A Comparative Study on Automatic Coding of Medical Letters with Explainability

This study aims to explore the implementation of Natural Language Processing (NLP) and machine learning (ML) techniques to automate the coding of medical letters with visualised explainability and light-weighted local computer settings. Currently in clinical settings, coding is a manual process that involves assigning codes to each condition, procedure, and medication in a patient's paperwork (e.g., 56265001 heart disease using SNOMED CT code). There are preliminary research on automatic coding in this field using state-of-the-art ML models; however, due to the complexity and size of the models, the real-world deployment is not achieved. To further facilitate the possibility of automatic coding practice, we explore some solutions in a local computer setting; in addition, we explore the function of explainability for transparency of AI models. We used the publicly available MIMIC-III database and the HAN/HLAN network models for ICD code prediction purposes. We also experimented with the mapping between ICD and SNOMED CT knowledge bases. In our experiments, the models provided useful information for 97.98\% of codes. The result of this investigation can shed some light on implementing automatic clinical coding in practice, such as in hospital settings, on the local computers used by clinicians , project page \url{https://github.com/Glenj01/Medical-Coding}.

Which Side Are You On? A Multi-task Dataset for End-to-End Argument Summarisation and Evaluation

With the recent advances of large language models (LLMs), it is no longer infeasible to build an automated debate system that helps people to synthesise persuasive arguments. Previous work attempted this task by integrating multiple components. In our work, we introduce an argument mining dataset that captures the end-to-end process of preparing an argumentative essay for a debate, which covers the tasks of claim and evidence identification (Task 1 ED), evidence convincingness ranking (Task 2 ECR), argumentative essay summarisation and human preference ranking (Task 3 ASR) and metric learning for automated evaluation of resulting essays, based on human feedback along argument quality dimensions (Task 4 SQE). Our dataset contains 14k examples of claims that are fully annotated with the various properties supporting the aforementioned tasks. We evaluate multiple generative baselines for each of these tasks, including representative LLMs. We find, that while they show promising results on individual tasks in our benchmark, their end-to-end performance on all four tasks in succession deteriorates significantly, both in automated measures as well as in human-centred evaluation. This challenge presented by our proposed dataset motivates future research on end-to-end argument mining and summarisation. The repository of this project is available at https://github.com/HarrywillDr/ArgSum-Datatset

The Multi-Range Theory of Translation Quality Measurement: MQM scoring models and Statistical Quality Control

The year 2024 marks the 10th anniversary of the Multidimensional Quality Metrics (MQM) framework for analytic translation quality evaluation. The MQM error typology has been widely used by practitioners in the translation and localization industry and has served as the basis for many derivative projects. The annual Conference on Machine Translation (WMT) shared tasks on both human and automatic translation quality evaluations used the MQM error typology. The metric stands on two pillars: error typology and the scoring model. The scoring model calculates the quality score from annotation data, detailing how to convert error type and severity counts into numeric scores to determine if the content meets specifications. Previously, only the raw scoring model had been published. This April, the MQM Council published the Linear Calibrated Scoring Model, officially presented herein, along with the Non-Linear Scoring Model, which had not been published before. This paper details the latest MQM developments and presents a universal approach to translation quality measurement across three sample size ranges. It also explains why Statistical Quality Control should be used for very small sample sizes, starting from a single sentence.

Exploration of Masked and Causal Language Modelling for Text Generation

Large Language Models (LLMs) have revolutionised the field of Natural Language Processing (NLP) and have achieved state-of-the-art performance in practically every task in this field. However, the prevalent approach used in text generation, Causal Language Modelling (CLM), which generates text sequentially from left to right, inherently limits the freedom of the model, which does not decide when and where each token is generated. In contrast, Masked Language Modelling (MLM), primarily used for language understanding tasks, can generate tokens anywhere in the text and any order. This paper conducts an extensive comparison of MLM and CLM approaches for text generation tasks. To do so, we pre-train several language models of comparable sizes on three different datasets, namely 1) medical discharge summaries, 2) movie plot synopses, and 3) authorship verification datasets. To assess the quality of the generations, we first employ quantitative metrics and then perform a qualitative human evaluation to analyse coherence and grammatical correctness. In addition, we evaluate the usefulness of the generated texts by using them in three different downstream tasks: 1) Entity Recognition, 2) Text Classification, and 3) Authorship Verification. The results show that MLM consistently outperforms CLM in text generation across all datasets, with higher quantitative scores and better coherence in the generated text. The study also finds \textit{no strong correlation} between the quality of the generated text and the performance of the models in the downstream tasks. With this study, we show that MLM for text generation has great potential for future research and provides direction for future studies in this area.

CANTONMT: Investigating Back-Translation and Model-Switch Mechanisms for Cantonese-English Neural Machine Translation

This paper investigates the development and evaluation of machine translation models from Cantonese to English, where we propose a novel approach to tackle low-resource language translations. The main objectives of the study are to develop a model that can effectively translate Cantonese to English and evaluate it against state-of-the-art commercial models. To achieve this, a new parallel corpus has been created by combining different available corpora online with preprocessing and cleaning. In addition, a monolingual Cantonese dataset has been created through web scraping to aid the synthetic parallel corpus generation. Following the data collection process, several approaches, including fine-tuning models, back-translation, and model switch, have been used. The translation quality of models has been evaluated with multiple quality metrics, including lexicon-based metrics (SacreBLEU and hLEPOR) and embedding-space metrics (COMET and BERTscore). Based on the automatic metrics, the best model is selected and compared against the 2 best commercial translators using the human evaluation framework HOPES. The best model proposed in this investigation (NLLB-mBART) with model switch mechanisms has reached comparable and even better automatic evaluation scores against State-of-the-art commercial models (Bing and Baidu Translators), with a SacreBLEU score of 16.8 on our test set. Furthermore, an open-source web application has been developed to allow users to translate between Cantonese and English, with the different trained models available for effective comparisons between models from this investigation and users. CANTONMT is available at https://github.com/kenrickkung/CantoneseTranslation

CantonMT: Cantonese to English NMT Platform with Fine-Tuned Models Using Synthetic Back-Translation Data

Neural Machine Translation (NMT) for low-resource languages is still a challenging task in front of NLP researchers. In this work, we deploy a standard data augmentation methodology by back-translation to a new language translation direction Cantonese-to-English. We present the models we fine-tuned using the limited amount of real data and the synthetic data we generated using back-translation including OpusMT, NLLB, and mBART. We carried out automatic evaluation using a range of different metrics including lexical-based and embedding-based. Furthermore. we create a user-friendly interface for the models we included in this\textsc{ CantonMT} research project and make it available to facilitate Cantonese-to-English MT research. Researchers can add more models into this platform via our open-source\textsc{ CantonMT} toolkit \url{https://github.com/kenrickkung/CantoneseTranslation}.

Neural Machine Translation of Clinical Text: An Empirical Investigation into Multilingual Pre-Trained Language Models and Transfer-Learning

We conduct investigations on clinical text machine translation by examining multilingual neural network models using deep learning such as Transformer based structures. Furthermore, to address the language resource imbalance issue, we also carry out experiments using a transfer learning methodology based on massive multilingual pre-trained language models (MMPLMs). The experimental results on three subtasks including 1) clinical case (CC), 2) clinical terminology (CT), and 3) ontological concept (OC) show that our models achieved top-level performances in the ClinSpEn-2022 shared task on English-Spanish clinical domain data. Furthermore, our expert-based human evaluations demonstrate that the small-sized pre-trained language model (PLM) won over the other two extra-large language models by a large margin, in the clinical domain fine-tuning, which finding was never reported in the field. Finally, the transfer learning method works well in our experimental setting using the WMT21fb model to accommodate a new language space Spanish that was not seen at the pre-training stage within WMT21fb itself, which deserves more exploitation for clinical knowledge transformation, e.g. to investigate into more languages. These research findings can shed some light on domain-specific machine translation development, especially in clinical and healthcare fields. Further research projects can be carried out based on our work to improve healthcare text analytics and knowledge transformation.

Generating Medical Prescriptions with Conditional Transformer

Access to real-world medication prescriptions is essential for medical research and healthcare quality improvement. However, access to real medication prescriptions is often limited due to the sensitive nature of the information expressed. Additionally, manually labelling these instructions for training and fine-tuning Natural Language Processing (NLP) models can be tedious and expensive. We introduce a novel task-specific model architecture, Label-To-Text-Transformer (\textbf{LT3}), tailored to generate synthetic medication prescriptions based on provided labels, such as a vocabulary list of medications and their attributes. LT3 is trained on a set of around 2K lines of medication prescriptions extracted from the MIMIC-III database, allowing the model to produce valuable synthetic medication prescriptions. We evaluate LT3's performance by contrasting it with a state-of-the-art Pre-trained Language Model (PLM), T5, analysing the quality and diversity of generated texts. We deploy the generated synthetic data to train the SpacyNER model for the Named Entity Recognition (NER) task over the n2c2-2018 dataset. The experiments show that the model trained on synthetic data can achieve a 96-98\% F1 score at Label Recognition on Drug, Frequency, Route, Strength, and Form. LT3 codes and data will be shared at \url{https://github.com/HECTA-UoM/Label-To-Text-Transformer}

Exploring the Consistency, Quality and Challenges in Manual and Automated Coding of Free-text Diagnoses from Hospital Outpatient Letters

Coding of unstructured clinical free-text to produce interoperable structured data is essential to improve direct care, support clinical communication and to enable clinical research.However, manual clinical coding is difficult and time consuming, which motivates the development and use of natural language processing for automated coding. This work evaluates the quality and consistency of both manual and automated clinical coding of diagnoses from hospital outpatient letters. Using 100 randomly selected letters, two human clinicians performed coding of diagnosis lists to SNOMED CT. Automated coding was also performed using IMO's Concept Tagger. A gold standard was constructed by a panel of clinicians from a subset of the annotated diagnoses. This was used to evaluate the quality and consistency of both manual and automated coding via (1) a distance-based metric, treating SNOMED CT as a graph, and (2) a qualitative metric agreed upon by the panel of clinicians. Correlation between the two metrics was also evaluated. Comparing human and computer-generated codes to the gold standard, the results indicate that humans slightly out-performed automated coding, while both performed notably better when there was only a single diagnosis contained in the free-text description. Automated coding was considered acceptable by the panel of clinicians in approximately 90% of cases.

Extraction of Medication and Temporal Relation from Clinical Text using Neural Language Models

Clinical texts, represented in electronic medical records (EMRs), contain rich medical information and are essential for disease prediction, personalised information recommendation, clinical decision support, and medication pattern mining and measurement. Relation extractions between medication mentions and temporal information can further help clinicians better understand the patients' treatment history. To evaluate the performances of deep learning (DL) and large language models (LLMs) in medication extraction and temporal relations classification, we carry out an empirical investigation of \textbf{MedTem} project using several advanced learning structures including BiLSTM-CRF and CNN-BiLSTM for a clinical domain named entity recognition (NER), and BERT-CNN for temporal relation extraction (RE), in addition to the exploration of different word embedding techniques. Furthermore, we also designed a set of post-processing roles to generate structured output on medications and the temporal relation. Our experiments show that CNN-BiLSTM slightly wins the BiLSTM-CRF model on the i2b2-2009 clinical NER task yielding 75.67, 77.83, and 78.17 for precision, recall, and F1 scores using Macro Average. BERT-CNN model also produced reasonable evaluation scores 64.48, 67.17, and 65.03 for P/R/F1 using Macro Avg on the temporal relation extraction test set from i2b2-2012 challenges. Code and Tools from MedTem will be hosted at \url{https://github.com/HECTA-UoM/MedTem}