Classifying Tumor Reportability Status From Unstructured Electronic Pathology Reports Using Language Models in a Population-Based Cancer Registry Setting
Bibliographic record
Abstract
PURPOSE: Population-based cancer registries (PBCRs) collect data on all new cancer diagnoses in a defined population. Data are sourced from pathology reports, and the PBCRs rely on manual and rule-based solutions. This study presents a state-of-the-art natural language processing (NLP) pipeline, built by fine-tuning pretrained language models (LMs). The pipeline is deployed at the British Columbia Cancer Registry (BCCR) to detect reportable tumors from a population-based feed of electronic pathology. METHODS: We fine-tune two publicly available LMs, GatorTron and BlueBERT, which are pretrained on clinical text. Fine-tuning is done using BCCR's pathology reports. For the final decision making, we combine both models' output using an OR approach. The fine-tuning data set consisted of 40,000 reports from the diagnosis year of 2021, and the test data sets consisted of 10,000 reports from the diagnosis year 2021, 20,000 reports from diagnosis year 2022, and 400 reports from diagnosis year 2023. RESULTS: The retrospective evaluation of our proposed approach showed boosted reportable accuracy, maintaining the true reportable threshold of 98%. CONCLUSION: Disadvantages of rule-based NLP in cancer surveillance include manual effort in rule design and sensitivity to language change. Deep learning approaches demonstrate superior performance in classification. PBCRs distinguish reportability status of incoming electronic cancer pathology reports. Deep learning methods provide significant advantages over rule-based NLP.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".