OBJECTIVE: Improving the AI-driven automated medical encoding of clinical text plays a vital role in gathering information on the occurrence of diseases to improve population-level health. This work presents a novel attention mechanism designed to enhance text classification models and ensure appropriate classification of medical concepts in unstructured electronic health records. MATERIALS AND METHODS: We developed a deformable, phrase-level attention mechanism to identify important lexical word-level and contextual phrase-level information from clinical text documents. We evaluated conventional and transformer-based deep learning models that we extended with our attention mechanism on the extraction of critical cancer information (e.g., site, subsite, laterality, histology, behavior) from 629,908 electronic pathology reports and on the automated medical encoding of 52,722 hospital discharge summaries. RESULTS: Transformer-based models with the deformable, phrase-level attention mechanism achieved the best performance on the extraction of critical cancer information from pathology reports. Conventional- and transformer-based models show similar or better performance than their baseline counterparts on the automated medical encoding of clinical documents. DISCUSSION: The addition of phrase-level information allowed models extended with our proposed method to outperform standard word-level attention. Our method showed favorable properties for the real-world application in terms of model robustness and phenotyping. These results indicate that our method is promising for automated data harmonization for common data models. CONCLUSION: This work proposes a novel deformable, phrase-level attention mechanism that enhances text classification models in the extraction of medical concepts from clinical text documents. We demonstrate strong performances on two clinical text datasets and showcase real-world deployability of our method.

Attention mechanisms are now a mainstay architecture in neural networks and improve the performance of biomedical text classification tasks. In particular, models that perform automated medical encoding of clinical documents make extensive use of the label-wise attention mechanism. A label-wise attention mechanism increases a model's discriminatory ability by using label-specific reference information. This information can either be implicitly learned during training or explicitly provided through embedded textual code descriptions or information on the code hierarchy; however, contemporary studies arbitrarily select the type of label-specific reference information. To address this shortcoming, we evaluated label-wise attention initialized with either implicit or explicit label-specific reference information against two common baseline methods-target-attention and text-encoder architecture-specific methods-to generate document embeddings across four text-encoder architectures-a convolutional neural network, two recurrent neural networks, and a transformer. We also present an extension of label-wise attention that can embed the information on the code hierarchy. We performed our experiments on the MIMIC III dataset, which is a standard dataset in the clinical text classification domain. Our experiments showed that using pretrained reference information and the hierarchical design helped improve classification performance. These performance improvements had less impact on larger datasets and label spaces across all text-encoder architectures. In our analysis, we used an attention mechanism's energy scores to explain the perceived differences in performance and interpretability between the text-encoder architectures and types of label-attention.

This study aims to effectively analyze and visualize the concept to concept network derived from the COVID-19 Open Research Dataset (CORD-19) dataset, where we have more than 48,000 concepts with more than 300,000 relationships between concepts. In analyzing networks, we focus on finding relationship patterns between the coronavirus disease 2019 (COVID-19) concepts and other concepts. Given the node and edge datasets, we construct directional graphs and calculate all pair shortest paths based on multiple edge weight schemes. However, statistical metrics are not sufficient to identify specific relationships represented in the network. Therefore, we also propose a visual analytics approach to effectively understand the knowledge graph. Our highly interactive visual analytics allows users to effectively analyze the evolving graphs and (COVID-19) concept nodes and other nodes related to the COVID-19 nodes. We envision that this study will pave the path to develop strategies to provide more accurate and scalable predictive analysis on knowledge graphs related to CORD19 and other biomedical knowledge graphs.

We are motivated by newly proposed methods for data mining large-scale corpora of scholarly publications, such as the full biomedical literature, which may consist of tens of millions of papers spanning decades of research. In this setting, analysts seek to discover how concepts relate to one another. They construct graph representations from annotated text databases and then formulate the relationship-mining problem as one of computing all-pairs shortest paths (APSP), which becomes a significant bottleneck. In this context, we present a new high-performance algorithm and implementation of the Floyd-Warshall algorithm for distributed-memory parallel computers accelerated by GPUs, which we call DSNAPSHOT (Distributed Accelerated Semiring All-Pairs Shortest Path). For our largest experiments, we ran DSNAPSHOT on a connected input graph with millions of vertices using 4, 096nodes (24,576GPUs) of the Oak Ridge National Laboratory's Summit supercomputer system. We find DSNAPSHOT achieves a sustained performance of $136\times 10^{15}$ floating-point operations per second (136petaflop/s) at a parallel efficiency of 90% under weak scaling and, in absolute speed, 70% of the best possible performance given our computation (in the single-precision tropical semiring or “min-plus” algebra). Looking forward, we believe this novel capability will enable the mining of scholarly knowledge corpora when embedded and integrated into artificial intelligence-driven natural language processing workflows at scale.

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