The International Classification of Diseases (ICD) serves as a definitive medical classification system encompassing a wide range of diseases and conditions. The primary objective of ICD indexing is to allocate a subset of ICD codes to a medical record, which facilitates standardized documentation and management of various health conditions. Most existing approaches have suffered from selecting the proper label subsets from an extremely large ICD collection with a heavy long-tailed label distribution. In this paper, we leverage a multi-stage “retrieve and re-rank” framework as a novel solution to ICD indexing, via a hybrid discrete retrieval method, and re-rank retrieved candidates with contrastive learning that allows the model to make more accurate predictions from a simplified label space. The retrieval model is a hybrid of auxiliary knowledge of the electronic health records (EHR) and a discrete retrieval method (BM25), which efficiently collects high-quality candidates. In the last stage, we propose a label co-occurrence guided contrastive re-ranking model, which re-ranks the candidate labels by pulling together the clinical notes with positive ICD codes. Experimental results show the proposed method achieves state-of-the-art performance on a number of measures on the MIMIC-III benchmark.

The International Classification of Diseases (ICD) is an authoritative medical classification system of different diseases and conditions for clinical and management purposes. ICD indexing aims to assign a subset of ICD codes to a medical record. Since human coding is labour-intensive and error-prone, many studies employ machine learning techniques to automate the coding process. ICD coding is a challenging task, as it needs to assign multiple codes to each medical document from an extremely large hierarchically organized collection. In this paper, we propose a novel approach for ICD indexing that adopts three ideas: (1) we use a multi-level deep dilated residual convolution encoder to aggregate the information from the clinical notes and learn document representations across different lengths of the texts; (2) we formalize the task of ICD classification with auxiliary knowledge of the medical records, which incorporates not only the clinical texts but also different clinical code terminologies and drug prescriptions for better inferring the ICD codes; and (3) we introduce a graph convolutional network to leverage the co-occurrence patterns among ICD codes, aiming to enhance the quality of label representations. Experimental results show the proposed method achieves state-of-the-art performance on a number of measures.

Currently, Medical Subject Headings (MeSH) are manually assigned to every biomedical article published and subsequently recorded in the PubMed database to facilitate retrieving relevant information. With the rapid growth of the PubMed database, large-scale biomedical document indexing becomes increasingly important. MeSH indexing is a challenging task for machine learning, as it needs to assign multiple labels to each article from an extremely large hierachically organized collection. To address this challenge, we propose KenMeSH, an end-to-end model that combines new text features and a dynamic knowledge-enhanced mask attention that integrates document features with MeSH label hierarchy and journal correlation features to index MeSH terms. Experimental results show the proposed method achieves state-of-the-art performance on a number of measures.

Medical Subject Heading (MeSH) indexing refers to the problem of assigning a given biomedical document with the most relevant labels from an extremely large set of MeSH terms. Currently, the vast number of biomedical articles in the PubMed database are manually annotated by human curators, which is time consuming and costly; therefore, a computational system that can assist the indexing is highly valuable. When developing supervised MeSH indexing systems, the availability of a large-scale annotated text corpus is desirable. A publicly available, large corpus that permits robust evaluation and comparison of various systems is important to the research community. We release a large scale annotated MeSH indexing corpus, MeSHup, which contains 1,342,667 full text articles, together with the associated MeSH labels and metadata, authors and publication venues that are collected from the MEDLINE database. We train an end-to-end model that combines features from documents and their associated labels on our corpus and report the new baseline.

Clinical machine learning is increasingly multimodal, collected in both structured tabular formats and unstructured forms such as free text. We propose a novel task of exploring fairness on a multimodal clinical dataset, adopting equalized odds for the downstream medical prediction tasks. To this end, we investigate a modality-agnostic fairness algorithm - equalized odds post processing - and compare it to a text-specific fairness algorithm: debiased clinical word embeddings. Despite the fact that debiased word embeddings do not explicitly address equalized odds of protected groups, we show that a text-specific approach to fairness may simultaneously achieve a good balance of performance classical notions of fairness. Our work opens the door for future work at the critical intersection of clinical NLP and fairness.

The goal of text classification is to automatically assign categories to documents. Deep learning automatically learns effective features from data instead of adopting human-designed features. In this paper, we focus specifically on biomedical document classification using a deep learning approach. We present a novel multichannel TextCNN model for MeSH term indexing. Beyond the normal use of the text from the abstract and title for model training, we also consider figure and table captions, as well as paragraphs associated with the figures and tables. We demonstrate that these latter text sources are important feature sources for our method. A new dataset consisting of these text segments curated from 257,590 full text articles together with the articles’ MEDLINE/PubMed MeSH terms is publicly available.