Recent Advances in Clinical Natural Language Processing in Support of Semantic Analysis.

OBJECTIVES: We present a review of recent advances in clinical Natural Language Processing (NLP), with a focus on semantic analysis and key subtasks that support such analysis. METHODS: We conducted a literature review of clinical NLP research from 2008 to 2014, emphasizing recent publications (2012-2014), based on PubMed and ACL proceedings as well as relevant referenced publications from the included papers. RESULTS: Significant articles published within this time-span were included and are discussed from the perspective of semantic analysis. Three key clinical NLP subtasks that enable such analysis were identified: 1) developing more efficient methods for corpus creation (annotation and de-identification), 2) generating building blocks for extracting meaning (morphological, syntactic, and semantic subtasks), and 3) leveraging NLP for clinical utility (NLP applications and infrastructure for clinical use cases). Finally, we provide a reflection upon most recent developments and potential areas of future NLP development and applications. CONCLUSIONS: There has been an increase of advances within key NLP subtasks that support semantic analysis. Performance of NLP semantic analysis is, in many cases, close to that of agreement between humans. The creation and release of corpora annotated with complex semantic information models has greatly supported the development of new tools and approaches. Research on non-English languages is continuously growing. NLP methods have sometimes been successfully employed in real-world clinical tasks. However, there is still a gap between the development of advanced resources and their utilization in clinical settings. A plethora of new clinical use cases are emerging due to established health care initiatives and additional patient-generated sources through the extensive use of social media and other devices.

Problem-solving strategies in dementia patient-caregiver dyads.

Examined was the applicability of concepts of the zone of proximal development and scaffolding to the study of dementia. Caregiver-patient dyads were compared to normal elderly dyads in the instructional strategies they used to complete the Block Design subtest of the WAIS-R. Shown by the results was that the use of a detailed behavioral coding scheme was successful in documenting systematic differences between the two groups. Potential use in assessment and intervention is discussed.

Improving the reliability of the U.S. vaccine supply: an evaluation of alternatives.

Since taking office, President Clinton has devoted considerable attention to childhood immunization and to the overall U.S. policy toward vaccine development, delivery, and pricing. But the reliability of U.S. vaccine supplies has received far less attention, despite several recent interruptions in vaccine production and supply. Moreover, the increasing producer concentration in the U.S. and global vaccine industries raises the possibility that more and more important vaccines will be produced by a single firm, often in a single production facility. Is a federal policy for vaccine supply assurance necessary, and what form should it take? Are sole-source suppliers a weak link in the U.S. vaccine supply chain? Are the recommendations of the Institute of Medicine's Committee on Emerging Infections for a publicly owned "standby production capacity" of critical vaccines feasible or cost-effective? We consider these and other issues in our discussion of the U.S. vaccine industry, the potential role of foreign vaccine suppliers, and the use of existing federal facilities and policies to address a possible interruption in critical vaccine supplies.