Extracting causal relationships from a medical case report is essential for comprehending the case, particularly its diagnostic process. Since the diagnostic process is regarded as a bottom-up inference, causal relationships in cases naturally form a multi-layered tree structure. The existing tasks, such as medical relation extraction, are insufficient for capturing the causal relationships of an entire case, as they treat all relations equally without considering the hierarchical structure inherent in the diagnostic process. Thus, we propose a novel task, Causal Tree Extraction (CTE), which receives a case report and generates a causal tree with the primary disease as the root, providing an intuitive understanding of a case's diagnostic process. Subsequently, we construct a Japanese case report CTE dataset, J-Casemap, propose a generation-based CTE method that outperforms the baseline by 20.2 points in the human evaluation, and introduce evaluation metrics that reflect clinician preferences. Further experiments also show that J-Casemap enhances the performance of solving other medical tasks, such as question answering.
Federated medical relation extraction enables multiple clients to train a deep network collaboratively without sharing their raw medical data. In order to handle the heterogeneous label distribution across clients, most of the existing works only involve enforcing regularization between local and global models during optimization. In this paper, we fully utilize the models of all clients and propose a novel concept of \textit{major classifier vectors}, where a group of class vectors is obtained in an ensemble rather than the weighted average method on the server. The major classifier vectors are then distributed to all clients and the local training of each client is Contrasted with Major Classifier vectors (FedCMC), so the local model is not prone to overfitting to the local label distribution. FedCMC requires only a small amount of additional transfer of classifier parameters without any leakage of raw data, extracted representations, and label distributions. Our extensive experiments show that FedCMC outperforms the other state-of-the-art FL algorithms on three medical relation extraction datasets.
Medical Relation Extraction (MRE) task aims to extract relations between entities in medical texts. Traditional relation extraction methods achieve impressive success by exploring the syntactic information, e.g., dependency tree. However, the quality of the 1-best dependency tree for medical texts produced by an out-of-domain parser is relatively limited so that the performance of medical relation extraction method may degenerate. To this end, we propose a method to jointly model semantic and syntactic information from medical texts based on causal explanation theory. We generate dependency forests consisting of the semantic-embedded 1-best dependency tree. Then, a task-specific causal explainer is adopted to prune the dependency forests, which are further fed into a designed graph convolutional network to learn the corresponding representation for downstream task. Empirically, the various comparisons on benchmark medical datasets demonstrate the effectiveness of our model.
Language model (LM) pretraining can learn various knowledge from text corpora, helping downstream tasks. However, existing methods such as BERT model a single document, and do not capture dependencies or knowledge that span across documents. In this work, we propose LinkBERT, an LM pretraining method that leverages links between documents, e.g., hyperlinks. Given a text corpus, we view it as a graph of documents and create LM inputs by placing linked documents in the same context. We then pretrain the LM with two joint self-supervised objectives: masked language modeling and our new proposal, document relation prediction. We show that LinkBERT outperforms BERT on various downstream tasks across two domains: the general domain (pretrained on Wikipedia with hyperlinks) and biomedical domain (pretrained on PubMed with citation links). LinkBERT is especially effective for multi-hop reasoning and few-shot QA (+5% absolute improvement on HotpotQA and TriviaQA), and our biomedical LinkBERT sets new states of the art on various BioNLP tasks (+7% on BioASQ and USMLE). We release our pretrained models, LinkBERT and BioLinkBERT, as well as code and data at https://github.com/michiyasunaga/LinkBERT.
There is an increasing interest in developing artificial intelligence (AI) systems to process and interpret electronic health records (EHRs). Natural language processing (NLP) powered by pretrained language models is the key technology for medical AI systems utilizing clinical narratives. However, there are few clinical language models, the largest of which trained in the clinical domain is comparatively small at 110 million parameters (compared with billions of parameters in the general domain). It is not clear how large clinical language models with billions of parameters can help medical AI systems utilize unstructured EHRs. In this study, we develop from scratch a large clinical language model - GatorTron - using >90 billion words of text (including >82 billion words of de-identified clinical text) and systematically evaluate it on 5 clinical NLP tasks including clinical concept extraction, medical relation extraction, semantic textual similarity, natural language inference (NLI), and medical question answering (MQA). We examine how (1) scaling up the number of parameters and (2) scaling up the size of the training data could benefit these NLP tasks. GatorTron models scale up the clinical language model from 110 million to 8.9 billion parameters and improve 5 clinical NLP tasks (e.g., 9.6% and 9.5% improvement in accuracy for NLI and MQA), which can be applied to medical AI systems to improve healthcare delivery. The GatorTron models are publicly available at: https://catalog.ngc.nvidia.com/orgs/nvidia/teams/clara/models/gatortron_og.
Artificial Intelligence (AI), along with the recent progress in biomedical language understanding, is gradually changing medical practice. With the development of biomedical language understanding benchmarks, AI applications are widely used in the medical field. However, most benchmarks are limited to English, which makes it challenging to replicate many of the successes in English for other languages. To facilitate research in this direction, we collect real-world biomedical data and present the first Chinese Biomedical Language Understanding Evaluation (CBLUE) benchmark: a collection of natural language understanding tasks including named entity recognition, information extraction, clinical diagnosis normalization, single-sentence/sentence-pair classification, and an associated online platform for model evaluation, comparison, and analysis. To establish evaluation on these tasks, we report empirical results with the current 11 pre-trained Chinese models, and experimental results show that state-of-the-art neural models perform by far worse than the human ceiling. Our benchmark is released at \url{https://tianchi.aliyun.com/dataset/dataDetail?dataId=95414&lang=en-us}.
Joint medical relation extraction refers to extracting triples, composed of entities and relations, from the medical text with a single model. One of the solutions is to convert this task into a sequential tagging task. However, in the existing works, the methods of representing and tagging the triples in a linear way failed to the overlapping triples, and the methods of organizing the triples as a graph faced the challenge of large computational effort. In this paper, inspired by the tree-like relation structures in the medical text, we propose a novel scheme called Bidirectional Tree Tagging (BiTT) to form the medical relation triples into two two binary trees and convert the trees into a word-level tags sequence. Based on BiTT scheme, we develop a joint relation extraction model to predict the BiTT tags and further extract medical triples efficiently. Our model outperforms the best baselines by 2.0\% and 2.5\% in F1 score on two medical datasets. What's more, the models with our BiTT scheme also obtain promising results in three public datasets of other domains.
Medical relation extraction discovers relations between entity mentions in text, such as research articles. For this task, dependency syntax has been recognized as a crucial source of features. Yet in the medical domain, 1-best parse trees suffer from relatively low accuracies, diminishing their usefulness. We investigate a method to alleviate this problem by utilizing dependency forests. Forests contain many possible decisions and therefore have higher recall but more noise compared with 1-best outputs. A graph neural network is used to represent the forests, automatically distinguishing the useful syntactic information from parsing noise. Results on two biomedical benchmarks show that our method outperforms the standard tree-based methods, giving the state-of-the-art results in the literature.
Biomedical text mining is becoming increasingly important as the number of biomedical documents rapidly grows. With the progress in natural language processing (NLP), extracting valuable information from biomedical literature has gained popularity among researchers, and deep learning has boosted the development of effective biomedical text mining models. However, directly applying the advancements in NLP to biomedical text mining often yields unsatisfactory results due to a word distribution shift from general domain corpora to biomedical corpora. In this article, we investigate how the recently introduced pre-trained language model BERT can be adapted for biomedical corpora. We introduce BioBERT (Bidirectional Encoder Representations from Transformers for Biomedical Text Mining), which is a domain-specific language representation model pre-trained on large-scale biomedical corpora. With almost the same architecture across tasks, BioBERT largely outperforms BERT and previous state-of-the-art models in a variety of biomedical text mining tasks when pre-trained on biomedical corpora. While BERT obtains performance comparable to that of previous state-of-the-art models, BioBERT significantly outperforms them on the following three representative biomedical text mining tasks: biomedical named entity recognition (0.62% F1 score improvement), biomedical relation extraction (2.80% F1 score improvement) and biomedical question answering (12.24% MRR improvement). Our analysis results show that pre-training BERT on biomedical corpora helps it to understand complex biomedical texts. We make the pre-trained weights of BioBERT freely available at https://github.com/naver/biobert-pretrained, and the source code for fine-tuning BioBERT available at https://github.com/dmis-lab/biobert.
Mining relationships between treatment(s) and medical problem(s) is vital in the biomedical domain. This helps in various applications, such as decision support system, safety surveillance, and new treatment discovery. We propose a deep learning approach that utilizes both word level and sentence-level representations to extract the relationships between treatment and problem. While deep learning techniques demand a large amount of data for training, we make use of a rule-based system particularly for relationship classes with fewer samples. Our final relations are derived by jointly combining the results from deep learning and rule-based models. Our system achieved a promising performance on the relationship classes of I2b2 2010 relation extraction task.
Simultaneous administration of multiple drugs can have synergistic or antagonistic effects as one drug can affect activities of other drugs. Synergistic effects lead to improved therapeutic outcomes, whereas, antagonistic effects can be life-threatening, may lead to increased healthcare cost, or may even cause death. Thus identification of unknown drug-drug interaction (DDI) is an important concern for efficient and effective healthcare. Although multiple resources for DDI exist, they are often unable to keep pace with rich amount of information available in fast growing biomedical texts. Most existing methods model DDI extraction from text as a classification problem and mainly rely on handcrafted features. Some of these features further depend on domain specific tools. Recently neural network models using latent features have been shown to give similar or better performance than the other existing models dependent on handcrafted features. In this paper, we present three models namely, {\it B-LSTM}, {\it AB-LSTM} and {\it Joint AB-LSTM} based on long short-term memory (LSTM) network. All three models utilize word and position embedding as latent features and thus do not rely on explicit feature engineering. Further use of bidirectional long short-term memory (Bi-LSTM) networks allow implicit feature extraction from the whole sentence. The two models, {\it AB-LSTM} and {\it Joint AB-LSTM} also use attentive pooling in the output of Bi-LSTM layer to assign weights to features. Our experimental results on the SemEval-2013 DDI extraction dataset show that the {\it Joint AB-LSTM} model outperforms all the existing methods, including those relying on handcrafted features. The other two proposed LSTM models also perform competitively with state-of-the-art methods.
Cognitive computing systems require human labeled data for evaluation, and often for training. The standard practice used in gathering this data minimizes disagreement between annotators, and we have found this results in data that fails to account for the ambiguity inherent in language. We have proposed the CrowdTruth method for collecting ground truth through crowdsourcing, that reconsiders the role of people in machine learning based on the observation that disagreement between annotators provides a useful signal for phenomena such as ambiguity in the text. We report on using this method to build an annotated data set for medical relation extraction for the $cause$ and $treat$ relations, and how this data performed in a supervised training experiment. We demonstrate that by modeling ambiguity, labeled data gathered from crowd workers can (1) reach the level of quality of domain experts for this task while reducing the cost, and (2) provide better training data at scale than distant supervision. We further propose and validate new weighted measures for precision, recall, and F-measure, that account for ambiguity in both human and machine performance on this task.