Unsupervised Ensemble Ranking of Terms in Electronic Health Record Notes Based on Their Importance to Patients

Background: Electronic health record (EHR) notes contain abundant medical jargon that can be difficult for patients to comprehend. One way to help patients is to reduce information overload and help them focus on medical terms that matter most to them. Objective: The aim of this work was to develop FIT (Finding Important Terms for patients), an unsupervised natural language processing (NLP) system that ranks medical terms in EHR notes based on their importance to patients. Methods: We built FIT on a new unsupervised ensemble ranking model derived from the biased random walk algorithm to combine heterogeneous information resources for ranking candidate terms from each EHR note. Specifically, FIT integrates four single views for term importance: patient use of medical concepts, document-level term salience, word-occurrence based term relatedness, and topic coherence. It also incorporates partial information of term importance as conveyed by terms' unfamiliarity levels and semantic types. We evaluated FIT on 90 expert-annotated EHR notes and compared it with three benchmark unsupervised ensemble ranking methods. Results: FIT achieved 0.885 AUC-ROC for ranking candidate terms from EHR notes to identify important terms. When including term identification, the performance of FIT for identifying important terms from EHR notes was 0.813 AUC-ROC. It outperformed the three ensemble rankers for most metrics. Its performance is relatively insensitive to its parameter. Conclusions: FIT can automatically identify EHR terms important to patients and may help develop personalized interventions to improve quality of care. By using unsupervised learning as well as a robust and flexible framework for information fusion, FIT can be readily applied to other domains and applications.

Ranking medical jargon in electronic health record notes by adapted distant supervision

Objective: Allowing patients to access their own electronic health record (EHR) notes through online patient portals has the potential to improve patient-centered care. However, medical jargon, which abounds in EHR notes, has been shown to be a barrier for patient EHR comprehension. Existing knowledge bases that link medical jargon to lay terms or definitions play an important role in alleviating this problem but have low coverage of medical jargon in EHRs. We developed a data-driven approach that mines EHRs to identify and rank medical jargon based on its importance to patients, to support the building of EHR-centric lay language resources. Methods: We developed an innovative adapted distant supervision (ADS) model based on support vector machines to rank medical jargon from EHRs. For distant supervision, we utilized the open-access, collaborative consumer health vocabulary, a large, publicly available resource that links lay terms to medical jargon. We explored both knowledge-based features from the Unified Medical Language System and distributed word representations learned from unlabeled large corpora. We evaluated the ADS model using physician-identified important medical terms. Results: Our ADS model significantly surpassed two state-of-the-art automatic term recognition methods, TF*IDF and C-Value, yielding 0.810 ROC-AUC versus 0.710 and 0.667, respectively. Our model identified 10K important medical jargon terms after ranking over 100K candidate terms mined from over 7,500 EHR narratives. Conclusion: Our work is an important step towards enriching lexical resources that link medical jargon to lay terms/definitions to support patient EHR comprehension. The identified medical jargon terms and their rankings are available upon request.

Learning for Biomedical Information Extraction: Methodological Review of Recent Advances

Biomedical information extraction (BioIE) is important to many applications, including clinical decision support, integrative biology, and pharmacovigilance, and therefore it has been an active research. Unlike existing reviews covering a holistic view on BioIE, this review focuses on mainly recent advances in learning based approaches, by systematically summarizing them into different aspects of methodological development. In addition, we dive into open information extraction and deep learning, two emerging and influential techniques and envision next generation of BioIE.