Abstract: We present an in-depth comparison of three clinical information extraction (IE) systems designed to perform entity recognition and negation detection on brain imaging reports: EdIE-R, a bespoke rule-based system, and two neural network models, EdIE-BiLSTM and EdIE-BERT, both multi-task learning models with a BiLSTM and BERT encoder respectively. We compare our models both on an in-sample and an out-of-sample dataset containing mentions of stroke findings and draw on our error analysis to suggest improvements for effective annotation when building clinical NLP models for a new domain. Our analysis finds that our rule-based system outperforms the neural models on both datasets and seems to generalise to the out-of-sample dataset. On the other hand, the neural models do not generalise negation to the out-of-sample dataset, despite metrics on the in-sample dataset suggesting otherwise.