Derive New Resources with nlp-insights and ACD

Some resources such as DiagnosticReports and DocumentReferences contain clinical notes or other unstructured text. When the nlp-insights service receives one of these resources, it can derive new FHIR resources for detected concepts.

nlp-insights can derive new resources from:

DiagnosticReport (from the text at the path DiagnosticReport.presentedForm[].data)
DocumentReference (from the text at the path DocumentReference.content[].attachment.data)

Three types of FHIR resources can be derived by the service: * Condition * MedicationStatement * Adverse Event (new as of 0.1.0)

Configure nlp-insights to use ACD for NLP

If the nlp-insights service has not been configured to use ACD by default, follow the steps here.

Derive new resources from a diagnostic report

This example creates a diagnostic report where the text mentions a condition (myocardial infarction) and a medication (Losartan).

The Text data in a diagnostic report must be base64 encoded, which can be done with the base64 command in bash.

B64_REPORT_TEXT=$(echo 'The patient had a myocardial infarction in 2015 and was prescribed Losartan.' | base64 -w 0)

The text can now be included in a diagnostic report and sent to the nlp-insights service. The curl command stores the response json in a file /tmp/output.json for future analysis.

curl  -w "\n%{http_code}\n" -s -o /tmp/output.json -XPOST localhost:5000/discoverInsights  -H 'Content-Type: application/json; charset=utf-8' --data-binary @- << EOF
{
    "resourceType": "Bundle",
    "id": "abc",
    "type": "transaction",
    "entry": [
        {
            "resource": {
                "id": "abcefg-1234567890",
                "status": "final",
                "code": {
                    "text": "Chief complaint Narrative - Reported"
                },
                "presentedForm": [
                    {
                        "contentType": "text",
                        "language": "en",
                        "data": "$B64_REPORT_TEXT",
                        "title": "ER VISIT",
                        "creation": "2020-08-02T12:44:55+08:00"
                    }
                ],
                "resourceType": "DiagnosticReport"
            },
            "request": {
                "method": "POST",
                "url": "DiagnosticReport"
            }
        }
    ]
}
EOF

output

200

cat /tmp/output.json | jq

Returned Bundle

{
  "id": "abc",
  "entry": [
    {
      "fullUrl": "urn:uuid:82c9b48b-04f7-4a9f-8d01-5b7619303b71",
      "request": {
        "method": "POST",
        "url": "DiagnosticReport"
      },
      "resource": {
        "id": "abcefg-1234567890",
        "code": {
          "text": "Chief complaint Narrative - Reported"
        },
        "presentedForm": [
          {
            "contentType": "text",
            "creation": "2020-08-02T12:44:55+08:00",
            "data": "VGhlIHBhdGllbnQgaGFkIGEgbXlvY2FyZGlhbCBpbmZhcmN0aW9uIGluIDIwMTUgYW5kIHdhcyBwcmVzY3JpYmVkIExvc2FydGFuLgo=",
            "language": "en",
            "title": "ER VISIT"
          }
        ],
        "status": "final",
        "resourceType": "DiagnosticReport"
      }
    },
    {
      "request": {
        "method": "POST",
        "url": "Condition"
      },
      "resource": {
        "meta": {
          "extension": [
            {
              "extension": [
                {
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-id",
                  "valueIdentifier": {
                    "system": "urn:alvearie.io/health_patterns/services/nlp_insights/acd",
                    "value": "3fffb27d5ebe1c952d6df03de996ed5fc90edb5d28c5972f89720eb5"
                  }
                },
                {
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/path",
                  "valueString": "Condition"
                },
                {
                  "extension": [
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference",
                      "valueReference": {
                        "reference": "urn:uuid:82c9b48b-04f7-4a9f-8d01-5b7619303b71"
                      }
                    },
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference-path",
                      "valueString": "DiagnosticReport.presentedForm[0].data"
                    },
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/evaluated-output",
                      "valueAttachment": {
                        "contentType": "application/json",
                        "data": "{"attributeValues": [{"begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "preferredName": "myocardial infarction", "values": [{"value": "myocardial infarction"}], "source": "Clinical Insights - Attributes", "sourceVersion": "v1.0", "concept": {"uid": 8}, "name": "Diagnosis", "icd9Code": "410.90", "icd10Code": "I21.9", "snomedConceptId": "22298006", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "ccsCode": "100", "hccCode": "86", "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}, {"begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "preferredName": "losartan", "values": [{"value": "losartan"}], "source": "Clinical Insights - Attributes", "sourceVersion": "v1.0", "concept": {"uid": 7}, "name": "PrescribedMedication", "rxNormId": "52175", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}}], "concepts": [{"type": "umls.Finding", "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C4552959", "preferredName": "Myocardial Infarction, CTCAE", "semanticType": "fndg", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C143691", "vocabs": "MTH,NCI_CTCAE_5,NCI"}, {"type": "umls.LaboratoryOrTestResult", "uid": 4, "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0428953", "preferredName": "Electrocardiogram: myocardial infarction (finding)", "semanticType": "lbtr", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "INVALID"}, "icd10Code": "I21.4,I21.29,I21.09,I21.19,R94.31,I25.2,I21.9", "nciCode": "C101589", "snomedConceptId": "164865005", "vocabs": "CHV,MTH,NCI_CDISC,NCI,SNOMEDCT_US"}, {"type": "umls.DiseaseOrSyndrome", "uid": 3, "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0027051", "preferredName": "Myocardial Infarction", "semanticType": "dsyn", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "icd10Code": "I21.9", "nciCode": "C27996", "snomedConceptId": "22298006", "meshId": "M0014340", "loincId": "MTHU035551,LA14274-7,LP98884-7,LA16286-9", "vocabs": "NCI_NICHD,MTH,LNC,CSP,MSH,CST,HPO,OMIM,NCI_CTCAE,COSTAR,AIR,CHV,NCI_FDA,MEDLINEPLUS,NCI,LCH_NW,AOD,SNOMEDCT_US,DXP", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}, {"type": "umls.HealthCareActivity", "begin": 56, "end": 66, "coveredText": "prescribed", "negated": false, "cui": "C0278329", "preferredName": "Prescribed", "semanticType": "hlca", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "vocabs": "MTH,CHV,LCH"}, {"type": "umls.OrganicChemical", "uid": 5, "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "semanticType": "orch", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "vocabs": "MTH,LNC,CSP,MSH,MTHSPL,RXNORM,NCI_NCI-GLOSS,CHV,ATC,NCI_CTRP,NCI_FDA,NCI,AOD,SNOMEDCT_US,DRUGBANK,VANDF"}, {"type": "umls.PharmacologicSubstance", "uid": 2, "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "semanticType": "phsu", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "vocabs": "MTH,LNC,CSP,MSH,MTHSPL,RXNORM,NCI_NCI-GLOSS,CHV,ATC,NCI_CTRP,NCI_FDA,NCI,AOD,SNOMEDCT_US,DRUGBANK,VANDF", "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}}, {"type": "ICDiagnosis", "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0027051", "preferredName": "Myocardial Infarction", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "icd10Code": "I21.9", "nciCode": "C27996", "snomedConceptId": "22298006", "meshId": "M0014340", "loincId": "MTHU035551,LA14274-7,LP98884-7,LA16286-9", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "ruleId": "698f2b19-27b6-4dab-9150-7d7ef3b03a5c", "derivedFrom": [{"uid": 3}], "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}, {"type": "ICNormality", "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0428953", "preferredName": "Electrocardiogram: myocardial infarction (finding)", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "INVALID"}, "ruleId": "c1e8d7d4-7d36-423b-b39d-4ebb5eb65b0c", "derivedFrom": [{"uid": 4}]}, {"type": "ICMedication", "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}, "ruleId": "7861c024-ad1c-47e6-b40e-c90cb7b19e26", "derivedFrom": [{"uid": 2}]}, {"type": "ICNormality", "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "ruleId": "d004df62-a65d-4136-aa32-161a43eb9506", "derivedFrom": [{"uid": 2}]}, {"type": "ICNormality", "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "NO_DECISION"}, "ruleId": "343e6158-2c30-4726-be71-33a570b28703", "derivedFrom": [{"uid": 5}]}], "MedicationInd": [{"type": "aci.MedicationInd", "uid": 7, "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "drug": [{"coveredText": "Losartan", "cui": "C0126174", "complex": "false", "end": 75, "type": "aci.Ind_Drug", "name1": [{"rxNormID": "52175", "coveredText": "Losartan", "cui": "C0126174", "drugSurfaceForm": "Losartan", "drugNormalizedName": "losartan", "end": 75, "type": "aci.DrugName", "begin": 67}], "begin": 67}], "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}, "disambiguationData": {"validity": "VALID", "comment": "marked VALID by clinical insight models."}}], "SymptomDiseaseInd": [{"type": "aci.SymptomDiseaseInd", "uid": 8, "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0027051", "icd10Code": "I21.9", "modality": "positive", "symptomDiseaseSurfaceForm": "myocardial infarction", "snomedConceptId": "22298006", "ccsCode": "100", "symptomDiseaseNormalizedName": "myocardial infarction", "icd9Code": "410.90", "hccCode": "86", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}], "spellCorrectedText": [{"correctedText": "The patient had a myocardial infarction in 2015 and was prescribed Losartan.\n"}], "temporalSpans": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}}]}"
                      }
                    },
                    {
                      "extension": [
                        {
                          "extension": [
                            {
                              "url": "http://ibm.com/fhir/cdm/StructureDefinition/covered-text",
                              "valueString": "myocardial infarction"
                            },
                            {
                              "url": "http://ibm.com/fhir/cdm/StructureDefinition/offset-begin",
                              "valueInteger": 18
                            },
                            {
                              "url": "http://ibm.com/fhir/cdm/StructureDefinition/offset-end",
                              "valueInteger": 39
                            },
                            {
                              "extension": [
                                {
                                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/method",
                                  "valueCodeableConcept": {
                                    "coding": [
                                      {
                                        "code": "Diagnosis_Explicit_Score",
                                        "system": "http://ibm.com/fhir/cdm/CodeSystem/1.0/acd-confidence-method"
                                      }
                                    ]
                                  }
                                },
                                {
                                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/score",
                                  "valueDecimal": 0.994
                                },
                                {
                                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/description",
                                  "valueString": "Explicit Score"
                                }
                              ],
                              "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-confidence"
                            },
                            {
                              "extension": [
                                {
                                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/method",
                                  "valueCodeableConcept": {
                                    "coding": [
                                      {
                                        "code": "Diagnosis_Patient_Reported_Score",
                                        "system": "http://ibm.com/fhir/cdm/CodeSystem/1.0/acd-confidence-method"
                                      }
                                    ]
                                  }
                                },
                                {
                                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/score",
                                  "valueDecimal": 0.003
                                },
                                {
                                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/description",
                                  "valueString": "Patient Reported Score"
                                }
                              ],
                              "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-confidence"
                            }
                          ],
                          "url": "http://ibm.com/fhir/cdm/StructureDefinition/span"
                        }
                      ],
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-result"
                    }
                  ],
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-detail"
                }
              ],
              "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight"
            }
          ]
        },
        "extension": [
          {
            "extension": [
              {
                "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-id",
                "valueIdentifier": {
                  "system": "urn:alvearie.io/health_patterns/services/nlp_insights/acd",
                  "value": "3fffb27d5ebe1c952d6df03de996ed5fc90edb5d28c5972f89720eb5"
                }
              },
              {
                "url": "http://ibm.com/fhir/cdm/StructureDefinition/category",
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "code": "natural-language-processing",
                      "display": "NLP",
                      "system": "http://ibm.com/fhir/cdm/CodeSystem/insight-category-code-system"
                    }
                  ],
                  "text": "NLP"
                }
              }
            ],
            "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-summary"
          }
        ],
        "code": {
          "coding": [
            {
              "code": "C0027051",
              "display": "myocardial infarction",
              "system": "http://terminology.hl7.org/CodeSystem/umls"
            },
            {
              "code": "22298006",
              "system": "http://snomed.info/sct"
            },
            {
              "code": "410.90",
              "system": "http://hl7.org/fhir/sid/icd-9-cm"
            },
            {
              "code": "I21.9",
              "system": "http://hl7.org/fhir/sid/icd-10-cm"
            }
          ],
          "text": "myocardial infarction"
        },
        "resourceType": "Condition"
      }
    },
    {
      "request": {
        "method": "POST",
        "url": "MedicationStatement"
      },
      "resource": {
        "meta": {
          "extension": [
            {
              "extension": [
                {
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-id",
                  "valueIdentifier": {
                    "system": "urn:alvearie.io/health_patterns/services/nlp_insights/acd",
                    "value": "52381140c4ee7bd330c374862852d0b822b436782acb6421b5685ef5"
                  }
                },
                {
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/path",
                  "valueString": "MedicationStatement"
                },
                {
                  "extension": [
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference",
                      "valueReference": {
                        "reference": "urn:uuid:82c9b48b-04f7-4a9f-8d01-5b7619303b71"
                      }
                    },
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference-path",
                      "valueString": "DiagnosticReport.presentedForm[0].data"
                    },
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/evaluated-output",
                      "valueAttachment": {
                        "contentType": "application/json",
                        "data": "{"attributeValues": [{"begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "preferredName": "myocardial infarction", "values": [{"value": "myocardial infarction"}], "source": "Clinical Insights - Attributes", "sourceVersion": "v1.0", "concept": {"uid": 8}, "name": "Diagnosis", "icd9Code": "410.90", "icd10Code": "I21.9", "snomedConceptId": "22298006", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "ccsCode": "100", "hccCode": "86", "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}, {"begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "preferredName": "losartan", "values": [{"value": "losartan"}], "source": "Clinical Insights - Attributes", "sourceVersion": "v1.0", "concept": {"uid": 7}, "name": "PrescribedMedication", "rxNormId": "52175", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}}], "concepts": [{"type": "umls.Finding", "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C4552959", "preferredName": "Myocardial Infarction, CTCAE", "semanticType": "fndg", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C143691", "vocabs": "MTH,NCI_CTCAE_5,NCI"}, {"type": "umls.LaboratoryOrTestResult", "uid": 4, "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0428953", "preferredName": "Electrocardiogram: myocardial infarction (finding)", "semanticType": "lbtr", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "INVALID"}, "icd10Code": "I21.4,I21.29,I21.09,I21.19,R94.31,I25.2,I21.9", "nciCode": "C101589", "snomedConceptId": "164865005", "vocabs": "CHV,MTH,NCI_CDISC,NCI,SNOMEDCT_US"}, {"type": "umls.DiseaseOrSyndrome", "uid": 3, "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0027051", "preferredName": "Myocardial Infarction", "semanticType": "dsyn", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "icd10Code": "I21.9", "nciCode": "C27996", "snomedConceptId": "22298006", "meshId": "M0014340", "loincId": "MTHU035551,LA14274-7,LP98884-7,LA16286-9", "vocabs": "NCI_NICHD,MTH,LNC,CSP,MSH,CST,HPO,OMIM,NCI_CTCAE,COSTAR,AIR,CHV,NCI_FDA,MEDLINEPLUS,NCI,LCH_NW,AOD,SNOMEDCT_US,DXP", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}, {"type": "umls.HealthCareActivity", "begin": 56, "end": 66, "coveredText": "prescribed", "negated": false, "cui": "C0278329", "preferredName": "Prescribed", "semanticType": "hlca", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "vocabs": "MTH,CHV,LCH"}, {"type": "umls.OrganicChemical", "uid": 5, "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "semanticType": "orch", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "vocabs": "MTH,LNC,CSP,MSH,MTHSPL,RXNORM,NCI_NCI-GLOSS,CHV,ATC,NCI_CTRP,NCI_FDA,NCI,AOD,SNOMEDCT_US,DRUGBANK,VANDF"}, {"type": "umls.PharmacologicSubstance", "uid": 2, "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "semanticType": "phsu", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "vocabs": "MTH,LNC,CSP,MSH,MTHSPL,RXNORM,NCI_NCI-GLOSS,CHV,ATC,NCI_CTRP,NCI_FDA,NCI,AOD,SNOMEDCT_US,DRUGBANK,VANDF", "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}}, {"type": "ICDiagnosis", "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0027051", "preferredName": "Myocardial Infarction", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "icd10Code": "I21.9", "nciCode": "C27996", "snomedConceptId": "22298006", "meshId": "M0014340", "loincId": "MTHU035551,LA14274-7,LP98884-7,LA16286-9", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "ruleId": "698f2b19-27b6-4dab-9150-7d7ef3b03a5c", "derivedFrom": [{"uid": 3}], "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}, {"type": "ICNormality", "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0428953", "preferredName": "Electrocardiogram: myocardial infarction (finding)", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "INVALID"}, "ruleId": "c1e8d7d4-7d36-423b-b39d-4ebb5eb65b0c", "derivedFrom": [{"uid": 4}]}, {"type": "ICMedication", "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}, "ruleId": "7861c024-ad1c-47e6-b40e-c90cb7b19e26", "derivedFrom": [{"uid": 2}]}, {"type": "ICNormality", "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "ruleId": "d004df62-a65d-4136-aa32-161a43eb9506", "derivedFrom": [{"uid": 2}]}, {"type": "ICNormality", "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "NO_DECISION"}, "ruleId": "343e6158-2c30-4726-be71-33a570b28703", "derivedFrom": [{"uid": 5}]}], "MedicationInd": [{"type": "aci.MedicationInd", "uid": 7, "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "drug": [{"coveredText": "Losartan", "cui": "C0126174", "complex": "false", "end": 75, "type": "aci.Ind_Drug", "name1": [{"rxNormID": "52175", "coveredText": "Losartan", "cui": "C0126174", "drugSurfaceForm": "Losartan", "drugNormalizedName": "losartan", "end": 75, "type": "aci.DrugName", "begin": 67}], "begin": 67}], "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}, "disambiguationData": {"validity": "VALID", "comment": "marked VALID by clinical insight models."}}], "SymptomDiseaseInd": [{"type": "aci.SymptomDiseaseInd", "uid": 8, "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0027051", "icd10Code": "I21.9", "modality": "positive", "symptomDiseaseSurfaceForm": "myocardial infarction", "snomedConceptId": "22298006", "ccsCode": "100", "symptomDiseaseNormalizedName": "myocardial infarction", "icd9Code": "410.90", "hccCode": "86", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}], "spellCorrectedText": [{"correctedText": "The patient had a myocardial infarction in 2015 and was prescribed Losartan.\n"}], "temporalSpans": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}}]}"
                      }
                    },
                    {
                      "extension": [
                        {
                          "extension": [
                            {
                              "url": "http://ibm.com/fhir/cdm/StructureDefinition/covered-text",
                              "valueString": "Losartan"
                            },
                            {
                              "url": "http://ibm.com/fhir/cdm/StructureDefinition/offset-begin",
                              "valueInteger": 67
                            },
                            {
                              "url": "http://ibm.com/fhir/cdm/StructureDefinition/offset-end",
                              "valueInteger": 75
                            },
                            {
                              "extension": [
                                {
                                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/method",
                                  "valueCodeableConcept": {
                                    "coding": [
                                      {
                                        "code": "Medication_Taken_Score",
                                        "system": "http://ibm.com/fhir/cdm/CodeSystem/1.0/acd-confidence-method"
                                      }
                                    ]
                                  }
                                },
                                {
                                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/score",
                                  "valueDecimal": 1
                                },
                                {
                                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/description",
                                  "valueString": "Medication Taken Score"
                                }
                              ],
                              "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-confidence"
                            }
                          ],
                          "url": "http://ibm.com/fhir/cdm/StructureDefinition/span"
                        }
                      ],
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-result"
                    }
                  ],
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-detail"
                }
              ],
              "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight"
            }
          ]
        },
        "extension": [
          {
            "extension": [
              {
                "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-id",
                "valueIdentifier": {
                  "system": "urn:alvearie.io/health_patterns/services/nlp_insights/acd",
                  "value": "52381140c4ee7bd330c374862852d0b822b436782acb6421b5685ef5"
                }
              },
              {
                "url": "http://ibm.com/fhir/cdm/StructureDefinition/category",
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "code": "natural-language-processing",
                      "display": "NLP",
                      "system": "http://ibm.com/fhir/cdm/CodeSystem/insight-category-code-system"
                    }
                  ],
                  "text": "NLP"
                }
              }
            ],
            "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-summary"
          }
        ],
        "medicationCodeableConcept": {
          "coding": [
            {
              "code": "C0126174",
              "display": "Losartan",
              "system": "http://terminology.hl7.org/CodeSystem/umls"
            },
            {
              "code": "52175",
              "system": "http://www.nlm.nih.gov/research/umls/rxnorm"
            }
          ],
          "text": "Losartan"
        },
        "status": "unknown",
        "resourceType": "MedicationStatement"
      }
    }
  ],
  "type": "transaction",
  "resourceType": "Bundle"
}

In addition to the original resources, the returned bundle has two new entries with derived resources. We'll look at the codes associated with these resources independently.

Resource Type	Description
DiagnosticReport	Chief complaint Narrative - Reported
Condition	myocardial infarction
MedicationStatement	Losartan

Derived condition codes

Included in the condition are coding values for a number of industry standard systems that ACD understands.

System	Code	Display
http://terminology.hl7.org/CodeSystem/umls	C0027051	myocardial infarction
http://snomed.info/sct	22298006
http://hl7.org/fhir/sid/icd-9-cm	410.90
http://hl7.org/fhir/sid/icd-10-cm	I21.9

Derived MedicationStatement codes

ACD understands RxNorm, an industry standard coding system for medications. When ACD is configured as the NLP service for nlp-insights, RxNorm codes will added to derived MedicationStatements in addition to UMLS codes.

System	Code	Display
http://terminology.hl7.org/CodeSystem/umls	C0126174	Losartan
http://www.nlm.nih.gov/research/umls/rxnorm	52175

Evidence

The structure of derived resources is based on the Alvearie FHIR IG.

The nlp-insights service adds detailed information to the derived resource to explain what caused the resource to be created.

Insight Summary

Each derived resource has an insight summary extension.

The summary extension for the derived Condition looks like this:

{
  "extension": [
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-id",
      "valueIdentifier": {
        "system": "urn:alvearie.io/health_patterns/services/nlp_insights/acd",
        "value": "3fffb27d5ebe1c952d6df03de996ed5fc90edb5d28c5972f89720eb5"
      }
    },
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/category",
      "valueCodeableConcept": {
        "coding": [
          {
            "code": "natural-language-processing",
            "display": "NLP",
            "system": "http://ibm.com/fhir/cdm/CodeSystem/insight-category-code-system"
          }
        ],
        "text": "NLP"
      }
    }
  ],
  "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-summary"
}

The insight id has a system and identifier that together identify the insight. In this example, the system tells us that the insight was discovered using ACD. The identifier value is unique (within the system) to this insight.

The category tells us that the resource was created using Natural Language Processing.

Insight Extension in Resource Meta

The insight identified by the summary extension has an insight extension in the resource's meta. The insight extension contains lots of details about what the insight applies to and why it was created.

Although the alvearie FHIR IG supports multiple insights, nlp-insights will create a single insight in the meta when a resource is derived. Other services are able to additional insights if they choose to.

Insight extension for the derived Condition

{
  "extension": [
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-id",
      "valueIdentifier": {
        "system": "urn:alvearie.io/health_patterns/services/nlp_insights/acd",
        "value": "3fffb27d5ebe1c952d6df03de996ed5fc90edb5d28c5972f89720eb5"
      }
    },
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/path",
      "valueString": "Condition"
    },
    {
      "extension": [
        {
          "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference",
          "valueReference": {
            "reference": "urn:uuid:82c9b48b-04f7-4a9f-8d01-5b7619303b71"
          }
        },
        {
          "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference-path",
          "valueString": "DiagnosticReport.presentedForm[0].data"
        },
        {
          "url": "http://ibm.com/fhir/cdm/StructureDefinition/evaluated-output",
          "valueAttachment": {
            "contentType": "application/json",
            "data": "{"attributeValues": [{"begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "preferredName": "myocardial infarction", "values": [{"value": "myocardial infarction"}], "source": "Clinical Insights - Attributes", "sourceVersion": "v1.0", "concept": {"uid": 8}, "name": "Diagnosis", "icd9Code": "410.90", "icd10Code": "I21.9", "snomedConceptId": "22298006", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "ccsCode": "100", "hccCode": "86", "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}, {"begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "preferredName": "losartan", "values": [{"value": "losartan"}], "source": "Clinical Insights - Attributes", "sourceVersion": "v1.0", "concept": {"uid": 7}, "name": "PrescribedMedication", "rxNormId": "52175", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}}], "concepts": [{"type": "umls.Finding", "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C4552959", "preferredName": "Myocardial Infarction, CTCAE", "semanticType": "fndg", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C143691", "vocabs": "MTH,NCI_CTCAE_5,NCI"}, {"type": "umls.LaboratoryOrTestResult", "uid": 4, "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0428953", "preferredName": "Electrocardiogram: myocardial infarction (finding)", "semanticType": "lbtr", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "INVALID"}, "icd10Code": "I21.4,I21.29,I21.09,I21.19,R94.31,I25.2,I21.9", "nciCode": "C101589", "snomedConceptId": "164865005", "vocabs": "CHV,MTH,NCI_CDISC,NCI,SNOMEDCT_US"}, {"type": "umls.DiseaseOrSyndrome", "uid": 3, "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0027051", "preferredName": "Myocardial Infarction", "semanticType": "dsyn", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "icd10Code": "I21.9", "nciCode": "C27996", "snomedConceptId": "22298006", "meshId": "M0014340", "loincId": "MTHU035551,LA14274-7,LP98884-7,LA16286-9", "vocabs": "NCI_NICHD,MTH,LNC,CSP,MSH,CST,HPO,OMIM,NCI_CTCAE,COSTAR,AIR,CHV,NCI_FDA,MEDLINEPLUS,NCI,LCH_NW,AOD,SNOMEDCT_US,DXP", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}, {"type": "umls.HealthCareActivity", "begin": 56, "end": 66, "coveredText": "prescribed", "negated": false, "cui": "C0278329", "preferredName": "Prescribed", "semanticType": "hlca", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "vocabs": "MTH,CHV,LCH"}, {"type": "umls.OrganicChemical", "uid": 5, "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "semanticType": "orch", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "vocabs": "MTH,LNC,CSP,MSH,MTHSPL,RXNORM,NCI_NCI-GLOSS,CHV,ATC,NCI_CTRP,NCI_FDA,NCI,AOD,SNOMEDCT_US,DRUGBANK,VANDF"}, {"type": "umls.PharmacologicSubstance", "uid": 2, "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "semanticType": "phsu", "source": "umls", "sourceVersion": "2020AA", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "vocabs": "MTH,LNC,CSP,MSH,MTHSPL,RXNORM,NCI_NCI-GLOSS,CHV,ATC,NCI_CTRP,NCI_FDA,NCI,AOD,SNOMEDCT_US,DRUGBANK,VANDF", "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}}, {"type": "ICDiagnosis", "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0027051", "preferredName": "Myocardial Infarction", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "icd10Code": "I21.9", "nciCode": "C27996", "snomedConceptId": "22298006", "meshId": "M0014340", "loincId": "MTHU035551,LA14274-7,LP98884-7,LA16286-9", "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "ruleId": "698f2b19-27b6-4dab-9150-7d7ef3b03a5c", "derivedFrom": [{"uid": 3}], "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}, {"type": "ICNormality", "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0428953", "preferredName": "Electrocardiogram: myocardial infarction (finding)", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "INVALID"}, "ruleId": "c1e8d7d4-7d36-423b-b39d-4ebb5eb65b0c", "derivedFrom": [{"uid": 4}]}, {"type": "ICMedication", "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "VALID"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}, "ruleId": "7861c024-ad1c-47e6-b40e-c90cb7b19e26", "derivedFrom": [{"uid": 2}]}, {"type": "ICNormality", "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "NO_DECISION"}, "nciCode": "C66869", "snomedConceptId": "96309000,373567002", "meshId": "M0029400", "rxNormId": "52175", "loincId": "LP171619-2", "ruleId": "d004df62-a65d-4136-aa32-161a43eb9506", "derivedFrom": [{"uid": 2}]}, {"type": "ICNormality", "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "preferredName": "losartan", "source": "Clinical Insights - Derived Concepts", "sourceVersion": "v1.0", "disambiguationData": {"validity": "NO_DECISION"}, "ruleId": "343e6158-2c30-4726-be71-33a570b28703", "derivedFrom": [{"uid": 5}]}], "MedicationInd": [{"type": "aci.MedicationInd", "uid": 7, "begin": 67, "end": 75, "coveredText": "Losartan", "negated": false, "cui": "C0126174", "drug": [{"coveredText": "Losartan", "cui": "C0126174", "complex": "false", "end": 75, "type": "aci.Ind_Drug", "name1": [{"rxNormID": "52175", "coveredText": "Losartan", "cui": "C0126174", "drugSurfaceForm": "Losartan", "drugNormalizedName": "losartan", "end": 75, "type": "aci.DrugName", "begin": 67}], "begin": 67}], "insightModelData": {"medication": {"usage": {"takenScore": 1.0, "consideringScore": 0.0, "discussedScore": 0.0, "labMeasurementScore": 0.0}, "doseChangedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "stoppedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "adverseEvent": {"score": 0.0, "allergyScore": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}, "startedEvent": {"score": 0.0, "usage": {"explicitScore": 0.0, "consideringScore": 0.0, "discussedScore": 0.0}}}}, "disambiguationData": {"validity": "VALID", "comment": "marked VALID by clinical insight models."}}], "SymptomDiseaseInd": [{"type": "aci.SymptomDiseaseInd", "uid": 8, "begin": 18, "end": 39, "coveredText": "myocardial infarction", "negated": false, "cui": "C0027051", "icd10Code": "I21.9", "modality": "positive", "symptomDiseaseSurfaceForm": "myocardial infarction", "snomedConceptId": "22298006", "ccsCode": "100", "symptomDiseaseNormalizedName": "myocardial infarction", "icd9Code": "410.90", "hccCode": "86", "disambiguationData": {"validity": "VALID"}, "insightModelData": {"diagnosis": {"usage": {"explicitScore": 0.994, "patientReportedScore": 0.003, "discussedScore": 0.004}, "suspectedScore": 0.021, "symptomScore": 0.001, "traumaScore": 0.0, "familyHistoryScore": 0.0}}, "temporal": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}, "relationTypes": {"overlapsScore": 0.998, "durationScore": 0.0}}]}], "spellCorrectedText": [{"correctedText": "The patient had a myocardial infarction in 2015 and was prescribed Losartan.\n"}], "temporalSpans": [{"begin": 43, "end": 47, "coveredText": "2015", "temporalType": {"dateScore": 0.998, "relativeScore": 0.0}}]}"
          }
        },
        {
          "extension": [
            {
              "extension": [
                {
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/covered-text",
                  "valueString": "myocardial infarction"
                },
                {
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/offset-begin",
                  "valueInteger": 18
                },
                {
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/offset-end",
                  "valueInteger": 39
                },
                {
                  "extension": [
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/method",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "code": "Diagnosis_Explicit_Score",
                            "system": "http://ibm.com/fhir/cdm/CodeSystem/1.0/acd-confidence-method"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/score",
                      "valueDecimal": 0.994
                    },
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/description",
                      "valueString": "Explicit Score"
                    }
                  ],
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-confidence"
                },
                {
                  "extension": [
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/method",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "code": "Diagnosis_Patient_Reported_Score",
                            "system": "http://ibm.com/fhir/cdm/CodeSystem/1.0/acd-confidence-method"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/score",
                      "valueDecimal": 0.003
                    },
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/description",
                      "valueString": "Patient Reported Score"
                    }
                  ],
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-confidence"
                }
              ],
              "url": "http://ibm.com/fhir/cdm/StructureDefinition/span"
            }
          ],
          "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-result"
        }
      ],
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-detail"
    }
  ],
  "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight"
}

The extensions of interest within the insight extension are:

extension	purpose
insight-id	identifier for the insight.
path	HL7 FHIR Path to the part of this resource that the insight applies to. In this case this will be the root of the derived object.
insight-detail	Detailed supporting evidence for the insight.

Insight detail

The insight detail extension provides information about why the insight got created:

Extension	Purpose
reference	The resource that contained the text that was used to create the insight
reference-path	HL7 FHIR Path that describes the location of the text used to create the insight (within reference)
evaluated-output	base64 response from the ACD Service
insight-result	value specific results for the insight. This structure contains one or more spans within the text at reference-path that support the insight.

Spans

The insight-result contains one or more span extensions. Each span contains

Extension	Purpose
covered text	text that the span covers
begin	offset in the original text that begins the span
end	offset in the original text that ends the span
confidence	repeatable extension with a confidence score

Confidence scores

ACD confidence scores are directional; they are indicators of confidence of "context", rather than simple concept detection correctness. A Span may have more than a single direction of confidence associated with it.

Confidence extension for a condition

{
  "extension": [
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/method",
      "valueCodeableConcept": {
        "coding": [
          {
            "code": "Diagnosis_Explicit_Score",
            "system": "http://ibm.com/fhir/cdm/CodeSystem/1.0/acd-confidence-method"
          }
        ]
      }
    },
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/score",
      "valueDecimal": 0.994
    },
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/description",
      "valueString": "Explicit Score"
    }
  ],
  "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-confidence"
}
{
  "extension": [
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/method",
      "valueCodeableConcept": {
        "coding": [
          {
            "code": "Diagnosis_Patient_Reported_Score",
            "system": "http://ibm.com/fhir/cdm/CodeSystem/1.0/acd-confidence-method"
          }
        ]
      }
    },
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/score",
      "valueDecimal": 0.003
    },
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/description",
      "valueString": "Patient Reported Score"
    }
  ],
  "url": "http://ibm.com/fhir/cdm/StructureDefinition/insight-confidence"
}

Condition confidence score

The span in the derived condition has two confidence scores

Description	Score
Explicit Score	0.994
Patient Reported Score	0.003

This tells us that ACD (strongly) believed the span indicated an explicit mention of the condition. It also tells us that ACD did not believe that this condition is something that the patient said they had.

Medication confidence score

The span in the derived medication resource has a different score than the condition.

Description	Score
Medication Taken Score	1

This score tells us that ACD strongly believes that the text says that the patient took the medication.