We propose a novel methodology to generate domain-specific large-scale question answering (QA) datasets by re-purposing existing annotations for other NLP tasks. We demonstrate an instance of this methodology in generating a large-scale QA dataset for electronic medical records by leveraging existing expert annotations on clinical notes for various NLP tasks from the community shared i2b2 datasets § . The resulting corpus (emrQA) has 1 million question-logical form and 400,000+ questionanswer evidence pairs. We characterize the dataset and explore its learning potential by training baseline models for question to logical form and question to answer mapping. § maximum representation of these templates comes from the i2b2 heart disease risk dataset
While much data within a patient's electronic health record (EHR) is coded, crucial information concerning the patient's care and management remain buried in unstructured clinical notes, making it difficult and time-consuming for physicians to review during their usual clinical workflow. In this paper, we present our clinical note processing pipeline, which extends beyond basic medical natural language processing (NLP) with concept recognition and relation detection to also include components specific to EHR data, such as structured data associated with the encounter, sentencelevel clinical aspects, and structures of the clinical notes. We report on the use of this pipeline in a disease-specific extractive text summarization task on clinical notes, focusing primarily on progress notes by physicians and nurse practitioners. We show how the addition of EHR-specific components to the pipeline resulted in an improvement in our overall system performance and discuss the potential impact of EHR-specific components on other higher-level clinical NLP tasks.
Cognitive computing systems like this Watson system hold the potential for accurate, problem-list-centered summarization of patient records, potentially leading to increased efficiency, better clinical decision support, and improved quality of patient care.
Background Although electronic health records (EHRs) have been widely adopted in health care, effective use of EHR data is often limited because of redundant information in clinical notes introduced by the use of templates and copy-paste during note generation. Thus, it is imperative to develop solutions that can condense information while retaining its value. A step in this direction is measuring the semantic similarity between clinical text snippets. To address this problem, we participated in the 2019 National NLP Clinical Challenges (n2c2)/Open Health Natural Language Processing Consortium (OHNLP) clinical semantic textual similarity (ClinicalSTS) shared task. Objective This study aims to improve the performance and robustness of semantic textual similarity in the clinical domain by leveraging manually labeled data from related tasks and contextualized embeddings from pretrained transformer-based language models. Methods The ClinicalSTS data set consists of 1642 pairs of deidentified clinical text snippets annotated in a continuous scale of 0-5, indicating degrees of semantic similarity. We developed an iterative intermediate training approach using multi-task learning (IIT-MTL), a multi-task training approach that employs iterative data set selection. We applied this process to bidirectional encoder representations from transformers on clinical text mining (ClinicalBERT), a pretrained domain-specific transformer-based language model, and fine-tuned the resulting model on the target ClinicalSTS task. We incrementally ensembled the output from applying IIT-MTL on ClinicalBERT with the output of other language models (bidirectional encoder representations from transformers for biomedical text mining [BioBERT], multi-task deep neural networks [MT-DNN], and robustly optimized BERT approach [RoBERTa]) and handcrafted features using regression-based learning algorithms. On the basis of these experiments, we adopted the top-performing configurations as our official submissions. Results Our system ranked first out of 87 submitted systems in the 2019 n2c2/OHNLP ClinicalSTS challenge, achieving state-of-the-art results with a Pearson correlation coefficient of 0.9010. This winning system was an ensembled model leveraging the output of IIT-MTL on ClinicalBERT with BioBERT, MT-DNN, and handcrafted medication features. Conclusions This study demonstrates that IIT-MTL is an effective way to leverage annotated data from related tasks to improve performance on a target task with a limited data set. This contribution opens new avenues of exploration for optimized data set selection to generate more robust and universal contextual representations of text in the clinical domain.
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