Cosmin Adrian Bejan

Desiderata for computable representations of electronic health records-driven phenotype algorithms.

Background Electronic health records (EHRs) are increasingly used for clinical and translational research through the creation of phenotype algorithms. Currently, phenotype algorithms are most commonly represented as noncomputable descriptive documents and knowledge artifacts that detail the protocols for querying diagnoses, symptoms, procedures, medications, and/or text-driven medical concepts, and are primarily meant for human comprehension. We present desiderata for developing a computable phenotype representation model (PheRM). Methods A team of clinicians and informaticians reviewed common features for multisite phenotype algorithms published in PheKB.org and existing phenotype representation platforms. We also evaluated well-known diagnostic criteria and clinical decision-making guidelines to encompass a broader category of algorithms. Results We propose 10 desired characteristics for a flexible, computable PheRM: (1) structure clinical data into queryable forms; (2) recommend use of a common data model, but also support customization for the variability and availability of EHR data among sites; (3) support both human-readable and computable representations of phenotype algorithms; (4) implement set operations and relational algebra for modeling phenotype algorithms; (5) represent phenotype criteria with structured rules; (6) support defining temporal relations between events; (7) use standardized terminologies and ontologies, and facilitate reuse of value sets; (8) define representations for text searching and natural language processing; (9) provide interfaces for external software algorithms; and (10) maintain backward compatibility. Conclusion A computable PheRM is needed for true phenotype portability and reliability across different EHR products and healthcare systems. These desiderata are a guide to inform the establishment and evolution of EHR phenotype algorithm authoring platforms and languages.

Unsupervised event coreference resolution

The task of event coreference resolution plays a critical role in many natural language processing applications such as information extraction, question answering, and topic detection and tracking. In this article, we describe a new class of unsupervised, nonparametric Bayesian models with the purpose of probabilistically inferring coreference clusters of event mentions from a collection of unlabeled documents. In order to infer these clusters, we automatically extract various lexical, syntactic, and semantic features for each event mention from the document collection. Extracting a rich set of features for each event mention allows us to cast event coreference resolution as the task of grouping together the mentions that share the same features (they have the same participating entities, share the same location, happen at the same time, etc.).Some of the most important challenges posed by the resolution of event coreference in an unsupervised way stem from (a) the choice of representing event mentions through a rich set of features and (b) the ability of modeling events described both within the same document and across multiple documents. Our first unsupervised model that addresses these challenges is a generalization of the hierarchical Dirichlet process. This new extension presents the hierarchical Dirichlet processs ability to capture the uncertainty regarding the number of clustering components and, additionally, takes into account any finite number of features associated with each event mention. Furthermore, to overcome some of the limitations of this extension, we devised a new hybrid model, which combines an infinite latent class model with a discrete time series model. The main advantage of this hybrid model stands in its capability to automatically infer the number of features associated with each event mention from data and, at the same time, to perform an automatic selection of the most informative features for the task of event coreference. The evaluation performed for solving both within- and cross-document event coreference shows significant improvements of these models when compared against two baselines for this task.

UTD-SRL: A Pipeline Architecture for Extracting Frame Semantic Structures

This paper describes our system for the task of extracting frame semantic structures in SemEval--2007. The system architecture uses two types of learning models in each part of the task: Support Vector Machines (SVM) and Maximum Entropy (ME). Designed as a pipeline of classifiers, the semantic parsing system obtained competitive precision scores on the test data.

Building bridges across electronic health record systems through inferred phenotypic topics

OBJECTIVE Data in electronic health records (EHRs) is being increasingly leveraged for secondary uses, ranging from biomedical association studies to comparative effectiveness. To perform studies at scale and transfer knowledge from one institution to another in a meaningful way, we need to harmonize the phenotypes in such systems. Traditionally, this has been accomplished through expert specification of phenotypes via standardized terminologies, such as billing codes. However, this approach may be biased by the experience and expectations of the experts, as well as the vocabulary used to describe such patients. The goal of this work is to develop a data-driven strategy to (1) infer phenotypic topics within patient populations and (2) assess the degree to which such topics facilitate a mapping across populations in disparate healthcare systems. METHODS We adapt a generative topic modeling strategy, based on latent Dirichlet allocation, to infer phenotypic topics. We utilize a variance analysis to assess the projection of a patient population from one healthcare system onto the topics learned from another system. The consistency of learned phenotypic topics was evaluated using (1) the similarity of topics, (2) the stability of a patient population across topics, and (3) the transferability of a topic across sites. We evaluated our approaches using four months of inpatient data from two geographically distinct healthcare systems: (1) Northwestern Memorial Hospital (NMH) and (2) Vanderbilt University Medical Center (VUMC). RESULTS The method learned 25 phenotypic topics from each healthcare system. The average cosine similarity between matched topics across the two sites was 0.39, a remarkably high value given the very high dimensionality of the feature space. The average stability of VUMC and NMH patients across the topics of two sites was 0.988 and 0.812, respectively, as measured by the Pearson correlation coefficient. Also the VUMC and NMH topics have smaller variance of characterizing patient population of two sites than standard clinical terminologies (e.g., ICD9), suggesting they may be more reliably transferred across hospital systems. CONCLUSIONS Phenotypic topics learned from EHR data can be more stable and transferable than billing codes for characterizing the general status of a patient population. This suggests that EHR-based research may be able to leverage such phenotypic topics as variables when pooling patient populations in predictive models.

Assessing the role of a medication-indication resource in the treatment relation extraction from clinical text

OBJECTIVE To evaluate the contribution of the MEDication Indication (MEDI) resource and SemRep for identifying treatment relations in clinical text. MATERIALS AND METHODS We first processed clinical documents with SemRep to extract the Unified Medical Language System (UMLS) concepts and the treatment relations between them. Then, we incorporated MEDI into a simple algorithm that identifies treatment relations between two concepts if they match a medication-indication pair in this resource. For a better coverage, we expanded MEDI using ontology relationships from RxNorm and UMLS Metathesaurus. We also developed two ensemble methods, which combined the predictions of SemRep and the MEDI algorithm. We evaluated our selected methods on two datasets, a Vanderbilt corpus of 6864 discharge summaries and the 2010 Informatics for Integrating Biology and the Bedside (i2b2)/Veterans Affairs (VA) challenge dataset. RESULTS The Vanderbilt dataset included 958 manually annotated treatment relations. A double annotation was performed on 25% of relations with high agreement (Cohens κ = 0.86). The evaluation consisted of comparing the manual annotated relations with the relations identified by SemRep, the MEDI algorithm, and the two ensemble methods. On the first dataset, the best F1-measure results achieved by the MEDI algorithm and the union of the two resources (78.7 and 80, respectively) were significantly higher than the SemRep results (72.3). On the second dataset, the MEDI algorithm achieved better precision and significantly lower recall values than the best system in the i2b2 challenge. The two systems obtained comparable F1-measure values on the subset of i2b2 relations with both arguments in MEDI. CONCLUSIONS Both SemRep and MEDI can be used to extract treatment relations from clinical text. Knowledge-based extraction with MEDI outperformed use of SemRep alone, but superior performance was achieved by integrating both systems. The integration of knowledge-based resources such as MEDI into information extraction systems such as SemRep and the i2b2 relation extractors may improve treatment relation extraction from clinical text.