Derive New Resources with nlp-insights and QuickUMLS

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)

Two types of FHIR resources can be derived by the service:

  • Condition
  • MedicationStatement

Configure nlp-insights to use QuickUMLS for NLP

If the nlp-insights service has not been configured to use QuickUMLS 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:894fc0f0-c6cb-4464-83eb-e42a6c92f9f6",
      "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/quickumls",
                    "value": "f2c75a905c5371833f3498356b4c4a5241be3b36c4d9ea85dd0545df"
                  }
                },
                {
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/path",
                  "valueString": "Condition"
                },
                {
                  "extension": [
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference",
                      "valueReference": {
                        "reference": "urn:uuid:894fc0f0-c6cb-4464-83eb-e42a6c92f9f6"
                      }
                    },
                    {
                      "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": "[{"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 1.0, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarction"}, {"cui": "C0428953", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T034"], "similarity": 1.0, "snomed_ct": ["2607355010", "108319019", "256460011", "520888012", "224368019", "224361013", "520880017", "256452010", "3300375014", "3300376010", "3300377018", "546248011", "2748878010", "546240016", "2730758010", "804656017", "2607362018", "2619221014", "2619214014", "2612497015", "2620977012", "2693159014"], "start": 18, "term": "myocardial infarction"}, {"cui": "C2926063", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T201"], "similarity": 1.0, "snomed_ct": [], "start": 18, "term": "myocardial infarction"}, {"cui": "C3810814", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T060"], "similarity": 1.0, "snomed_ct": [], "start": 18, "term": "myocardial infarction"}, {"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.95, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarctions"}, {"cui": "C0155668", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.8260869565217391, "snomed_ct": ["241798016", "299752018", "4031011", "535621012", "299751013", "4032016", "1221564010", "2740994017", "744868013", "578857010", "299754017", "299753011", "2748854017"], "start": 18, "term": "old myocardial infarction"}, {"cui": "C0428953", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T034"], "similarity": 0.8260869565217391, "snomed_ct": ["2607355010", "108319019", "256460011", "520888012", "224368019", "224361013", "520880017", "256452010", "3300375014", "3300376010", "3300377018", "546248011", "2748878010", "546240016", "2730758010", "804656017", "2607362018", "2619221014", "2619214014", "2612497015", "2620977012", "2693159014"], "start": 18, "term": "ecg myocardial infarction"}, {"cui": "C0489577", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T201"], "similarity": 0.8260869565217391, "snomed_ct": [], "start": 18, "term": "myocardial infarction age"}, {"cui": "C3640911", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.8260869565217391, "snomed_ct": [], "start": 18, "term": "new myocardial infarction"}, {"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7916666666666666, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarction (mi)"}, {"cui": "C0155668", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7916666666666666, "snomed_ct": ["241798016", "299752018", "4031011", "535621012", "299751013", "4032016", "1221564010", "2740994017", "744868013", "578857010", "299754017", "299753011", "2748854017"], "start": 18, "term": "past myocardial infarction"}, {"cui": "C0428953", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T034"], "similarity": 0.7916666666666666, "snomed_ct": ["2607355010", "108319019", "256460011", "520888012", "224368019", "224361013", "520880017", "256452010", "3300375014", "3300376010", "3300377018", "546248011", "2748878010", "546240016", "2730758010", "804656017", "2607362018", "2619221014", "2619214014", "2612497015", "2620977012", "2693159014"], "start": 18, "term": "ecg: myocardial infarction"}, {"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarction, (mi)"}, {"cui": "C0155626", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": ["241795018", "395858019", "299702010", "94884017", "94885016", "299721019", "1231678011", "299699015", "395862013", "241793013", "241794019", "395857012", "299705012", "795634013", "578838018"], "start": 18, "term": "acute myocardial infarction"}, {"cui": "C3541950", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "acute myocardial infarction"}, {"cui": "C0155626", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": ["241795018", "395858019", "299702010", "94884017", "94885016", "299721019", "1231678011", "299699015", "395862013", "241793013", "241794019", "395857012", "299705012", "795634013", "578838018"], "start": 18, "term": "myocardial infarction acute"}, {"cui": "C3829910", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T170"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "had a myocardial infarction"}, {"cui": "C0746727", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "septal myocardial infarction"}, {"cui": "C2348362", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "septal myocardial infarction"}, {"cui": "C0155668", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": ["241798016", "299752018", "4031011", "535621012", "299751013", "4032016", "1221564010", "2740994017", "744868013", "578857010", "299754017", "299753011", "2748854017"], "start": 18, "term": "healed myocardial infarction"}, {"cui": "C0340324", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": ["299698011", "350376014", "350377017", "622083013"], "start": 18, "term": "silent myocardial infarction"}, {"cui": "C3898652", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 5 myocardial infarction"}, {"cui": "C3898656", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 3 myocardial infarction"}, {"cui": "C3898657", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T170"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 2 myocardial infarction"}, {"cui": "C3898658", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 1 myocardial infarction"}, {"cui": "C2825159", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T201"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "date of myocardial infarction"}, {"cui": "C3845502", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "myocardial infarction, stroke"}, {"cui": "C3898653", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "type 4c myocardial infarction"}, {"cui": "C3898654", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "type 4b myocardial infarction"}, {"cui": "C3898655", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "type 4a myocardial infarction"}, {"cui": "C0278329", "end": 66, "ngram": "prescribed", "preferred": 1, "semtypes": ["T058"], "similarity": 1.0, "snomed_ct": [], "start": 56, "term": "prescribed"}, {"cui": "C0126174", "end": 75, "ngram": "Losartan", "preferred": 1, "semtypes": ["T121", "T109"], "similarity": 1.0, "snomed_ct": ["1212034011", "159413015", "3488999015", "3499885011", "1205454017", "840645014", "1198867013"], "start": 67, "term": "losartan"}, {"cui": "C1550655", "end": 11, "ngram": "patient", "preferred": 1, "semtypes": ["T031"], "similarity": 1.0, "snomed_ct": [], "start": 4, "term": "patient"}, {"cui": "C1578485", "end": 11, "ngram": "patient", "preferred": 1, "semtypes": ["T170"], "similarity": 1.0, "snomed_ct": [], "start": 4, "term": "patient"}, {"cui": "C1578486", "end": 11, "ngram": "patient", "preferred": 1, "semtypes": ["T170"], "similarity": 1.0, "snomed_ct": [], "start": 4, "term": "patient"}]"
                      }
                    },
                    {
                      "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
                            }
                          ],
                          "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/quickumls",
                  "value": "f2c75a905c5371833f3498356b4c4a5241be3b36c4d9ea85dd0545df"
                }
              },
              {
                "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",
              "system": "http://terminology.hl7.org/CodeSystem/umls"
            }
          ],
          "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/quickumls",
                    "value": "16f3982942687e142241c6145467accf85c314d47b4698edbe210b83"
                  }
                },
                {
                  "url": "http://ibm.com/fhir/cdm/StructureDefinition/path",
                  "valueString": "MedicationStatement"
                },
                {
                  "extension": [
                    {
                      "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference",
                      "valueReference": {
                        "reference": "urn:uuid:894fc0f0-c6cb-4464-83eb-e42a6c92f9f6"
                      }
                    },
                    {
                      "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": "[{"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 1.0, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarction"}, {"cui": "C0428953", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T034"], "similarity": 1.0, "snomed_ct": ["2607355010", "108319019", "256460011", "520888012", "224368019", "224361013", "520880017", "256452010", "3300375014", "3300376010", "3300377018", "546248011", "2748878010", "546240016", "2730758010", "804656017", "2607362018", "2619221014", "2619214014", "2612497015", "2620977012", "2693159014"], "start": 18, "term": "myocardial infarction"}, {"cui": "C2926063", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T201"], "similarity": 1.0, "snomed_ct": [], "start": 18, "term": "myocardial infarction"}, {"cui": "C3810814", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T060"], "similarity": 1.0, "snomed_ct": [], "start": 18, "term": "myocardial infarction"}, {"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.95, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarctions"}, {"cui": "C0155668", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.8260869565217391, "snomed_ct": ["241798016", "299752018", "4031011", "535621012", "299751013", "4032016", "1221564010", "2740994017", "744868013", "578857010", "299754017", "299753011", "2748854017"], "start": 18, "term": "old myocardial infarction"}, {"cui": "C0428953", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T034"], "similarity": 0.8260869565217391, "snomed_ct": ["2607355010", "108319019", "256460011", "520888012", "224368019", "224361013", "520880017", "256452010", "3300375014", "3300376010", "3300377018", "546248011", "2748878010", "546240016", "2730758010", "804656017", "2607362018", "2619221014", "2619214014", "2612497015", "2620977012", "2693159014"], "start": 18, "term": "ecg myocardial infarction"}, {"cui": "C0489577", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T201"], "similarity": 0.8260869565217391, "snomed_ct": [], "start": 18, "term": "myocardial infarction age"}, {"cui": "C3640911", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.8260869565217391, "snomed_ct": [], "start": 18, "term": "new myocardial infarction"}, {"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7916666666666666, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarction (mi)"}, {"cui": "C0155668", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7916666666666666, "snomed_ct": ["241798016", "299752018", "4031011", "535621012", "299751013", "4032016", "1221564010", "2740994017", "744868013", "578857010", "299754017", "299753011", "2748854017"], "start": 18, "term": "past myocardial infarction"}, {"cui": "C0428953", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T034"], "similarity": 0.7916666666666666, "snomed_ct": ["2607355010", "108319019", "256460011", "520888012", "224368019", "224361013", "520880017", "256452010", "3300375014", "3300376010", "3300377018", "546248011", "2748878010", "546240016", "2730758010", "804656017", "2607362018", "2619221014", "2619214014", "2612497015", "2620977012", "2693159014"], "start": 18, "term": "ecg: myocardial infarction"}, {"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarction, (mi)"}, {"cui": "C0155626", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": ["241795018", "395858019", "299702010", "94884017", "94885016", "299721019", "1231678011", "299699015", "395862013", "241793013", "241794019", "395857012", "299705012", "795634013", "578838018"], "start": 18, "term": "acute myocardial infarction"}, {"cui": "C3541950", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "acute myocardial infarction"}, {"cui": "C0155626", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": ["241795018", "395858019", "299702010", "94884017", "94885016", "299721019", "1231678011", "299699015", "395862013", "241793013", "241794019", "395857012", "299705012", "795634013", "578838018"], "start": 18, "term": "myocardial infarction acute"}, {"cui": "C3829910", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T170"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "had a myocardial infarction"}, {"cui": "C0746727", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "septal myocardial infarction"}, {"cui": "C2348362", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "septal myocardial infarction"}, {"cui": "C0155668", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": ["241798016", "299752018", "4031011", "535621012", "299751013", "4032016", "1221564010", "2740994017", "744868013", "578857010", "299754017", "299753011", "2748854017"], "start": 18, "term": "healed myocardial infarction"}, {"cui": "C0340324", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": ["299698011", "350376014", "350377017", "622083013"], "start": 18, "term": "silent myocardial infarction"}, {"cui": "C3898652", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 5 myocardial infarction"}, {"cui": "C3898656", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 3 myocardial infarction"}, {"cui": "C3898657", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T170"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 2 myocardial infarction"}, {"cui": "C3898658", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 1 myocardial infarction"}, {"cui": "C2825159", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T201"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "date of myocardial infarction"}, {"cui": "C3845502", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "myocardial infarction, stroke"}, {"cui": "C3898653", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "type 4c myocardial infarction"}, {"cui": "C3898654", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "type 4b myocardial infarction"}, {"cui": "C3898655", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "type 4a myocardial infarction"}, {"cui": "C0278329", "end": 66, "ngram": "prescribed", "preferred": 1, "semtypes": ["T058"], "similarity": 1.0, "snomed_ct": [], "start": 56, "term": "prescribed"}, {"cui": "C0126174", "end": 75, "ngram": "Losartan", "preferred": 1, "semtypes": ["T121", "T109"], "similarity": 1.0, "snomed_ct": ["1212034011", "159413015", "3488999015", "3499885011", "1205454017", "840645014", "1198867013"], "start": 67, "term": "losartan"}, {"cui": "C1550655", "end": 11, "ngram": "patient", "preferred": 1, "semtypes": ["T031"], "similarity": 1.0, "snomed_ct": [], "start": 4, "term": "patient"}, {"cui": "C1578485", "end": 11, "ngram": "patient", "preferred": 1, "semtypes": ["T170"], "similarity": 1.0, "snomed_ct": [], "start": 4, "term": "patient"}, {"cui": "C1578486", "end": 11, "ngram": "patient", "preferred": 1, "semtypes": ["T170"], "similarity": 1.0, "snomed_ct": [], "start": 4, "term": "patient"}]"
                      }
                    },
                    {
                      "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
                            }
                          ],
                          "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/quickumls",
                  "value": "16f3982942687e142241c6145467accf85c314d47b4698edbe210b83"
                }
              },
              {
                "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",
              "system": "http://terminology.hl7.org/CodeSystem/umls"
            }
          ],
          "text": "losartan"
        },
        "status": "unknown",
        "resourceType": "MedicationStatement"
      }
    }
  ],
  "type": "transaction",
  "resourceType": "Bundle"
}

The returned bundle has two new entries for 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 is the UMLS code that was detected by QuickUMLS.

System Code Display
http://terminology.hl7.org/CodeSystem/umls C0027051

Derived MedicationStatement codes

The derived MedicationStatement also contains the UMLS code that was detected by QuickUMLS

System Code Display
http://terminology.hl7.org/CodeSystem/umls C0126174

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/quickumls",
        "value": "f2c75a905c5371833f3498356b4c4a5241be3b36c4d9ea85dd0545df"
      }
    },
    {
      "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 QuickUMLS. 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/quickumls",
        "value": "f2c75a905c5371833f3498356b4c4a5241be3b36c4d9ea85dd0545df"
      }
    },
    {
      "url": "http://ibm.com/fhir/cdm/StructureDefinition/path",
      "valueString": "Condition"
    },
    {
      "extension": [
        {
          "url": "http://ibm.com/fhir/cdm/StructureDefinition/reference",
          "valueReference": {
            "reference": "urn:uuid:894fc0f0-c6cb-4464-83eb-e42a6c92f9f6"
          }
        },
        {
          "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": "[{"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 1.0, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarction"}, {"cui": "C0428953", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T034"], "similarity": 1.0, "snomed_ct": ["2607355010", "108319019", "256460011", "520888012", "224368019", "224361013", "520880017", "256452010", "3300375014", "3300376010", "3300377018", "546248011", "2748878010", "546240016", "2730758010", "804656017", "2607362018", "2619221014", "2619214014", "2612497015", "2620977012", "2693159014"], "start": 18, "term": "myocardial infarction"}, {"cui": "C2926063", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T201"], "similarity": 1.0, "snomed_ct": [], "start": 18, "term": "myocardial infarction"}, {"cui": "C3810814", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T060"], "similarity": 1.0, "snomed_ct": [], "start": 18, "term": "myocardial infarction"}, {"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.95, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarctions"}, {"cui": "C0155668", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.8260869565217391, "snomed_ct": ["241798016", "299752018", "4031011", "535621012", "299751013", "4032016", "1221564010", "2740994017", "744868013", "578857010", "299754017", "299753011", "2748854017"], "start": 18, "term": "old myocardial infarction"}, {"cui": "C0428953", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T034"], "similarity": 0.8260869565217391, "snomed_ct": ["2607355010", "108319019", "256460011", "520888012", "224368019", "224361013", "520880017", "256452010", "3300375014", "3300376010", "3300377018", "546248011", "2748878010", "546240016", "2730758010", "804656017", "2607362018", "2619221014", "2619214014", "2612497015", "2620977012", "2693159014"], "start": 18, "term": "ecg myocardial infarction"}, {"cui": "C0489577", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T201"], "similarity": 0.8260869565217391, "snomed_ct": [], "start": 18, "term": "myocardial infarction age"}, {"cui": "C3640911", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.8260869565217391, "snomed_ct": [], "start": 18, "term": "new myocardial infarction"}, {"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7916666666666666, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarction (mi)"}, {"cui": "C0155668", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7916666666666666, "snomed_ct": ["241798016", "299752018", "4031011", "535621012", "299751013", "4032016", "1221564010", "2740994017", "744868013", "578857010", "299754017", "299753011", "2748854017"], "start": 18, "term": "past myocardial infarction"}, {"cui": "C0428953", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T034"], "similarity": 0.7916666666666666, "snomed_ct": ["2607355010", "108319019", "256460011", "520888012", "224368019", "224361013", "520880017", "256452010", "3300375014", "3300376010", "3300377018", "546248011", "2748878010", "546240016", "2730758010", "804656017", "2607362018", "2619221014", "2619214014", "2612497015", "2620977012", "2693159014"], "start": 18, "term": "ecg: myocardial infarction"}, {"cui": "C0027051", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": ["500448019", "350357012", "622062019", "37436014", "37437017", "299703017", "241792015", "395860017", "500449010", "299700019", "395861018", "241791010", "37443015", "37440017", "37441018", "37438010", "241790011", "500450010", "395863015", "1784873012", "37442013", "37439019", "500452019", "1784872019", "2747117014", "751689013"], "start": 18, "term": "myocardial infarction, (mi)"}, {"cui": "C0155626", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": ["241795018", "395858019", "299702010", "94884017", "94885016", "299721019", "1231678011", "299699015", "395862013", "241793013", "241794019", "395857012", "299705012", "795634013", "578838018"], "start": 18, "term": "acute myocardial infarction"}, {"cui": "C3541950", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "acute myocardial infarction"}, {"cui": "C0155626", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": ["241795018", "395858019", "299702010", "94884017", "94885016", "299721019", "1231678011", "299699015", "395862013", "241793013", "241794019", "395857012", "299705012", "795634013", "578838018"], "start": 18, "term": "myocardial infarction acute"}, {"cui": "C3829910", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T170"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "had a myocardial infarction"}, {"cui": "C0746727", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "septal myocardial infarction"}, {"cui": "C2348362", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.76, "snomed_ct": [], "start": 18, "term": "septal myocardial infarction"}, {"cui": "C0155668", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": ["241798016", "299752018", "4031011", "535621012", "299751013", "4032016", "1221564010", "2740994017", "744868013", "578857010", "299754017", "299753011", "2748854017"], "start": 18, "term": "healed myocardial infarction"}, {"cui": "C0340324", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": ["299698011", "350376014", "350377017", "622083013"], "start": 18, "term": "silent myocardial infarction"}, {"cui": "C3898652", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 5 myocardial infarction"}, {"cui": "C3898656", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 3 myocardial infarction"}, {"cui": "C3898657", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T170"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 2 myocardial infarction"}, {"cui": "C3898658", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T033"], "similarity": 0.7307692307692307, "snomed_ct": [], "start": 18, "term": "type 1 myocardial infarction"}, {"cui": "C2825159", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T201"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "date of myocardial infarction"}, {"cui": "C3845502", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "myocardial infarction, stroke"}, {"cui": "C3898653", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "type 4c myocardial infarction"}, {"cui": "C3898654", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "type 4b myocardial infarction"}, {"cui": "C3898655", "end": 39, "ngram": "myocardial infarction", "preferred": 1, "semtypes": ["T047"], "similarity": 0.7037037037037037, "snomed_ct": [], "start": 18, "term": "type 4a myocardial infarction"}, {"cui": "C0278329", "end": 66, "ngram": "prescribed", "preferred": 1, "semtypes": ["T058"], "similarity": 1.0, "snomed_ct": [], "start": 56, "term": "prescribed"}, {"cui": "C0126174", "end": 75, "ngram": "Losartan", "preferred": 1, "semtypes": ["T121", "T109"], "similarity": 1.0, "snomed_ct": ["1212034011", "159413015", "3488999015", "3499885011", "1205454017", "840645014", "1198867013"], "start": 67, "term": "losartan"}, {"cui": "C1550655", "end": 11, "ngram": "patient", "preferred": 1, "semtypes": ["T031"], "similarity": 1.0, "snomed_ct": [], "start": 4, "term": "patient"}, {"cui": "C1578485", "end": 11, "ngram": "patient", "preferred": 1, "semtypes": ["T170"], "similarity": 1.0, "snomed_ct": [], "start": 4, "term": "patient"}, {"cui": "C1578486", "end": 11, "ngram": "patient", "preferred": 1, "semtypes": ["T170"], "similarity": 1.0, "snomed_ct": [], "start": 4, "term": "patient"}]"
          }
        },
        {
          "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
                }
              ],
              "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 QuickUMLS 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