Department of Medical Informatics, Amsterdam UMC (location AMC), Amsterdam, The Netherlands.
Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
PLoS One. 2023 Jan 3;18(1):e0279842. doi: 10.1371/journal.pone.0279842. eCollection 2023.
To reduce adverse drug events (ADEs), hospitals need a system to support them in monitoring ADE occurrence routinely, rapidly, and at scale. Natural language processing (NLP), a computerized approach to analyze text data, has shown promising results for the purpose of ADE detection in the context of pharmacovigilance. However, a detailed qualitative assessment and critical appraisal of NLP methods for ADE detection in the context of ADE monitoring in hospitals is lacking. Therefore, we have conducted a scoping review to close this knowledge gap, and to provide directions for future research and practice. We included articles where NLP was applied to detect ADEs in clinical narratives within electronic health records of inpatients. Quantitative and qualitative data items relating to NLP methods were extracted and critically appraised. Out of 1,065 articles screened for eligibility, 29 articles met the inclusion criteria. Most frequent tasks included named entity recognition (n = 17; 58.6%) and relation extraction/classification (n = 15; 51.7%). Clinical involvement was reported in nine studies (31%). Multiple NLP modelling approaches seem suitable, with Long Short Term Memory and Conditional Random Field methods most commonly used. Although reported overall performance of the systems was high, it provides an inflated impression given a steep drop in performance when predicting the ADE entity or ADE relation class. When annotating corpora, treating an ADE as a relation between a drug and non-drug entity seems the best practice. Future research should focus on semi-automated methods to reduce the manual annotation effort, and examine implementation of the NLP methods in practice.
为了减少药物不良事件 (ADE),医院需要一个系统来支持他们常规、快速和大规模地监测 ADE 的发生。自然语言处理 (NLP) 是一种计算机化的方法,可以分析文本数据,在药物警戒背景下用于检测 ADE 方面显示出有希望的结果。然而,在医院 ADE 监测背景下,针对 ADE 检测的 NLP 方法缺乏详细的定性评估和批判性评价。因此,我们进行了范围综述,以弥补这一知识空白,并为未来的研究和实践提供方向。我们纳入了将 NLP 应用于检测电子病历中住院患者临床叙述中 ADE 的文章。提取并批判性评价了与 NLP 方法相关的定量和定性数据项。在筛选出的 1065 篇符合条件的文章中,有 29 篇符合纳入标准。最常见的任务包括命名实体识别 (n = 17; 58.6%) 和关系提取/分类 (n = 15; 51.7%)。有 9 项研究报告了临床参与 (31%)。似乎多种 NLP 建模方法都适用,最常用的是长短期记忆和条件随机场方法。尽管报告的系统总体性能较高,但由于预测 ADE 实体或 ADE 关系类的性能急剧下降,因此给人留下了过高的印象。在标注语料库时,将 ADE 视为药物与非药物实体之间的关系似乎是最佳实践。未来的研究应集中在半自动方法上,以减少手动标注的工作量,并研究 NLP 方法在实践中的实施情况。