Melax Technologies, Inc, Houston, Texas, USA.
School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
J Am Med Inform Assoc. 2021 Jun 12;28(6):1275-1283. doi: 10.1093/jamia/ocab015.
The COVID-19 pandemic swept across the world rapidly, infecting millions of people. An efficient tool that can accurately recognize important clinical concepts of COVID-19 from free text in electronic health records (EHRs) will be valuable to accelerate COVID-19 clinical research. To this end, this study aims at adapting the existing CLAMP natural language processing tool to quickly build COVID-19 SignSym, which can extract COVID-19 signs/symptoms and their 8 attributes (body location, severity, temporal expression, subject, condition, uncertainty, negation, and course) from clinical text. The extracted information is also mapped to standard concepts in the Observational Medical Outcomes Partnership common data model. A hybrid approach of combining deep learning-based models, curated lexicons, and pattern-based rules was applied to quickly build the COVID-19 SignSym from CLAMP, with optimized performance. Our extensive evaluation using 3 external sites with clinical notes of COVID-19 patients, as well as the online medical dialogues of COVID-19, shows COVID-19 SignSym can achieve high performance across data sources. The workflow used for this study can be generalized to other use cases, where existing clinical natural language processing tools need to be customized for specific information needs within a short time. COVID-19 SignSym is freely accessible to the research community as a downloadable package (https://clamp.uth.edu/covid/nlp.php) and has been used by 16 healthcare organizations to support clinical research of COVID-19.
COVID-19 疫情在全球迅速蔓延,感染了数百万人。一种能够从电子健康记录 (EHR) 中的自由文本中准确识别 COVID-19 重要临床概念的有效工具,对于加速 COVID-19 临床研究将是非常有价值的。为此,本研究旨在适应现有的 CLAMP 自然语言处理工具,快速构建 COVID-19 SignSym,该工具可以从临床文本中提取 COVID-19 症状及其 8 个属性(身体部位、严重程度、时间表达、主体、情况、不确定性、否定和病程)。提取的信息也映射到观察性医学结局伙伴关系通用数据模型中的标准概念。本研究采用了深度学习模型、精心策划的词汇表和基于模式的规则相结合的混合方法,从 CLAMP 中快速构建 COVID-19 SignSym,并进行了优化性能。我们使用 3 个包含 COVID-19 患者临床记录的外部站点以及 COVID-19 的在线医疗对话进行了广泛的评估,结果表明 COVID-19 SignSym 在不同数据源上都能达到很高的性能。本研究中使用的工作流程可以推广到其他用例,在这些用例中,需要在短时间内为特定的信息需求定制现有的临床自然语言处理工具。COVID-19 SignSym 作为可下载的软件包(https://clamp.uth.edu/covid/nlp.php)免费提供给研究界,并已被 16 家医疗机构用于支持 COVID-19 的临床研究。