The feasibility of using natural language processing to extract clinical information from breast pathology reports

Objective: The opportunity to integrate clinical decision support systems into clinical practice is limited due to the lack of structured, machine readable data in the current format of the electronic health record. Natural language processing has been designed to convert free text into machine readable data. The aim of the current study was to ascertain the feasibility of using natural language processing to extract clinical information from >76,000 breast pathology reports. Approach and Procedure: Breast pathology reports from three institutions were analyzed using natural language processing software (Clearforest, Waltham, MA) to extract information on a variety of pathologic diagnoses of interest. Data tables were created from the extracted information according to date of surgery, side of surgery, and medical record number. The variety of ways in which each diagnosis could be represented was recorded, as a means of demonstrating the complexity of machine interpretation of free text. Results: There was widespread variation in how pathologists reported common pathologic diagnoses. We report, for example, 124 ways of saying invasive ductal carcinoma and 95 ways of saying invasive lobular carcinoma. There were >4000 ways of saying invasive ductal carcinoma was not present. Natural language processor sensitivity and specificity were 99.1% and 96.5% when compared to expert human coders. Conclusion: We have demonstrated how a large body of free text medical information such as seen in breast pathology reports, can be converted to a machine readable format using natural language processing, and described the inherent complexities of the task

Emergence and Evolution of ATM Networks in the UK, 1967-2000

Research in this article traces the origins of a process of competitive change in British retail financial markets by looking at the emergence of cash dispensers technology, how it transformed into automated teller machines (ATMs) and how proprietary ATM networks gave way to total interoperability of cash withdrawals through a single common switch. Cash dispensers were an industry-specific innovation developed by British manufacturers (e.g. Chubb and De La Rue) which were, in turn, overtaken by US (e.g. NCR) and German (e.g. Siemens-Wincor) manufacturers. However, as the ATM became a global technology some of the leading providers (i.e. Burroughs, IBM and NCR) kept manufacturing and even their main design facilities in Scotland. The evolution of this technology illustrates changing boundaries of the banking organisation, the challenges faced by financial intermediaries to adopt on-line, real-time computing and highlights the role of network externalities in financial markets. From a business history perspective, the ATM, electronic funds transfer and other retail payment media have largely been neglected by British historians and management scholars. Yet the success of automated cash dispensers as a distribution channel in retail banking epitomises a shift in bank strategy, namely how applications of computer technology moved from being potential sources of competitive advantage to being a minimum requirement for effective competition in retail finance. This article thus promotes the idea that the history of technology must consider its users, their strategies and business models inasmuch as business histories of the late twentieth century will be incomplete without attention to developments in information and communications technologies

Defence contractors and diversification into the civil sector: Rolls-Royce, 1945-2005

A number of studies have shown that defence contractors have exhibited a marked reluctance to diversify away from defence and develop civil applications. However, the aero engine manufacturer Rolls-Royce is one defence contractor to which this does not apply. Over a 60-year period it has moved from being almost entirely dependent on defence work to a point where defence now constitutes barely one-fifth of its turnover. This article examines the development of the company's civil aerospace business over the period since 1945. It focuses specifically on the strategies used by Rolls-Royce in the civil aerospace field. These strategies are explored in the context of changes in market conditions, technology, and governance arrangements. The effectiveness of the various strategies, including their contribution to the company's current position, is evaluated.Aerospace Industry, Defence Diversification, Strategy, Technology, Gas Turbine, Rolls-Royce,