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1.
Bioengineering (Basel) ; 11(1)2023 Dec 26.
Article in English | MEDLINE | ID: mdl-38247906

ABSTRACT

Diagnostic errors represent a critical issue in clinical diagnosis and treatment. In China, the rate of misdiagnosis in clinical diagnostics is approximately 27.8%. By comparison, in the United States, which boasts the most developed medical resources globally, the average rate of misdiagnosis is estimated to be 11.1%. It is estimated that annually, approximately 795,000 Americans die or suffer permanent disabilities due to diagnostic errors, a significant portion of which can be attributed to physicians' failure to make accurate clinical diagnoses based on patients' clinical presentations. Differential diagnosis, as an indispensable step in the clinical diagnostic process, plays a crucial role. Accurately excluding differential diagnoses that are similar to the patient's clinical manifestations is key to ensuring correct diagnosis and treatment. Most current research focuses on assigning accurate diagnoses for specific diseases, but studies providing reasonable differential diagnostic assistance to physicians are scarce. This study introduces a novel solution specifically designed for this scenario, employing machine learning techniques distinct from conventional approaches. We develop a differential diagnosis recommendation computation method for clinical evidence-based medicine, based on interpretable representations and a visualized computational workflow. This method allows for the utilization of historical data in modeling and recommends differential diagnoses to be considered alongside the primary diagnosis for clinicians. This is achieved by inputting the patient's clinical manifestations and presenting the analysis results through an intuitive visualization. It can assist less experienced doctors and those in areas with limited medical resources during the clinical diagnostic process. Researchers discuss the effective experimental results obtained from a subset of general medical records collected at Shengjing Hospital under the premise of ensuring data quality, security, and privacy. This discussion highlights the importance of addressing these issues for successful implementation of data-driven differential diagnosis recommendations in clinical practice. This study is of significant value to researchers and practitioners seeking to improve the efficiency and accuracy of differential diagnoses in clinical diagnostics using data analysis.

2.
Front Genet ; 13: 900242, 2022.
Article in English | MEDLINE | ID: mdl-35938002

ABSTRACT

As a typical knowledge-intensive industry, the medical field uses knowledge graph technology to construct causal inference calculations, such as "symptom-disease", "laboratory examination/imaging examination-disease", and "disease-treatment method". The continuous expansion of large electronic clinical records provides an opportunity to learn medical knowledge by machine learning. In this process, how to extract entities with a medical logic structure and how to make entity extraction more consistent with the logic of the text content in electronic clinical records are two issues that have become key in building a high-quality, medical knowledge graph. In this work, we describe a method for extracting medical entities using real Chinese clinical electronic clinical records. We define a computational architecture named MLEE to extract object-level entities with "object-attribute" dependencies. We conducted experiments based on randomly selected electronic clinical records of 1,000 patients from Shengjing Hospital of China Medical University to verify the effectiveness of the method.

3.
AMIA Annu Symp Proc ; 2022: 662-671, 2022.
Article in English | MEDLINE | ID: mdl-37128396

ABSTRACT

Previous work on clinical relation extraction from free-text sentences leveraged information about semantic types from clinical knowledge bases as a part of entity representations. In this paper, we exploit additional evidence by also making use of domain-specific semantic type dependencies. We encode the relation between a span of tokens matching a Unified Medical Language System (UMLS) concept and other tokens in the sentence. We implement our method and compare against different named entity recognition (NER) architectures (i.e., BiLSTM-CRF and BiLSTM-GCN-CRF) using different pre-trained clinical embeddings (i.e., BERT, BioBERT, UMLSBert). Our experimental results on clinical datasets show that in some cases NER effectiveness can be significantly improved by making use of domain-specific semantic type dependencies. Our work is also the first study generating a matrix encoding to make use of more than three dependencies in one pass for the NER task.


Subject(s)
Natural Language Processing , Semantics , Unified Medical Language System , Humans , Knowledge Bases , Datasets as Topic/standards , Sample Size , Reproducibility of Results
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