The practice of fine-tuning Pre-trained Language Models (PLMs) from general or domain-specific data to a specific task with limited resources, has gained popularity within the field of natural language processing (NLP). In this work, we re-visit this assumption and carry out an investigation in clinical NLP, specifically Named Entity Recognition (NER) on drugs and their related attributes. We compare Transformer models that are trained from scratch to fine-tuned BERT-based Large Language Models (LLMs) namely BERT, BioBERT, and ClinicalBERT. Furthermore, we examine the impact of an additional Conditional Random Field (CRF) layer on such models to encourage contextual learning. We use n2c2-2018 shared task data for model development and evaluations. The experimental outcomes show that 1) CRF layers improved all language models; 2) referring to BIO-strict span level evaluation using macro-average F1 score, although the fine-tuned LLMs achieved 0.83+ scores, the TransformerCRF model trained from scratch achieved 0.78+, demonstrating comparable performances with much lower cost, e.g. with 39.80% less training parameters; 3) referring to BIO-strict span-level evaluation using weighted-average F1 score, ClinicalBERT-CRF, BERT-CRF, and TransformerCRF exhibited lower score differences, with 97.59%/97.44%/96.84% respectively. 4) applying efficient training by down-sampling for better data distribution further reduced the training cost and need for data, while maintaining similar scores -i.e. around 0.02 points lower compared to using the full dataset. This This TRANSFORMERCRF project is hosted at https://github.com/HECTA-UoM/TransformerCRF

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 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 https://github.com/HECTA-UoM/MedTem