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All sourcesNASA NTRSDOE OSTI
DOE OSTI2019

Semi-Supervised Information Extraction for Cancer Pathology Reports

Pathology reports are a main source of data for cancer surveillance programs. Manual coding of pathology reports is labor-intensive but necessary for obtaining labeled data to train automated information extraction systems. In this study, we investigated semi-supervised deep learning, improving the performance of a multitask information extraction system for automated annotation of pathology reports. We used a set of over 374,000 pathology reports from the Louisiana Tumor Registry and a novel convolutional attention-based auto-encoder. We performed a set of experiments comparing supervised training augmented with unlabeled data at 1%, 5%, 10%, and 50% of the original data size. We also compared the impact of extending text processing to include unlabeled tokens. We find that semi-supervised training consistently improved individual performance with increased micro-averaged F-scores between 0.012 and 0.064 and increased macro-averaged F-scores of up to 0.158. This demonstrates that semantic information learned via unsupervised learning can be used to improve supervised clinical task performance.

Qiu, John X.↗
DOE OSTI2017

Deep Learning for Automated Extraction of Primary Sites from Cancer Pathology Reports

Pathology reports are a primary source of information for cancer registries which process high volumes of free-text reports annually. Information extraction and coding is a manual, labor-intensive process. Here in this study we investigated deep learning and a convolutional neural network (CNN), for extracting ICDO- 3 topographic codes from a corpus of breast and lung cancer pathology reports. We performed two experiments, using a CNN and a more conventional term frequency vector approach, to assess the effects of class prevalence and inter-class transfer learning. The experiments were based on a set of 942 pathology reports with human expert annotations as the gold standard. CNN performance was compared against a more conventional term frequency vector space approach. We observed that the deep learning models consistently outperformed the conventional approaches in the class prevalence experiment, resulting in micro and macro-F score increases of up to 0.132 and 0.226 respectively when class labels were well populated. Specifically, the best performing CNN achieved a micro-F score of 0.722 over 12 ICD-O-3 topography codes. Transfer learning provided a consistent but modest performance boost for the deep learning methods but trends were contingent on CNN method and cancer site. Finally, these encouraging results demonstrate the potential of deep learning for automated abstraction of pathology reports.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2019

Inverse Regression for Extraction of Tumor Site from Cancer Pathology Reports

Pathology reports are the primary source of information for cancer diagnosis of millions of the cancer patients across the United States. Cancer registries label these reports every year. The coded labels incorporate pertinent information such as cancer location, behavior, and histology. This information when combined with clinical information, medical imaging and even genomic information have a great potential to fuel discoveries in cancer research. The coding process is manual and requires many human experts to label the large volume of pathology reports in a timely manner. In this study, we have developed a supervised inverse regression based auto-labeler to automate the task. The experiments were conducted on a set of 942 pathology reports with human expert labels as the ground truth. We observed that the inverse regression based auto-labeler consistently performed better than or comparable to the best performing state-of-the-art method. These results demonstrate the potential of inverse regression for reliable information extraction from the pathology reports.

Dubey, Abhishek↗
DOE OSTI2019

Extraction of Tumor Site from Cancer Pathology Reports using Deep Filters

Purpose: Pathology reports are the primary source of information concerning the millions of cancer cases across the United States. Cancer registries manually process the pathology reports to extract the pertinent information including primary tumor site, behavior, histology, laterality, and grade. Processing a large volume of the pathology reports in a timely manner is a continuing challenge for cancer registries. The purpose of this study is to develop an information extraction pipeline to reliably and efficiently extract reportable information. Method: We have developed a novel inverse-regression (IR) based information extraction pipeline. The inverse-regression based supervised filter has been successfully applied to many application domains. However, its application to the information extraction from unstructured text is hindered primarily by the extreme high-dimensionality of n-gram representations of text. In this study, we attempt to overcome the obstacles by a novel bootstrapping strategy. First, we use an information-theoretic mutual information based filter to discard the excessive and redundant n-gram features. This step reduces the size and improves the condition number of the sample covariance matrix, thus reducing the computational cost and improving the numerical stability of the subsequent inverse-regression step. Then we use localized sliced inverse-regression (LSIR) to learn a low-dimensional discriminatory subspace for information inference. In particular, we use the k-nearest neighbors of an unlabeled pathology report in the learned representation to infer the desired information from the labeled data in a supervised manner. Results: The experiments were conducted on a set of de-identified pathology reports with human expert labels as the ground truth. Our pipeline consistently performed better than or comparable to the best performing state-of-the-art methods while reducing the training and inference times substantially. Conclusion: Our results demonstrate the potential of inverse-regression based information extraction pipeline for reliable and efficient information extraction from unstructured text. The information extracted from the pathology reports can be used along with clinical information, medical imaging, and genomic information to instigate discoveries in cancer research.

Dubey, Abhishek↗
DOE OSTI2024

Path-BigBird: An AI-Driven Transformer Approach to Classification of Cancer Pathology Reports

PURPOSE Surgical pathology reports are critical for cancer diagnosis and management. To accurately extract information about tumor characteristics from pathology reports in near real time, we explore the impact of using domain-specific transformer models that understand cancer pathology reports. METHODS We built a pathology transformer model, Path-BigBird, by using 2.7 million pathology reports from six SEER cancer registries. We then compare different variations of Path-BigBird with two less computationally intensive methods: Hierarchical Self-Attention Network (HiSAN) classification model and an offthe-shelf clinical transformer model (Clinical BigBird). We use five pathology information extraction tasks for evaluation: site, subsite, laterality, histology, and behavior. Model performance is evaluated by using macro and micro F 1 scores. RESULTS We found that Path-BigBird and Clinical BigBird outperformed the HiSAN in all tasks. Clinical BigBird performed better on the site and laterality tasks. Versions of the Path-BigBird model performed best on the two most difficult tasks: subsite (micro F 1 score of 72.53, macro F 1 score of 35.76) and histology (micro F 1 score of 80.96, macro F 1 score of 37.94). The largest performance gains over the HiSAN model were for histology, for which a Path-BigBird model increased the micro F 1 score by 1.44 points and the macro F 1 score by 3.55 points. Overall, the results suggest that a Path-BigBird model with a vocabulary derived from wellcurated and deidentified data is the best-performing model. CONCLUSION The Path-BigBird pathology transformer model improves automated information extraction from pathology reports. Although Path-BigBird outperforms Clinical BigBird and HiSAN, these less computationally expensive models still have utility when resources are constrained.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2019

Automatic extraction of cancer registry reportable information from free-text pathology reports using multitask convolutional neural networks

Objective: In this work we implement 2 different multitask learning (MTL) techniques, hard parameter sharing and cross-stitch, to train a word-level convolutional neural network (CNN) specifically designed for automatic extraction of cancer data from unstructured text in pathology reports. We show the importance of learning related information extraction (IE) tasks leveraging shared representations across the tasks to achieve state-of-the-art performance in classification accuracy and computational efficiency. Materials and Methods: Multitask CNN (MTCNN) attempts to tackle document information extraction by learning to extract multiple key cancer characteristics simultaneously. We trained our MTCNN to perform 5 information extraction tasks: (1) primary cancer site (65 classes), (2) laterality (4 classes), (3) behavior (3 classes), (4) histological type (63 classes), and (5) histological grade (5 classes). We evaluated the performance on a corpus of 95 231 pathology documents (71 223 unique tumors) obtained from the Louisiana Tumor Registry. We compared the performance of the MTCNN models against single-task CNN models and 2 traditional machine learning approaches, namely support vector machine (SVM) and random forest classifier (RFC). Results: MTCNNs offered superior performance across all 5 tasks in terms of classification accuracy as compared with the other machine learning models. Based on retrospective evaluation, the hard parameter sharing and cross-stitch MTCNN models correctly classified 59.04% and 57.93% of the pathology reports respectively across all 5 tasks. The baseline models achieved 53.68% (CNN), 46.37% (RFC), and 36.75% (SVM). Based on prospective evaluation, the percentages of correctly classified cases across the 5 tasks were 60.11% (hard parameter sharing), 58.13% (cross-stitch), 51.30% (single-task CNN), 42.07% (RFC), and 35.16% (SVM). Moreover, hard parameter sharing MTCNNs outperformed the other models in computational efficiency by using about the same number of trainable parameters as a single-task CNN. Conclusions: The hard parameter sharing MTCNN offers superior classification accuracy for automated coding support of pathology documents across a wide range of cancers and multiple information extraction tasks while maintaining similar training and inference time as those of a single task–specific model.

96 KNOWLEDGE MANAGEMENT AND PRESERVATION↗
DOE OSTI2025

Large-scale deep learning for metastasis detection in pathology reports

Objectives No existing algorithm can reliably identify metastasis from pathology reports across multiple cancer types and the entire US population. In this study, we develop a deep learning model that automatically detects patients with metastatic cancer by using pathology reports from many laboratories and of multiple cancer types. Materials and Methods We use 60 471 unstructured pathology reports from 4 Surveillance, Epidemiology, and End Results (SEER) registries. The reports were coded into 1 of 3 labels: metastasis negative, metastases positive, or metastasis undetermined. We utilize a task-specific deep neural network trained from scratch and compare its performance with a widely used large language model (LLM). Results Our deep learning architecture trained on task-specific data outperforms a general-purpose LLM, with a recall of 0.894 compared to 0.824. We quantified model uncertainty and used it to defer reports for human review. We found that retaining 72.9% of reports increased recall from 0.894 to 0.969. Discussion A smaller deep learning architecture trained on task-specific data outperforms a general LLM. Equally critical to model performance is the incorporation of uncertainty quantification, achieved here through an abstention mechanism. Conclusions This study’s finding demonstrate the feasibility of developing algorithms to automatically identify metastatic cancer cases from unstructured pathology reports.

machine learning↗
DOE OSTI2018

Coarse-to-Fine Multi-Task Training of Convolutional Neural Networks for Automated Information Extraction from Cancer Pathology Reports

Information extraction and coding of free-text pathology reports is an important activity for cancer registries to support national cancer surveillance. Cancer registrars must process high volumes of pathology reports on an annual basis. In this study, we investigated an automated approach using a coarse-to-fine training of convolutional neural networks (CNNs) for extracting the primary site, histological grade and laterality from unstructured cancer pathology text reports. Our proposed training scheme consists of two stages. In the first stage, the multi-task learning (MTL) with hard parameter sharing approach is used to train a multi-task MT-CNN model for all the tasks. Then, the TM-CNN parameters are used to initialize a CNN model for each task to be fine trained individually using its corresponding dataset. The performance of our proposed model was compared against a state-of-the-art CNN and the commonly used SVM classifier. We observed that the proposed model consistently outperformed the base line models, especially for the less prevalent classes. Specifically, the proposed training approach achieved a micro-F score of 0.7749 over 12 ICD- O-3 topography codes which is a significant improvement as compared with state-of-the-art CNN (0.7101) and the SVM (0.6019) classifiers. Also, the results demonstrate the potential of the proposed method for handling class imbalance within each task. It significantly improves macro-F score by 24% and 12% of the primary site and histology grade tasks, respectively.

Alawad, Mohammed↗
DOE OSTI2019

Classifying Cancer Pathology Reports with Hierarchical Self-Attention Networks

We introduce a deep learning architecture, hierarchical self-attention networks (HiSANs), designed for classifying pathology reports and show how its unique architecture leads to a new state-of-the-art in accuracy, faster training, and clear interpretability. We evaluate performance on a corpus of 374,899 pathology reports obtained from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program. Each pathology report is associated with five clinical classification tasks – site, laterality, behavior, histology, and grade. We compare the performance of the HiSAN against other machine learning and deep learning approaches commonly used on medical text data – Naive Bayes, logistic regression, convolutional neural networks, and hierarchical attention networks (the previous state-of-the-art). We show that HiSANs are superior to other machine learning and deep learning text classifiers in both accuracy and macro F-score across all five classification tasks. Compared to the previous state-of-the-art, hierarchical attention networks, HiSANs not only are an order of magnitude faster to train, but also achieve about 1% better relative accuracy and 5% better relative macro F-score.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

Automatic information extraction from childhood cancer pathology reports

The International Classification of Childhood Cancer (ICCC) facilitates the effective classification of a heterogeneous group of cancers in the important pediatric population. However, there has been no development of machine learning models for the ICCC classification. We developed deep learning-based information extraction models from cancer pathology reports based on the ICD-O-3 coding standard. In this article, we describe extending the models to perform ICCC classification. We developed 2 models, ICD-O-3 classification and ICCC recoding (Model 1) and direct ICCC classification (Model 2), and 4 scenarios subject to the training sample size. We evaluated these models with a corpus consisting of 29206 reports with age at diagnosis between 0 and 19 from 6 state cancer registries. Our findings suggest that the direct ICCC classification (Model 2) is substantially better than reusing the ICD-O-3 classification model (Model 1). Applying the uncertainty quantification mechanism to assess the confidence of the algorithm in assigning a code demonstrated that the model achieved a micro-F1 score of 0.987 while abstaining (not sufficiently confident to assign a code) on only 14.8% of ambiguous pathology reports. Our experimental results suggest that the machine learning-based automatic information extraction from childhood cancer pathology reports in the ICCC is a reliable means of supplementing human annotators at state cancer registries by reading and abstracting the majority of the childhood cancer pathology reports accurately and reliably.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2025

Evaluating algorithmic bias on biomarker classification of breast cancer pathology reports

Objectives: This work evaluated algorithmic bias in biomarkers classification using electronic pathology reports from female breast cancer cases. Bias was assessed across 5 subgroups: cancer registry, race, Hispanic ethnicity, age at diagnosis, and socioeconomic status. Materials and Methods: We utilized 594 875 electronic pathology reports from 178 121 tumors diagnosed in Kentucky, Louisiana, New Jersey, New Mexico, Seattle, and Utah to train 2 deep-learning algorithms to classify breast cancer patients using their biomarkers test results. We used balanced error rate (BER), demographic parity (DP), equalized odds (EOD), and equal opportunity (EOP) to assess bias. Results: We found differences in predictive accuracy between registries, with the highest accuracy in the registry that contributed the most data (Seattle Registry, BER ratios for all registries >1.25). BER showed no significant algorithmic bias in extracting biomarkers (estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2) for race, Hispanic ethnicity, age at diagnosis, or socioeconomic subgroups (BER ratio <1.25). DP, EOD, and EOP all showed insignificant results. Discussion: We observed significant differences in BER by registry, but no significant bias using the DP, EOD, and EOP metrics for socio-demographic or racial categories. This highlights the importance of employing a diverse set of metrics for a comprehensive evaluation of model fairness. Conclusion: A thorough evaluation of algorithmic biases that may affect equality in clinical care is a critical step before deploying algorithms in the real world. We found little evidence of algorithmic bias in our biomarker classification tool. Artificial intelligence tools to expedite information extraction from clinical records could accelerate clinical trial matching and improve care.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2020

Using case-level context to classify cancer pathology reports

Individual electronic health records (EHRs) and clinical reports are often part of a larger sequence—for example, a single patient may generate multiple reports over the trajectory of a disease. In applications such as cancer pathology reports, it is necessary not only to extract information from individual reports, but also to capture aggregate information regarding the entire cancer case based off case-level context from all reports in the sequence. In this paper, we introduce a simple modular add-on for capturing case-level context that is designed to be compatible with most existing deep learning architectures for text classification on individual reports. We test our approach on a corpus of 431,433 cancer pathology reports, and we show that incorporating case-level context significantly boosts classification accuracy across six classification tasks—site, subsite, laterality, histology, behavior, and grade. We expect that with minimal modifications, our add-on can be applied towards a wide range of other clinical text-based tasks.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2019

Deep Transfer Learning Across Cancer Registries for Information Extraction from Pathology Reports

Automated text information extraction from cancer pathology reports is an active area of research to support national cancer surveillance. A well-known challenge is how to develop information extraction tools with robust performance across cancer registries. In this study we investigated whether transfer learning (TL) with a convolutional neural network (CNN) can facilitate cross-registry knowledge sharing. Specifically, we performed a series of experiments to determine whether a CNN trained with single-registry data is capable of transferring knowledge to another registry or whether developing a cross-registry knowledge database produces a more effective and generalizable model. Using data from two cancer registries and primary tumor site and topography as the information extraction task of interest, our study showed that TL results in 6.90% and 17.22% improvement of classification m acro F -score o ver the baseline single-registry models. Detailed analysis illustrated that the observed improvement is evident in the low prevalence classes.

Alawad, Mohammed↗
DOE OSTI2024

Development of message passing-based graph convolutional networks for classifying cancer pathology reports

Abstract Background Applying graph convolutional networks (GCN) to the classification of free-form natural language texts leveraged by graph-of-words features (TextGCN) was studied and confirmed to be an effective means of describing complex natural language texts. However, the text classification models based on the TextGCN possess weaknesses in terms of memory consumption and model dissemination and distribution. In this paper, we present a fast message passing network (FastMPN), implementing a GCN with message passing architecture that provides versatility and flexibility by allowing trainable node embedding and edge weights, helping the GCN model find the better solution. We applied the FastMPN model to the task of clinical information extraction from cancer pathology reports, extracting the following six properties: main site, subsite, laterality, histology, behavior, and grade. Results We evaluated the clinical task performance of the FastMPN models in terms of micro- and macro-averaged F1 scores. A comparison was performed with the multi-task convolutional neural network (MT-CNN) model. Results show that the FastMPN model is equivalent to or better than the MT-CNN. Conclusions Our implementation revealed that our FastMPN model, which is based on the PyTorch platform, can train a large corpus (667,290 training samples) with 202,373 unique words in less than 3 minutes per epoch using one NVIDIA V100 hardware accelerator. Our experiments demonstrated that using this implementation, the clinical task performance scores of information extraction related to tumors from cancer pathology reports were highly competitive.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2022

Using ensembles and distillation to optimize the deployment of deep learning models for the classification of electronic cancer pathology reports

One of the goals of the Surveillance, Epidemiology, and End Results (SEER) program is to estimate incidence, prevalence, and mortality of all cancers. To that end, cancer registries across the country maintain a massive database of cancer pathology reports which contain rich information to understand cancer trends. However, these reports are stored in the form of unstructured text, and human annotators are required to read and extract relevant information. In this article, we show that existing deep learning models for automating information extraction from cancer pathology reports can be significantly improved by using ensemble model distillation. We found that by training multiple predictive models and transferring their knowledge to a single, low-resource model, we can reduce the number of highly confident wrong predictions. Our results show that our implemented methods could save 1000s of manual annotation hours.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2019

Selective Information Extraction Strategies for Cancer Pathology Reports with Convolutional Neural Networks

To trust model predictions, it is important to ensure new data scored by the model comes from the same population used for model training. If the model is used to score new data different than the model’s training data, then predictions and model performance metrics cannot be trusted. Identifying and excluding these anomalous data points is an important task when using models in the real world. Traditional machine learning algorithms and classifiers don’t have the capability to abstain in this case. Here we propose a data-novelty detection algorithm for the Convolutional Neural Network classifier, yielding a rejection score for each new data point scored. It is a post-modeling procedure which examines the distribution of convolution filters to determine if the prediction should be trusted. We apply this algorithm to an information extraction model for a natural language text corpus. We evaluated the algorithm performance using a primary cancer site classification model applied to cancer pathology reports. Results demonstrate that the algorithm is an effective way to exclude cancer pathology reports from model scoring when they do not contain the expected information necessary to accurately classify the primary cancer type.

Yoon, Hong-Jun↗
DOE OSTI2021

Deep active learning for classifying cancer pathology reports

Abstract Background Automated text classification has many important applications in the clinical setting; however, obtaining labelled data for training machine learning and deep learning models is often difficult and expensive. Active learning techniques may mitigate this challenge by reducing the amount of labelled data required to effectively train a model. In this study, we analyze the effectiveness of 11 active learning algorithms on classifying subsite and histology from cancer pathology reports using a Convolutional Neural Network as the text classification model. Results We compare the performance of each active learning strategy using two differently sized datasets and two different classification tasks. Our results show that on all tasks and dataset sizes, all active learning strategies except diversity-sampling strategies outperformed random sampling, i.e., no active learning. On our large dataset (15K initial labelled samples, adding 15K additional labelled samples each iteration of active learning), there was no clear winner between the different active learning strategies. On our small dataset (1K initial labelled samples, adding 1K additional labelled samples each iteration of active learning), marginal and ratio uncertainty sampling performed better than all other active learning techniques. We found that compared to random sampling, active learning strongly helps performance on rare classes by focusing on underrepresented classes. Conclusions Active learning can save annotation cost by helping human annotators efficiently and intelligently select which samples to label. Our results show that a dataset constructed using effective active learning techniques requires less than half the amount of labelled data to achieve the same performance as a dataset constructed using random sampling.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2018

PathRepHAN: Hierarchical attention networks for pathology report classification

Developers at ORNL explored how a deep learning (DL) approach based on hierarchical attention networks (HANs) can improve model performance for multiple information extraction tasks from unstructured cancer pathology reports compared to conventional methods that do not sufficiently capture syntactic and semantic contexts from free-text documents. The HAN was implemented for 2 information extraction tasks: (1) primary site, matched to 12 International Classification of Diseases for Oncology topography codes (7 breast, 5 lung primary sites), and (2) histological grade classification, matched to G1–G4. Our results demonstrate that for both information tasks, HAN performed significantly better compared to the conventional ML and DL techniques.

Ramanathan, Arvind↗