similarly to LSTM. Our model consists of four components: the WordPiece module, the BERT module, the soft lattice structure Transformer module, and the CRF module.ResultOur experiments demonstrated that this approach increased the F1 by 1–5% in the CCKS NER task compared to other models based on LSTM with CRF and consumed less training time. Additional evaluations showed that lattice structure transformer shows good performance for recognizing long medical terms, abbreviations, and numbers. The proposed model achieve 91.6% f-measure in recognizing long medical terms and 90.36% f-measure in abbreviations, and numbers.ConclusionsBy using soft lattice structure Transformer, the method proposed in this paper captured Chinese words to lattice information, making our model suitable for Chinese clinical medical records. Transformers with Mutilayer soft lattice Chinese word construction can capture potential interactions between Chinese characters and words.

Evaluation of clinical named entity recognition methods for Serbian electronic health records

Background and objectivesThe importance of clinical natural language processing (NLP) has increased with the adoption of electronic health records (EHRs). One of the critical tasks in clinical NLP is named entity recognition (NER). Clinical NER in the Serbian language is a severely under-researched area. The few approaches that have been proposed so far are based on rules or machine-learning models with hand-crafted features, while current state-of-the-art models have not been explored. The objective of this paper is to assess the performance of state-of-the-art NER methods on clinical narratives in the Serbian language. Materials and methodsWe designed an experimental setup for a comprehensive evaluation of state-of-the-art NER models. The gold standard corpus we used for the evaluation is comprised of discharge summaries from the Clinic for Nephrology at the University Clinical Center of Serbia. The following models were evaluated: conditional random fields (CRF), multilingual transformers (BERT Multilingual and XLM RoBERTa), and long short-term memory (LSTM) recurrent neural networks, and their ensembles. In addition, we investigated the necessity of the pretraining task of transformer based models and the use of pretrained word embeddings with LSTM model. ResultsOur results show that individually CRF had the best precision, the pretrained BERT Multilingual model had the best recall values, and the LSTM model had the best F1 score. The best performance was achieved by combining the existing models in a majority voting ensemble with an F1 score of 0.892. The presented results are similar to the inter annotator agreement on our gold standard corpus and are comparable to existing state-of-the-art results for clinical NER reported in literature. ConclusionExisting state-of-the-art models can provide viable results for clinical named entity recognition when applied to languages with the complexity of the Serbian language without major modifications.

Chinese Clinical Named Entity Recognition with ALBERT and MHA Mechanism.

Traditional clinical named entity recognition methods fail to balance the effectiveness of feature extraction of unstructured text and the complexity of neural network models. We propose a model based on ALBERT and a multihead attention (MHA) mechanism to solve this problem. Structurally, the model first obtains character-level word embeddings through the ALBERT pretraining language model, then inputs the word embeddings into the iterated dilated convolutional neural network model to quickly extract global semantic information, and decodes the predicted labels through conditional random fields to obtain the optimal label sequence. Also, we apply the MHA mechanism to capture intercharacter dependencies from multiple aspects. Furthermore, we use the RAdam optimizer to boost the convergence speed and improve the generalization ability of our model. Experimental results show that our model achieves an F1 score of 85.63% on the CCKS-2019 dataset—an increase of 4.36% compared to the baseline model.

An RG-FLAT-CRF Model for Named Entity Recognition of Chinese Electronic Clinical Records

The goal of Clinical Named Entity Recognition (CNER) is to identify clinical terms from medical records, which is of great importance for subsequent clinical research. Most of the current Chinese CNER models use a single set of features that do not consider the linguistic characteristics of the Chinese language, e.g., they do not use both word and character features, and they lack morphological information and specialized lexical information on Chinese characters in the medical field. We propose a RoBerta Glyce-Flat Lattice Transformer-CRF (RG-FLAT-CRF) model to address this problem. The model uses a convolutional neural network to discern the morphological information hidden in Chinese characters, and a pre-trained model to obtain vectors with medical features. The different vectors are stitched together to form a multi-feature vector. To use lexical information and avoid the problem of word separation errors, the model uses a lattice structure to add lexical information associated with each word, which can be used to avoid the problem of word separation errors. The RG-FLAT-CRF model scored 95.61%, 85.17%, and 91.2% for F1 on the CCKS 2017, 2019, and 2020 datasets, respectively. We used statistical tests to compare with other models. The results show that most p-values less than 0.05 are statistically significant.

Privacy-preserving mimic models for clinical named entity recognition in French

A vast amount of crucial information about patients resides solely in unstructured clinical narrative notes. There has been a growing interest in clinical Named Entity Recognition (NER) task using deep learning models. Such approaches require sufficient annotated data. However, there is little publicly available annotated corpora in the medical field due to the sensitive nature of the clinical text. In this paper, we tackle this problem by building privacy-preserving shareable models for French clinical Named Entity Recognition using the mimic learning approach to enable the knowledge transfer through a teacher model trained on a private corpus to a student model. This student model could be publicly shared without any access to the original sensitive data. We evaluated three privacy-preserving models using three medical corpora and compared the performance of our models to those of baseline models such as dictionary-based models. An overall macro F-measure of 70.6% could be achieved by a student model trained using silver annotations produced by the teacher model, compared to 85.7% for the original private teacher model. Our results revealed that these privacy-preserving mimic learning models offer a good compromise between performance and data privacy preservation.

Leveraging Multi-source knowledge for Chinese clinical named entity recognition via relational graph convolutional network.

External knowledge, such as lexicon of words in Chinese and domain knowledge graph (KG) of concepts, has been recently adopted to improve the performance of machine learning methods for named entity recognition (NER) as it can provide additional information beyond context. However, most existing studies only consider knowledge from one source (i.e., either lexicon or knowledge graph) in different ways and consider lexicon words or KG concepts independently with their boundaries. In this paper, we focus on leveraging multi-source knowledge in a unified manner where lexicon words or KG concepts are well combined with their boundaries for Chinese Clinical NER (CNER). We propose a novel method based on relational graph convolutional network (RGCN), called MKRGCN, to utilize multi-source knowledge in a unified manner for CNER. For any sentence, a relational graph based on words or concepts in each knowledge source is constructed, where lexicon words or KG concepts appearing in the sentence are linked to the containing tokens with the boundary information of the lexicon words or KG concepts. RGCN is used to model all relational graphs constructed from multi-source knowledge, and the representations of tokens from multi-source knowledge are integrated into the context representations of tokens via an attention mechanism. Based on the knowledge-enhanced representations of tokens, we deploy a conditional random field (CRF) layer for named entity label prediction. In this study, a lexicon of words and a medical knowledge graph are used as knowledge sources for Chinese CNER. Our proposed method achieves the best performance on CCKS2017 and CCKS2018 in Chinese with F1-scores of 91.88% and 89.91%, respectively, significantly outperforming existing methods. The extended experiments on NCBI-Disease and BC2GM in English also prove the effectiveness of our method when only considering one knowledge source via RGCN. The MKRGCN model can integrate knowledge from the external lexicon and knowledge graph effectively for Chinese CNER and has the potential to be applied to English NER.

Chinese clinical named entity recognition via multi-head self-attention based BiLSTM-CRF

Clinical named entity recognition (CNER) is a fundamental step for many clinical Natural Language Processing (NLP) systems, which aims to recognize and classify clinical entities such as diseases, symptoms, exams, body parts and treatments in clinical free texts. In recent years, with the development of deep learning technology, deep neural networks (DNNs) have been widely used in Chinese clinical named entity recognition and many other clinical NLP tasks. However, these state-of-the-art models failed to make full use of the global information and multi-level semantic features in clinical texts. We design an improved character-level representation approach which integrates the character embedding and the character-label embedding to enhance the specificity and diversity of feature representations. Then, a multi-head self-attention based Bi-directional Long Short-Term Memory Conditional Random Field (MUSA-BiLSTM-CRF) model is proposed. By introducing the multi-head self-attention and combining a medical dictionary, the model can more effectively capture the weight relationships between characters and multi-level semantic feature information, which is expected to greatly improve the performance of Chinese clinical named entity recognition. We evaluate our model on two CCKS challenge (CCKS2017 Task 2 and CCKS2018 Task 1) benchmark datasets and the experimental results show that our proposed model achieves the best performance competing with the state-of-the-art DNN based methods.

Bi-level artificial intelligence model for risk classification of acute respiratory diseases based on Chinese clinical data.

Objective: The high incidence of respiratory diseases has dramatically increased the medical burden under the COVID-19 pandemic in the year 2020. It is of considerable significance to utilize a new generation of information technology to improve the artificial intelligence level of respiratory disease diagnosis. Methods: Based on the semi-structured data of Chinese Electronic Medical Records (CEMRs) from the China Hospital Pharmacovigilance System, this paper proposed a bi-level artificial intelligence model for the risk classification of acute respiratory diseases. It includes two levels. The first level is a dedicated design of the “BiLSTM+Dilated Convolution+3D Attention+CRF” deep learning model that is used for Chinese Clinical Named Entity Recognition (CCNER) to extract valuable information from the unstructured data in the CEMRs. Incorporating the transfer learning and semi-supervised learning technique into the proposed deep learning model achieves higher accuracy and efficiency in the CCNER task than the popular “Bert+BiLSTM+CRF” approach. Combining the extracted entity data with other structured data in the CEMRs, the second level is a customized XGBoost to realize the risk classification of acute respiratory diseases. Results: The empirical study shows that the proposed model could provide practical technical support for improving diagnostic accuracy. Conclusion: Our study provides a proof-of-concept for implementing a hybrid artificial intelligence-based system as a tool to aid clinicians in tackling CEMR data and enhancing the diagnostic evaluation under diagnostic uncertainty.

Investigation of the Utility of Features in a Clinical De-identification Model: A Demonstration Using EHR Pathology Reports for Advanced NSCLC Patients.

BackgroundElectronic health record (EHR) systems contain a large volume of texts, including visit notes, discharge summaries, and various reports. To protect the confidentiality of patients, these records often need to be fully de-identified before circulating for secondary use. Machine learning (ML) based named entity recognition (NER) model has emerged as a popular technique of automatic de-identification.ObjectiveThe performance of a machine learning model highly depends on the selection of appropriate features. The objective of this study was to investigate the usability of multiple features in building a conditional random field (CRF) based clinical de-identification NER model.MethodsUsing open-source natural language processing (NLP) toolkits, we annotated protected health information (PHI) in 1,500 pathology reports and built supervised NER models using multiple features and their combinations. We further investigated the dependency of a model's performance on the size of training data.ResultsAmong the 10 feature extractors explored in this study, n-gram, prefix–suffix, word embedding, and word shape performed the best. A model using combination of these four feature sets yielded precision, recall, and F1-score for each PHI as follows: NAME (0.80; 0.79; 0.80), LOCATION (0.85; 0.83; 0.84), DATE (0.86; 0.79; 0.82), HOSPITAL (0.96; 0.93; 0.95), ID (0.99; 0.82; 0.90), and INITIALS (0.97; 0.49; 0.65). We also found that the model's performance becomes saturated when the training data size is beyond 200.ConclusionManual de-identification of large-scale data is an impractical procedure since it is time-consuming and subject to human errors. Analysis of the NER model's performance in this study sheds light on a semi-automatic clinical de-identification pipeline for enterprise-wide data warehousing.