1,441 research outputs found
Towards a New Science of a Clinical Data Intelligence
In this paper we define Clinical Data Intelligence as the analysis of data
generated in the clinical routine with the goal of improving patient care. We
define a science of a Clinical Data Intelligence as a data analysis that
permits the derivation of scientific, i.e., generalizable and reliable results.
We argue that a science of a Clinical Data Intelligence is sensible in the
context of a Big Data analysis, i.e., with data from many patients and with
complete patient information. We discuss that Clinical Data Intelligence
requires the joint efforts of knowledge engineering, information extraction
(from textual and other unstructured data), and statistics and statistical
machine learning. We describe some of our main results as conjectures and
relate them to a recently funded research project involving two major German
university hospitals.Comment: NIPS 2013 Workshop: Machine Learning for Clinical Data Analysis and
Healthcare, 201
J Biomed Inform
We followed a systematic approach based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify existing clinical natural language processing (NLP) systems that generate structured information from unstructured free text. Seven literature databases were searched with a query combining the concepts of natural language processing and structured data capture. Two reviewers screened all records for relevance during two screening phases, and information about clinical NLP systems was collected from the final set of papers. A total of 7149 records (after removing duplicates) were retrieved and screened, and 86 were determined to fit the review criteria. These papers contained information about 71 different clinical NLP systems, which were then analyzed. The NLP systems address a wide variety of important clinical and research tasks. Certain tasks are well addressed by the existing systems, while others remain as open challenges that only a small number of systems attempt, such as extraction of temporal information or normalization of concepts to standard terminologies. This review has identified many NLP systems capable of processing clinical free text and generating structured output, and the information collected and evaluated here will be important for prioritizing development of new approaches for clinical NLP.CC999999/ImCDC/Intramural CDC HHS/United States2019-11-20T00:00:00Z28729030PMC6864736694
A Health eLearning Ontology and Procedural Reasoning Approach for Developing Personalized Courses to Teach Patients about Their Medical Condition and Treatment
We propose a methodological framework to support the development of personalized courses that improve patientsâ understanding of their condition and prescribed treatment. Inspired by Intelligent Tutoring Systems (ITSs), the framework uses an eLearning ontology to express domain and learner models and to create a course. We combine the ontology with a procedural reasoning approach and precompiled plans to operationalize a design across disease conditions. The resulting courses generated by the framework are personalized across four patient axesâcondition and treatment, comprehension level, learning style based on the VARK (Visual, Aural, Read/write, Kinesthetic) presentation model, and the level of understanding of specific course content according to Bloomâs taxonomy. Customizing educational materials along these learning axes stimulates and sustains patientsâ attention when learning about their conditions or treatment options. Our proposed framework creates a personalized course that prepares patients for their meetings with specialists and educates them about their prescribed treatment. We posit that the improvement in patientsâ understanding of prescribed care will result in better outcomes and we validate that the constructs of our framework are appropriate for representing content and deriving personalized courses for two use cases: anticoagulation treatment of an atrial fibrillation patient and lower back pain management to treat a lumbar degenerative disc condition. We conduct a mostly qualitative study supported by a quantitative questionnaire to investigate the acceptability of the framework among the target patient population and medical practitioners
Front-Line Physicians' Satisfaction with Information Systems in Hospitals
Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe
Building realistic potential patient queries for medical information retrieval evaluation
To evaluate and improve medical information retrieval, benchmarking data sets need to be created. Few benchmarks have been focusing on patientsâ information needs. There is a need for additional benchmarks to enable research into effective retrieval methods. In this paper we describe the manual creation of patient queries and investigate their automatic generation. This work is conducted in the framework of a medical evaluation campaign, which aims to evaluate and improve technologies to help patients and laypeople access eHealth data. To this end, the campaign is composed of different tasks, including a medical information retrieval (IR) task. Within this IR task, a web crawl of medically related documents, as well as patient queries are provided to participants. The queries are built to represent the potential information needs patients may have while reading their medical report. We start by describing typical types of patientsâ information needs. We then describe how these queries have been manually generated from medical reports for the first two years of the eHealth campaign. We then explore techniques that would enable us to automate the query generation process. This
process is particularly challenging, as it requires an understanding of the patientsâ information needs, and of the electronic health records. We describe various approaches to automatically generate potential patient queries from medical reports and describe our future
development and evaluation phase
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A modular, open-source information extraction framework for identifying clinical concepts and processes of care in clinical narratives
In this thesis, a synthesis is presented of the knowledge models required by clinical informa- tion systems that provide decision support for longitudinal processes of care. Qualitative research techniques and thematic analysis are novelly applied to a systematic review of the literature on the challenges in implementing such systems, leading to the development of an original conceptual framework. The thesis demonstrates how these process-oriented systems make use of a knowledge base derived from workflow models and clinical guidelines, and argues that one of the major barriers to implementation is the need to extract explicit and implicit information from diverse resources in order to construct the knowledge base. Moreover, concepts in both the knowledge base and in the electronic health record (EHR) must be mapped to a common ontological model. However, the majority of clinical guideline information remains in text form, and much of the useful clinical information residing in the EHR resides in the free text fields of progress notes and laboratory reports. In this thesis, it is shown how natural language processing and information extraction techniques provide a means to identify and formalise the knowledge components required by the knowledge base. Original contributions are made in the development of lexico-syntactic patterns and the use of external domain knowledge resources to tackle a variety of information extraction tasks in the clinical domain, such as recognition of clinical concepts, events, temporal relations, term disambiguation and abbreviation expansion. Methods are developed for adapting existing tools and resources in the biomedical domain to the processing of clinical texts, and approaches to improving the scalability of these tools are proposed and evalu- ated. These tools and techniques are then combined in the creation of a novel approach to identifying processes of care in the clinical narrative. It is demonstrated that resolution of coreferential and anaphoric relations as narratively and temporally ordered chains provides a means to extract linked narrative events and processes of care from clinical notes. Coreference performance in discharge summaries and progress notes is largely dependent on correct identification of protagonist chains (patient, clinician, family relation), pronominal resolution, and string matching that takes account of experiencer, temporal, spatial, and anatomical context; whereas for laboratory reports additional, external domain knowledge is required. The types of external knowledge and their effects on system performance are identified and evaluated. Results are compared against existing systems for solving these tasks and are found to improve on them, or to approach the performance of recently reported, state-of-the- art systems. Software artefacts developed in this research have been made available as open-source components within the General Architecture for Text Engineering framework
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