? ? Many NLP applications have been successfully developed to extract information from text. Most of the ? applications have focused on identifying individual clinical conditions in textual records, which is the first step in making the conditions available to computerized applications. However, identifying individual instances of clinical conditions is not sufficient for many medical informatics tasks - the context surrounding the condition is crucial for integrating the information within the text to determine the clinical state of a patient. We propose to perform in-depth studies on NLP issues requiring knowledge of the context of clinical conditions in clinical records. We will focus our research by using syndromic surveillance from emergency department (ED) reports as a case study. ? ? For this proposal, we will test the following hypothesis: An NLP system that indexes clinical concepts and integrates contextual information modifying the concepts can identify acute clinical conditions from ED reports as well as physicians can. ? ? We will identify clinical concepts necessary for surveillance of seven syndromes, including respiratory, ? gastrointestinal, neurological, rash, hemorrhagic, constitutional, and botulinic. To evaluate the hypothesis, we will perform the following specific aims: ? ? Aim 1. Perform in-depth, foundational studies on four NLP topics to gain a deeper understanding of the ? ? pertinent NLP research capabilities required for identification of acute clinical conditions from ED reports, including negation, uncertainty, temporal discrimination, and finding validation; ? ? Aim 2. Apply the knowledge learned from the foundational studies to develop and evaluate an automated application for ED reports that will determine the values for clinical variables relevant to identifying patients with any of seven syndromes. ? ? The research is innovative, because it will generate an in-depth study of multiple NLP topics crucial to ? understanding a patient's clinical state from textual records and will focus on contextual understanding and analysis. The research will be guided by linguistic principles, by the semantics and discourse structure of ED reports, and by the application area of biosurveillance. Because we will develop research methods and tools that are customized to a particular domain, we will constrain the research space, which will provide direction and enhance the chance for success. However, the methods and tools generated by this research should be extensible to other clinical report types and to other domain applications, because we will explicitly specify and study NLP concepts and relationships that are common to many application areas. ? ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Library of Medicine (NLM)
Type
Research Project (R01)
Project #
5R01LM009427-02
Application #
7469551
Study Section
Biomedical Library and Informatics Review Committee (BLR)
Program Officer
Sim, Hua-Chuan
Project Start
2007-07-16
Project End
2010-07-15
Budget Start
2008-07-16
Budget End
2009-07-15
Support Year
2
Fiscal Year
2008
Total Cost
$392,337
Indirect Cost
Name
University of Pittsburgh
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
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Conway, Mike; Dowling, John N; Chapman, Wendy W (2013) Using chief complaints for syndromic surveillance: a review of chief complaint based classifiers in North America. J Biomed Inform 46:734-43
Henriksson, Aron; Conway, Mike; Duneld, Martin et al. (2013) Identifying synonymy between SNOMED clinical terms of varying length using distributional analysis of electronic health records. AMIA Annu Symp Proc 2013:600-9
Mowery, Danielle; Wiebe, Janyce; Visweswaran, Shyam et al. (2012) Building an automated SOAP classifier for emergency department reports. J Biomed Inform 45:71-81
Harkema, Henk; Chapman, Wendy W; Saul, Melissa et al. (2011) Developing a natural language processing application for measuring the quality of colonoscopy procedures. J Am Med Inform Assoc 18 Suppl 1:i150-6
Piwowar, Heather A; Chapman, Wendy W (2010) Public sharing of research datasets: a pilot study of associations. J Informetr 4:148-156
Chapman, Wendy W; Dowling, John N; Baer, Atar et al. (2010) Developing syndrome definitions based on consensus and current use. J Am Med Inform Assoc 17:595-601
Harkema, Henk; Dowling, John N; Thornblade, Tyler et al. (2009) ConText: an algorithm for determining negation, experiencer, and temporal status from clinical reports. J Biomed Inform 42:839-51
Piwowar, Heather A; Chapman, Wendy W; Chapman, Wendy (2008) Identifying data sharing in biomedical literature. AMIA Annu Symp Proc :596-600
South, Brett R; South, Brett Ray; Chapman, Wendy W et al. (2008) Optimizing A syndromic surveillance text classifier for influenza-like illness: Does document source matter? AMIA Annu Symp Proc :692-6

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