National Centre for Text Mining, School of Computer Science, University of Manchester, Manchester, United Kingdom.
J Am Med Inform Assoc. 2019 Jun 1;26(6):537-546. doi: 10.1093/jamia/ocz004.
We seek to quantify the mortality risk associated with mentions of medical concepts in textual electronic health records (EHRs). Recognizing mentions of named entities of relevant types (eg, conditions, symptoms, laboratory tests or behaviors) in text is a well-researched task. However, determining the level of risk associated with them is partly dependent on the textual context in which they appear, which may describe severity, temporal aspects, quantity, etc.
To take into account that a given word appearing in the context of different risk factors (medical concepts) can make different contributions toward risk level, we propose a multitask approach, called context-aware linear modeling, which can be applied using appropriately regularized linear regression. To improve the performance for risk factors unseen in training data (eg, rare diseases), we take into account their distributional similarity to other concepts.
The evaluation is based on a corpus of 531 reports from EHRs with 99 376 risk factors rated manually by experts. While context-aware linear modeling significantly outperforms single-task models, taking into account concept similarity further improves performance, reaching the level of human annotators' agreements.
Our results show that automatic quantification of risk factors in EHRs can achieve performance comparable to human assessment, and taking into account the multitask structure of the problem and the ability to handle rare concepts is crucial for its accuracy.
我们旨在量化电子病历(EHR)文本中提及医学概念与死亡率之间的关联风险。识别文本中相关类型(如病症、症状、实验室检查或行为)的命名实体提及已得到充分研究。然而,确定与它们相关的风险水平部分取决于它们出现的文本上下文,上下文可能描述严重程度、时间方面、数量等。
为了考虑到在不同风险因素(医学概念)的上下文中出现的给定单词可能对风险水平有不同的贡献,我们提出了一种称为上下文感知线性建模的多任务方法,它可以使用适当正则化的线性回归来应用。为了提高对训练数据中未见过的风险因素(例如罕见疾病)的性能,我们考虑了它们与其他概念的分布相似性。
评估基于一个由 531 份来自 EHR 的报告组成的语料库,其中 99376 个风险因素由专家手动评分。虽然上下文感知线性建模明显优于单任务模型,但考虑到概念相似性进一步提高了性能,达到了人类注释者协议的水平。
我们的研究结果表明,EHR 中风险因素的自动量化可以达到与人类评估相当的性能,并且考虑到问题的多任务结构和处理罕见概念的能力对于准确性至关重要。