In electronic health records, text data is considered a valuable resource as it complements a medical history and may contain information that cannot be easily included in tables. But why does the inclusion of clinical texts as additional input into multimodal models, not always significantly improve the performance of medical decision-support systems? Explainable AI (XAI) might provide the answer. We examine which information in text and structured data influences the performance of models in the context of multimodal decision support for biomedical tasks. Using data from an intensive care unit and targeting a mortality prediction task, we compare information that has been considered relevant by XAI methods to the opinion of a physician.
In emergency wards, patients are prioritized by clinical staff according to the urgency of their medical condition. This can be achieved by categorizing patients into different labels of urgency ranging from immediate to not urgent. However, in order to train machine learning models offering support in this regard, there is more than approaching this as a multi-class problem. This work explores the challenges and obstacles of automatic triage using anonymized real-world multi-modal ambulance data in Germany.
User-generated data sources have gained significance in uncovering Adverse Drug Reactions (ADRs), with an increasing number of discussions occurring in the digital world. However, the existing clinical corpora predominantly revolve around scientific articles in English. This work presents a multilingual corpus of texts concerning ADRs gathered from diverse sources, including patient fora, social media, and clinical reports in German, French, and Japanese. Our corpus contains annotations covering 12 entity types, four attribute types, and 13 relation types. It contributes to the development of real-world multilingual language models for healthcare. We provide statistics to highlight certain challenges associated with the corpus and conduct preliminary experiments resulting in strong baselines for extracting entities and relations between these entities, both within and across languages.
This paper provides an overview of Task 2 from the Social Media Mining for Health 2024 shared task (#SMM4H 2024), which focused on Named Entity Recognition (NER, Subtask 2a) and the joint task of NER and Relation Extraction (RE, Subtask 2b) for detecting adverse drug reactions (ADRs) in German, Japanese, and French texts written by patients. Participants were challenged with a few-shot learning scenario, necessitating models that can effectively generalize from limited annotated examples. Despite the diverse strategies employed by the participants, the overall performance across submissions from three teams highlighted significant challenges. The results underscored the complexity of extracting entities and relations in multi-lingual contexts, especially from the noisy and informal nature of user-generated content. Further research is required to develop robust systems capable of accurately identifying and associating ADR-related information in low-resource and multilingual settings.
For the past nine years, the Social Media Mining for Health Applications (#SMM4H) shared tasks have promoted community-driven development and evaluation of advanced natural language processing systems to detect, extract, and normalize health-related information in publicly available user-generated content. This year, #SMM4H included seven shared tasks in English, Japanese, German, French, and Spanish from Twitter, Reddit, and health forums. A total of 84 teams from 22 countries registered for #SMM4H, and 45 teams participated in at least one task. This represents a growth of 180% and 160% in registration and participation, respectively, compared to the last iteration. This paper provides an overview of the tasks and participating systems. The data sets remain available upon request, and new systems can be evaluated through the post-evaluation phase on CodaLab.
This survey analyses how external knowledge can be integrated into language models in the context of retrieval-augmentation.The main goal of this work is to give an overview of: (1) Which external knowledge can be augmented? (2) Given a knowledge source, how to retrieve from it and then integrate the retrieved knowledge? To achieve this, we define and give a mathematical formulation of retrieval-augmented knowledge integration (RAKI). We discuss retrieval and integration techniques separately in detail, for each of the following knowledge formats: knowledge graph, tabular and natural language.
Since medical text cannot be shared easily due to privacy concerns, synthetic data bears much potential for natural language processing applications. In the context of social media and user-generated messages about drug intake and adverse drug effects, this work presents different methods to examine the authenticity of synthetic text. We conclude that the generated tweets are untraceable and show enough authenticity from the medical point of view to be used as a replacement for a real Twitter corpus. However, original data might still be the preferred choice as they contain much more diversity.
While text-based medical applications have become increasingly prominent, access to clinicaldata remains a major concern. To resolve this issue, further de-identification and anonymization of the data are required. This might, however, alter the contextual information within the clinical texts and therefore influence the learning and performance of possible language models. This paper systematically analyses the potential effects of various anonymization techniques on the performance of state-of-the-art machine learning models based on several datasets corresponding to five different NLP tasks. On this basis, we derive insightful findings and recommendations concerning text anonymization with regard to the performance of machine learning models. In addition, we present a simple re-identification attack applied to the anonymized text data, which can break the anonymization.
We present an overview of the Biomedical Translation Task that was part of the Eighth Conference on Machine Translation (WMT23). The aim of the task was the automatic translation of biomedical abstracts from the PubMed database. It included twelve language directions, namely, French, Spanish, Portuguese, Italian, German, and Russian, from and into English. We received submissions from 18 systems and for all the test sets that we released. Our comparison system was based on ChatGPT 3.5 and performed very well in comparison to many of the submissions.
In the seventh edition of the WMT Biomedical Task, we addressed a total of seven languagepairs, namely English/German, English/French, English/Spanish, English/Portuguese, English/Chinese, English/Russian, English/Italian. This year’s test sets covered three types of biomedical text genre. In addition to scientific abstracts and terminology items used in previous editions, we released test sets of clinical cases. The evaluation of clinical cases translations were given special attention by involving clinicians in the preparation of reference translations and manual evaluation. For the main MEDLINE test sets, we received a total of 609 submissions from 37 teams. For the ClinSpEn sub-task, we had the participation of five teams.
For different reasons, text can be difficult to read and understand for many people, especially if the text’s language is too complex. In order to provide suitable text for the target audience, it is necessary to measure its complexity. In this paper we describe subjective experiments to assess the readability of German text. We compile a new corpus of sentences provided by a German IT service provider. The sentences are annotated with the subjective complexity ratings by two groups of participants, namely experts and non-experts for that text domain. We then extract an extensive set of linguistically motivated features that are supposedly interacting with complexity perception. We show that a linear regression model with a subset of these features can be a very good predictor of text complexity.
In recent years, machine learning for clinical decision support has gained more and more attention. In order to introduce such applications into clinical practice, a good performance might be essential, however, the aspect of trust should not be underestimated. For the treating physician using such a system and being (legally) responsible for the decision made, it is particularly important to understand the system’s recommendation. To provide insights into a model’s decision, various techniques from the field of explainability (XAI) have been proposed whose output is often enough not targeted to the domain experts that want to use the model. To close this gap, in this work, we explore how explanations could possibly look like in future. To this end, this work presents a dataset of textual explanations in context of decision support. Within a reader study, human physicians estimated the likelihood of possible negative patient outcomes in the near future and justified each decision with a few sentences. Using those sentences, we created a novel corpus, annotated with different semantic layers. Moreover, we provide an analysis of how those explanations are constructed, and how they change depending on physician, on the estimated risk and also in comparison to an automatic clinical decision support system with feature importance.
In this work, we present the first corpus for German Adverse Drug Reaction (ADR) detection in patient-generated content. The data consists of 4,169 binary annotated documents from a German patient forum, where users talk about health issues and get advice from medical doctors. As is common in social media data in this domain, the class labels of the corpus are very imbalanced. This and a high topic imbalance make it a very challenging dataset, since often, the same symptom can have several causes and is not always related to a medication intake. We aim to encourage further multi-lingual efforts in the domain of ADR detection and provide preliminary experiments for binary classification using different methods of zero- and few-shot learning based on a multi-lingual model. When fine-tuning XLM-RoBERTa first on English patient forum data and then on the new German data, we achieve an F1-score of 37.52 for the positive class. We make the dataset and models publicly available for the community.
In the sixth edition of the WMT Biomedical Task, we addressed a total of eight language pairs, namely English/German, English/French, English/Spanish, English/Portuguese, English/Chinese, English/Russian, English/Italian, and English/Basque. Further, our tests were composed of three types of textual test sets. New to this year, we released a test set of summaries of animal experiments, in addition to the test sets of scientific abstracts and terminologies. We received a total of 107 submissions from 15 teams from 6 countries.
Machine translation of scientific abstracts and terminologies has the potential to support health professionals and biomedical researchers in some of their activities. In the fifth edition of the WMT Biomedical Task, we addressed a total of eight language pairs. Five language pairs were previously addressed in past editions of the shared task, namely, English/German, English/French, English/Spanish, English/Portuguese, and English/Chinese. Three additional languages pairs were also introduced this year: English/Russian, English/Italian, and English/Basque. The task addressed the evaluation of both scientific abstracts (all language pairs) and terminologies (English/Basque only). We received submissions from a total of 20 teams. For recurring language pairs, we observed an improvement in the translations in terms of automatic scores and qualitative evaluations, compared to previous years.
Many people share information in social media or forums, like food they eat, sports activities they do or events which have been visited. Information we share online unveil directly or indirectly information about our lifestyle and health situation. Particularly when text input is getting longer or multiple messages can be linked to each other. Those information can be then used to detect possible risk factors of diseases or adverse drug reactions of medications. However, as most people are not medical experts, language used might be more descriptive rather than the precise medical expression as medics do. To detect and use those relevant information, laymen language has to be translated and/or linked against the corresponding medical concept. This work presents baseline data sources in order to address this challenge for German language. We introduce a new dataset which annotates medical laymen and technical expressions in a patient forum, along with a set of medical synonyms and definitions, and present first baseline results on the data.
In research best practices can change over time as new discoveries are made and novel methods are implemented. Scientific publications reporting about the latest facts and current state-of-the-art can be possibly outdated after some years or even proved to be false. A publication usually sheds light only on the knowledge of the period it has been published. Thus, the aspect of time can play an essential role in the reliability of the presented information. In Natural Language Processing many methods focus on information extraction from text, such as detecting entities and their relationship to each other. Those methods mostly focus on the facts presented in the text itself and not on the aspects of knowledge which changes over time. This work instead examines the evolution in biomedical knowledge over time using scientific literature in terms of diachronic change. Mainly the usage of temporal and distributional concept representations are explored and evaluated by a proof-of-concept.
In many societies alcohol is a legal and common recreational substance and socially accepted. Alcohol consumption often comes along with social events as it helps people to increase their sociability and to overcome their inhibitions. On the other hand we know that increased alcohol consumption can lead to serious health issues, such as cancer, cardiovascular diseases and diseases of the digestive system, to mention a few. This work examines alcohol consumption during the FIFA Football World Cup 2018, particularly the usage of alcohol related information on Twitter. For this we analyse the tweeting behaviour and show that the tournament strongly increases the interest in beer. Furthermore we show that countries who had to leave the tournament at early stage might have done something good to their fans as the interest in beer decreased again.
Radiology reports express the results of a radiology study and contain information about anatomical entities, findings, measures and impressions of the medical doctor. The use of information extraction techniques can help physicians to access this information in order to understand data and to infer further knowledge. Supervised machine learning methods are very popular to address information extraction, but are usually domain and language dependent. To train new classification models, annotated data is required. Moreover, annotated data is also required as an evaluation resource of information extraction algorithms. However, one major drawback of processing clinical data is the low availability of annotated datasets. For this reason we performed a manual annotation of radiology reports written in Spanish. This paper presents the corpus, the annotation schema, the annotation guidelines and further insight of the data.
In this work we present a fine-grained annotation schema to detect named entities in German clinical data of chronically ill patients with kidney diseases. The annotation schema is driven by the needs of our clinical partners and the linguistic aspects of German language. In order to generate annotations within a short period, the work also presents a semi-automatic annotation which uses additional sources of knowledge such as UMLS, to pre-annotate concepts in advance. The presented schema will be used to apply novel techniques from natural language processing and machine learning to support doctors treating their patients by improved information access from unstructured German texts.
An important subtask in clinical text mining tries to identify whether a clinical finding is expressed as present, absent or unsure in a text. This work presents a system for detecting mentions of clinical findings that are negated or just speculated. The system has been applied to two different types of German clinical texts: clinical notes and discharge summaries. Our approach is built on top of NegEx, a well known algorithm for identifying non-factive mentions of medical findings. In this work, we adjust a previous adaptation of NegEx to German and evaluate the system on our data to detect negation and speculation. The results are compared to a baseline algorithm and are analyzed for both types of clinical documents. Our system achieves an F1-Score above 0.9 on both types of reports.