Skip to main content
PMC home page
Journal of the American Medical Informatics Association : JAMIA logoLink to Journal of the American Medical Informatics Association : JAMIA
. 1994 Mar-Apr;1(2):142–160. doi: 10.1136/jamia.1994.95236145

Natural language processing and the representation of clinical data.

N Sager 1, M Lyman 1, C Bucknall 1, N Nhan 1, L J Tick 1
PMCID: PMC116193  PMID: 7719796

Abstract

OBJECTIVE: Develop a representation of clinical observations and actions and a method of processing free-text patient documents to facilitate applications such as quality assurance. DESIGN: The Linguistic String Project (LSP) system of New York University utilizes syntactic analysis, augmented by a sublanguage grammar and an information structure that are specific to the clinical narrative, to map free-text documents into a database for querying. MEASUREMENTS: Information precision (I-P) and information recall (I-R) were measured for queries for the presence of 13 asthma-health-care quality assurance criteria in a database generated from 59 discharge letters. RESULTS: I-P, using counts of major errors only, was 95.7% for the 28-letter training set and 98.6% for the 31-letter test set. I-R, using counts of major omissions only, was 93.9% for the training set and 92.5% for the test set.

Full Text

The Full Text of this article is available as a PDF (2.0 MB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barnett G. O., Cimino J. J., Hupp J. A., Hoffer E. P. DXplain. An evolving diagnostic decision-support system. JAMA. 1987 Jul 3;258(1):67–74. doi: 10.1001/jama.258.1.67. [DOI] [PubMed] [Google Scholar]
  2. Baud R. H., Rassinoux A. M., Scherrer J. R. Natural language processing and semantical representation of medical texts. Methods Inf Med. 1992 Jun;31(2):117–125. [PubMed] [Google Scholar]
  3. Borst F., Lyman M., Nhàn N. T., Tick L. J., Sager N., Scherrer J. R. TEXTINFO: a tool for automatic determination of patient clinical profiles using text analysis. Proc Annu Symp Comput Appl Med Care. 1991:63–67. [PMC free article] [PubMed] [Google Scholar]
  4. Bucknall C. E., Robertson C., Moran F., Stevenson R. D. Differences in hospital asthma management. Lancet. 1988 Apr 2;1(8588):748–750. doi: 10.1016/s0140-6736(88)91549-8. [DOI] [PubMed] [Google Scholar]
  5. Bucknall C. E., Robertson C., Moran F., Stevenson R. D. Management of asthma in hospital: a prospective audit. Br Med J (Clin Res Ed) 1988 Jun 11;296(6637):1637–1639. doi: 10.1136/bmj.296.6637.1637. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Campbell K. E., Musen M. A. Representation of clinical data using SNOMED III and conceptual graphs. Proc Annu Symp Comput Appl Med Care. 1992:354–358. [PMC free article] [PubMed] [Google Scholar]
  7. Chute C. G., Yang Y., Evans D. A. Latent Semantic Indexing of medical diagnoses using UMLS semantic structures. Proc Annu Symp Comput Appl Med Care. 1991:185–189. [PMC free article] [PubMed] [Google Scholar]
  8. Cimino J. J. Representation of clinical laboratory terminology in the Unified Medical Language System. Proc Annu Symp Comput Appl Med Care. 1991:199–203. [PMC free article] [PubMed] [Google Scholar]
  9. Dunham G. S., Pacak M. G., Pratt A. W. Automatic indexing of pathology data. J Am Soc Inf Sci. 1978 Mar;29(2):81–90. doi: 10.1002/asi.4630290207. [DOI] [PubMed] [Google Scholar]
  10. Evans D. A., Rothwell D. J., Monarch I. A., Lefferts R. G., Cote R. A. Toward representations for medical concepts. Med Decis Making. 1991 Oct-Dec;11(4 Suppl):S102–S108. [PubMed] [Google Scholar]
  11. Gabrieli E. R. Computer-assisted assessment of patient care in the hospital. J Med Syst. 1988 Jun;12(3):135–146. doi: 10.1007/BF00996636. [DOI] [PubMed] [Google Scholar]
  12. Gabrieli E. R. Computerizing text from office records. MD Comput. 1987 May-Jun;4(3):44-9, 56. [PubMed] [Google Scholar]
  13. Hirschman L., Story G., Marsh E., Lyman M., Sager N. An experiment in automated health care evaluation from narrative medical records. Comput Biomed Res. 1981 Oct;14(5):447–463. doi: 10.1016/0010-4809(81)90021-5. [DOI] [PubMed] [Google Scholar]
  14. Lin R., Lenert L., Middleton B., Shiffman S. A free-text processing system to capture physical findings: Canonical Phrase Identification System (CAPIS). Proc Annu Symp Comput Appl Med Care. 1991:843–847. [PMC free article] [PubMed] [Google Scholar]
  15. Masarie F. E., Jr, Miller R. A., Bouhaddou O., Giuse N. B., Warner H. R. An interlingua for electronic interchange of medical information: using frames to map between clinical vocabularies. Comput Biomed Res. 1991 Aug;24(4):379–400. doi: 10.1016/0010-4809(91)90035-u. [DOI] [PubMed] [Google Scholar]
  16. McCray A. T. Extending a natural language parser with UMLS knowledge. Proc Annu Symp Comput Appl Med Care. 1991:194–198. [PMC free article] [PubMed] [Google Scholar]
  17. Miller R. A., Pople H. E., Jr, Myers J. D. Internist-1, an experimental computer-based diagnostic consultant for general internal medicine. N Engl J Med. 1982 Aug 19;307(8):468–476. doi: 10.1056/NEJM198208193070803. [DOI] [PubMed] [Google Scholar]
  18. Miller R., Masarie F. E., Myers J. D. Quick medical reference (QMR) for diagnostic assistance. MD Comput. 1986 Sep-Oct;3(5):34–48. [PubMed] [Google Scholar]
  19. Musen M. A. Dimensions of knowledge sharing and reuse. Comput Biomed Res. 1992 Oct;25(5):435–467. doi: 10.1016/0010-4809(92)90003-s. [DOI] [PubMed] [Google Scholar]
  24. Sager N., Lyman M. Computerized language processing: implications for health care evaluation. Med Rec News. 1978 Jun;49(3):20-1, 23-4, 26-8 passim. [PubMed] [Google Scholar]
  25. Sager N., Wong R. Developing a database from free-text clinical data. J Clin Comput. 1983;11(5-6):184–194. [PubMed] [Google Scholar]
  26. Vries J. K., Marshalek B., D'Abarno J. C., Yount R. J., Dunner L. L. An automated indexing system utilizing semantic net expansion. Comput Biomed Res. 1992 Apr;25(2):153–167. doi: 10.1016/0010-4809(92)90018-6. [DOI] [PubMed] [Google Scholar]
  27. Wolff S. The use of morphosemantic regularities in the medical vocabulary for automatic lexical coding. Methods Inf Med. 1984 Oct;23(4):195–203. [PubMed] [Google Scholar]
  28. Zingmond D., Lenert L. A. Monitoring free-text data using medical language processing. Comput Biomed Res. 1993 Oct;26(5):467–481. doi: 10.1006/cbmr.1993.1033. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the American Medical Informatics Association are provided here courtesy of Oxford University Press

RESOURCES