Knowledge-based best of breed approach for automated detection of clinical events based on German free text digital hospital discharge letters

OBJECTIVES: The secondary use of medical data contained in electronic medical records, such as hospital discharge letters, is a valuable resource for the improvement of clinical care (e.g. in terms of medication safety) or for research purposes. However, the automated processing and analysis of medical free text still poses a huge challenge to available natural language processing (NLP) systems. The aim of this study was to implement a knowledge-based best of breed approach, combining a terminology server with integrated ontology, a NLP pipeline and a rules engine. METHODS: We tested the performance of this approach in a use case. The clinical event of interest was the particular drug-disease interaction "proton-pump inhibitor [PPI] use and osteoporosis". Cases were to be identified based on free text digital discharge letters as source of information. Automated detection was validated against a gold standard. RESULTS: Precision of recognition of osteoporosis was 94.19%, and recall was 97.45%. PPIs were detected with 100% precision and 97.97% recall. The F-score for the detection of the given drug-disease-interaction was 96,13%. CONCLUSION: We could show that our approach of combining a NLP pipeline, a terminology server, and a rules engine for the purpose of automated detection of clinical events such as drug-disease interactions from free text digital hospital discharge letters was effective. There is huge potential for the implementation in clinical and research contexts, as this approach enables analyses of very high numbers of medical free text documents within a short time period

Can we ID from CCTV? Image quality in digital CCTV and face identification performance

CCTV is used for an increasing number Of purposes, and the new generation of digital systems can be tailored to serve a wide range of security requirements. However, configuration decisions are often made without considering specific task requirements, e.g. the video quality needed for reliable person identification. Our Study investigated the relationship between video quality and the ability of untrained viewers to identify faces from digital CCTV images. The task required 80 participants to identify 64 faces belonging to 4 different ethnicities. Participants compared face images taken from a high quality photographs and low quality CCTV stills, which were recorded at 4 different video quality bit rates (32, 52, 72 and 92 Kbps). We found that the number of correct identifications decreased by 12 (similar to 18%) as MPEG-4 quality decreased from 92 to 32 Kbps, and by 4 (similar to 6%) as Wavelet video quality decreased from 92 to 32 Kbps. To achieve reliable and effective face identification, we recommend that MPEG-4 CCTV systems should be used over Wavelet, and video quality should not be lowered below 52 Kbps during video compression. We discuss the practical implications of these results for security, and contribute a contextual methodology for assessing CCTV video quality

A multi-data source surveillance system to detect a bioterrorism attack during the G8 summit in Scotland

In 18 weeks, Health Protection Scotland (HPS) deployed a syndromic surveillance system to early-detect natural or intentional disease outbreaks during the G8 Summit 2005 at Gleneagles, Scotland. The system integrated clinical and non-clinical datasets. Clinical datasets included Accident and Emergency (A and E) syndromes, and General Practice (GPs) codes grouped into syndromes. Non-clinical data included telephone calls to a nurse helpline, laboratory test orders, and hotel staff absenteeism. A cumulative sum-based detection algorithm and a log-linear regression model identified signals in the data. The system had a fax-based track for real-time identification of unusual presentations. Ninety-five signals were triggered by the detection algorithms and four forms were faxed to HPS. Thirteen signals were investigated. The system successfully complemented a traditional surveillance system in identifying a small cluster of gastroenteritis among the police force and triggered interventions to prevent further cases