Dynamic Generation of a Table of Contents with Consumer-Friendly Labels

Consumers increasingly look to the Internet for health information, but available resources are too difficult for the majority to understand. Interactive tables of contents (TOC) can help consumers access health information by providing an easy to understand structure. Using natural language processing and the Unified Medical Language System (UMLS), we have automatically generated TOCs for consumer health information. The TOC are categorized according to consumer-friendly labels for the UMLS semantic types and semantic groups. Categorizing phrases by semantic types is significantly more correct and relevant. Greater correctness and relevance was achieved with documents that are difficult to read than with those at an easier reading level. Pruning TOCs to use categories that consumers favor further increases relevancy and correctness while reducing structural complexity

Using data-driven sublanguage pattern mining to induce knowledge models: application in medical image reports knowledge representation

Background: The use of knowledge models facilitates information retrieval, knowledge base development, and therefore supports new knowledge discovery that ultimately enables decision support applications. Most existing works have employed machine learning techniques to construct a knowledge base. However, they often suffer from low precision in extracting entity and relationships. In this paper, we described a data-driven sublanguage pattern mining method that can be used to create a knowledge model. We combined natural language processing (NLP) and semantic network analysis in our model generation pipeline. Methods: As a use case of our pipeline, we utilized data from an open source imaging case repository, Radiopaedia.org, to generate a knowledge model that represents the contents of medical imaging reports. We extracted entities and relationships using the Stanford part-of-speech parser and the “Subject:Relationship:Object” syntactic data schema. The identified noun phrases were tagged with the Unified Medical Language System (UMLS) semantic types. An evaluation was done on a dataset comprised of 83 image notes from four data sources. Results: A semantic type network was built based on the co-occurrence of 135 UMLS semantic types in 23,410 medical image reports. By regrouping the semantic types and generalizing the semantic network, we created a knowledge model that contains 14 semantic categories. Our knowledge model was able to cover 98% of the content in the evaluation corpus and revealed 97% of the relationships. Machine annotation achieved a precision of 87%, recall of 79%, and F-score of 82%. Conclusion: The results indicated that our pipeline was able to produce a comprehensive content-based knowledge model that could represent context from various sources in the same domain

Semantic reclassification of the UMLS concepts

Summary: Accurate semantic classification is valuable for text mining and knowledge-based tasks that perform inference based on semantic classes. To benefit applications using the semantic classification of the Unified Medical Language System (UMLS) concepts, we automatically reclassified the concepts based on their lexical and contextual features. The new classification is useful for auditing the original UMLS semantic classification and for building biomedical text mining applications

Abstraction, extension and structural auditing with the UMLS semantic network

The Unified Medical Language System (UMLS) is a two-level biomedical terminological knowledge base, consisting of the Metathesaurus (META) and the Semantic Network (SN), which is an upper-level ontology of broad categories called semantic types (STs). The two levels are related via assignments of one or more STs to each concept of the META. Although the SN provides a high-level abstraction for the META, it is not compact enough. Various metaschemas, which are compact higher-level abstraction networks of the SN, have been derived. A methodology is presented to evaluate and compare two given metaschemas, based on their structural properties. A consolidation algorithm is designed to yield a consolidated metaschema maintaining the best and avoiding the worst of the two given metaschemas. The methodology and consolidation algorithm were applied to the pair of heuristic metaschemas, the top-down metaschema and the bottom-up metaschema, which have been derived from two studies involving two groups of UMLS experts. The results show that the consolidated metaschema has better structural properties than either of the two input metaschemas. Better structural properties are expected to lead to better utilization of a metaschema in orientation and visualization of the SN. Repetitive consolidation, which leads to further structural improvements, is also shown. The META and SN were created in the absence of a comprehensive curated genomics terminology. The internal consistency of the SN\u27s categories which are relevant to genomics is evaluated and changes to improve its ability to express genomic knowledge are proposed. The completeness of the SN with respect to genomic concepts is evaluated and conesponding extensions to the SN to fill identified gaps are proposed. Due to the size and complexity of the UMLS, errors are inevitable. A group auditing methodolgy is presented, where the ST assignments for groups of similar concepts are audited. The extent of an ST, which is the group of all concepts assigned this ST, is divided into groups of concepts that have been assigned exactly the same set of STs. An algorithm finds subgroups of suspicious concepts. The auditor is presented with these subgroups, which purportedly exhibit the same semantics, and thus he will notice different concepts with wrong or missing ST assignments. Another methodology partitions these groups into smaller, singly rooted, hierarchically organized sets used to audit the hierarchical relationships. The algorithmic methodologies are compared with a comprehensive manual audit and show a very high error recall with a much higher precision than the manual exhaustive review

A lightweight, pattern-based approach to identification and formalisation of TimeML expressions in clinical narratives

General Architecture for Text Engineering (GATE) components for identifying clinical events and temporal expressions are developed and evaluated against a corpus of 120 discharge summaries

Source authenticity in the UMLS – A case study of the Minimal Standard Terminology

AbstractAs the UMLS integrates multiple source vocabularies, the integration process requires that certain adaptation be applied to the source. Our interest is in examining the relationship between the UMLS representation of a source vocabulary and the source vocabulary itself. We investigated the integration of the Minimal Standard Terminology (MST) into the UMLS in order to examine how close its UMLS representation is to the source MST. The MST was conceived as a “minimal” list of terms and structure intended for use within computer systems to facilitate standardized reporting of gastrointestinal endoscopic examinations. Although the MST has an overall schema and implied relationship structure, many of the UMLS integrated MST terms were found to be hierarchically orphaned, and with lateral relationships that do not closely adhere to the source MST. Thus, the MST representation within the UMLS significantly differs from that of the source MST. These representation discrepancies may affect the usability of the MST representation in the UMLS for knowledge acquisition. Furthermore, they pose a problem from the perspective of application developers. While these findings may not necessarily apply to other source terminologies, they highlight the conflict between preservation of authentic concept orientation and the UMLS overall desire to provide fully specified names for all source terms

The cohesive metaschema: a higher-level abstraction of the UMLS Semantic Network

AbstractThe Unified Medical Language System (UMLS) joins together a group of established medical terminologies in a unified knowledge representation framework. Two major resources of the UMLS are its Metathesaurus, containing a large number of concepts, and the Semantic Network (SN), containing semantic types and forming an abstraction of the Metathesaurus. However, the SN itself is large and complex and may still be difficult to view and comprehend. Our structural partitioning technique partitions the SN into structurally uniform sets of semantic types based on the distribution of the relationships within the SN. An enhancement of the structural partition results in cohesive, singly rooted sets of semantic types. Each such set is named after its root which represents the common nature of the group. These sets of semantic types are represented by higher-level components called meta-semantic types. A network, called a metaschema, which consists of the meta-semantic types connected by hierarchical and semantic relationships is obtained and provides an abstract view supporting orientation to the SN. The metaschema is utilized to audit the UMLS classifications. We present a set of graphical views of the SN based on the metaschema to help in user orientation to the SN. A study compares the cohesive metaschema to metaschemas derived semantically by UMLS experts

Doctor of Philosophy

dissertationBiomedical data are a rich source of information and knowledge. Not only are they useful for direct patient care, but they may also offer answers to important population-based questions. Creating an environment where advanced analytics can be performed against biomedical data is nontrivial, however. Biomedical data are currently scattered across multiple systems with heterogeneous data, and integrating these data is a bigger task than humans can realistically do by hand; therefore, automatic biomedical data integration is highly desirable but has never been fully achieved. This dissertation introduces new algorithms that were devised to support automatic and semiautomatic integration of heterogeneous biomedical data. The new algorithms incorporate both data mining and biomedical informatics techniques to create "concept bags" that are used to compute similarity between data elements in the same way that "word bags" are compared in data mining. Concept bags are composed of controlled medical vocabulary concept codes that are extracted from text using named-entity recognition software. To test the new algorithm, three biomedical text similarity use cases were examined: automatically aligning data elements between heterogeneous data sets, determining degrees of similarity between medical terms using a published benchmark, and determining similarity between ICU discharge summaries. The method is highly configurable and 5 different versions were tested. The concept bag method performed particularly well aligning data elements and outperformed the compared algorithms by iv more than 5%. Another configuration that included hierarchical semantics performed particularly well at matching medical terms, meeting or exceeding 30 of 31 other published results using the same benchmark. Results for the third scenario of computing ICU discharge summary similarity were less successful. Correlations between multiple methods were low, including between terminologists. The concept bag algorithms performed consistently and comparatively well and appear to be viable options for multiple scenarios. New applications of the method and ideas for improving the algorithm are being discussed for future work, including several performance enhancements, configuration-based enhancements, and concept vector weighting using the TF-IDF formulas

A comparison of machine learning techniques for detection of drug target articles

Important progress in treating diseases has been possible thanks to the identification of drug targets. Drug targets are the molecular structures whose abnormal activity, associated to a disease, can be modified by drugs, improving the health of patients. Pharmaceutical industry needs to give priority to their identification and validation in order to reduce the long and costly drug development times. In the last two decades, our knowledge about drugs, their mechanisms of action and drug targets has rapidly increased. Nevertheless, most of this knowledge is hidden in millions of medical articles and textbooks. Extracting knowledge from this large amount of unstructured information is a laborious job, even for human experts. Drug target articles identification, a crucial first step toward the automatic extraction of information from texts, constitutes the aim of this paper. A comparison of several machine learning techniques has been performed in order to obtain a satisfactory classifier for detecting drug target articles using semantic information from biomedical resources such as the Unified Medical Language System. The best result has been achieved by a Fuzzy Lattice Reasoning classifier, which reaches 98% of ROC area measure.This research paper is supported by Projects TIN2007-67407- C03-01, S-0505/TIC-0267 and MICINN project TEXT-ENTERPRISE 2.0 TIN2009-13391-C04-03 (Plan I + D + i), as well as for the Juan de la Cierva program of the MICINN of SpainPublicad

Profiling risk factors for chronic uveitis in juvenile idiopathic arthritis: a new model for EHR-based research.

BackgroundJuvenile idiopathic arthritis is the most common rheumatic disease in children. Chronic uveitis is a common and serious comorbid condition of juvenile idiopathic arthritis, with insidious presentation and potential to cause blindness. Knowledge of clinical associations will improve risk stratification. Based on clinical observation, we hypothesized that allergic conditions are associated with chronic uveitis in juvenile idiopathic arthritis patients.MethodsThis study is a retrospective cohort study using Stanford's clinical data warehouse containing data from Lucile Packard Children's Hospital from 2000-2011 to analyze patient characteristics associated with chronic uveitis in a large juvenile idiopathic arthritis cohort. Clinical notes in patients under 16 years of age were processed via a validated text analytics pipeline. Bivariate-associated variables were used in a multivariate logistic regression adjusted for age, gender, and race. Previously reported associations were evaluated to validate our methods. The main outcome measure was presence of terms indicating allergy or allergy medications use overrepresented in juvenile idiopathic arthritis patients with chronic uveitis. Residual text features were then used in unsupervised hierarchical clustering to compare clinical text similarity between patients with and without uveitis.ResultsPreviously reported associations with uveitis in juvenile idiopathic arthritis patients (earlier age at arthritis diagnosis, oligoarticular-onset disease, antinuclear antibody status, history of psoriasis) were reproduced in our study. Use of allergy medications and terms describing allergic conditions were independently associated with chronic uveitis. The association with allergy drugs when adjusted for known associations remained significant (OR 2.54, 95% CI 1.22-5.4).ConclusionsThis study shows the potential of using a validated text analytics pipeline on clinical data warehouses to examine practice-based evidence for evaluating hypotheses formed during patient care. Our study reproduces four known associations with uveitis development in juvenile idiopathic arthritis patients, and reports a new association between allergic conditions and chronic uveitis in juvenile idiopathic arthritis patients