DEEPEN: A negation detection system for clinical text incorporating dependency relation into NegEx.

Journal: Journal of biomedical informatics
Published Date:

Abstract

In Electronic Health Records (EHRs), much of valuable information regarding patients' conditions is embedded in free text format. Natural language processing (NLP) techniques have been developed to extract clinical information from free text. One challenge faced in clinical NLP is that the meaning of clinical entities is heavily affected by modifiers such as negation. A negation detection algorithm, NegEx, applies a simplistic approach that has been shown to be powerful in clinical NLP. However, due to the failure to consider the contextual relationship between words within a sentence, NegEx fails to correctly capture the negation status of concepts in complex sentences. Incorrect negation assignment could cause inaccurate diagnosis of patients' condition or contaminated study cohorts. We developed a negation algorithm called DEEPEN to decrease NegEx's false positives by taking into account the dependency relationship between negation words and concepts within a sentence using Stanford dependency parser. The system was developed and tested using EHR data from Indiana University (IU) and it was further evaluated on Mayo Clinic dataset to assess its generalizability. The evaluation results demonstrate DEEPEN, which incorporates dependency parsing into NegEx, can reduce the number of incorrect negation assignment for patients with positive findings, and therefore improve the identification of patients with the target clinical findings in EHRs.

Authors

  • Saeed Mehrabi
    Secure Exchange Solution, Rockville, MD.
  • Anand Krishnan
    Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
  • Sunghwan Sohn
    Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, USA.
  • Alexandra M Roch
    Department of Surgery, Indiana University, Indianapolis, IN.
  • Heidi Schmidt
    University Health Network-Princess Margaret Cancer Centre and Toronto General Hospital, Toronto, Ontario, Canada.
  • Joe Kesterson
    Regenstrief Institute Inc., Indianapolis, IN.
  • Chris Beesley
    Regenstrief Institute Inc., Indianapolis, IN.
  • Paul Dexter
    Regenstrief Institute Inc., Indianapolis, IN.
  • C Max Schmidt
    Department of Surgery, Indiana University, Indianapolis, IN, USA.
  • Hongfang Liu
    Department of Artificial Intelligence & Informatics, Mayo Clinic, Rochester, MN, United States.
  • Mathew Palakal
    School of Informatics and Computing, Indiana University, Indianapolis, IN.