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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Automated Narrative Extraction from Administrative Records</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Karine Megerdoomian</string-name>
          <email>karine@mitre.org</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Amy B. Marsh</string-name>
          <email>amarsh@mitre.org</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Eric O. Scott</string-name>
          <email>escott@mitre.org</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Karl Branting</string-name>
          <email>lbranting@mitre.org</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Nick Modly</string-name>
          <email>nmodly@mitre.org</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Sujit B. Wariyar</string-name>
          <email>swariyar@mitre.org</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Charles E. Horowitz</string-name>
          <email>chorowitz@mitre.org</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Stacy J. Petersen</string-name>
          <email>spetersen@mitre.org</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>The MITRE Corporation</institution>
          ,
          <addr-line>McLean, VA</addr-line>
          ,
          <country country="US">USA</country>
        </aff>
      </contrib-group>
      <pub-date>
        <year>2019</year>
      </pub-date>
      <abstract>
        <p>The U.S. Probation and Pretrial Services Office staff produce billions of pages of information on defendants' and offenders' profile and conduct. While it is critical for probation officers and district chiefs to have up-to-date knowledge on their clients to better assist and reduce risk of recidivism, the data are often stored in narrative texts in multiple large documents. As a result, these records remain mostly out of reach without the use of painstaking manual review. This paper describes an analytic prototype developed to automatically acquire structured information from natural language text in probation office documents through the application of PDF content extraction, text mining, and language analytics. Since serious mental illness is very prevalent in the U.S. corrections system, the first phase of the project focused on extracting information and constructing timelines from narrative text regarding the defendants' mental health conditions, substance use and treatment history. Automated narrative extraction and the construction of an event timeline for defendants' mental and emotional health</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>-</title>
      <p>*In Proceedings of the Workshop on Artificial Intelligence and the Administrative
State (AIAS 2019), June 17, 2019, Montreal, QC, Canada.</p>
      <p>Copyright © 2019 for this paper by The MITRE Corporation. Use permitted under
Creative Commons License Attribution 4.0 International (CC BY 4.0).
Published at http://ceur-ws.org
** Approved for Public Release; Distribution Unlimited 19-1482. Throughout this
document, all names of people, places, facilities and dates are replaced with
fictitious ones to anonymize the information.
history have allowed the probation office to have a better
understanding of their client population and to perform
analyses that were previously unavailable to the organization.
This technical approach can be applied across organizations,
legal institutions, clinical administrations, and government
agencies that maintain large amounts of information in the
form of free text narratives.</p>
    </sec>
    <sec id="sec-2">
      <title>1 Introduction</title>
      <p>
        The U.S. Probation and Pretrial Services Office (PPSO) staff
supervise more than 300,000 people a year and collect and
produce billions of pages of information on defendants’ and
offenders’ profile and conduct, as well as on the strategies and
actions of officers and their outcomes. While it is critical for
probation officers to have up-to-date knowledge on their
clients to reduce the risk of recidivism, the data are often stored
in narrative texts in multiple large documents, making it very
challenging and time-consuming to collect all relevant case
information manually. This renders 70 terabytes of mostly
unstructured data on more than a million defendants, and
strategies used by thousands of officers over decades, mostly
unusable by PPSO [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]. As a result, policy makers, program
evaluators, and probation and pretrial services staff have been
denied valuable data with which to do their jobs.
      </p>
      <p>
        A significant number of offenders supervised by the U.S.
probation services have a current mental health condition,
most of them with co-occurring substance use disorders.
Defendants who suffer from mental disorders often require
more intensive monitoring and specialized treatment [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ]. We
therefore focus on addressing important PPSO business
questions to better understand the nature of the mental
conditions in the officers’ caseload and gain knowledge of the
defendants’ diagnosis and treatment history. The information
was automatically obtained from the free text sections of
Presentence Investigation Reports (PSIR), which represent
investigations into the history of the person convicted of a
crime before sentencing to determine if there are extenuating
circumstances. To automatically extract and analyze the free
text information in the PSIRs, we applied language analytics
technology to detect the events of interest (substance use,
diagnosis, treatment sessions, prescriptions) in the defendant’s
life and visualized them as a timeline of activities that could be
reviewed by the probation and parole officers.
      </p>
      <p>
        The system leverages Apache cTAKES (clinical Text Analysis
and Knowledge Extraction System), an open-source Natural
Language Processing (NLP) system developed specifically to
extract and analyze clinical information from unstructured text
[
        <xref ref-type="bibr" rid="ref3">3</xref>
        ]. cTAKES identifies clinical terms such as drugs, diseases and
disorders, symptoms, and medical and treatment procedures.
It also performs deep textual analysis and can identify, for
instance, if a sentence is negated or not, or if the person being
discussed is the patient or a family member. The prototype
system combines the results of cTAKES with rich linguistic
analysis from other open source systems such as concept
ontologies and the Stanford CoreNLP parser and entity
recognizer [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ]. These syntactic and semantic analyses are then
enhanced to adapt to the use case, by identifying significant
terms for the events of interest for the mental health domain,
applying linguistic analysis to improve argument and negation
detection, and implementing recent advances in NLP to
improve precision (e.g., vector space semantics, algorithms for
building a narrative timeline).
      </p>
      <p>All extracted information on a defendant’s narrative is stored
in a graph database and displayed on a dynamic map, allowing
filtering of results based on judicial district, defendants’
demographic information (age, education, citizenship),
criminal category, mental conditions or medications
prescribed.</p>
      <p>As large amounts of information in business, government and
administration are maintained in the form of narratives
(clinical records, legal and financial summaries, progress
reports, human resources assessments, etc.), the approach
described in this paper for acquiring structured information
from narrative text can be reapplied across organizations and
government agencies.</p>
    </sec>
    <sec id="sec-3">
      <title>2 Background</title>
      <p>Past clinical information extraction systems have tended to rely
on shallow NLP techniques (pattern-matching, simple parses,
linear pattern interpretation rules). More recently, however,
several projects have adopted knowledge-based approaches
adapted for the clinical domain.</p>
      <p>While the advantages of machine learning methods for
information extraction cannot be denied, they also present a
number of limitations in applications for narrative extraction
from clinical data. To begin with, machine learning algorithms
require large amounts of training data which are pre-tagged for
the relevant features and parameters. Preparing the
preannotated data sets can be time-consuming and expensive. In
addition, such probabilistic approaches might miss rare
phenomena that need to be identified since they do not occur
often enough in the training data to be picked up by the
learning algorithms. Another challenge for using machine
learning methods in the clinical domain is that users often
expect high level of consistency in the results and precise
information on how the computational decisions were made. In
such instances, a rule-based approach might be more
transparent and easier to understand and modify.</p>
      <p>
        The approach described in this paper leverages in-depth
linguistic and semantic analysis to detect the domain
information in narrative text, more in line with recent
knowledge-based approaches [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ] [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ]. Machine learning
approaches often require a large amount of pre-annotated data
on which to train the algorithms. Since the PSIR data had not
previously been tagged for the events of interest and mental
conditions, a purely machine learning approach was not readily
available. Hence, the prototype applies a hybrid method. It
leverages rich linguistic and semantic information through the
application of open-source Natural Language Processing
systems, adapted for the existing use case by applying a
combination of rule-based linguistic analysis, vector space
semantics, and machine learning techniques to enhance the
results. These were used to improve negation detection and
argument identification (i.e., entities the events refer to), and to
develop temporal reasoning algorithms. Ontologies (lexicons)
of mental health and medication terms, vetted by a subject
matter expert, were used for concept identification. The rest of
this section provides a detailed description of the technical
steps in building the analytic prototype.
      </p>
    </sec>
    <sec id="sec-4">
      <title>3 Technical Approach</title>
      <p>The technical approach is a hybrid one, leveraging open source
NLP applications often developed by training machine learning
algorithms, and refining the syntactic and semantic analyses
with a combination of knowledge-based and probabilistic
approaches.
3.1</p>
    </sec>
    <sec id="sec-5">
      <title>Analytic Pipeline</title>
      <p>The presentence reports undergo several steps in order to
extract the defendant’s mental health and substance use
narratives. These are shown in Error! Reference source not
found. and are described in detail in the rest of this section. The
specific steps involved are:
1. Content Extraction: parsing the different sections of the
PDF documents and extracting the structured profile and
criminal information as well as all free text content. This
component also “cleans” the data by normalizing the
textual content to maximize processing.
2. Language Analytics: The extracted text for each PSIR is
run through the Natural Language Processing
components, providing a full linguistic parse, a list of
entities and events of interest, and semantic relationships.
3. Knowledge Discovery: This step is the heart of the
textual analytics where the system identifies all concepts,
events, and their relationships for the domain of interest.
• Identifies the events of interest associated with the
defendant (arrests, diagnoses, treatments,
prescriptions, drug use, suffering from a mental
condition);
• Determines whether the information is obtained from
medical records or if it is reported by the defendant,
by a medical professional, or by a third party;
• Provides full event description including date,
location, persons involved, treatment provider,
nature of treatment and medication prescribed;
• Computes the temporal relationships between the
various events to build a narrative timeline for a
defendant.</p>
      <p>Neo4j Database: Neo4j is a graph database management
system and is available as open source software. All
extracted information from the Knowledge Discovery
component, as well as the client demographic metadata,
and structured information on arrest history and federal
offenses extracted from the presentence reports are
loaded into the database.
5.</p>
      <p>User Interface (UI): This component interacts with the
Neo4j database and displays results on a Google Earth
map. The UI allows the user to run queries, to review the
details on particular defendants, and to see aggregate
results on the data set.
3.2</p>
    </sec>
    <sec id="sec-6">
      <title>Content Extraction</title>
      <p>The Content Extraction component parses the PDF presentence
reports, identifies all subsections and extracts the textual
content. To analyze the mental health and substance use
information of defendants, the text content of the Mental and
Emotional Health (MEH) and Substance Abuse (SA) sections in
presentence reports are automatically extracted. In addition,
this step identifies and extracts all federal charges from the
cover sheet of the PSIR, criminal history information from the
Juvenile Adjudications and Adult Criminal Convictions sections
of the report, Arrest Dates and associated charges from the
Criminal History information, and Criminal History Score and
Category from the Criminal History Computation section.
The prototype’s Content Extraction component successfully
extracted information from 92% of the original PDF
documents, providing us with a data set of 11,243 extracted
narrative text documents to analyze. Given that some
defendants have more than one presentence report associated
with them, the successfully extracted content corresponds to
10,973 defendants. The free text content extracted from the
MEH and SA sections amount to 22,486 text items. These can
range from a few sentences to several paragraphs depending
on the report.
3.3</p>
    </sec>
    <sec id="sec-7">
      <title>Language Analytics</title>
      <p>The Language Analytics component leverages existing Natural
Language Processing software to perform various linguistic
analyses on a piece of text. NLP is a subset of Artificial
Intelligence (AI) and is fast becoming an essential technology
in modern-day organizations to gain significant insights from
unstructured content, such as email communications, social
media, videos, customer reviews, customer support request,
and administrative records in business and government.
Natural Language Processing tools and techniques help to
automatically process, analyze, and understand large amounts
of data, providing structure and meaning to information that
originally was in unstructured form.</p>
      <p>In this step of the analysis, the texts extracted from the Mental
and Emotional Health and Substance Abuse sections of the
PSIRs are run through several NLP software tools. The software
packages currently in use are Apache cTAKES (clinical Text
Analysis and Knowledge Extraction System), Stanford Named
Entity Recognizer, and FONS (Framework for Operation NLP
Services) – a software package pipeline leveraging open source
tools and was built by a research team at MITRE to detect
events of interest to national security.
cTAKES output forms the primary basis for further analytics. It
was chosen primarily because of its entity recognition
capabilities in the clinical domain, which aligned with the
desire to obtain data about PPSO clients’ mental and emotional
health and substance use. Entities identified by cTAKES include
medical conditions, drugs/medications, medical procedures,
and medical symptoms. The entities identified by cTAKES
outof-the-box were supplemented with additional entities
frequently encountered by analysts in PSIRs. We worked
closely with a PPSO subject matter expert to review the list of
conditions and medications that cTAKES recognized, and
identify the ones that were of interest in the mental and
emotional health and substance use domain. The subject
matter expert also identified a more general superclass for each
of these specific mental and emotional conditions so that
further analysis could be conducted at the appropriate level of
granularity. For example, conditions such as depression, chronic
depression, and major depressive disorder were all mapped to
the more general term depressive disorder.
cTAKES also provides domain-independent NLP capabilities of
syntactic parsing, dependency parsing, and semantic role
labelling – it can give the base forms of words, their parts of
speech, mark up the structure of sentences in terms of phrases
and syntactic relations, detect negation in the sentence and
identify the role of the entities in a sentence (e.g., agent of
event). The results of all these capabilities were used to identify
events of interest in a client’s mental and emotional health and
substance use history. However, we found it useful to
supplement the cTAKES output with other natural language
processing systems to achieve the most accurate analysis. The
Stanford Named Entity Recognizer was applied to identify
people, places, organizations, dates, times, and locations, none
of which are identified by cTAKES. Additionally, the FONS
system, which also generates entities, syntactic parsing and
dependency parsing output, was used to supplement cTAKES’
output to obtain a higher level of accuracy. In particular, FONS
was applied to the PSIR text data to tag entities (people,
facilities, locations, dates and times), and to categorize all
events into conceptual classes by detecting event types (e.g.,
state, transfer, communication) and different verb meanings
(e.g., prescribe can either be the verb denoting the prescription
of medication by a medical professional or a communication
event meaning ‘to advise’, ‘to recommend’).
3.4</p>
    </sec>
    <sec id="sec-8">
      <title>Domain-Specific Entity and Event</title>
    </sec>
    <sec id="sec-9">
      <title>Identification</title>
      <p>The Knowledge Discovery phase of the analytics involves
processing the output from the Natural Language Processing
systems to perform several steps in knowledge discovery in
natural language text:
1. Identify concepts (entities and events) of interest
associated with the client, including mentions of a client
suffering from a mental condition, diagnoses, treatments,
prescriptions and drug use.
2. Detect the event description such as the date and location
when it occurred, the persons involved, the treatment
provider, the nature of treatment (e.g., inpatient or
outpatient, anger management, drug rehabilitation) and
the medication prescribed.
3. Detect the source of the information – was the information
reported by the client, was it obtained from medical
records or a medical professional, or reported by a third
party?
As described, cTAKES detects these entities of interest in the
mental and emotional health domain. However, to identify
whether a client is suffering from a mental condition, it does
not suffice to simply retrieve sentences with a mental condition
mention. It is also important to detect the subject of the
sentence to distinguish cases where a family member is
mentioned to suffer from a mental condition (e.g., “the
defendant’s mother suffered from Schizophrenia”), and to
exclude any negated events (e.g., “the defendant does not suffer
from a severe mental disease or defect”). Fortunately, when
cTAKES identifies a concept, it also identifies that sentence’s
polarity (whether the entity appears in a negated context or
not), and the event’s subject (whether that event or concept
should be ascribed to the client described in the text, a family
member of the client, or someone else). Some modifications to
the cTAKES source code were made to improve the accuracy of
these attribute identifications.</p>
      <p>While the cTAKES entities can be counted to obtain statistics on
the prevalence of various mental conditions among the
defendant population, further processing is necessary to
identify more complicated events, such as receiving a
diagnosis, attending treatment, being prescribed medication,
or using drugs. To identify the events of interest, a small sample
of PSIRs was reviewed to identify the verbs commonly
associated with these events. An iterative process was used in
reviewing the event detection results and updating the
predicates for the domain. The verbal predicates associated
with each type of event are listed in Table 1.</p>
      <sec id="sec-9-1">
        <title>Event Type</title>
        <p>Diagnosis
Prescription
Treatment
Usage</p>
        <p>Predicate
diagnose
prescribe, treat (with)
admit, attend, complete, discharge,
enroll, enter, hospitalize, meet,
participate, place, receive, see, seek,
speak, treat, undergo
abuse, addict, consume, drink,
experiment, ingest, inhale, relapse,
smoke, snort, take, try, use
Once the predicates are identified, the semantic roles
associated with each occurrence of the predicate are
automatically extracted to enable the identification of the
predicate’s agent, affected entity, and whether the predicate
was negated. The sentence in which the predicate appeared
was also examined to identify medications, drugs, mental
conditions, medical procedures, and treatments associated
with that event.</p>
        <p>To detect the source of the information, all sentences with
Communication events identified by the FONS software
package were analyzed and the subject of the verbs extracted.
For example, in “Dr. Gray stated that the defendant has never
been hospitalized for emotional disorders of any kind”, the
communication verb stated is detected and its subject, Dr. Gray
(a medical professional), is identified as the source of the
information. Similarly, in the example “the defendant’s mother
also reported he was diagnosed with Bi-Polar Disorder several
years ago”, the source of information is identified as the
defendant’s mother (a third party).</p>
        <p>If the subject of the communication verb is mentioned as the
defendant, the system treats it as a self-reported event. In the
writing style of the presentence reports, mentions of he or she
tend to refer overwhelmingly to the defendant. Since the
current version of the analytic system does not include a
“coreference resolution” component that can accurately
identify who the pronouns refer to, the assumption is made to
treat these cases as self-reported events. This can be seen in the
following example where the events in both sentences are
automatically labeled as self-reported: “The defendant
expressed feelings of depression, helplessness, and hopelessness.
He also admitted to occasional auditory hallucinations.”
If the name of the defendant is mentioned as the subject of the
communication verb (e.g., “McKenna could not recall being
prescribed medication to treat his Depression”), an additional
step is performed to verify the name McKenna against the
defendant metadata information – if the system finds a match,
then the information is labeled as self-reported.</p>
        <p>Certain automated enhancements had to be made to the
Communication event detection, however, since the automatic
classification by FONS included verbs such as stuttered and
snorted. In order to improve the results, we computed semantic
vector measures that capture the similarity in usage of verbs
against canonical Communication events such as reported and
stated. The verbs that are closest in the context of use within
the text and thus have closer meaning to the report/state verbs
produce higher values and are thus more likely to be indicative
of the source of information. The top verbs identified as
Communication events are listed in Table 2.</p>
      </sec>
      <sec id="sec-9-2">
        <title>Event Type Predicate</title>
        <p>Communication state, indicate, note, explain,
report, say, acknowledge, discuss,
identify, confirm, deny, address,
agree, communicate, question,
suggest, tell, describe, claim,
mention, inform, disclose
Other formulation according to</p>
        <p>Table 2: Terms used to identify the source of information.
This linguistically rich event-based narrative analysis
methodology allows the Language Analytics component to
extract information of interest including the people involved in
the event, the time it occurred, and the places mentioned. A
sample analyzed sentence is shown in the following example:
The defendant&lt;source-of-info&gt; reported
she&lt;affected-entity/diagnose-event&gt; was
diagnosed&lt;diagnose-event&gt; at the age of 14&lt;time&gt;
with depression&lt;mental-condition&gt;,
schizophrenia&lt;mental-condition&gt; and bi-polar
disorder&lt;mental-condition&gt; and was not
prescribed&lt;prescribe-event|NEGATIVE&gt; any
medication&lt;medication-mention&gt;.
3.5</p>
      </sec>
    </sec>
    <sec id="sec-10">
      <title>Generalized Event Analysis</title>
      <p>While cTAKES proved very useful for identifying events in the
clinical domain, it is not specifically tuned for identifying more
general events. Events that are not directly related to
diagnoses, prescriptions, substance abuse, or treatment may
still be of interest when analyzing a client’s mental and
emotional health history. For example, in “He became depressed
when his infant brother died”, the event of the infant brother’s
death does not fall into one of the domain-specific event
categories, but it is still relevant to indicate a trigger or risk
factor. To try to capture these types of events, a more general
approach to parsing free text was used, producing an
eventbased analysis for every verb encountered in the Mental and
Emotional Health and Substance Abuse sections.</p>
      <p>As part of the Knowledge Discovery phase, the linguistic output
from the NLP systems loaded into the Neo4j graph database is
used as the basis for generating events that do not rely on a
domain-specific vocabulary. In this framework, events are
generally identified by the presence of a verb and an
eventbased analysis is performed on the sentence. In simple
sentences, this means that one event corresponds to the entire
sentence. However, if a sentence contains multiple clauses,
each clause could potentially represent one event. In the
sentence “he became depressed when his infant brother died”,
becoming depressed is one event, and his infant brother died is a
separate event. The two clauses are linked by the conjunction
when, which indicates the temporal relationship between them.
To handle sentences such as these, a list of terms that signify a
subordinate clause was created and sentences were divided
into clauses when one of these terms was found. The list of
terms used is in Table 3 below. These terms are used in further
analytics to identify temporal or causal relations between
events.</p>
      <sec id="sec-10-1">
        <title>Relationship Type Clause Marker Terms</title>
        <p>Temporal after, before, during, following, prior
to, throughout, until, upon, when,
while
Causal although, as a result of, because, due
to, in order to, since
Other according to, along with, in addition
to, relating to
Table 3: Terms signifying the presence of a subordinate clause in
a sentence.</p>
        <p>After all clauses have been identified, an event is generated for
each clause. If the clause contains a verb, the verb phrase forms
the basis of the event. If there is no verb phrase in the clause,
(e.g., in the sentence “while in prison, the defendant used heroin”,
“while in prison” is a clause without an explicit verb), the
phrase after the clause marker forms an event description
which is the basis of the event. Then, information from the
syntactic parses, dependency parses, semantic roles, and
named entities are used to identify agents, affected entities,
indirect objects, locations, and temporal mentions related to
the basis of the event for a complete narrative analysis.
3.6</p>
      </sec>
    </sec>
    <sec id="sec-11">
      <title>Temporal Reasoning</title>
      <p>
        Once all relevant events have been extracted from the text of
the PSIRs, it is possible to make a timeline of the relevant events
with temporal mentions in a client’s history. To accomplish
this, we adapted TimeML (Markup Language for Temporal and
Event Expressions) standards to the narratives generated [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ].
TimeML is designed to provide a standard way to annotate
events with a time stamp and place events in chronological
order; it is thus optimal for the problem of timeline generation.
In TimeML, events are typically described by verbs, which
aligns with our approach to narrative generation. In the actual
TimeML specification, temporal expressions are marked as
separate entities, falling into the categories of date (for events
that take place at a specific time, which might be a date, month,
or year), time (for events that take place at a specific time of
day), duration (for events that have clear start and end points),
and set (for periodic events). In our adaptation, we recorded
the type of temporal expression as an attribute of the event it
was associated with, and did not use the category of time since
the specific time of day of various events is not typically
specified in PSIRs. The category of set was recorded but is not
currently used for timeline generation. The start date and end
date of each event are also recorded as additional attributes.
      </p>
      <p>To place events in order, TimeML uses the TLINK tag, which
records the id’s of two related events and the temporal
relationship between the two. In this project, temporal
relationships are marked as an attribute of the event rather
than a separate entity, and an abbreviated set of seven
temporal relationships are used, rather than the fourteen
defined in TimeML. The temporal relationships utilized are
listed in Table 4.</p>
      <sec id="sec-11-1">
        <title>Relationship Description</title>
        <p>AFTER Event 1 occurs some time after Event 2
BEFORE Event 1 occurs some time before Event 2
BEGINS_AT Event 1 occurs immediately after Event
2
ENDS_AT Event 1 occurs immediately before</p>
        <p>Event 2
INCLUDES Event 1 starts before and ends after</p>
        <p>Event 2
IS_INCLUDED Event 1 starts after and ends before</p>
        <p>Event 2
SIMULTANEOUS Event 1 and Event 2 start and end at the
same time</p>
        <p>Table 4: Temporal relationships used for timeline generation.
Determining the values of the temporal type, start time, end
time, and temporal relationships for the generated events is a
three-step process. In the first pass through the events, any
temporal mentions associated with each event were parsed
with regular expressions and used to set the event’s type, start
date, and end date. Next, temporal relationships were
identified by examining events to see if they contained any of
the subordinate clause markers listed in Table 5. Rules were
then applied to relate two events connected by a subordinate
clause marker. One final pass through the events was used to
set any additional start and end dates that could be inferred
after the temporal relationship was determined.</p>
        <p>We can follow this entire process on the sentence “He began
smoking marijuana at the age of 16 until his arrest in 2014”,
which contains the events he began smoking marijuana and his
arrest in 2014. The first step after the identification of the two
clauses is to identify the presence of the temporal expressions
in each clause – at the age of 16 in the smoking event (EV1) and
in 2014 in the arrest event (EV2). In EV1, the start time can be
obtained from the defendant’s date of birth in the profile
information available in the database. In EV2, the Knowledge
Discovery component establishes that the temporal expression
is of type date, with a start and end time set to span the whole
year as shown in Table 5, since the time is not more clearly
specified than that. The second step will identify the
subordinate clause marker until, and follow a rule that
establishes that the smoking marijuana event ended at his
arrest in 2014. The final step will use the presence of the
Clause/Event
detection
Step 1:
temporal
expressions when
available
Step 2: Establish
temporal relation
between events
Step 3: Temporal
reasoning to set
temporal
expression
ENDS_AT relationship to set the end time of he began smoking
marijuana to the start time of his arrest in 2014. The final event
analysis associated with a temporal range is then used to build
a timeline and visualize on the web-based interface.
[He began smoking marijuana]clause1/EV1
until &lt;clause-marker&gt;
[his arrest in 2014] clause2/EV2
Detect EV1: &lt;type: “date”, startAt: {year: ‘1992’,
month: ‘6’, day: ‘12’}, endAt: None&gt;
EV2: &lt;type: “date”, startAt: {year: ‘2014’,
month: ‘1’, day: ‘1’},
endAt: {year: ‘2015’, month: ‘1’, day: ‘1’}&gt;
id: “EV1”,
relType: “ENDS_AT EV2”</p>
      </sec>
    </sec>
    <sec id="sec-12">
      <title>4 Graph-Based Representation</title>
      <p>The main motivation for using a graph database to store the
parse output is that syntactic parse outputs are often modeled
in linguistic theory in the form of trees (a graph in which each
node has a single parent) and dependency parses capture the
semantic relationship associated with two nodes, so storing the
parse outputs as a graph allows to use Neo4j API (Application
Programming Interface) and CQL (Cypher Query Language) to
directly access these grammatical relationships and handle the
recursion inherent in language. Additionally, once the natural
language parsing outputs are stored in graph format, it is easy
to align and merge the outputs from the different NLP systems
being used. Finally, Neo4j provides a visualization of the graph
for linguists and developers that assists in understanding the
structure of the language.</p>
      <p>Once the output from the NLP systems is stored in the database,
we apply several enhancements to the raw system output to
improve the parses’ accuracy and generalizability. These
enhancements include labelling all nodes with a more
coarsegrained part-of-speech tag, grouping together multi-word verb
phrases into a single entity (e.g. merging the nodes for the
terms in the phrase has been attending into a single node attend
with appropriate tense and aspect information), and combining
coordinated phrases with conjunctions into a single entity (e.g.
merging the nodes for the terms in the phrase mental and
emotional into a single node to facilitate further analysis).
The User Interface interacts with the Neo4j database to access
all content and narrative analytics output and displays the
results on a Cesium Server. The web-based interface allows the
user to run queries of interest, filter based on the defendant’s
profile information, and view the retrieved information on a
spatial map of judicial districts or States.</p>
      <p>The UI displays an aggregate report of the data for the provided
query as shown in Figure 2. This display can be further filtered
based on the mental conditions, medications and substances of
interest, as well as the defendant’s demographic information
and criminal category.
The user can then select to view the identified defendants on a
map to the level of street detail. The user may also select to
view a particular client’s information in more detail, such as
mental conditions reported, and see associated text from the
Presentence Investigation Report with relevant sections
highlighted. In addition, the data are used to visualize a
timeline of the defendant’s life events including arrests,
diagnoses, substance use, and treatments.</p>
    </sec>
    <sec id="sec-13">
      <title>5 Results of Analytics</title>
      <p>The programmatically important questions of interest to PPSO
that are addressed in the current prototype are (i) determining
how many defendants sentenced had a mental health
condition; (ii) the types of conditions present; (iii) the source
of the diagnosis; (iv) prior treatment exposure; and reporting
of that information by demographic, offense and prior criminal
history information.</p>
      <p>To identify the number of defendants with a mental illness, the
system extracts all the client cases where a mental illness was
mentioned as attributed to the defendant (whether officially
diagnosed or not). It was found that 3,959 defendants in the
data set (about 36% of the studied population) had a history of
one or more mental conditions. If Substance Use Disorder is
included as a mental health condition, that number increases to
58%. Figure 3 provides the heuristics for the mental health
conditions mentioned in the Mental and Emotional Health
sections of presentence reports studied. However, the total
number of defendants who have officially been diagnosed with
a mental condition is 2,238 (20% of the studied population). In
addition, 82% of the defendants had a history of substance use
(mainly Marijuana and alcohol), and 53% of cases had a prior
criminal record cited. Most common prescriptions are Prozac,
Ritalin, Seroquel and Xanax, and top substances include
Marijuana, Alcohol, Cocaine, Methamphetamine and Heroin.</p>
      <p>As described earlier, the analytic prototype identifies the source
of information for each detected event of interest. There are
five distinct categories for the source: (i) self (client
selfreport), (ii) medical professional, (iii) medical records, (iv)
report (official non-medical records, including evaluations and
assessments), and (v) third party (third party corroboration
such as a family member, defense counsel, probation agent, or
pretrial services agency). In the presentence reports studied, the
majority of the events (about 89% of all events found) are
selfreported.</p>
      <p>The full set of results in response to the PPSO business questions
is shown in Table 6.</p>
      <p>System performance was evaluated by creating a small
reference sample of about 500 sentences to measure the
accuracy of the information extracted for each event type. The
500 sentences were manually annotated by team members
indicating the expected mental conditions, event types
(diagnosis, treatment, prescription, usage), and medications.
The annotations also included important event-related
information such as the agent (prescriber, diagnoser), polarity
(whether the event is negated or not), and the temporal
expression associated with the event. The language analytics
results were then compared to the pre-annotated reference set
to measure how many of the detected elements were accurate
and to also calculate how many of the expected elements were
not picked up by the system.</p>
      <p>We also explored the aggregated national and district data for
potential correlations and analyses across defendants. Figure 4
illustrates one such analysis, which shows the onset of
substance use among the defendants studied. This examination
automatically detects any mentions of the age of the defendants
in the Substance Abuse texts and identifies any sentences that
refer to the onset of using a drug or alcohol by the defendant.
For instance, a sentence such as “he began using cocaine at age
17”, is labeled as an “inception predicate” and associated with
the age of the defendant (i.e., 17). The results show that the
onset of substance use among defendants starts at age 10, with
a steady increase to age 16 and peaks at age 18.</p>
      <p>This analysis is only one example of the types of aggregated
correlations and computations that are available after the full
language analytics have been performed on the data. Other
correlations explored include automatically detecting
instances of co-morbidity to understand which mental
conditions tend to co-occur most often among the population,
automatic detection of defendants with previous suicide
attempts or history of suicidal ideation, and identification of
events that may trigger mental health issues (e.g., death of a
family member, history of sexual or domestic abuse, fatal
medical diagnosis, divorce).
6</p>
    </sec>
    <sec id="sec-14">
      <title>Application to Risk Assessment</title>
      <p>
        Analysts working in the Probation and Pretrial Services domain
leverage a variety of data-driven instruments to measure
trends, train officers, and assess the recidivism risk in
individual clients. At a high level, these efforts are typically
described in terms of the popular Risk, Needs, and Responsivity
model, which dictates that effective offender supervision ought
to allocate more treatment resources to high-risk clients, that
treatment should target specific criminogenic needs in the
client’s case, and that officers should apply
cognitivebehavioral techniques to respond to the details of a client’s
particular situation [
        <xref ref-type="bibr" rid="ref7 ref8">7, 8</xref>
        ]. In recent years there has been a
trend toward using data-driven approaches for the first step,
and actuarial risk assessment instruments such as “Levels of
Service” surveys [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ] and the federally developed
PostConviction Risk Assessment (PCRA) [
        <xref ref-type="bibr" rid="ref10">10</xref>
        ] have played an
increasingly important role in the allocation of treatment
resources. These tools are typically based on survey questions
that must be administered and recorded by the officer, which
then serve as inputs to traditional statistical modeling
techniques (e.g., logistic linear regression). Such tools are
timeconsuming to use, and they offer only a limited, static snapshot
of the specific criminogenic needs that are present in a client’s
case. Risk/needs assessment is an active area of research, and
efforts are ongoing to identify next generation tools that can
offer improved data-driven methods that can help support
probation officer responses during their regular interactions
with clients. Leveraging the wealth of unstructured
information that is present in the existing documentation that
is available in probation case tracking systems is one promising
approach to solving this problem.
      </p>
      <p>
        Any application of AI or data analysis to officer
decisionmaking can end up having a significant impact on the
population under supervision, and so it is important to be
aware of the various ethical concerns that surround the
application of data analysis software to social issues [
        <xref ref-type="bibr" rid="ref11">11</xref>
        ]. Such
concerns include the need for general algorithmic
accountability [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ], the need for assurance that algorithms that
are used for such important tasks as recidivism prediction do
not exhibit unacceptable biases [
        <xref ref-type="bibr" rid="ref13">13</xref>
        ], the need for judicial
review of algorithm-assisted decision-making (where such
review may be called for), and more practically, the need to
inspire trust in users, who tend to be unwilling to rely on
algorithms whose inner workings are poorly understood.
Some of these issues are of greater concern than others in a
probation domain. Judicial review, for example, is a legal
necessity when algorithms directly impact a judge’s decisions,
but risk/needs assessments for offenders who are on
supervised release are not normally referred to in judicial
decision-making.
      </p>
      <p>In this work, we focus on the foundational question of
extracting information from unstructured text that can inform
the decisions of officers and analysts working within the
federal probation system. We defer questions about automated
risk assessment, and the fairness thereof, to future research.
The current work focuses instead on extracting and arranging
raw facts from various sources in a visualization that a human
can use to support their professional judgement in a particular
case and that an officer can potentially leverage in detecting
patterns that had previously been unavailable.</p>
    </sec>
    <sec id="sec-15">
      <title>7 Future Directions</title>
      <p>The paper describes a successful approach to the automatic
extraction and analysis of narrative text in the mental health
and substance use domain. The approach has since been
applied to other domains such as employment history and
financial history. The results provide evidence that the use of
technology in identifying important information in free
narrative text in administrative records is feasible and
costeffective, and any adaptations to new domains can be
accelerated through probabilistic methods. These analytics can
be further developed in various directions, depending on the
mission needs of the organization. This section provides some
directions to pursue.</p>
      <p>The current results of the analytics can further be improved
upon by annotating more data and performing a larger-scale
evaluation and refinement cycle. Although event extraction
accuracy ranged in the 90-percentile, an evaluation conducted
on a larger data set will provide better accuracy measures and
can identify low frequency events that may have been missed
in the current version of the analytics. Further work can also be
performed on negation and argument detection to achieve
higher precision. In addition, the analytics results have not yet
been fully validated by a subject matter expert to ensure that
the data identified and the way the results are presented are
valuable for the PPSO officer or mental health analyst.
Building a timeline of a defendant’s life events from narrative
text is a very complex task and the topic of much current
research in the field of NLP. We successfully identified the
temporal expressions associated with events and introduced a
temporal reasoning component which is tightly integrated into
the system’s syntactic parse and semantic relations output. Yet,
identifying the temporal relations between events is not an
easy task and oftentimes, the system needs to infer a
relationship that is not overtly mentioned in the sentence.
Building a hybrid method combining knowledge-based
linguistic analysis with a statistical machine learning approach
will provide more robust temporal relationship analyses.
One of the issues that were left unaddressed in the current
version of the analytics was the distinction between events
(e.g., diagnoses, treatments) that occurred in the past and those
that are currently valid. This can be accomplished by leveraging
the tense and aspect information that the system computes and
adding a filter on the UI to allow the user to view only events
that are current.</p>
      <p>Building a complete timeline of a defendant’s life events will
provide the important information at the individual level for
PPSO officers to view and analyze, helping them identify
precursor events and triggering factors. For instance, in
addition to the mental health and substance use information,
the personal history of the defendant (e.g., whether he or she
graduated high school, history of domestic violence or neglect),
existence of dependents (e.g., number of dependents and their
age, learning issues, custodian), family relations (e.g., siblings
and whether they have a criminal or substance abuse history),
employment status, gang or terrorism activity, etc. are all
important information elements that could shed light on the
defendant’s situation and allow probation officers to provide
more efficient supervision and intervention measures to
reduce recidivism. This requires fusing all events and
information extracted from presentence documents onto a
single timeline to view and analyze.</p>
      <p>An important goal for analytics research is to leverage the large
amount of data from diverse sources available to the probation
office—including treatment reports, Chrono notes, social
media, structured metadata, risk assessments, and court
documents—to obtain a more complete picture of the
defendant’s history, conduct and status. The data analytics
methods will be applied to these data sources and all results
combined into a unified database available for query and
analysis. Building on a multi-source analysis, the system can
begin identifying precursor events to criminal activity or
noncompliance, or detecting triggers for mental health issues
or substance use relapses, and leverage that information to
build a predictive model to forecast potential risk and generate
automatic alerts. Such an alerting system can help direct an
officer’s attention to elements of a client’s case history that
indicate a special cause for concern.</p>
    </sec>
    <sec id="sec-16">
      <title>ACKNOWLEDGMENTS</title>
      <p>We would like to acknowledge the guidance and support of the
U.S. Probation and Pretrial Services Office throughout this
project. In particular, we would like to thank Steve Levinsohn
for providing essential subject matter expertise to the team.
The project was led and funded by the Technology Solutions
Office at the Administrative Office of the U.S. Courts as part of
the Applied Technology Research and Development program
managed by the Judiciary Engineering and Modernization
Center operated by the MITRE Corporation.</p>
      <p>This (software/technical data) was produced for the U. S.
Government under Contract Number USCA16D2019, and is
subject to Judiciary Policy Clause 6-60, Rights in Data—General
(JUN 2012).</p>
      <p>No other use other than that granted to the U. S. Government,
or to those acting on behalf of the U. S. Government under that
Clause is authorized without the express written permission of
The MITRE Corporation.
© 2019 The MITRE Corporation.</p>
    </sec>
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