{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T03:48:11Z","timestamp":1788839291751,"version":"build-2803163510"},"reference-count":89,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T00:00:00Z","timestamp":1657843200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Digital Health","award":["APP1134919"],"award-info":[{"award-number":["APP1134919"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Electronic medical records are increasingly used to store patient information in hospitals and other clinical settings. There has been a corresponding proliferation of clinical natural language processing (cNLP) systems aimed at using text data in these records to improve clinical decision-making, in comparison to manual clinician search and clinical judgment alone. However, these systems have delivered marginal practical utility and are rarely deployed into healthcare settings, leading to proposals for technical and structural improvements. In this paper, we argue that this reflects a violation of Friedman\u2019s \u201cFundamental Theorem of Biomedical Informatics,\u201d and that a deeper epistemological change must occur in the cNLP field, as a parallel step alongside any technical or structural improvements. We propose that researchers shift away from designing cNLP systems independent of clinical needs, in which cNLP tasks are ends in themselves\u2014\u201ctasks as decisions\u201d\u2014and toward systems that are directly guided by the needs of clinicians in realistic decision-making contexts\u2014\u201ctasks as needs.\u201d A case study example illustrates the potential benefits of developing cNLP systems that are designed to more directly support clinical needs.<\/jats:p>","DOI":"10.1093\/jamia\/ocac121","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T12:34:51Z","timestamp":1658147691000},"page":"1810-1817","source":"Crossref","is-referenced-by-count":52,"title":["Tasks as needs: reframing the paradigm of clinical natural language processing research for real-world decision support"],"prefix":"10.1093","volume":"29","author":[{"given":"Asher","family":"Lederman","sequence":"first","affiliation":[{"name":"Faculty of Engineering and IT, School of Computing and Information Systems, University of Melbourne , Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reeva","family":"Lederman","sequence":"additional","affiliation":[{"name":"Faculty of Engineering and IT, School of Computing and Information Systems, University of Melbourne , Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8661-1544","authenticated-orcid":false,"given":"Karin","family":"Verspoor","sequence":"additional","affiliation":[{"name":"STEM College, School of Computing Technologies, RMIT University , Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,14]]},"reference":[{"key":"2022091407554160700_ocac121-B1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jbi.2017.11.011","article-title":"Clinical information extraction applications: a literature 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