Is In-hospital Meta-information Useful for Abstractive Discharge Summary Generation?

During the patient's hospitalization, the physician must record daily observations of the patient and summarize them into a brief document called "discharge summary" when the patient is discharged. Automated generation of discharge summary can greatly relieve the physicians' burden, and has been addressed recently in the research community. Most previous studies of discharge summary generation using the sequence-to-sequence architecture focus on only inpatient notes for input. However, electric health records (EHR) also have rich structured metadata (e.g., hospital, physician, disease, length of stay, etc.) that might be useful. This paper investigates the effectiveness of medical meta-information for summarization tasks. We obtain four types of meta-information from the EHR systems and encode each meta-information into a sequence-to-sequence model. Using Japanese EHRs, meta-information encoded models increased ROUGE-1 by up to 4.45 points and BERTScore by 3.77 points over the vanilla Longformer. Also, we found that the encoded meta-information improves the precisions of its related terms in the outputs. Our results showed the benefit of the use of medical meta-information.

Exploring Optimal Granularity for Extractive Summarization of Unstructured Health Records: Analysis of the Largest Multi-Institutional Archive of Health Records in Japan

Automated summarization of clinical texts can reduce the burden of medical professionals. "Discharge summaries" are one promising application of the summarization, because they can be generated from daily inpatient records. Our preliminary experiment suggests that 20-31% of the descriptions in discharge summaries overlap with the content of the inpatient records. However, it remains unclear how the summaries should be generated from the unstructured source. To decompose the physician's summarization process, this study aimed to identify the optimal granularity in summarization. We first defined three types of summarization units with different granularities to compare the performance of the discharge summary generation: whole sentences, clinical segments, and clauses. We defined clinical segments in this study, aiming to express the smallest medically meaningful concepts. To obtain the clinical segments, it was necessary to automatically split the texts in the first stage of the pipeline. Accordingly, we compared rule-based methods and a machine learning method, and the latter outperformed the formers with an F1 score of 0.846 in the splitting task. Next, we experimentally measured the accuracy of extractive summarization using the three types of units, based on the ROUGE-1 metric, on a multi-institutional national archive of health records in Japan. The measured accuracies of extractive summarization using whole sentences, clinical segments, and clauses were 31.91, 36.15, and 25.18, respectively. We found that the clinical segments yielded higher accuracy than sentences and clauses. This result indicates that summarization of inpatient records demands finer granularity than sentence-oriented processing. Although we used only Japanese health records, it can be interpreted as follows: physicians extract "concepts of medical significance" from patient records and recombine them ...