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Knowledge sources for Natural Language Processing.

This paper aims at reviewing the problem of feeding Natural Language Processing (NLP) tools with convenient linguistic knowledge in the medical domain. A syntactic approach lacks the potential to solve a number of typical situations with ambiguities and is clearly insufficient for quality treatment of natural language. On the other hand, a conceptual approach relies on some modelling of the domain, of which the elaboration is d long-term process and where the ultimate solutions are far from being recognised and universally accepted. In-between is the beauty of the compromise. How can we significantly improve the coverage of linguistic knowledge in the years to come?

Artificial Intelligence↗

The natural language processing of medical databases.

The consideration of natural language as a domain for computer processing has been one of the long-term projects in the history of data processing. Computers were developed in the late 40's and early 50's in the United States and from the very beginning there was a desire and intent that someday the computer would handle speech and be able to understand normal English literature and text with the coherency of a student or perhaps even an expert. Such breakthroughs have also been anticipated in the medical area. This paper will present a series of design specifications that facilitate the processing of natural language medical databases. Using these techniques it will be possible to expand the use of our traditional tools and exploit the effort that has been invested in these literary creations.

Information Systems↗

Recent advances in natural language processing for biomedical applications.

We survey a set a recent advances in natural language processing applied to biomedical applications, which were presented in Geneva, Switzerland, in 2004 at an international workshop. While text mining applied to molecular biology and biomedical literature can report several interesting achievements, we observe that studies applied to clinical contents are still rare. In general, we argue that clinical corpora, including electronic patient records, must be made available to fill the gap between bioinformatics and medical informatics.

Abstracting and Indexing↗

Facilitating research in pathology using natural language processing.

Clinical research projects frequently rely on manual extraction of information from pathology reports, which is a costly and time-consuming process. This paper describes use of a natural language processing (NLP) system to automatically extract and structure information in textual pathology reports that is needed for clinical research.

Biomedical Research↗

Medical facts to support inferencing in natural language processing.

We report on the use of medical facts to support the enhancement of natural language processing of biomedical text. Inferencing in semantic interpretation depends on a fact repository as well as an ontology. We used statistical methods to construct a repository of drug-disorder co-occurrences from a large collection of clinical notes, and this resource is used to validate inferences automatically drawn during semantic interpretation of Medline citations about pharmacologic interventions for disease. We evaluated the results against a published reference standard for treatment of diseases.

Disease↗

Extracting phenotypic information from the literature via natural language processing.

In recent years, the amount of biomedical knowledge has been increasing exponentially. Several Natural Language Processing (NLP) systems have been developed to help researchers extract, encode and organize new information automatically from textual literature or narrative reports. Some of these systems focus on extracting biological entities or molecular interactions while others retrieve and encode clinical information. To exploit gene functions in the post-genome era, it is necessary to extract phenotypic information automatically from the literature as well. However, few NLP projects have focused on this. We present the development of a system called BioMedLEE that extracts a broad variety of phenotypic information from the biomedical literature. The system was developed by adapting MedLEE, an existing clinical information extraction NLP engine. A feasibility evaluation study of BioMedLEE was performed using 300 randomly chosen journal titles. Results showed that experts achieved an average precision rate of 65.4%, (95%CI: [58.0%, 72.8%]) and a recall rate of 73.0%, (95%CI: [66.2%, 80.0%]). BioMedLEE had 64.0% precision and 77.1% recall respectively, according to expert agreements.

Databases as Topic↗

Automated encoding of clinical documents based on natural language processing.

OBJECTIVE: The aim of this study was to develop a method based on natural language processing (NLP) that automatically maps an entire clinical document to codes with modifiers and to quantitatively evaluate the method. METHODS: An existing NLP system, MedLEE, was adapted to automatically generate codes. The method involves matching of structured output generated by MedLEE consisting of findings and modifiers to obtain the most specific code. Recall and precision applied to Unified Medical Language System (UMLS) coding were evaluated in two separate studies. Recall was measured using a test set of 150 randomly selected sentences, which were processed using MedLEE. Results were compared with a reference standard determined manually by seven experts. Precision was measured using a second test set of 150 randomly selected sentences from which UMLS codes were automatically generated by the method and then validated by experts. RESULTS: Recall of the system for UMLS coding of all terms was .77 (95% CI.72-.81), and for coding terms that had corresponding UMLS codes recall was .83 (.79-.87). Recall of the system for extracting all terms was .84 (.81-.88). Recall of the experts ranged from .69 to .91 for extracting terms. The precision of the system was .89 (.87-.91), and precision of the experts ranged from .61 to .91. CONCLUSION: Extraction of relevant clinical information and UMLS coding were accomplished using a method based on NLP. The method appeared to be comparable to or better than six experts. The advantage of the method is that it maps text to codes along with other related information, rendering the coded output suitable for effective retrieval.

Abstracting and Indexing↗

Natural language processing in psychiatry. Artificial intelligence technology and psychopathology.

The potential benefit of artificial intelligence (AI) technology as a tool of psychiatry has not been well defined. In this essay, the technology of natural language processing and its position with regard to the two main schools of AI is clearly outlined. Past experiments utilizing AI techniques in understanding psychopathology are reviewed. Natural language processing can automate the analysis of transcripts and can be used in modeling theories of language comprehension. In these ways, it can serve as a tool in testing psychological theories of psychopathology and can be used as an effective tool in empirical research on verbal behavior in psychopathology.

Computer Simulation↗

Assessing the feasibility of large-scale natural language processing in a corpus of ordinary medical records: a lexical analysis.

OBJECTIVE: Identify the lexical content of a large corpus of ordinary medical records to assess the feasibility of large-scale natural language processing. METHODS: A corpus of 560 megabytes of medical record text from an academic medical center was broken into individual words and compared with the words in six medical vocabularies, a common word list, and a database of patient names. Unrecognized words were assessed for algorithmic and contextual approaches to identifying more words, while the remainder were analyzed for spelling correctness. RESULTS: About 60% of the words occurred in the medical vocabularies, common word list, or names database. Of the remainder, one-third were recognizable by other means. Of the remaining unrecognizable words, over three-fourths represented correctly spelled real words and the rest were misspellings. CONCLUSIONS: Large-scale generalized natural language processing methods for the medical record will require expansion of existing vocabularies, spelling error correction, and other algorithmic approaches to map words into those from clinical vocabularies.

Algorithms↗

GENIES: a natural-language processing system for the extraction of molecular pathways from journal articles.

Systems that extract structured information from natural language passages have been highly successful in specialized domains. The time is opportune for developing analogous applications for molecular biology and genomics. We present a system, GENIES, that extracts and structures information about cellular pathways from the biological literature in accordance with a knowledge model that we developed earlier. We implemented GENIES by modifying an existing medical natural language processing system, MedLEE, and performed a preliminary evaluation study. Our results demonstrate the value of the underlying techniques for the purpose of acquiring valuable knowledge from biological journals.

Artificial Intelligence↗

Natural language processing and semantical representation of medical texts.

For medical records, the challenge for the present decade is Natural Language Processing (NLP) of texts, and the construction of an adequate Knowledge Representation. This article describes the components of an NLP system, which is currently being developed in the Geneva Hospital, and within the European Community's AIM programme. They are: a Natural Language Analyser, a Conceptual Graphs Builder, a Data Base Storage component, a Query Processor, a Natural Language Generator and, in addition, a Translator, a Diagnosis Encoding System and a Literature Indexing System. Taking advantage of a closed domain of knowledge, defined around a medical specialty, a method called proximity processing has been developed. In this situation no parser of the initial text is needed, and the system is based on semantical information of near words in sentences. The benefits are: easy implementation, portability between languages, robustness towards badly-formed sentences, and a sound representation using conceptual graphs.

Abstracting and Indexing↗

Evaluating UMLS strings for natural language processing.

The National Library of Medicine's Unified Medical Language System (UMLS) is a rich source of knowledge in the biomedical domain. The UMLS is used for research and development in a range of different applications, including natural language processing (NLP). In this paper we investigate the nature of the strings found in the UMLS Metathesaurus and evaluate them for their usefulness in NLP. We begin by identifying a number of properties that might allow us to predict the likelihood of a given string being found or not found in a corpus. We use a statistical model to test these predictors against our corpus, which is derived from the MEDLINE database. For one set of properties the model correctly predicted 77% of the strings that do not belong to the corpus, and 85% of the strings that do belong to the corpus. For another set of properties the model correctly predicted 96% of the strings that do not belong to the corpus and 29% of the strings that do belong to the corpus.

MEDLINE↗

Representing information in patient reports using natural language processing and the extensible markup language.

OBJECTIVE: To design a document model that provides reliable and efficient access to clinical information in patient reports for a broad range of clinical applications, and to implement an automated method using natural language processing that maps textual reports to a form consistent with the model. METHODS: A document model that encodes structured clinical information in patient reports while retaining the original contents was designed using the extensible markup language (XML), and a document type definition (DTD) was created. An existing natural language processor (NLP) was modified to generate output consistent with the model. Two hundred reports were processed using the modified NLP system, and the XML output that was generated was validated using an XML validating parser. RESULTS: The modified NLP system successfully processed all 200 reports. The output of one report was invalid, and 199 reports were valid XML forms consistent with the DTD. CONCLUSIONS: Natural language processing can be used to automatically create an enriched document that contains a structured component whose elements are linked to portions of the original textual report. This integrated document model provides a representation where documents containing specific information can be accurately and efficiently retrieved by querying the structured components. If manual review of the documents is desired, the salient information in the original reports can also be identified and highlighted. Using an XML model of tagging provides an additional benefit in that software tools that manipulate XML documents are readily available.

Humans↗

Natural language processing to extract medical problems from electronic clinical documents: performance evaluation.

In this study, we evaluate the performance of a Natural Language Processing (NLP) application designed to extract medical problems from narrative text clinical documents. The documents come from a patient's electronic medical record and medical problems are proposed for inclusion in the patient's electronic problem list. This application has been developed to help maintain the problem list and make it more accurate, complete, and up-to-date. The NLP part of this system-analyzed in this study-uses the UMLS MetaMap Transfer (MMTx) application and a negation detection algorithm called NegEx to extract 80 different medical problems selected for their frequency of use in our institution. When using MMTx with its default data set, we measured a recall of 0.74 and a precision of 0.756. A custom data subset for MMTx was created, making it faster and significantly improving the recall to 0.896 with a non-significant reduction in precision.

Algorithms↗

Identification of suspected tuberculosis patients based on natural language processing of chest radiograph reports.

Identification of eligible patients from electronically available patient data is a key difficulty in computerizing clinical practice guidelines because a large amount of the relevant data is stored as free text. We have been using MedLEE (Medical Language Extraction and Encoding System), a natural language processing system, to encode the clinical information in all chest radiograph and mammogram reports. This paper describes a retrospective study to determine if MedLEE can identify patients at risk for having tuberculosis (TB) based on their admission chest radiographs. Reports of 171 adult inpatients with culture-positive TB during 1992 and 1993 were manually coded (by a TB specialist) using seven terms suggestive of TB, and were also encoded by MedLEE. Using manual coding as the gold standard, MedLEE agreed on the classification of 152/171 (88.9%) reports--129/142 (90.8%) suspicious for TB and 23/29 (79.3%) not suspicious for TB; and 1072/1197 (89.6%) terms indicative of TB. Analysis showed that most of the discrepancies were caused by MedLEE not finding the location of the infiltrate. By ignoring the location of the infiltrate, the agreement became 157/171 (91.8%) reports and 946/1026 (92.2%) terms. Thus, natural language processing offers a practical alternative for using free-text reports to determine patient eligibility for computerized clinical practice guidelines.

Adult↗

Formal ontology for natural language processing and the integration of biomedical databases.

The central hypothesis underlying this communication is that the methodology and conceptual rigor of a philosophically inspired formal ontology can bring significant benefits in the development and maintenance of application ontologies [A. Flett, M. Dos Santos, W. Ceusters, Some Ontology Engineering Procedures and their Supporting Technologies, EKAW2002, 2003]. This hypothesis has been tested in the collaboration between Language and Computing (L&C), a company specializing in software for supporting natural language processing especially in the medical field, and the Institute for Formal Ontology and Medical Information Science (IFOMIS), an academic research institution concerned with the theoretical foundations of ontology. In the course of this collaboration L&C's ontology, LinKBase, which is designed to integrate and support reasoning across a plurality of external databases, has been subjected to a thorough auditing on the basis of the principles underlying IFOMIS's Basic Formal Ontology (BFO) [B. Smith, Basic Formal Ontology, 2002. http://ontology.buffalo.edu/bfo]. The goal is to transform a large terminology-based ontology into one with the ability to support reasoning applications. Our general procedure has been the implementation of a meta-ontological definition space in which the definitions of all the concepts and relations in LinKBase are standardized in the framework of first-order logic. In this paper we describe how this principles-based standardization has led to a greater degree of internal coherence of the LinKBase structure, and how it has facilitated the construction of mappings between external databases using LinKBase as translation hub. We argue that the collaboration here described represents a new phase in the quest to solve the so-called "Tower of Babel" problem of ontology integration [F. Montayne, J. Flanagan, Formal Ontology: The Foundation for Natural Language Processing, 2003. http://www.landcglobal.com/].

Artificial Intelligence↗

Building an ontology of pulmonary diseases with natural language processing tools using textual corpora.

Pathologies and acts are classified in thesauri to help physicians to code their activity. In practice, the use of thesauri is not sufficient to reduce variability in coding and thesauri are not suitable for computer processing. We think the automation of the coding task requires a conceptual modeling of medical items: an ontology. Our task is to help lung specialists code acts and diagnoses with software that represents medical knowledge of this concerned specialty by an ontology. The objective of the reported work was to build an ontology of pulmonary diseases dedicated to the coding process. To carry out this objective, we develop a precise methodological process for the knowledge engineer in order to build various types of medical ontologies. This process is based on the need to express precisely in natural language the meaning of each concept using differential semantics principles. A differential ontology is a hierarchy of concepts and relationships organized according to their similarities and differences. Our main research hypothesis is to apply natural language processing tools to corpora to develop the resources needed to build the ontology. We consider two corpora, one composed of patient discharge summaries and the other being a teaching book. We propose to combine two approaches to enrich the ontology building: (i) a method which consists of building terminological resources through distributional analysis and (ii) a method based on the observation of corpus sequences in order to reveal semantic relationships. Our ontology currently includes 1550 concepts and the software implementing the coding process is still under development. Results show that the proposed approach is operational and indicates that the combination of these methods and the comparison of the resulting terminological structures give interesting clues to a knowledge engineer for the building of an ontology.

France↗

Discovering protein similarity using natural language processing.

Extracting protein interaction relationships from textual repositories, such as MEDLINE, may prove useful in generating novel biological hypotheses. Using abstracts relevant to two known functionally related proteins, we modified an existing natural language processing tool to extract protein interaction terms. We were able to obtain functional information about two proteins, Amyloid Precursor Protein and Prion Protein, that have been implicated in the etiology of Alzheimer's Disease and Creutzfeldt-Jakob Disease, respectively.

Amyloid beta-Protein Precursor↗