Comparing representations of long clinical texts for the task of patient note-identification

In this paper, we address the challenge of patient-note identification, which involves accurately matching an anonymized clinical note to its corresponding patient, represented by a set of related notes. This task has broad applications, including duplicate records detection and patient similarity analysis, which require robust patient-level representations. We explore various embedding methods, including Hierarchical Attention Networks (HAN), three-level Hierarchical Transformer Networks (HTN), LongFormer, and advanced BERT-based models, focusing on their ability to process mediumto-long clinical texts effectively. Additionally, we evaluate different pooling strategies (mean, max, and mean_max) for aggregating wordlevel embeddings into patient-level representations and we examine the impact of sliding windows on model performance. Our results indicate that BERT-based embeddings outperform traditional and hierarchical models, particularly in processing lengthy clinical notes and capturing nuanced patient representations. Among the pooling strategies, mean_max pooling consistently yields the best results, highlighting its ability to capture critical features from clinical notes. Furthermore, the reproduction of our results on both MIMIC dataset and Necker hospital data warehouse illustrates the generalizability of these approaches to real-world applications, emphasizing the importance of both embedding methods and aggregation strategies in optimizing patient-note identification and enhancing patient-level modeling.

Facilitating phenotyping from clinical texts: the medkit library

Phenotyping consists in applying algorithms to identify individuals associated with a specific, potentially complex, trait or condition, typically out of a collection of Electronic Health Records (EHRs). Because a lot of the clinical information of EHRs are lying in texts, phenotyping from text takes an important role in studies that rely on the secondary use of EHRs. However, the heterogeneity and highly specialized aspect of both the content and form of clinical texts makes this task particularly tedious, and is the source of time and cost constraints in observational studies. To facilitate the development, evaluation and reproductibility of phenotyping pipelines, we developed an open-source Python library named medkit. It enables composing data processing pipelines made of easy-to-reuse software bricks, named medkit operations. In addition to the core of the library, we share the operations and pipelines we already developed and invite the phenotyping community for their reuse and enrichment. medkit is available at https://github.com/medkit-lib/medkit

The Smart Data Extractor, a Clinician Friendly Solution to Accelerate and Improve the Data Collection During Clinical Trials

In medical research, the traditional way to collect data, i.e. browsing patient files, has been proven to induce bias, errors, human labor and costs. We propose a semi-automated system able to extract every type of data, including notes. The Smart Data Extractor pre-populates clinic research forms by following rules. We performed a cross-testing experiment to compare semi-automated to manual data collection. 20 target items had to be collected for 79 patients. The average time to complete one form was 6'81'' for manual data collection and 3'22'' with the Smart Data Extractor. There were also more mistakes during manual data collection (163 for the whole cohort) than with the Smart Data Extractor (46 for the whole cohort). We present an easy to use, understandable and agile solution to fill out clinical research forms. It reduces human effort and provides higher quality data, avoiding data re-entry and fatigue induced errors.