# Negation detection in Dutch clinical texts: an evaluation of rule-based and machine learning methods

arXiv: https://arxiv.org/abs/2209.00470 · HTML: https://mlsanity.com/paper/2209.00470/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 13 of its 53 references that are in the map.
- First posted on arXiv 1 Sep 2022.

## Builds on (most cited first, 13 of 13)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Exploring the Limits of Transfer Learning with a Unified Text-to-Text Transformer](https://mlsanity.com/paper/1910.10683/) (2019)
- [RoBERTa: A Robustly Optimized BERT Pretraining Approach](https://mlsanity.com/paper/1907.11692/) (2019)
- [Cross-lingual Language Model Pretraining](https://mlsanity.com/paper/1901.07291/) (2019)
- [Bidirectional LSTM-CRF Models for Sequence Tagging](https://mlsanity.com/paper/1508.01991/) (2015)
- [RobBERT: a Dutch RoBERTa-based Language Model](https://mlsanity.com/paper/2001.06286/) (2020)
- [NegBio: a high-performance tool for negation and uncertainty detection in radiology reports](https://mlsanity.com/paper/1712.05898/) (2017)
- [Multi-domain Clinical Natural Language Processing with MedCAT: the Medical Concept Annotation Toolkit](https://mlsanity.com/paper/2010.01165/) (2020)
- [Launching into clinical space with medspaCy: a new clinical text processing toolkit in Python](https://mlsanity.com/paper/2106.07799/) (2021)
- [NegBERT: A Transfer Learning Approach for Negation Detection and Scope Resolution](https://mlsanity.com/paper/1911.04211/) (2019)
- [Comparative Analysis of Text Classification Approaches in Electronic Health Records](https://mlsanity.com/paper/2005.06624/) (2020)
- [FastContext: an efficient and scalable implementation of the ConText algorithm](https://mlsanity.com/paper/1905.00079/) (2019)

## Built on by (most cited first, 1 of 1)

- [Diagnosis extraction from unstructured Dutch echocardiogram reports using span- and document-level characteristic classification](https://mlsanity.com/paper/2408.06930/) (2024)

## Abstract (arXiv)

As structured data are often insufficient, labels need to be extracted from free text in electronic health records when developing models for clinical information retrieval and decision support systems. One of the most important contextual properties in clinical text is negation, which indicates the absence of findings. We aimed to improve large scale extraction of labels by comparing three methods for negation detection in Dutch clinical notes. We used the Erasmus Medical Center Dutch Clinical Corpus to compare a rule-based method based on ContextD, a biLSTM model using MedCAT and (finetuned) RoBERTa-based models. We found that both the biLSTM and RoBERTa models consistently outperform the rule-based model in terms of F1 score, precision and recall. In addition, we systematically categorized the classification errors for each model, which can be used to further improve model performance in particular applications. Combining the three models naively was not beneficial in terms of performance. We conclude that the biLSTM and RoBERTa-based models in particular are highly accurate accurate in detecting clinical negations, but that ultimately all three approaches can be viable depending on the use case at hand.