Automated tabulation of clinical trial results: A joint entity and relation extraction approach with transformer-based language representations

Abstract

Evidence-based medicine, the practice in which healthcare professionals refer to the best available evidence when making decisions, forms the foundation of modern healthcare. However, it relies on labour-intensive systematic reviews, where domain specialists must aggregate and extract information from thousands of publications, primarily of randomised controlled trial (RCT) results, into evidence tables. This paper investigates automating evidence table generation by decomposing the problem across two language processing tasks: named entity recognition, which identifies key entities within text, such as drug names, and relation extraction, which maps their relationships for separating them into ordered tuples. We focus on the automatic tabulation of sentences from published RCT abstracts that report the results of the study outcomes. Two deep neural net models were developed as part of a joint extraction pipeline, using the principles of transfer learning and transformer-based language representations. To train and test these models, a new gold-standard corpus was developed, comprising over 550 result sentences from six disease areas. This approach demonstrated significant advantages, with our system performing well across multiple natural language processing tasks and disease areas, as well as in generalising to disease domains unseen during training. Furthermore, we show these results were achievable through training our models on as few as 170 example sentences. The final system is a proof of concept that the generation of evidence tables can be semi-automated, representing a step towards fully automating systematic reviews.

Keywords: BERT; Evidence table; Information extraction; Natural language processing; Randomised controlled trial; Systematic review; Transformer.