Objective: Clinical notes contain unstructured representations of patient histories, including the relationships between medical problems and prescription drugs. To investigate the relationship between cancer drugs and their associated symptom burden, we extract structured, semantic representations of medical problem and drug information from the clinical narratives of oncology notes.
Materials And Methods: We present Clinical concept Annotations for Cancer Events and Relations (CACER), a novel corpus with fine-grained annotations for over 48 000 medical problems and drug events and 10 000 drug-problem and problem-problem relations. Leveraging CACER, we develop and evaluate transformer-based information extraction models such as Bidirectional Encoder Representations from Transformers (BERT), Fine-tuned Language Net Text-To-Text Transfer Transformer (Flan-T5), Large Language Model Meta AI (Llama3), and Generative Pre-trained Transformers-4 (GPT-4) using fine-tuning and in-context learning (ICL).
Results: In event extraction, the fine-tuned BERT and Llama3 models achieved the highest performance at 88.2-88.0 F1, which is comparable to the inter-annotator agreement (IAA) of 88.4 F1. In relation extraction, the fine-tuned BERT, Flan-T5, and Llama3 achieved the highest performance at 61.8-65.3 F1. GPT-4 with ICL achieved the worst performance across both tasks.
Discussion: The fine-tuned models significantly outperformed GPT-4 in ICL, highlighting the importance of annotated training data and model optimization. Furthermore, the BERT models performed similarly to Llama3. For our task, large language models offer no performance advantage over the smaller BERT models.
Conclusions: We introduce CACER, a novel corpus with fine-grained annotations for medical problems, drugs, and their relationships in clinical narratives of oncology notes. State-of-the-art transformer models achieved performance comparable to IAA for several extraction tasks.
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http://dx.doi.org/10.1093/jamia/ocae231 | DOI Listing |
Postgrad Med J
January 2025
Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Background: Smartphone overuse is associated with both psychological and physical health problems, including depression and musculoskeletal disorders. However, the association between smartphone overuse and neck pain remains unclear. We performed a meta-analysis to examine the relation between smartphone overuse and neck pain, and to identify high-risk usage patterns.
View Article and Find Full Text PDFCureus
December 2024
Centre for Population Research, Institute of Economic Growth, Delhi University, New Delhi, IND.
Introduction: Anemia is a severe public health problem in India, affecting more than 50% of individuals across most age groups. The Anemia Mukt Bharat (AMB) program, with a target of a three-percentage point reduction in anemia prevalence per year, developed a monitoring mechanism based on a set of 18 indicators and six key performance indicators (KPIs) derived from routine reporting in the Health Management Information System (HMIS). The study's objective was to assess the status of anemia control measures in the district of Faridabad, Haryana, India, using AMB HMIS indicators from April 2018 to March 2019.
View Article and Find Full Text PDFCureus
December 2024
Department of Pediatric Emergency Care and Intensive Care Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, JPN.
Aim Preventing leaving-without-being-seen (LWBS) in children is crucial due to their inability to seek medical care independently. Because there are no studies of LWBS in Japan, the extent of this problem in Japan and its impacts on healthcare are uncertain. The present study seeks to fill this gap by investigating LWBS after triage and identifying the associated factors.
View Article and Find Full Text PDFIt is critical to recognize pulmonary embolism as soon as possible in patients who have gastrointestinal problems pre- and post-surgery. Even in the absence of conventional risk factors, the Factor V Leiden mutation emphasizes the importance of a thorough thrombophilia assessment. To effectively manage and prevent thrombotic episodes, prompt anticoagulant medication and genetic screening for family members are essential.
View Article and Find Full Text PDFInt J Chron Obstruct Pulmon Dis
December 2024
School of Nursing and Health Sciences Hong Kong Metropolitan University, Hong Kong Special Administrative Region, People's Republic of China.
Background: Persistently high rates of inhaler errors and poor adherence among Chronic Obstructive Pulmonary Disease (COPD) patients contribute to ineffective symptomatic control, high care burdens, and increased healthcare resource utilization.
Objective: This study aimed to report (i) nurses-identified common problems and errors of inhaler use in COPD patients, (ii) nurses' attitudes, practices, training needs and required support in inhaler education.
Methods: An online questionnaire survey was conducted with nurses working in Hong Kong from May to June 2023 using an exponential, non-discriminative snowball sampling strategy.
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