(Work in progress.)

This system includes several different modules. Presently, heartCases is capable of:

• Counting documents within a set of MEDLINE-format entries matching a given set of MeSH terms, along with their synonyms, whether they are in the entry's given MeSH terms or title
• Filtering documents based on their citation count
• Performing basic named entity recognition within document abstracts, using MeSH terms as entities
• Building a classifier to expand the set of MeSH terms appropriately applied to each document

Future functionality will include:

• Additional term sources for entity labeling and document indexing (e.g. Wikidata)
• Concept-level annotation based on document text in order (e.g. "patient had symptom" vs "patient did not report symptom" are distinct in meaning but not distinguished by the MeSH term for "symptom")
• Deep learning approaches for entity and concept recognition within case reports
• Quantificaiton and analysis of associations between multiple terms across document sets (e.g. likelihood of "heart attack" in documents involving "hypercholesterolemia", vs. all documents)
• A system for computationally generating new case reports as part of a model corpus, tunable for different distributions of symptoms, diseases, and other clinical narrative features.
• A system for translating medical language used in case reports to a higher-level representation requiring less technical knowledge (akin to that employed by patient-facing EHR system output, though assuming less structure within the input text).

This part of the system is intended for parsing MEDLINE format files and specifically isolating those relevant to cardiovascular disease (CVD).

This script attempts to expand on existing MeSH annotations by performing tag classification with MeSH terms and adding terms to records where appropriate. These terms can optionally include just those used to search records (e.g., if only terms related to heart disease are provided, a classifier will be trained only to add those terms when missing.) Similar approaches have been employed by Huang et al. (2011) JAMIA. (Huang et al. used a k-nearest neighbors approach to get related articles and their highest-ranking MeSH terms. They achieved ~71% recall on average.)

Both previously present and newly added annotations are used to further annotate records with relevant ICD-10 disease codes.

A separate classifier is then used to determine medically-relevant content within abstracts, including demographic details, symptoms, and lab values, among other features.

Matching abstracts are labeled as part of a NER system. Labels may be visualized using the BRAT environment (http://brat.nlplab.org/).

Requires the following packages. All packaged may be installed using pip.

• bokeh
• numpy *
• nltk
• scikit-learn
• scipy *
• tqdm.

*Note that numpy and scipy can be difficult to set up in some environments (e.g. Windows) so using a system like Anaconda may help. Or, find directions and Windows binaries for scipy here and for numpy here.

Uses the Disease Ontology project database; see http://www.disease-ontology.org/ or Kibbe et al. (2015) NAR.

Uses the 2017 MeSH Data Files provided by the NIH NLM. These files are used without modification.

Uses the 2017 SPECIALIST Lexicon. See SPECIALIST.txt for terms and conditions regarding the use of the SPECIALIST NLP tools (don't worry, they're short).

The three data sets listed above are downloaded if not present locally.

Run as: python heartCases_read.py

Run with the -h option to see additional arguments.

Text files containing literature references in MEDLINE format. Files to process should be placed in the "input" folder - create this folder in the same location as the heartCases modules if it does not exist.

Alternatively, provide the input file as an argument: --inputfile INPUT_FILE_NAME

where INPUT_FILE_NAME is a text file containing one or more documents in MEDLINE format.

Input may also be provided as a text file of PubMed IDs, with one ID per line, using the argument: --pmids INPUT_FILE_OF_PMIDS

Outputs are saved to the "output" folder at the end of each run. These include three files containing the name of the input (or "medline_entries_" if more than one input file is provided) appended with the number of documents contained in the output and one of the following:

• _out.txt - all documents provided in the input file(s) which match the given seach space (in this case, cardiovascular disease) with additional MeSH terms and ICD-10 annotations, where possible.
• _plots.html - Bokeh plots of document counts and properties.
• _raw_ne.txt - all document titles, PMIDs, and the raw dictionary of abstract text and NER labels (labels include entity types and locations).

Output of labeled abstracts is also provided in BRAT-compatible format in the "brat" folder within "output". Each abstract text is provided as [PMID].txt, while annotations are provided in [PMID].ann. The corresponding annotation.conf and visual.conf files are also generated.

Named entities used for abstract labeling are written to the file NE_dump.tsv.

Citation counts, if requested using the argument --citation_counts TRUE, are provided in citation_counts.tsv (as one record per line, including PMID, PMC citation count, and publication name) and in searched_documents.xml (including the raw XML record source of citation counts, as provided by PubMed).

Work in progress.

The following modules assist with additional case report filtering and labeling tasks.

This provides common functions for interfacing with the NCBI eutils, specifically for downloading records through PubMed and retrieving citation counts from PubMed Central.

Given a text file containing a list of MeSH unique IDs, provides the corresponding MeSH terms. Requires the MeSH ontology file AND the MeSH Supplementary Records file, both in ASCII format (.bin) to be present in the same directory.

If the use_supplementary_terms option is True, IDs for supplementary terms will be converted to the terms for their corresponding headings, e.g. C537043 corresponds to the Supplementary Concept of "Albinism ocular late onset sensorineural deafness" but maps to the headings "Hearing Loss, Sensorineural" and "Albinism, Ocular".

A medical language processing system that classifies case reports into single or multiple patient categories using their abstracts and MeSH terms.

This system is intended to classify whether or not a case report is about a single patient or multiple patients.

Run as: python caseReport_classify.py

Run with the -h option to see additional arguments.

This program can take 3 types of inputs:

• Run the program as python caseReport_classify.py --folder FOLDERNAME if using a folder containing MEDLINE files as input (see example_FOLDER_format for reference).
• Run the program as python caseReport_classify.py --pmids PMIDS if using a .txt file of PubMed IDs as input (see example_PMIDS_format.txt for reference).
• Run the program as python caseReport_classify.py --medline MEDLINE if using .txt file containing MEDLINE files as input (see example_MEDLINE_format.txt for reference). The files must be in the same location as caseReport_classify.py

The results will be stored as a tab separated .txt file called Classification_Results.txt containing the PubMed IDs as the first column and single/multiple as the second column.

A medical language processing system that parses through full texts of case reports, retrieves the lab values, and finds the entity being measured by each lab value.

Running this file extracts the lab values of the passed in XML files of case reports and stores the results in Lab Values.txt.

Run as: python extractLabValue.py --extract FOLDERNAME

Run with the '-h' option to see additional arguments.

• You will need a folder containing XML formatted full texts of case reports (see example_FOLDERNAME_format for reference). Once you have the folder stored in the same location as extractLabValue.py, run python extractLabValue.py --folder FOLDERNAME

The results will be stored in Lab Values.txt with double new line separating the results for each case report in the following format:

PMID: ########
lab value: LAB VALUE
measured: ENTITY
lab value: LAB VALUE
measured: ENTITY
lab value: LAB VALUE
measured: ENTITY
...

Running this file will create ANN formatted files with labeled lab items in case reports from .txt files. This is used to produce annotations for the cardiacbd2k.com interface.

Run as: python extractLabValue.py --bart FOLDERNAME

• You will need a folder containing txt files of case reports

The ANN results will be stored in the same folder as the case reports in txt files.

(In Progress) This program uses machine learning and NLP to determine if the patient(s) in the case report survived, died, or unspecified

This is the main file that contains the classifier and helper functions.

This file is used to manually label the case report outcomes

This is a pattern mining analysis of MESH terms in 3000 ACCR case reports. The Apriori algorithm to find frequent occurring sets in case reports and visualizations were made based on the patterns.