Synth-SBDH: A Synthetic Dataset of Social and Behavioral Determinants of Health for Clinical Text

Social and behavioral determinants of health (SBDH) play a crucial role in health outcomes and are frequently documented in clinical text. Automatically extracting SBDH information from clinical text relies on publicly available good-quality datasets. However, existing SBDH datasets exhibit substantial limitations in their availability and coverage. In this study, we introduce Synth-SBDH, a novel synthetic dataset with detailed SBDH annotations, encompassing status, temporal information, and rationale across 15 SBDH categories. We showcase the utility of Synth-SBDH on three tasks using real-world clinical datasets from two distinct hospital settings, highlighting its versatility, generalizability, and distillation capabilities. Models trained on Synth-SBDH consistently outperform counterparts with no Synth-SBDH training, achieving up to 62.5% macro-F improvements. Additionally, Synth-SBDH proves effective for rare SBDH categories and under-resource constraints. Human evaluation demonstrates a Human-LLM alignment of 71.06% and uncovers areas for future refinements.

ODD: A Benchmark Dataset for the NLP-based Opioid Related Aberrant Behavior Detection

Opioid related aberrant behaviors (ORAB) present novel risk factors for opioid overdose. Previously, ORAB have been mainly assessed by survey results and by monitoring drug administrations. Such methods however, cannot scale up and do not cover the entire spectrum of aberrant behaviors. On the other hand, ORAB are widely documented in electronic health record notes. This paper introduces a novel biomedical natural language processing benchmark dataset named ODD, for ORAB Detection Dataset. ODD is an expert-annotated dataset comprising of more than 750 publicly available EHR notes. ODD has been designed to identify ORAB from patients' EHR notes and classify them into nine categories; 1) Confirmed Aberrant Behavior, 2) Suggested Aberrant Behavior, 3) Opioids, 4) Indication, 5) Diagnosed opioid dependency, 6) Benzodiapines, 7) Medication Changes, 8) Central Nervous System-related, and 9) Social Determinants of Health. We explored two state-of-the-art natural language processing (NLP) models (finetuning pretrained language models and prompt-tuning approaches) to identify ORAB. Experimental results show that the prompt-tuning models outperformed the finetuning models in most cateogories and the gains were especially higher among uncommon categories (Suggested aberrant behavior, Diagnosed opioid dependency and Medication change). Although the best model achieved the highest 83.92% on area under precision recall curve, uncommon classes (Suggested Aberrant Behavior, Diagnosed Opioid Dependence, and Medication Change) still have a large room for performance improvement.

Automated Identification of Eviction Status from Electronic Health Record Notes

Objective: Evictions are involved in a cascade of negative events that can lead to unemployment, homelessness, long-term poverty, and mental health problems. In this study, we developed a natural language processing system to automatically detect eviction incidences and their attributes from electronic health record (EHR) notes. Materials and Methods: We annotated eviction status in 5000 EHR notes from the Veterans Health Administration. We developed a novel model, called Knowledge Injection based on Ripple Effects of Social and Behavioral Determinants of Health (KIRESH), that has shown to substantially outperform other state-of-the-art models such as fine-tuning pre-trained language models like BioBERT and Bio_ClinicalBERT. Moreover, we designed a prompt to further improve the model performance by using the intrinsic connection between the two sub-tasks of eviction presence and period prediction. Finally, we used the Temperature Scaling-based Calibration on our KIRESH-Prompt method to avoid over-confidence issues arising from the imbalance dataset. Results: KIRESH-Prompt achieved a Macro-F1 of 0.6273 (presence) and 0.7115 (period), which was significantly higher than 0.5382 (presence) and 0.67167 (period) for just fine-tuning Bio_ClinicalBERT model. Conclusion and Future Work: KIRESH-Prompt has substantially improved eviction status classification. In future work, we will evaluate the generalizability of the model framework to other applications.