Abstract
OBJECTIVE: Develop a representation of clinical observations and actions and a method of processing free-text patient documents to facilitate applications such as quality assurance. DESIGN: The Linguistic String Project (LSP) system of New York University utilizes syntactic analysis, augmented by a sublanguage grammar and an information structure that are specific to the clinical narrative, to map free-text documents into a database for querying. MEASUREMENTS: Information precision (I-P) and information recall (I-R) were measured for queries for the presence of 13 asthma-health-care quality assurance criteria in a database generated from 59 discharge letters. RESULTS: I-P, using counts of major errors only, was 95.7% for the 28-letter training set and 98.6% for the 31-letter test set. I-R, using counts of major omissions only, was 93.9% for the training set and 92.5% for the test set.
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- Barnett G. O., Cimino J. J., Hupp J. A., Hoffer E. P. DXplain. An evolving diagnostic decision-support system. JAMA. 1987 Jul 3;258(1):67–74. doi: 10.1001/jama.258.1.67. [DOI] [PubMed] [Google Scholar]
- Baud R. H., Rassinoux A. M., Scherrer J. R. Natural language processing and semantical representation of medical texts. Methods Inf Med. 1992 Jun;31(2):117–125. [PubMed] [Google Scholar]
- Borst F., Lyman M., Nhàn N. T., Tick L. J., Sager N., Scherrer J. R. TEXTINFO: a tool for automatic determination of patient clinical profiles using text analysis. Proc Annu Symp Comput Appl Med Care. 1991:63–67. [PMC free article] [PubMed] [Google Scholar]
- Bucknall C. E., Robertson C., Moran F., Stevenson R. D. Differences in hospital asthma management. Lancet. 1988 Apr 2;1(8588):748–750. doi: 10.1016/s0140-6736(88)91549-8. [DOI] [PubMed] [Google Scholar]
- Bucknall C. E., Robertson C., Moran F., Stevenson R. D. Management of asthma in hospital: a prospective audit. Br Med J (Clin Res Ed) 1988 Jun 11;296(6637):1637–1639. doi: 10.1136/bmj.296.6637.1637. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Campbell K. E., Musen M. A. Representation of clinical data using SNOMED III and conceptual graphs. Proc Annu Symp Comput Appl Med Care. 1992:354–358. [PMC free article] [PubMed] [Google Scholar]
- Chute C. G., Yang Y., Evans D. A. Latent Semantic Indexing of medical diagnoses using UMLS semantic structures. Proc Annu Symp Comput Appl Med Care. 1991:185–189. [PMC free article] [PubMed] [Google Scholar]
- Cimino J. J. Representation of clinical laboratory terminology in the Unified Medical Language System. Proc Annu Symp Comput Appl Med Care. 1991:199–203. [PMC free article] [PubMed] [Google Scholar]
- Dunham G. S., Pacak M. G., Pratt A. W. Automatic indexing of pathology data. J Am Soc Inf Sci. 1978 Mar;29(2):81–90. doi: 10.1002/asi.4630290207. [DOI] [PubMed] [Google Scholar]
- Evans D. A., Rothwell D. J., Monarch I. A., Lefferts R. G., Cote R. A. Toward representations for medical concepts. Med Decis Making. 1991 Oct-Dec;11(4 Suppl):S102–S108. [PubMed] [Google Scholar]
- Gabrieli E. R. Computer-assisted assessment of patient care in the hospital. J Med Syst. 1988 Jun;12(3):135–146. doi: 10.1007/BF00996636. [DOI] [PubMed] [Google Scholar]
- Gabrieli E. R. Computerizing text from office records. MD Comput. 1987 May-Jun;4(3):44-9, 56. [PubMed] [Google Scholar]
- Hirschman L., Story G., Marsh E., Lyman M., Sager N. An experiment in automated health care evaluation from narrative medical records. Comput Biomed Res. 1981 Oct;14(5):447–463. doi: 10.1016/0010-4809(81)90021-5. [DOI] [PubMed] [Google Scholar]
- Lin R., Lenert L., Middleton B., Shiffman S. A free-text processing system to capture physical findings: Canonical Phrase Identification System (CAPIS). Proc Annu Symp Comput Appl Med Care. 1991:843–847. [PMC free article] [PubMed] [Google Scholar]
- Masarie F. E., Jr, Miller R. A., Bouhaddou O., Giuse N. B., Warner H. R. An interlingua for electronic interchange of medical information: using frames to map between clinical vocabularies. Comput Biomed Res. 1991 Aug;24(4):379–400. doi: 10.1016/0010-4809(91)90035-u. [DOI] [PubMed] [Google Scholar]
- McCray A. T. Extending a natural language parser with UMLS knowledge. Proc Annu Symp Comput Appl Med Care. 1991:194–198. [PMC free article] [PubMed] [Google Scholar]
- Miller R. A., Pople H. E., Jr, Myers J. D. Internist-1, an experimental computer-based diagnostic consultant for general internal medicine. N Engl J Med. 1982 Aug 19;307(8):468–476. doi: 10.1056/NEJM198208193070803. [DOI] [PubMed] [Google Scholar]
- Miller R., Masarie F. E., Myers J. D. Quick medical reference (QMR) for diagnostic assistance. MD Comput. 1986 Sep-Oct;3(5):34–48. [PubMed] [Google Scholar]
- Musen M. A. Dimensions of knowledge sharing and reuse. Comput Biomed Res. 1992 Oct;25(5):435–467. doi: 10.1016/0010-4809(92)90003-s. [DOI] [PubMed] [Google Scholar]
- Sager N., Lyman M. Computerized language processing: implications for health care evaluation. Med Rec News. 1978 Jun;49(3):20-1, 23-4, 26-8 passim. [PubMed] [Google Scholar]
- Sager N., Wong R. Developing a database from free-text clinical data. J Clin Comput. 1983;11(5-6):184–194. [PubMed] [Google Scholar]
- Vries J. K., Marshalek B., D'Abarno J. C., Yount R. J., Dunner L. L. An automated indexing system utilizing semantic net expansion. Comput Biomed Res. 1992 Apr;25(2):153–167. doi: 10.1016/0010-4809(92)90018-6. [DOI] [PubMed] [Google Scholar]
- Wolff S. The use of morphosemantic regularities in the medical vocabulary for automatic lexical coding. Methods Inf Med. 1984 Oct;23(4):195–203. [PubMed] [Google Scholar]
- Zingmond D., Lenert L. A. Monitoring free-text data using medical language processing. Comput Biomed Res. 1993 Oct;26(5):467–481. doi: 10.1006/cbmr.1993.1033. [DOI] [PubMed] [Google Scholar]