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Clinical Note Processing Pipeline Driver and Framework

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mush

Mush is a pipeline driver and application framework for developing highly concurrent and performant clinical note processing pipelines. It acts as a root event loop for actuating a processing pipeline that may or may not rely on networked services.

It is used internally in UW Medicine Research IT's NLP infrastructure. It can be used to process a static set of notes or listen for notes as they become available.

Architecture

Mush composes three core pieces of functionality:

  • The stream package implements a streaming mechanism on top of any static store of clinical notes.
  • The wp package implements a configurable worker pool for concurrently processing notes into results.
  • The sink package implements a configurable concurrent IO sink for capturing results.

These packages are connected and managed by the root mush package via the Compose function.

Benchmarks

To date, we've seen mush sustain ~600,000 notes/hour, CPU 10%, <70MB memory. This run was pointed at an API endpoint that de-identified the notes, the endpoint was capped at 80 TPS. The application was sharing a VM with the SQL Server instance it was using for storage. SQL Server used 90% CPU, 12GB memory.

Examples

A prototypical mush application must define how to fetch a batch of notes, what to do with a single note, and how to store the results of a single note. Concretely, you must implement a stream.BatchProvider, a wp.Runner, wp.Handler, and a sink.Writer.

stream.BatchProvider

nio/reader.go

package nio

import (
    "context"
    "database/sql"
    "strconv"

    // driver
    _ "github.com/denisenkom/go-mssqldb"
    "github.com/pkg/errors"
    "github.com/uwrit/mush/note"
)

// NewBatchProvider returns a new stream.BatchProvider for MS SQL Server.
func NewBatchProvider(ctx context.Context, db *sql.DB) *MSSQLBatchProvider {
    return &MSSQLBatchProvider{ctx, db}
}

// MSSQLBatchProvider implements stream.BatchProvider for MS SQL Server.
type MSSQLBatchProvider struct {
    ctx context.Context
    db  *sql.DB
}

// Batch retrieves a batch of notes no greater than provided batchSize.
func (m *MSSQLBatchProvider) Batch(batchSize int) ([]*note.Note, error) {
    tx, err := m.db.BeginTx(m.ctx, nil)
    if err != nil {
        return nil, errors.Wrap(err, "could not start transaction")
    }
    rows, err := tx.QueryContext(m.ctx, "exec dbo.sp_FetchNotes @p1", batchSize)
    if err != nil {
        return nil, errors.Wrap(err, "could not fetch note batch")
    }
    notes := []*note.Note{}
    for rows.Next() {
        var id int
        var text string
        err = rows.Scan(&id, &text)
        if err != nil {
            tx.Rollback()
            return nil, errors.Wrap(err, "could not scan note row")
        }
        notes = append(notes, note.New(id, text))
    }
    return notes, tx.Commit()
}

sink.Writer

nio/writer.go

package nio

import (
    "context"
    "database/sql"

    // driver
    _ "github.com/denisenkom/go-mssqldb"
    "github.com/pkg/errors"
    "github.com/uwrit/mush/note"
)

// StatusCodes ...
const (
    ThrottledErr note.Status = -1
    Success      note.Status = 1
    EncodingErr  note.Status = 2
    TooLongErr   note.Status = 3
    ValidateErr  note.Status = 4
    APIErr       note.Status = 5
    MarshalErr   note.Status = 6
)

// NewWriter returns a new sink.Writer for MS SQL Server.
func NewWriter(ctx context.Context, db *sql.DB) *MSSQLWriter {
    return &MSSQLWriter{ctx, db}
}

// MSSQLWriter implements sink.Writer for MS SQL Server.
type MSSQLWriter struct {
    ctx context.Context
    db  *sql.DB
}

// Write persists a note.Result to a SQL Server.
func (w *MSSQLWriter) Write(r *note.Result) error {
    tx, err := w.db.BeginTx(w.ctx, nil)
    if err != nil {
        return errors.Wrapf(err, "could not start transaction to save result: %s", r)
    }
    _, err = tx.ExecContext(w.ctx, "exec dbo.sp_SaveResult @p1, @p2, @p3", r.ID, r.Status, r.Body)
    if err != nil {
        return errors.Wrapf(err, "could not save result: %s", r)
    }
    return tx.Commit()
}

cmd/main.go

package main

import (
    "context"
    "database/sql"
    "fmt"
    "log"
    "os"
    "unicode/utf8"

    "github.com/my-user/my-mush-impl/nio"

    "github.com/uwrit/mush"
    "github.com/uwrit/mush/note"
    "github.com/uwrit/mush/utf"

    "github.com/pkg/errors"

    _ "github.com/denisenkom/go-mssqldb"
)

const databaseConnectionString = "DEMO_MUSH_DBSTRING"
const poolWorkerCount = "DEMO_MUSH_WORKER_COUNT"

func init() {
    log.SetOutput(os.Stdout)
    log.SetFlags(log.Ldate | log.Ltime | log.Lmicroseconds | log.Lshortfile)
}

func main() {
    log.Println("demonstrating mush...")
    ctx, _ := context.WithCancel(context.Background())
    reader, writer := mustGetServices(ctx)
    config := mush.Config {
        StreamBatchSize: 100,
        StreamWaterline: 40,
        SinkWorkerCount: 4,
    }

    musher := mush.Compose(ctx, reader, run, handle, writer, config)
    musher.Mush()

    musher.Wait()
    log.Println("done!")
}

func mustGetServices(ctx context.Context) (mush.BatchProvider, mush.Writer) {
    cstring := os.Getenv(databaseConnectionString)
    if cstring == "" {
        log.Fatalln(fmt.Sprintf("no connection string found in env var %s", databaseConnectionString))
    }
    db, err := sql.Open("sqlserver", cstring)
    if err != nil {
        log.Fatalln(fmt.Sprintf("could not open db pool: %s", err))
    }
    return nio.NewBatchProvider(ctx, db), nio.NewWriter(ctx, db)
}

// wp.Runner
func run(p *Pool) {

    // Get total workers
    workerstr := os.Getenv(poolWorkerCount)
    if workers == "" {
        log.Fatalln(fmt.Sprintf("no worker count found in env var %s", poolWorkerCount))
    }
    workercount, err := strconv.Atoi(s)
    if err != nil {
        log.Fatal(fmt.Sprintf("worker count %s is not an integer", workerstr))
    }

    // This loop is functionally the same as the default wp.DefaultRunner() but 
    // defined here as an example of how to do custom implementations.
	for i := 0; i < workercount; i++ {
		p.WaitGroup().Add(1)
		num := i
		go func() {
			log.Println("worker", num, "starting up")
			for {
				select {
				case n, ok := <-p.Incoming():
					if !ok {
						log.Println("worker", num, "shutting down")
						p.WaitGroup().Done()
						return
					}
					log.Println("worker", num, "received note", n.ID)
					p.Results() <- p.handler(n)
				case <-p.ctx.Done():
					log.Println("worker", num, "shutting down")
					p.WaitGroup().Done()
					return
				}
			}
		}()
	}
	p.WaitGroup().Wait()
	log.Println("worker pool shut down")
	close(p.Results())
}

// wp.Handler
func handle(n *note.Note) *note.Result {
    log.Println(fmt.Sprintf("processing note %d", n.ID))
    result := note.Result{
        ID: n.ID,
    }

    set := func(status note.Status, e error) *note.Result {
        result.Status = status
        result.Err = e
        if e != nil {
            log.Println("note", n.ID, "processing failed:", &result)
        }
        return &result
    }

    text := utf.EncodeUTF8(n.Text)

    if !utf8.ValidString(text) {
        return set(nio.EncodingErr, errors.New("note contains invalid utf8 characters"))
    }

    if bl := len([]byte(text)); bl >= 20000 {
        return set(nio.TooLongErr, errors.Errorf("note too long: %d", bl))
    }

    result.Body = "{\"Entities\":[],\"UnmappedAttributes\":[]}"
    return set(nio.Success, nil)
}

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