用NLP分析癌症病历,挖掘临床数据价值
Natural Language Processing for Analyzing Electronic Health Records and Clinical Notes in Cancer Research: A Review
- 基于文献综述,梳理近年NLP在癌症研究中的应用
- 乳腺、肺癌、结直肠癌是主要研究对象,文本分类与信息抽取为主流任务
- 推动从规则系统向Transformer模型演进,助力临床决策
本综述旨在分析自然语言处理(NLP)技术在利用电子健康记录(EHRs)和临床笔记开展癌症研究中的应用。通过在Scopus数据库中检索2019至2024年间发表的94篇相关研究,提取了研究特征、癌症类型、NLP方法、数据集信息、性能指标、挑战与未来方向。研究按癌症类型和NLP应用分类。结果显示,癌症研究中NLP应用呈上升趋势,乳腺癌、肺癌和结直肠癌为最常见研究对象;信息提取与文本分类成为主流任务;从规则系统向先进机器学习模型,尤其是基于Transformer的模型转变明显。现有研究使用的数据集规模差异显著。主要挑战包括解决方案泛化能力有限及与临床工作流程整合不足。结论认为,NLP在分析癌症病历方面潜力巨大,未来应关注提升模型泛化性、增强对复杂临床语言的鲁棒性,并拓展至研究较少的癌症类型。将NLP工具融入临床实践并解决伦理问题,对提升癌症诊疗与患者预后至关重要。
原文摘要 · Abstract (English)
Objective: This review aims to analyze the application of natural language processing (NLP) techniques in cancer research using electronic health records (EHRs) and clinical notes. This review addresses gaps in the existing literature by providing a broader perspective than previous studies focused on specific cancer types or applications. Methods: A comprehensive literature search was conducted using the Scopus database, identifying 94 relevant studies published between 2019 and 2024. Data extraction included study characteristics, cancer types, NLP methodologies, dataset information, performance metrics, challenges, and future directions. Studies were categorized based on cancer types and NLP applications. Results: The results showed a growing trend in NLP applications for cancer research, with breast, lung, and colorectal cancers being the most studied. Information extraction and text classification emerged as predominant NLP tasks. A shift from rule-based to advanced machine learning techniques, particularly transformer-based models, was observed. The Dataset sizes used in existing studies varied widely. Key challenges included the limited generalizability of proposed solutions and the need for improved integration into clinical workflows. Conclusion: NLP techniques show significant potential in analyzing EHRs and clinical notes for cancer research. However, future work should focus on improving model generalizability, enhancing robustness in handling complex clinical language, and expanding applications to understudied cancer types. Integration of NLP tools into clinical practice and addressing ethical considerations remain crucial for utilizing the full potential of NLP in enhancing cancer diagnosis, treatment, and patient outcomes.
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