Catching Misdiagnosed Limb Fractures in the Emergency Department Using Cross-institution Transfer Learning

Filip Rusak, Bevan Koopman, Nathan J. Brown, Kevin Chu, Jinghui Liu, Anthony Nguyen


Abstract
We investigated the development of a Machine Learning (ML)-based classifier to identify abnormalities in radiology reports from Emergency Departments (EDs) that can help automate the radiology report reconciliation process. Often, radiology reports become available to the ED only after the patient has been treated and discharged, following ED clinician interpretation of the X-ray. However, occasionally ED clinicians misdiagnose or fail to detect subtle abnormalities on X-rays, so they conduct a manual radiology report reconciliation process as a safety net. Previous studies addressed this problem of automated reconciliation using ML-based classification solutions that require data samples from the target institution that is heavily based on feature engineering, implying lower transferability between hospitals. In this paper, we investigated the benefits of using pre-trained BERT models for abnormality classification in a cross-institutional setting where data for fine-tuning was unavailable from the target institution. We also examined how the inclusion of synthetically generated radiology reports from ChatGPT affected the performance of the BERT models. Our findings suggest that BERT-like models outperform previously proposed ML-based methods in cross-institutional scenarios, and that adding ChatGPT-generated labelled radiology reports can improve the classifier’s performance by reducing the number of misdiagnosed discharged patients.
Anthology ID:
2023.alta-1.8
Volume:
Proceedings of the 21st Annual Workshop of the Australasian Language Technology Association
Month:
November
Year:
2023
Address:
Melbourne, Australia
Editors:
Smaranda Muresan, Vivian Chen, Kennington Casey, Vandyke David, Dethlefs Nina, Inoue Koji, Ekstedt Erik, Ultes Stefan
Venue:
ALTA
SIG:
Publisher:
Association for Computational Linguistics
Note:
Pages:
78–87
Language:
URL:
https://aclanthology.org/2023.alta-1.8
DOI:
Bibkey:
Cite (ACL):
Filip Rusak, Bevan Koopman, Nathan J. Brown, Kevin Chu, Jinghui Liu, and Anthony Nguyen. 2023. Catching Misdiagnosed Limb Fractures in the Emergency Department Using Cross-institution Transfer Learning. In Proceedings of the 21st Annual Workshop of the Australasian Language Technology Association, pages 78–87, Melbourne, Australia. Association for Computational Linguistics.
Cite (Informal):
Catching Misdiagnosed Limb Fractures in the Emergency Department Using Cross-institution Transfer Learning (Rusak et al., ALTA 2023)
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PDF:
https://aclanthology.org/2023.alta-1.8.pdf