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<article xmlns:xlink="http://www.w3.org/1999/xlink">
  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>CLEF 2018 Technologically Assisted Reviews in Empirical Medicine Overview</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Evangelos Kanoulas</string-name>
          <email>E.Kanoulas@uva.nl</email>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Dan Li</string-name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Leif Azzopardi</string-name>
          <email>leif.azzopardi@strath.ac.uk</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Rene Spijker</string-name>
          <email>R.Spijker-2@umcutrecht.nl</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Cochrane Netherlands and UMC Utrecht, Julius Center for Health Sciences and Primary Care</institution>
          ,
          <country country="NL">Netherlands</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Computer and Information Sciences, University of Strathclyde</institution>
          ,
          <addr-line>Glasgow</addr-line>
          ,
          <country country="UK">UK</country>
        </aff>
        <aff id="aff2">
          <label>2</label>
          <institution>Informatics Institute, University of Amsterdam</institution>
          ,
          <country country="NL">Netherlands</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>s for inclusion in the review. Seven teams participated in the task, with a total of 12 runs submitted for subtask 1 and 19 runs for subtask 2. This paper reports both the methodology used to construct the benchmark collection, and the results of the evaluation.</p>
      </abstract>
      <kwd-group>
        <kwd>Systematic Reviews</kwd>
        <kwd>Technology Assisted Reviews</kwd>
        <kwd>TAR</kwd>
        <kwd>Diagnostic Test Accuracy</kwd>
        <kwd>DTA</kwd>
        <kwd>PubMed</kwd>
        <kwd>Cochrane</kwd>
        <kwd>e-Health</kwd>
        <kwd>Information Retrieval</kwd>
        <kwd>Text Classification</kwd>
        <kwd>Evaluation</kwd>
        <kwd>Test Collection</kwd>
        <kwd>Benchmarking</kwd>
        <kwd>High Recall</kwd>
        <kwd>Active Learning</kwd>
        <kwd>Relevance Feedback</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>-</title>
      <p>
        Evidence-based medicine has become an important pillar in health care and
policy making. In order to practice evidence-based medicine, it is important to
have a clear overview over the current scientific consensus. These overviews are
provided in systematic review articles, that summarize all available evidence
regarding a certain topic (e.g., a treatment or a diagnostic test). To write a
systematic review, researchers have to conduct a search that will retrieve all the
studies that are relevant to the topic. The large and growing number of published
studies, and their increasing rate of publication, makes the task of identifying
relevant studies in an unbiased way both complex and time consuming to the
extent that jeopardizes the validity of their findings and the ability to inform
policy and practice in a timely manner. Hence, the need for automation in this
process becomes of utmost importance. Finding all relevant studies in a corpus
is a difficult task, known in the Information Retrieval (IR) domain as the “total
recall” problem [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ].
      </p>
      <p>To this date, the retrieval of studies that contain the necessary evidence to
inform systematic reviews is being conducted in multiple stages:
1. Identification: At the first stage a systematic review protocol, which describes
the rationale, hypothesis, and planned methods of the review, is prepared.
The protocol is used as a guide to carry out the review. Beyond other
information, it provides the criteria that need to be met for a study to be
included in the review. Further, a Boolean query that attempts to express
these criteria is constructed by an information specialist. The query is then
submitted to a medical database containing titles, abstracts, and indexing
terms of a controlled vocabulary of medical studies. The result is a set, A,
of potentially relevant studies.
2. Screening: At a second stage experts are screening the titles and abstracts of
the returned set and decide which one of those hold potential value for their
systematic review, a set D. If screening an abstract has a cost Ca, screening
all |A| abstracts has a cost of Ca jAj.
3. Eligibility: At a third stage experts are downloading the full text of the
potentially relevant abstracts, D, identified in the previous phase and examine
the content to decide whether indeed these studies are relevant or not.
Examining a document has typically a larger cost than the cost of examining
an abstract, Cd &gt; Ca. The result of the second screening is the set of studies
to be included in the systematic review.</p>
      <p>Unfortunately, the precision of the Boolean query is typically low, hence
reviewers often need to manually examine many thousands of irrelevant titles
and abstracts in order to identify a small number of relevant ones. Further,
there is no guarantee that the Boolean query will retrieve all relevant studies,
jeopardizing the validity of the reviews. To overcome some of the limitations of
the Boolean search, researchers have been testing the effectiveness of machine
learning and information retrieval methods. O’Mara-Eves et al. [15] provide a
systematic review of the use of text mining techniques for study identification
in systematic reviews.</p>
      <p>
        The focus of the CLEF 2018 e-Health Technology Assisted Reviews in
Empirical Medicine (TAR), similar to last year [
        <xref ref-type="bibr" rid="ref10">10</xref>
        ], lies on Diagnostic Test Accuracy
(DTA) reviews. Search in this area is generally considered the hardest, and a
breakthrough in this field would likely be applicable to other areas as well [
        <xref ref-type="bibr" rid="ref11">11</xref>
        ].
      </p>
      <p>The goal of the lab is to bring together academic, commercial, and
government researchers that will conduct experiments and share results on automatic
methods to retrieve relevant studies with high precision and high recall, and
release a reusable test collection that can be used as a reference for
comparing different retrieval and mining approaches in the field of medical systematic
reviews.</p>
      <p>This paper is organized as follows: Section 2 describes the two subtasks of
the lab in detail, Section 3 describes the constructed benchmark collection, and
Section 4 the evaluation measures used; in Section 5 we briefly describe the
participating systems, and in Section 6 we discuss the results of the evaluation.</p>
    </sec>
    <sec id="sec-2">
      <title>Section 7 concludes the article.</title>
      <p>2</p>
      <sec id="sec-2-1">
        <title>Task Description</title>
        <p>In this section we describe the two subtasks of the TAR lab, the input provided
to participants for each one of the subtasks and the expected participant’s output
submitted to the lab for evaluation.
2.1</p>
        <sec id="sec-2-1-1">
          <title>Subtask 1: No Boolean Search</title>
          <p>Prior to constructing a Boolean Query researchers have to design and write
a systematic review protocol that in detail defines what constitutes a relevant
study for their review. In this experimental task of the TAR lab, participants are
provided with the relevant pieces of a protocol, in an attempt to complete search
effectively and efficiently by-passing the construction of the Boolean query.</p>
          <p>In particular, for each systematic review that needs to be conducted (also
referred to as topic in the IR terminology), participants are provided with the
following input data:</p>
        </sec>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>1. topic ID;</title>
    </sec>
    <sec id="sec-4">
      <title>2. the title of the review written by Cochrane experts; 3. parts of the protocol, which includes the Objective, the Type of Study, the</title>
      <p>Participants, the Index Tests, the Target Conditions, and the Reference
Standards;
4. the PubMed database, provided by the National Center for Biotechnology
Information (NCBI), part of the U.S. National Library of Medicine (NLM).</p>
      <p>Participants are provided with 30 topics on Diagnostic Test Accuracy (DTA)
reviews. For each one of these topics participants are asked to submit: (a) a
ranked linked of PubMed articles, and (b) a threshold over this ranked list.
Participant can submit up to 3 submissions (“runs”). A run is the output of the
participants’ algorithm for all the topics, in the form of a text file, with each line
of the file following the format:</p>
      <p>TOPIC-ID</p>
      <p>THRESHOLD</p>
      <p>PMID</p>
      <p>RANK</p>
      <p>SCORE</p>
      <p>Each line represents a PubMed article in the ranked list for a given topic,
with RANK indicating the index of this article in the ranked list. TOPIC-ID is
the id of the topic for which the document has been retrieved, and THRESHOLD
is either 0 or 1, with 1 indicating that the given rank is the rank of the threshold.
PMID is the PubMed Document Identifier of the article ranked at that position,
SCORE is the score the algorithm gives to the article, and RUN-ID is an identifier
for the submitted run. Participants are allowed to submit a maximum of 5,000
ranked PMIDs per topic, i.e. a total maximum of 150,000 lines per run.
Given the results of the Boolean Search from the first stage of the systematic
review process as the starting point, participants are asked to rank the set of
abstracts. The task has two goals: (i) to produce an the efficient ordering of
the documents, such that all of the relevant abstracts are retrieved as early as
possible, and (ii) to identify a subset which contains all or as many of the relevant
abstracts for the least effort (i.e. total number of abstracts to be assessed).</p>
      <p>In particular, for each systematic review that needs to be conducted (also
refereed to as topic in the IR terminology), participants are provided with the
following input data:</p>
    </sec>
    <sec id="sec-5">
      <title>1. topic ID</title>
    </sec>
    <sec id="sec-6">
      <title>2. the title of the review written by Cochrane experts;</title>
    </sec>
    <sec id="sec-7">
      <title>3. the Boolean query manually constructed by Cochrane experts;</title>
      <p>4. the set of PubMed Document Identifiers (PMID’s) returned by running the
query in MEDLINE.</p>
      <p>
        Participants are provided with 30 topics on Diagnostic Test Accuracy (DTA)
reviews, which are the same topics as those provided in subtask 1. As in subtask
1 participants are asked to submit: (a) a ranked linked of the PubMed articles in
the given set, and (b) a threshold over this ranked list. Participant can submit
up to 3 submissions, and the format of each submission follows the format of
subtask 1 submissions. Further, given that subtask 2 was the main task of the
CLEF 2017 e-Health Technology Assisted Reviews in Empirical Medicine [
        <xref ref-type="bibr" rid="ref10">10</xref>
        ],
participants were allowed, if not encouraged, to also submit any of their 2017
system over the new 30 topics outputs.
3
      </p>
      <sec id="sec-7-1">
        <title>Benchmark Collection</title>
        <p>In what follows we describe the collection of articles used in the task, the topics
released to participants, and how they were developed, as well as the relevance
labels used in the evaluation.
3.1</p>
        <sec id="sec-7-1-1">
          <title>Articles</title>
          <p>The collection used in the lab is PubMed Baseline Repository last updated on
November 28, 2017, and available on the NCBI FTP site under the ftp://
ftp.ncbi.nlm.nih.gov/pubmed/baseline directories. PubMed comprises more
than 27 million citations for biomedical literature from MEDLINE, life science
journals, and online books. Citations may include links to full-text content from
PubMed Central and publisher web sites. NLM produces a baseline set of
MEDLINE/PubMed citation records in XML format for download on an annual basis.
The annual baseline is released in December of each year. The complete baseline
consists of files pubmed18n0001 through pubmed18n0928.
3.2</p>
        </sec>
        <sec id="sec-7-1-2">
          <title>Topics</title>
          <p>To construct the benchmark collection, the organizers of the task considered 30
systematic reviews on Diagnostic Test Accuracy already conducted by Cochrane
researchers. These reviews are publicly available and can be found in the Cochrane
Library4; they can be identified by setting the topic filter in the library to
"Diagnosis" and "Diagnostic Test Accuracy" and the stage filter to "Review".</p>
          <p>
            At the time of the topic construction 88 such systematic reviews were
available; 50 of them were used in the 2017 task [
            <xref ref-type="bibr" rid="ref10 ref6">10,6</xref>
            ], and out of the remaining
38, 30 were chosen to constitute the 2018 topic set. The 30 systematic reviews
considered can be found in Tables 9 and 10. The tables provide the topic id,
a substring of DOI of the document (e.g. the DOI for the topic ID CD008122
is 10.1002/14651858.CD008122.pub2), the title of the systematic review that
corresponds to the topic, and the publication date.
          </p>
          <p>Participants were provided with two sets of topics: (a) a development set,
and (b) a test set. The development set consisted of 42 topics out of the 50
topics provided in the 2017 version of the lab. 5 The 50 topics released in 2017
were re-examined by our Cochrane information specialist, and co-author of this
paper, Rene Spijker, and 8 of them were found not reliable for training or testing
purposes, and hence removed from the development set. In particular, the search
strategies used within these reviews had a different objective than the objective
of the lab. For this task we set-out to use searches that are sensitive in nature
to inform a specific question for one review. Some of the reviews we removed
were part of an overarching project where one search query was used to inform
multiple reviews. We believe that including these would not reflect our intended
practice and would misinform the algorithms and strategies developed. Other
reviews had a different approach where a local registry was built on a broad topic
(dementia) which would inform the review and the MEDLINE search was only
intended as a highly specific top-up search, again not the intended approach for
this task. So the reviews themselves were reliable but the methods used deviated
from this task making them unsuitable. The IDs of the 8 topics are the following:
4 http://www.cochranelibrary.com/
5 For subtask 1, two topics, CD011548 and CD011984, were not provided to
participants, resulting in 40 training topics.</p>
          <p>CD007431 (10), CD010772 (41), CD010775 (2), CD010896 (39), CD010771 (45),
CD011145 (42), CD010783 (56), CD010860 (57), where in parenthesis is the
filename of the topic in the 2017 release of the data.</p>
          <p>Topic Description for Subtask 1: In subtask 1 each topic file was generated
through the following procedure: First, the topic ID was extracted from the DOI
of the systematic review. Then, the title of the systematic review was considered.
Last, for each systematic review, the corresponding protocol was identified, and
the objective of the review as described in the protocol was also considered.
These three elements, topic ID, title and objective constitute the topic provided
to participants. An example can be seen below:
Title: Rapid diagnostic tests for diagnosing uncomplicated P. falciparum
malaria in endemic countries
Objectives: To assess the diagnostic accuracy of RDTs for detecting
clinical P. falciparum malaria (symptoms suggestive of
malaria plus P. falciparum parasitaemia detectable by
microscopy) in persons living in malaria endemic areas
who present to ambulatory healthcare facilities with
symptoms of malaria, and to identify which types and
brands of commercial test best detect clinical P. falciparum
malaria.</p>
          <p>
            Cochrane DTA review titles follow a particular structure [
            <xref ref-type="bibr" rid="ref9">9</xref>
            ] with a few
alternatives. For instance, in the example above the title follows the structure:
“Index test(s) for [target condition(s) in [participant description]”. The objective
of a DTA systematic review can be: (a) to make comparisons between tests
concerning their global accuracy, (b) to estimate the accuracy of a test operating at
a particular threshold, or (c) to understand why results of studies vary. In the
example above the objective is to estimate accuracy. Furthermore, participants
were provided with other relevant parts of the protocol and in particular, the
secondary objectives, if any, the type of study, the participants, the index tests,
the target conditions, the comparator tests, and the reference standards.
          </p>
          <p>
            The description of these relevant parts of the protocol as described in the
Cochrane Handbook for DTA reviews [
            <xref ref-type="bibr" rid="ref8">8</xref>
            ] is can be found in the gray box below.
          </p>
          <p>Types of studies: Identifiable design features of eligible studies must be
stated. Review authors should describe the design as well as using a design
name, as there is no universal terminology for diagnostic study designs. Key
aspects include whether only prospective or both prospective and retrospective
studies are to be included, to describe how and where participants were
recruited (e.g. as a consecutive series of new presentations in primary care), and
whether the study was cross-sectional or included longitudinal assessment for
the reference standard. Authors should always state whether they included or
excluded diagnostic case-control studies or the strategy used to make this
decision. Any restrictions based on a minimal quality standard, minimal sample
sizes, or numbers of diseased cases should be stated, but there is no clear
guidance on how these limitations should be determined. In reviews that include
comparisons between tests, alternative study designs which make within-study
comparisons of tests may be sought, notably studies where all individuals
receive all tests, and those where all individuals receive the reference standard
but are randomized to receive different index tests. These latter studies should
be described as randomized trials of test accuracy. Some reviews which
compare tests may restrict study inclusion only to studies of these designs which
make within-study comparisons, but others may include studies that evaluate
one or other of the tests individually (particularly where few such published
studies exist). Any such restrictions should be stated. Randomized trials of
patient outcomes are rarely eligible for inclusion. They can only be included if
individuals received both the index test and a reference standard – occasionally
this information is available.</p>
          <p>Participants: Review authors should specify the participants for whom the
test would be applicable, including any restrictions on diagnoses, age groups
and settings. Planned subgroup analyses related to participant characteristics
should not be listed here – they should be listed under the sources of
heterogeneity in the secondary objectives.</p>
          <p>Index tests: Review authors should specify the test(s) to be evaluated in
the review. If multiple tests are being reviewed and compared with each other
details for each test should be given. In the first Cochrane DTA protocols and
reviews tests were separated into new index tests or existing comparator tests.
However it is often difficult to distinguish index from comparator tests and
tests are no longer divided into these two categories. However, where it is clear
that some tests are new experimental tests and others are existing standard
comparative tests this should be noted.</p>
          <p>Target conditions: The target condition is a particular disease or disease
stage that the index test is intended to identify. Some reviews may evaluate
the ability of tests to differentiate between several target conditions – if this is
the case, the multiple target conditions should all be listed here.</p>
          <p>Reference standards: Describe the clinical reference standards required to
establish the presence or absence of the target condition in the tested
population. If any reference standards are commonly used but considered inadequate
this should be stated here as an exclusion criteria. If the review covers multiple
target conditions, the reference standard for each should be stated.</p>
          <p>Topic Description for Subtask 2: In subtask 2 each topic file was generated
through the following procedure: For each systematic review, we reviewed the
search strategy from the corresponding study in Cochrane Library. A search
strategy, among other things, consists of the exact Boolean query developed and
submitted to a medical database, at the time the review was conducted, and
typically can be found in the Appendix of the study. Rene Spijker, a co-author of
this work and a Cochrane information specialist examined the grammatical
correctness of the search query and specified the date range which dictated the valid
dates for the articles to be included in this systematic review. The date range
was necessary because a study published after the systematic review should not
be included even though it might be relevant, since that would require manually
examining its content to quantify its relevance.</p>
          <p>A number of medical databases, and search interfaces to these databases
is available for search, and for each one information specialists construct a
different variation of their query that better fits the data and meta-data of
the database. For this task, we only considered the Boolean query constructed
for the MEDLINE database, using the Wolters Kluwer Ovid interface. Then
we submitted the constructed Boolean query to the OVID system at http:
//demo.ovid.com/demo/ovidsptools/launcher.htm and collected all the
returned PubMed document identification numbers (PMID’s) which satisfied the
date range constraint. This step was automated by a Python script we put
together and through an interface available to the University of Amsterdam.</p>
          <p>The topic file is in a text format and contains four sections, Topic, Title,
Query, and PMID’s. PMID’s are the PubMed document IDs returned by the
Boolean query. The PMIDs can be used to access the corresponding document
through the National Center for Biotechnology Information (NCBI)6. An
example of a topic file can be viewed below.
6 https://www.ncbi.nlm.nih.gov/books/NBK25497/
Pids:
19164769
9557953
7688346
18509532
...
3.3</p>
        </sec>
        <sec id="sec-7-1-3">
          <title>Relevance Labels</title>
          <p>The original systematic reviews written by Cochrane experts included a reference
section that listed Included, Excluded, and Additional references to medical
studies. Included are the studies that are relevant to the systematic review.
Excluded are the studies that in the abstract and title screening stage were
considered relevant, but at the article screening phase were considered irrelevant
to the study and hence excluded from it. Additional are the studies that do
not impact the outcome of the review, and hence irrelevant to it. The union of
Included and Excluded references are the studies that were screened at a Title
and Abstract level and were considered for further examination at a full content
level. These constituted the relevant documents at the abstract level, while the
Included references constituted the relevant documents at the full content level.</p>
          <p>The majority of the references included their corresponding PMID, but not
all of them. For those references missing the PMID, the title was extracted from
the reference, and it was used as a query to Google Search Engine over the
domain https://www.ncbi.nlm.nih.gov/pubmed/. The top-scored document
returned by Google was selected, and the title of the study contained in landing
page, as identified in the metadata extracted. The title was compared then with
the title of the study used as search query. If the Edit Distance between the
two titles was up to 3 (just to account for spaces, parentheses, etc.) then the
study reference was replaced by the PMID also extracted from the metadata of
the landing page. If (a) the title had an edit distance greater than 3 but less
than 20, or (b) the study was an included study, or (c) no title was contained
in the Google result metadata, or (d) no Google results were returned, then
the query was submitted at https://www.ncbi.nlm.nih.gov/pubmed/ and the
results were manually examined. All other studies were discarded under the
assumption that they are not contained in PubMed. The format of the qrels
followed the standard TREC format:</p>
        </sec>
      </sec>
    </sec>
    <sec id="sec-8">
      <title>Topic Iteration</title>
    </sec>
    <sec id="sec-9">
      <title>Document</title>
      <p>Relevance
where Topic is the topic ID of the systematic review, Iteration in our case is a
dummy field always zero and not used, Document is the PMID, and Relevancy
is a binary code of 0 for not relevant and 1 for relevant studies. The order
of documents in the qrel files is not indicative of relevance. Studies that were
returned by the Boolean query but were not relevant based on the above process,
were considered irrelevant. Those are studies that were excluded at the abstract
and title screening phase. All other documents in MEDLINE were also assumed
to be irrelevant, given that they were not judged by the human assessor.</p>
      <p>Note that, as mentioned earlier, the references of a systematic review were
produced after a number of Boolean queries were submitted to a number of
medical databases, and their titles and abstracts were screened. The PMID’s provided
however were only those that came out of the MEDLINE query. Therefore, there
was a number of abstract-level relevant studies (the gray area in the Venn
diagram below) that were not part of the result set of the Boolean query provided
to the participants. Studies that were cited in the systematic review but did not
appear in the results of the Boolean query were excluded from the label set for
Subtask 2, but included for Subtask 1. Hence, the total number of relevant
abstracts in the test set for Subtask 1 is 4,656, while in Subtask 2 it is 3,964; further
the total number of relevant studies in Subtask 1 is 759, while for Subtask 2 it
is 678.</p>
    </sec>
    <sec id="sec-10">
      <title>MEDLINE Boolean Query</title>
    </sec>
    <sec id="sec-11">
      <title>Relevant Studies</title>
      <p>CD010438
CD007427
CD009593
CD011549
CD011134
CD008686
CD011975
CD009323
CD009020
CD011548
CD011984
CD010409
CD008054
CD009591
CD008691
CD010632
CD007394
CD008643
CD009944
CD008803
CD008782
CD009647
CD009135
CD008760
CD009519
CD009372
CD010276
CD009551
CD012019
CD008081
CD009185
CD010339
CD010653
CD010542
CD010023
CD010705
CD010633
CD010173
CD009786
CD010386
CD009579
CD009925
CD008122
CD012599
CD009175
CD009694
CD009263
CD010502
CD010680
CD010864
CD011431
CD011602
CD011420
CD011686
CD012179
CD012281
CD011053
CD011515
CD008587
CD011926
CD012165
CD012083
CD008892
CD011126
CD010657
CD008759
CD010296
CD010213
CD012009
CD011912
CD012010
CD012216</p>
      <p>Table 1 and Table 2 show the distribution of the relevant documents at
abstract or document level for all the topics in the development set and the
test set. The total number of unique PMID’s released for the training set was
241,669 (an average of 5754 per topic) and for the test set 218,496 (an average
of 7283 per topic). The average percentage of relevant documents at Abstract
level in the training set is 3.8% of the total number of PMID’s released, and in
the test set 4.7%, while at the content level the average percentage is 1.5% in the
training set, and 1% in the test set. In [17], a test collection was developed based
on a random selection of 93 Cochrane systematic reviews (not just DTAs), and
reported a slightly higher rate of relevance ( 111549 = 1:2%). However, compared
with the TREC campaign, the rate of relevant documents is 5.45% and 2.78%
for the Adhoc track of TREC 8, and the Web track of TREC 2002, respectively.
Overall, the number of relevant documents is not very high in this lab, making
locating them quite a difficult task.
4</p>
      <sec id="sec-11-1">
        <title>Evaluation</title>
        <p>Evaluation within the context of using technology to assist in the reviewing
process is very much dependent on how the users interact with the system, and
on the goal of the technology assistance. For example, if the goal of the assistance
is to autonomously predict which studies should be assessed by the end-user at a
document level, then the problem can be viewed as a classification problem; the
system screens all abstracts and returns a subset of them as relevant. If the goal
of the assistance is to identify all the relevant documents as quick as possible but
let the human decide when to stop screening, then the problem can be viewed as
a ranking problem. There are, of course, many other possible variations. For the
purposes of the 2018 lab, we consider the problem as a ranking problem - that
is, to rank the set of documents associated with the topic in decreasing order of
relevance.</p>
        <p>Furthermore, the two subtasks although very similar in terms of evaluation,
i.e. in both subtasks participants’ runs are rankings of article, with a designated
threshold, they also differ: in subtask 2 the set of articles to be prioritized
contains all the relevant articles, while in subtask 1 the relevant articles need to be
found within the entire PubMed database, and hence there is no guarantee that
all relevant articles will appear in the top 5000. Further, in subtask 1, the length
of the ranked lists vary significantly across different topics.</p>
        <p>
          For the evaluation of runs employ a number of standard IR measures, along
with measures that have been developed for the particular task of technology
assisted reviews [
          <xref ref-type="bibr" rid="ref2 ref4">4,2</xref>
          ]. A list of the used measures can be seen below:
– Subtask 1
1. Average Precision
2. Number of Relevant Found
3. Precision @ last relevant found
4. Recall @ rank k, with k in [50, 100, 200, 500, 1000, 2000, 5000]
        </p>
        <p>The lab organizers developed an evaluation software similar to trec_eval for
the easy evaluation of the submitted runs, also provided to participants. The code
of the tar_eval software is available at https://github.com/CLEF-TAR/tar.
5</p>
      </sec>
      <sec id="sec-11-2">
        <title>Participants</title>
        <p>The 2018 task received submissions from 7 teams, including one team from
Canada (UWA), one team from the USA (UIC/OHSU), one team from the UK
(Sheffield), one team from China (ECNU), one team from Greece (AUTH), one
team from Italy (UNIPD), one team from France (Limsi-CNRS). The
participating teams are:</p>
        <p>For the subtask 1, we received 12 runs from 4 teams. For the subtask 2, we
received 19 runs from 7 teams.</p>
        <p>The 7 teams used a variety of learning methods including batch supervised
learning, continuous active learning, a variety of learning algorithms including
logistic regression, support vector machines, and neural networks, as well as
unsupervised retrieval methods, such as TT-IDF, BM25, with or without
traditional relevance feedback methods, such as the Rocchio’s Algorithm, and a
variety of text representation methods including simple count-based methods
and neural embeddings.</p>
        <p>Tables 3 and 4 categorize the participating runs in the two subtasks along
five dimensions: (a) automatic vs manual runs; (b) use of the development set;
(c) use of supervised and semi-supervised learning algorithms, and (d) use of
Run
auth_run1
auth_run2
auth_run3
ECNU_RUN1
ECNU_RUN2
ECNU_RUN3
shef-bm25
shef-tfidf
shef-bool
UWA
UWG
UWX</p>
        <p>Automatic Development Supervision</p>
        <p>X X X
X X X
X X X
X x x
X X X
X X X
X x x
X x x
X x x
X x X
x x X
x x X
relevance feedback, and (e) the type of thresholding used. The categorization
has been performed by the lab coordinators – not by the participants – based
on the submitted participants description of their algorithms. Hence, there is
always a chance of mis-classifying some run. In subtask 1 participants employed
both supervised and unsupervised methods for ranking articles. A total of 5
runs were trained over the provided development set, and their generalization
was tested against the test topics, while 7 made no explicit use of it; it may be
the case that participants tried different models and algorithms over the
development set, and selected to submit the best performing ones, hence there may
be a flavor of model selection, however we did not consider this as use of the
development set. Participants represented the textual data in a variety of ways,
including document-topic features, bag-of-words, topic model distributions,
embeddings, metadata. Out of the 19 runs submitted for subtask 2, 6 trained over
the development set, 12 used the relevance feedback provided per topic, either at
an abstract or content level, while 6 runs used a fixed threshold, 2 an automatic
thresholding method, and the rest did not threshold the ranking at all. Below
we provide a short description of the submitted runs for both subtask 1 and 2.</p>
        <p>
          AUTH took a learning-to-rank approach, using both batch and active
learning. Their model consists of two parts: an inter-topic model which utilizes
XGBoost and is trained over the entire development corpus (for subtask 1 it is 2500
articles returned by PubMed search, and for subtask 2 the articles provided
by the organizers) and an intra-topic model, an iteratively-built SVM, trained
over relevance feedback provided partially in the test topics. For the inter-topic
model a total of 48 for subtask 1 and 31 for subtask 2 topic-document (or solely
topic) features were computed over the title and the abstract of the articles and
the query. For the intra-topic model a TF-IDF vectorization of the articles was
used [
          <xref ref-type="bibr" rid="ref12">12</xref>
          ].
        </p>
        <p>
          CNRS trained a logistic regression model on a large number (&gt; 500,000)
of features over the development set. The logistic regression model is intended
to capture features that are related to DTA studies independent of the topic.
They further used an active learning approach which continuously learn to find
relevant articles within each topic. A model that combines the two using a
feedforward neural network was also used [
          <xref ref-type="bibr" rid="ref13">13</xref>
          ].
        </p>
        <p>ECNU used the BM25 algorithm for subtask 1 to acquire a baseline.
Furthermore, query expansion based on MeSH terms and pseudo relevance feedback
(PRF) was used to improve the results. In sub-task 2, they employed
Paragraph2Vector to represent query and documents for similarity calculation [18].</p>
        <p>
          UIC/OHSU first applied a clustering algorithm over a large number of
PubMed articles to identify 6 publication types, including DTA studies, but
also Randomized Controlled Trials, Cross-sectional Studies, Cross-over Studies,
Cohort Studies, and Case-Control Studies. The clusters were then represented
by a feature vector of the centroid with each article in the cluster represented
by 300 weighted terms most associated to the words in the article. Then, each
article in the provided dataset was compared to the 6 clusters and a number of
similarity measures were computed. These were used as features to be used by
an SVM to classify articles against the 6 clusters. [
          <xref ref-type="bibr" rid="ref3">3</xref>
          ]
        </p>
        <p>UNIPD used a two-dimensional probabilistic version of BM25 to rank
articles, using relevance feedback up to a certain number of articles shown to the
user, and switched to a Naive Bayes classifier for the remaining of the articles
until a fixed threshold point [14].</p>
        <p>
          Sheffield used RAKE [16] keyword extraction algorithm for subtask 1 to
interpret protocols, extract keywords and form them into queries designed to
retrieve relevant documents, while Apache Lucene was used as the IR engine.
Their approach to subtask 2 was to enrich queries with terms designed to identify
diagnostic test accuracy studies and also by making use of relevance feedback [
          <xref ref-type="bibr" rid="ref1">1</xref>
          ].
        </p>
        <p>
          UWA applied the Baseline Model Implementation (BMI) from the TREC
Total Recall Track (2015-2016) and the CLEF 2017 eHealth. They further
applied their "knee-method" stopping criterion to BMI to determine how many
abstracts should be examined for each topic. The difference between different
submissions came from the selection of feedback to be used to retrain the model
with the options being abstract-level, content-level, or manual feedback provided
by the participants themselves [
          <xref ref-type="bibr" rid="ref5">5</xref>
          ].
6
        </p>
      </sec>
      <sec id="sec-11-3">
        <title>Results</title>
        <p>In this section we provide the results of the evaluation for both subtasks.</p>
        <p>Fig. 1. Average precision using the document level relevance judgments.
d
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l l</p>
        <p>T</p>
        <p>Figure 2 shows the recall-effort curves for the participats’ runs, that is the
recall value at different percentage of documents shown to the user. The green
curve with the square marker corresponds to the Oracle run, which achieves an
optimal recall at the different effort levels.</p>
        <p>Figure 3 presents the recall obtained by the participants’ runs at the point of
the threshold as a function of the number of documents presented to the user. As
expected the more documents presented to the user (the lower the threshold) the
higher the achieved recall. Nevertheless, there are still algorithms that dominate
others. The figure present the Pareto frontier.</p>
        <p>Figure 4 demonstrates the bar plot of average precision values per topic; the
dashed blue line in the box plots designates the average Average Precision (AAP)
for each topic, a measure that can be seen as a proxy for topic difficulty.</p>
        <p>Fig. 4. Average Average Precision at document level relevance labels.
R
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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0</p>
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3 1 1 3 3 3 5 6 5 4 1 8 3 3 3 3 1 6 4
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7 7 7 7</p>
        <p>1 2 7 7 7 1 2 2 1
0 4 3 0 0 0 0 1 4 6 0 5 0 0 0 3 6 0 7
0 4 4 0 0 0 2 7 3 5 2 4 0 0 0 1 7 9 2
.0 .</p>
        <p>9 .</p>
        <p>9 .</p>
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1 0 0 1 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0
4 1 2 8 8 8 7 2 9 9 1 0 8 8 8 6 6 9 7
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.3 .</p>
        <p>1 .</p>
        <p>1 .</p>
        <p>3 .</p>
        <p>3 .</p>
        <p>3 .</p>
        <p>4 .</p>
        <p>5 .</p>
        <p>4 .</p>
        <p>2 .</p>
        <p>2 .</p>
        <p>2 .</p>
        <p>3 .</p>
        <p>3 .</p>
        <p>3 .</p>
        <p>3 .</p>
        <p>2 .
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 1 1 9 5 7 9 7 0 1 7 3 8 4 7 1 8 4
9 9 8 7 8 8 6 2 1 0 7 6 8 4 0 7 9 8 9
.8 .</p>
        <p>8 .</p>
        <p>8 .</p>
        <p>7 .</p>
        <p>7 .</p>
        <p>7 .</p>
        <p>4 .</p>
        <p>4 .</p>
        <p>5 .</p>
        <p>8 .</p>
        <p>7 .</p>
        <p>6 .</p>
        <p>6 .</p>
        <p>4 .</p>
        <p>WW
l
a
r y e e</p>
        <p>l8 l7
_ ee
d en re
e</p>
        <p>d d
u o o
q m m
%
a o 5
5 5 9 0 8 2 5 7 3 2 1 2 0 2 0 5 6 9 5
1 1 1 1 0 1 0 5 3 1 1 1 7 7 4 0 0 1 2</p>
        <p>Figure 6 shows the recall-effort curves for the participats’ runs, that is the
recall value at different percentage of abstracts shown to the user.</p>
        <p>Figure 7 presents the recall obtained by the participants’ runs at the point of
the threshold as a function of the number of abstracts presented to the user. As
expected the more abstract presented to the user (the lower the threshold) the
higher the achieved recall. Nevertheless, there are still algorithms that dominate
others. The figure present the Pareto frontier.</p>
        <p>Figure 8 demonstrates the bar plot of average precision values per topic; the
dashed blue line in the box plots designates the average Average Precision (AAP)
for each topic, a measure that can be seen as a proxy for topic difficulty.
7</p>
      </sec>
      <sec id="sec-11-4">
        <title>Conclusions</title>
        <p>The CLEF 2018 e-Health Lab Task 2 constructed a benchmark collection of 30
Diagnostic Test Accuracy systematic reviews to study the effectiveness and
effi</p>
        <p>Fig. 8. Average Average Precision at abstract level relevance labels.
ciency of information retrieval and machine learning algorithms both in finding
relevant articles in a large medical databse without explicitely constructing a
Boolean query and in prioritizing the studies to be screened at the abstract and
title screening stage, and providing a stopping criterion over the ranked list. The
results demonstrate that automatic methods can be trusted for finding most, if
not all, relevant studies in a fraction of the time manual screening can do the
same. Further, many of the algorithms retrieved articles that were not in the
results of the Boolean query, hence raising even concerns for the validity of the
current practice in conducting systematic reviews. Given that across different
runs many parameters change simultaneously it is not easy to come to certain
conclusions about the relative performance of automatic methods.</p>
        <p>Regarding the benchmark collection itself, there is a number of limitations to
be considered: (a) Pivoting on the results of the the OVID MEDLINE Boolean
query limits our ability to identify all relevant studies, i.e. relevant studies that
are outputted by Boolean queries over different databases, and relevant studies
that are actually not found by these Boolean queries. The former can be overcome
by considering all the different queries submitted; for the latter extra manual
judgments would be required. (b) Pivoting on abstract and title only we miss the
opportunity to study the effect of automatic methods when applied to the full
text of the studies, that would present an opportunity to completely overcome
the multi-stage process of systematic reviews. However, most of the full text
articles are protected under copyright laws that do not give all participants access
to those. (c) The evaluation setup of ranking does not allows us to consider the
cost of the process, since given a ranking a researcher would have to still go over
all studies ranked. A more realistic setup, e.g. a double-screening setup, could
be considered. (d) In the construction of relevant judgments we considered the
included and excluded references of the systematic reviews under study, which
prevented us to study the noise and disagreement between reviewers. (e) In our
effort to allow iterative algorithms, e.g. active learning algorithms, to be
submitted, we handed the test sets’ relevant judgments directly to the participants,
which is rather unusual for this type of evaluation exercises. An alternative would
be the setup used by the TREC Total Recall, where participants submitted their
running algorithms to the organizers. (f) When it comes to evaluation measures
there is a large variety of those, all of which take a different often useful view
point on the effectiveness of algorithm, but which makes it difficult to decide
upon a single golden measure to rank participants’ runs.
14. Nunzio, G.M.D., Ciuffreda, G., Vezzani, F.: Interactive sampling for systematic
reviews. ims unipd at clef 2018 ehealth task 2. In: Working Notes of CLEF 2018
Conference and Labs of the Evaluation forum, Avignon, France, September 10-14,
2018. CEUR Workshop Proceedings, CEUR-WS.org (2018)
15. O’Mara-Eves, A., Thomas, J., McNaught, J., Miwa, M., Ananiadou, S.: Using text
mining for study identification in systematic reviews: a systematic review of current
approaches. Systematic Reviews 4(1), 5 (2015)
16. Rose, S., Engel, D., Cramer, N., Cowley, W.: Automatic keyword extraction from
individual documents. Text Mining: Applications and Theory pp. 1–20 (2010)
17. Scells, H., Zuccon, G., Koopman, B., Deacon, A., Geva, S., Azzopardi, L.: A test
collection for evaluating retrieval of studies for inclusion in systematic reviews.
In: To appear in Proceedings of the 40th international ACM SIGIR conference on
Research and development in Information Retrieval. ACM (2017)
18. Wu, H., Wang, T., Chen, J., Chen, S., Hu, Q., He, L.: Ecnu at 2018 ehealth task 2:
Technologically assisted reviews in empirical medicine. In: Working Notes of CLEF
2018 - Conference and Labs of the Evaluation forum, Avignon, France, September
10-14, 2018. CEUR Workshop Proceedings, CEUR-WS.org (2018)
CD008122
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Rapid diagnostic tests for diagnosing uncomplicated P.
falciparum malaria in endemic countries
First and second trimester serum tests with and
without first trimester ultrasound tests for Down’s syndrome
screening
Clinical symptoms and signs for the diagnosis of
Mycoplasma pneumoniae in children and adolescents with
community-acquired pneumonia
Computed tomography (CT) angiography for
confirmation of the clinical diagnosis of brain death
123I-MIBG scintigraphy and 18F-FDG-PET imaging for
diagnosing neuroblastoma
Rapid antigen detection test for group A streptococcus
in children with pharyngitis
Ankle brachial index for the diagnosis of lower limb
peripheral arterial disease
D-dimer test for excluding the diagnosis of pulmonary
embolism
Rapid diagnostic tests for diagnosing uncomplicated
nonfalciparum or Plasmodium vivax malaria in endemic
countries
Ultrasonography for diagnosis of alcoholic cirrhosis in
people with alcoholic liver disease
Lateral flow urine lipoarabinomannan assay for detecting
active tuberculosis in HIV-positive adults
Triage tools for detecting cervical spine injury in
pediatric trauma patients
Blood biomarkers for the non-invasive diagnosis of
endometriosis
Combination of the non-invasive tests for the diagnosis
of endometriosis
Imaging for the exclusion of pulmonary embolism in
pregnancy
2011/08/25
2012/06/26
2012/08/31
2012/09/21
2013/02/01
2013/02/01
2013/12/12
2013/12/31
2015/01/31
2015/02/28
2015/02/28
2015/05/01
2015/05/31
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Diagnostic accuracy of different imaging modalities
following computed tomography (CT) scanning for
assessing the resectability with curative intent in pancreatic
and periampullary cancer
Cytology versus HPV testing for cervical cancer screening
in the general population
Molecular assays for the diagnosis of sepsis in neonates
Endometrial biomarkers for the non-invasive diagnosis of
endometriosis
Ultrasonography for confirmation of gastric tube
placement
Rapid diagnostic tests for typhoid and paratyphoid
(enteric) fever
Three-dimensional saline infusion sonography compared
to two-dimensional saline infusion sonography for the
diagnosis of focal intracavitary lesions
Dimercaptosuccinic acid scan or ultrasound in
screening for vesicoureteral reflux among children with urinary
tract infections
Platelet count, spleen length, and platelet
count-tospleen length ratio for the diagnosis of oesophageal
varices in people with chronic liver disease or portal vein
thrombosis
Ultrasonography for endoleak detection after
endoluminal abdominal aortic aneurysm repair
Imaging modalities for characterising focal pancreatic
lesions
Amylase in drain fluid for the diagnosis of pancreatic leak
in post-pancreatic resection
Pulse oximetry screening for critical congenital heart
defects
Serum amylase and lipase and urinary trypsinogen and
amylase for diagnosis of acute pancreatitis
18F PET with florbetapir for the early diagnosis of
AlzheimerâĂŹs disease dementia and other dementias in
people with mild cognitive impairment (MCI)
2016/01/19
2016/02/16
2016/02/28
2016/03/01
2016/03/30
2016/03/31
2016/06/30
2016/07/01
2016/07/19
2017/02/28
2017/03/30
2017/03/30
2017/05/01</p>
      </sec>
    </sec>
  </body>
  <back>
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