Medical Information Extraction With NLP-Powered QABots: A Real-World Scenario.

Journal: IEEE journal of biomedical and health informatics
Published Date:

Abstract

The advent of computerized medical recording systems in healthcare facilities has made data retrieval tasks easier, compared to manual recording. Nevertheless, the potential of the information contained within medical records remains largely untapped, mostly due to the time and effort required to extract data from unstructured documents. Natural Language Processing (NLP) represents a promising solution to this challenge, as it enables the use of automated text-mining tools for clinical practitioners. In this work, we present the architecture of the Virtual Dementia Institute (IVD), a consortium of sixteen Italian hospitals, using the NLP Extraction and Management Tool (NEMT), a (semi-) automated end-to-end pipeline that extracts relevant information from clinical documents and stores it in a centralized REDCap database. After defining a common Case Report Form (CRF) across the IVD hospitals, we implemented NEMT, the core of which is a Question Answering Bot (QABot) based on a modern NLP model. This QABot is fine-tuned on thousands of examples from IVD centers. Detailed descriptions of the process to define a common minimum dataset, Inter-Annotator Agreement calculated on clinical documents, and NEMT results are provided. The best QABot performance show an Exact Match score (EM) of 78.1%, a F1-score of 84.7%, a Lenient Accuracy (LAcc) of 0.834, and a Mean Reciprocal Rank (MRR) of 0.810. EM and F1 scores outperform the same metrics obtained with ChatGPTv3.5 (68.9% and 52.5%, respectively). With NEMT the IVD has been able to populate a database that will contain data from thousands of Italian patients, all screened with the same procedure. NEMT represents an efficient tool that paves the way for medical information extraction and exploitation for new research studies.

Authors

  • Claudio Crema
    Laboratory of Neuroinformatics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, 25125, Italy.
  • Federico Verde
  • Pietro Tiraboschi
  • Camillo Marra
    Memory Clinic, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
  • Andrea Arighi
  • Silvia Fostinelli
  • Guido Maria Giuffrè
    Memory Clinic, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
  • Vera Pacoova Dal Maschio
  • Federica L'Abbate
  • Federica Solca
  • Barbara Poletti
  • Vincenzo Silani
  • Emanuela Rotondo
  • Vittoria Borracci
  • Roberto Vimercati
  • Valeria Crepaldi
  • Emanuela Inguscio
  • Massimo Filippi
    Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy.
  • Francesca Caso
  • Alessandra Maria Rosati
  • Davide Quaranta
  • Giuliano Binetti
  • Ilaria Pagnoni
  • Manuela Morreale
  • Francesca Burgio
  • Michelangelo Stanzani Maserati
  • Sabina Capellari
    Department of Biomedical and Neuromotor Sciences University of Bologna Bologna 40123 Italy.
  • Matteo Pardini
    Department of Neuroscience (DINOGMI), University of Genoa and Neurology Clinics, Polyclinic San Martino Hospital, Genoa, Italy.
  • Nicola Girtler
  • Federica Piras
    Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy.
  • Fabrizio Piras
    Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy.
  • Stefania Lalli
  • Elena Perdixi
  • Gemma Lombardi
  • Sonia Di Tella
  • Alfredo Costa
  • Marco Capelli
  • Cira Fundarò
    Neurophysiopathology Unit, Istituti Clinici Scientifici Maugeri, IRCSS, Montescano (PV), Italy.
  • Marina Manera
  • Cristina Muscio
  • Elisa Pellencin
    Department of Psychology and Cognitive Science, University of Trento, Rovereto, Trento 38068, Italy.
  • Raffaele Lodi
    Functional MR Unit, Policlinico S. Orsola - Malpighi, Via Massarenti 9, 40138, Bologna, Italy; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Via U. Foscolo 7, 40123, Bologna, Italy. Electronic address: raffaele.lodi@unibo.it.
  • Fabrizio Tagliavini
    † Neurologic Institute "Carlo Besta", Milan, Italy.
  • Alberto Redolfi
    Laboratory of Neuroinformatics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.