The disease coding task involves assigning a unique identifier from a controlled vocabulary to each disease mentioned in a clinical document. This task is relevant since it allows information extraction from unstructured data to perform, for example, epidemiological studies about the incidence and prevalence of diseases in a determined context. However, the manual coding process is subject to errors as it requires medical personnel to be competent in coding rules and terminology. In addition, this process consumes a lot of time and energy, which could be allocated to more clinically relevant tasks. These difficulties can be addressed by developing computational systems that automatically assign codes to diseases. In this way, we propose a two-step system for automatically coding diseases in referrals from the Chilean public healthcare system. Specifically, our model uses a state-of-the-art NER model for recognizing disease mentions and a search engine system based on Elasticsearch for assigning the most relevant codes associated with these disease mentions. The system’s performance was evaluated on referrals manually coded by clinical experts. Our system obtained a MAP score of 0.63 for the subcategory level and 0.83 for the category level, close to the best-performing models in the literature. This system could be a support tool for health professionals, optimizing the coding and management process. Finally, to guarantee reproducibility, we publicly release the code of our models and experiments.

Using language models created from large data sources has improved the performance of several deep learning-based architectures, obtaining state-of-the-art results in several NLP extrinsic tasks. However, little research is related to creating intrinsic tests that allow us to compare the quality of different language models when obtaining contextualized embeddings. This gap increases even more when working on specific domains in languages other than English. This paper proposes a novel graph-based intrinsic test that allows us to measure the quality of different language models in clinical and biomedical domains in Spanish. Our results show that our intrinsic test performs better for clinical and biomedical language models than a general one. Also, it correlates with better outcomes for a NER task using a probing model over contextualized embeddings. We hope our work will help the clinical NLP research community to evaluate and compare new language models in other languages and find the most suitable models for solving downstream tasks.

Word embeddings have been widely used in Natural Language Processing (NLP) tasks. Although these representations can capture the semantic information of words, they cannot learn the sequence-level semantics. This problem can be handled using contextual word embeddings derived from pre-trained language models, which have contributed to significant improvements in several NLP tasks. Further improvements are achieved when pre-training these models on domain-specific corpora. In this paper, we introduce Clinical Flair, a domain-specific language model trained on Spanish clinical narratives. To validate the quality of the contextual representations retrieved from our model, we tested them on four named entity recognition datasets belonging to the clinical and biomedical domains. Our experiments confirm that incorporating domain-specific embeddings into classical sequence labeling architectures improves model performance dramatically compared to general-domain embeddings, demonstrating the importance of having these resources available.

In this work we describe the Waiting List Corpus consisting of de-identified referrals for several specialty consultations from the waiting list in Chilean public hospitals. A subset of 900 referrals was manually annotated with 9,029 entities, 385 attributes, and 284 pairs of relations with clinical relevance. A trained medical doctor annotated these referrals, and then together with other three researchers, consolidated each of the annotations. The annotated corpus has nested entities, with 32.2% of entities embedded in other entities. We use this annotated corpus to obtain preliminary results for Named Entity Recognition (NER). The best results were achieved by using a biLSTM-CRF architecture using word embeddings trained over Spanish Wikipedia together with clinical embeddings computed by the group. NER models applied to this corpus can leverage statistics of diseases and pending procedures within this waiting list. This work constitutes the first annotated corpus using clinical narratives from Chile, and one of the few for the Spanish language. The annotated corpus, the clinical word embeddings, and the annotation guidelines are freely released to the research community.