Evidence map›Paper›PMID 36990288›Full record

ArticleInternational journal of radiation oncology, biology, physics2023

An End-to-End Natural Language Processing System for Automatically Extracting Radiation Therapy Events From Clinical Texts.

Danielle S Bitterman, Eli Goldner, Sean Finan, David Harris, Eric B Durbin, Harry Hochheiser, Jeremy L Warner, Raymond H Mak, Timothy Miller, Guergana K Savova

Abstract read
In one paragraph

Article in International journal of radiation oncology, biology, physics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Danielle S BittermanComputational Health Informatics Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts; Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, Massachusetts. Electronic address: Danielle_Bitterman@dfci.harvard.edu.
Eli GoldnerComputational Health Informatics Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Sean FinanComputational Health Informatics Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
David HarrisComputational Health Informatics Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Eric B DurbinCollege of Medicine, University of Kentucky, Lexington, Kentucky; Kentucky Cancer Registry, Lexington, Kentucky.
Harry HochheiserDepartment of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Jeremy L WarnerPopulation Sciences Program, Legorreta Cancer Center, Brown University, Providence, Rhode Island; Lifespan Cancer Institute, Providence, Rhode Island.
Raymond H MakDepartment of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts; Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, Massachusetts.
Timothy MillerComputational Health Informatics Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Guergana K SavovaComputational Health Informatics Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Funding

University of Kentucky Markey Cancer Center Support Grant ECIA SupplementP30CA177558 · NCI · UNIVERSITY OF KENTUCKY · PI Bernard Mark Evers · 2013 to 2026
$38.3M
Temporal relation discovery for clinical textR01LM010090 · NLM · BOSTON CHILDREN'S HOSPITAL · PI MARTIN, JAMES H., SAVOVA, GUERGANA K. · 2010 to 2022
$7.1M
Cancer Deep Phenotyping from Electronic Medical RecordsU24CA248010 · NCI · BOSTON CHILDREN'S HOSPITAL · PI HARRY S HOCHHEISER, GUERGANA K. SAVOVA · 2020 to 2026
$6.1M
Extended Methods and Software Development for Health NLPR01GM114355 · NIGMS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI BETHARD, STEVEN, SAVOVA, GUERGANA K. · 2016 to 2024
$5.0M
Enhancing the HemOnc Knowledgebase of Chemotherapy Drugs and RegimensU24CA265879 · NCI · RHODE ISLAND HOSPITAL · PI Jeremy L Warner · 2022 to 2026
$3.4M
Natural Language Processing Platform for Cancer SurveillanceUH3CA243120 · NCI · BOSTON CHILDREN'S HOSPITAL · PI DURBIN, ERIC B., HOCHHEISER, HARRY S · 2021 to 2023
$2.1M
Transfer Learning for Digital Curation of the EMR Clinical NarrativeR01LM013486 · NLM · BOSTON CHILDREN'S HOSPITAL · PI SAVOVA, GUERGANA K. · 2021 to 2024
$1.5M
Natural Language Processing Platform for Cancer SurveillanceUG3CA243120 · NCI · BOSTON CHILDREN'S HOSPITAL · PI DURBIN, ERIC B., HOCHHEISER, HARRY S · 2019 to 2020
$872k
NCI NIH HHS HHSN261201800013INCI NIH HHS P30 CA177558NCI NIH HHS U24 CA248010NCI NIH HHS U24 CA265879NCI NIH HHS UG3 CA243120NCI NIH HHS UH3 CA243120NIGMS NIH HHS R01 GM114355NLM NIH HHS R01 LM010090NLM NIH HHS R01 LM013486
6 · The paper itself

Abstract

purposeReal-world evidence for radiation therapy (RT) is limited because it is often documented only in the clinical narrative. We developed a natural language processing system for automated extraction of detailed RT events from text to support clinical phenotyping. METHODS AND MATERIALS: A multi-institutional data set of 96 clinician notes, 129 North American Association of Central Cancer Registries cancer abstracts, and 270 RT prescriptions from HemOnc.org was used and divided into train, development, and test sets. Documents were annotated for RT events and associated properties: dose, fraction frequency, fraction number, date, treatment site, and boost. Named entity recognition models for properties were developed by fine-tuning BioClinicalBERT and RoBERTa transformer models. A multiclass RoBERTa-based relation extraction model was developed to link each dose mention with each property in the same event. Models were combined with symbolic rules to create a hybrid end-to-end pipeline for comprehensive RT event extraction.

resultsNamed entity recognition models were evaluated on the held-out test set with F1 results of 0.96, 0.88, 0.94, 0.88, 0.67, and 0.94 for dose, fraction frequency, fraction number, date, treatment site, and boost, respectively. The relation model achieved an average F1 of 0.86 when the input was gold-labeled entities. The end-to-end system F1 result was 0.81. The end-to-end system performed best on North American Association of Central Cancer Registries abstracts (average F1 0.90), which are mostly copy-paste content from clinician notes.

conclusionsWe developed methods and a hybrid end-to-end system for RT event extraction, which is the first natural language processing system for this task. This system provides proof-of-concept for real-world RT data collection for research and is promising for the potential of natural language processing methods to support clinical care.

Indexed as

Natural Language ProcessingNeoplasmsElectronic Health RecordsHumans

Identifiers

PMID36990288
PMCPMC10522797

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.