Clinical notes contain crucial information about medical decisions, including diagnosis, treatment choices, and follow-up plans. However, these decisions are embedded within unstructured text, making it challenging to systematically analyze decision-making patterns or support clinical workflows. We present MedDecXtract, an open-source interactive system that automatically extracts and visualizes medical decisions from clinical text. The system combines a RoBERTa-based model for identifying ten categories of medical decisions (e.g., diagnosis, treatment, follow-up) according to the DICTUM framework, with an intuitive interface for exploration, visualization, and annotation. The system enables various applications including clinical decision support, research on decision patterns, and creation of training data for improved medical language models. The system and its source code can be accessed at https://mohdelgaar-clinical-decisions.hf.space. A video demo is available at https://youtu.be/19j6-XtIE_s.

Medical decisions directly impact individuals’ health and well-being. Extracting decision spans from clinical notes plays a crucial role in understanding medical decision-making processes. In this paper, we develop a new dataset called “MedDec,” which contains clinical notes of eleven different phenotypes (diseases) annotated by ten types of medical decisions. We introduce the task of medical decision extraction, aiming to jointly extract and classify different types of medical decisions within clinical notes. We provide a comprehensive analysis of the dataset, develop a span detection model as a baseline for this task, evaluate recent span detection approaches, and employ a few metrics to measure the complexity of data samples. Our findings shed light on the complexities inherent in clinical decision extraction and enable future work in this area of research. The dataset and code are available through https://github.com/CLU-UML/MedDec.

We introduce the problem of curriculum discovery and describe a curriculum learning framework capable of discovering effective curricula in a curriculum space based on prior knowledge about sample difficulty. Using annotation entropy and loss as measures of difficulty, we show that (i): the top-performing discovered curricula for a given model and dataset are often non-monotonic as apposed to monotonic curricula in existing literature, (ii): the prevailing easy-to-hard or hard-to-easy transition curricula are often at the risk of underperforming, and (iii): the curricula discovered for smaller datasets and models perform well on larger datasets and models respectively. The proposed framework encompasses some of the existing curriculum learning approaches and can discover curricula that outperform them across several NLP tasks.

We employ a characterization of linguistic complexity from psycholinguistic and language acquisition research to develop data-driven curricula to understand the underlying linguistic knowledge that models learn to address NLP tasks. The novelty of our approach is in the development of linguistic curricula derived from data, existing knowledge about linguistic complexity, and model behavior during training. Through the evaluation of several benchmark NLP datasets, our curriculum learning approaches identify sets of linguistic metrics (indices) that inform the challenges and reasoning required to address each task. Our work will inform future research in all NLP areas, allowing linguistic complexity to be considered early in the research and development process. In addition, our work prompts an examination of gold standards and fair evaluation in NLP.