Information from Searching Content with an Ontology-Utilizing Toolkit (iSCOUT)

Radiology reports are permanent legal documents that serve as official interpretation of imaging tests. Manual analysis of textual information contained in these reports requires significant time and effort. This study describes the development and initial evaluation of a toolkit that enables automated identification of relevant information from within these largely unstructured text reports. We developed and made publicly available a natural language processing toolkit, Information from Searching Content with an Ontology-Utilizing Toolkit (iSCOUT). Core functions are included in the following modules: the Data Loader, Header Extractor, Terminology Interface, Reviewer, and Analyzer. The toolkit enables search for specific terms and retrieval of (radiology) reports containing exact term matches as well as similar or synonymous term matches within the text of the report. The Terminology Interface is the main component of the toolkit. It allows query expansion based on synonyms from a controlled terminology (e.g., RadLex or National Cancer Institute Thesaurus [NCIT]). We evaluated iSCOUT document retrieval of radiology reports that contained liver cysts, and compared precision and recall with and without using NCIT synonyms for query expansion. iSCOUT retrieved radiology reports with documented liver cysts with a precision of 0.92 and recall of 0.96, utilizing NCIT. This recall (i.e., utilizing the Terminology Interface) is significantly better than using each of two search terms alone (0.72, p = 0.03 for liver cyst and 0.52, p = 0.0002 for hepatic cyst). iSCOUT reliably assembled relevant radiology reports for a cohort of patients with liver cysts with significant improvement in document retrieval when utilizing controlled lexicons.

[1]  Guergana K. Savova,et al.  Discerning Tumor Status from Unstructured MRI Reports—Completeness of Information in Existing Reports and Utility of Automated Natural Language Processing , 2009, Journal of Digital Imaging.

[2]  P. Loy International Classification of Diseases--9th revision. , 1978, Medical record and health care information journal.

[3]  Peter J. Haug,et al.  Natural language processing to extract medical problems from electronic clinical documents: Performance evaluation , 2006, J. Biomed. Informatics.

[4]  Wendy W. Chapman,et al.  A Simple Algorithm for Identifying Negated Findings and Diseases in Discharge Summaries , 2001, J. Biomed. Informatics.

[5]  R A Côté,et al.  [Progress in medical information management. Systematized nomenclature of medicine (SNOMED)]. , 1980, L'union medicale du Canada.

[6]  Scott T. Weiss,et al.  Extracting principal diagnosis, co-morbidity and smoking status for asthma research: evaluation of a natural language processing system , 2006, BMC Medical Informatics Decis. Mak..

[7]  L A Lenert,et al.  Monitoring free-text data using medical language processing. , 1993, Computers and biomedical research, an international journal.

[8]  S. Soderland,et al.  Automatic structuring of radiology free-text reports. , 2001, Radiographics : a review publication of the Radiological Society of North America, Inc.

[9]  Katherine P Andriole,et al.  Implementing a replacement PACS: issues to consider. , 2007, Journal of the American College of Radiology : JACR.

[10]  D. M. Titterington,et al.  [Neural Networks: A Review from Statistical Perspective]: Rejoinder , 1994 .

[11]  Daniel I Rosenthal,et al.  Automated computer-assisted categorization of radiology reports. , 2005, AJR. American journal of roentgenology.

[12]  James H Thrall,et al.  Application of Recently Developed Computer Algorithm for Automatic Classification of Unstructured Radiology Reports: Validation Study 1 , 2004 .

[13]  Ramin Khorasani,et al.  Leveraging terminologies for retrieval of radiology reports with critical imaging findings. , 2011, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[14]  Shuying Shen,et al.  2010 i2b2/VA challenge on concepts, assertions, and relations in clinical text , 2011, J. Am. Medical Informatics Assoc..

[15]  Peter J. Haug,et al.  Comparing Natural Language Processing Tools to Extract Medical Problems from Narrative Text , 2005, AMIA.

[16]  Peter J. Haug,et al.  Automatic extraction of PIOPED interpretations from ventilation/perfusion lung scan reports , 1998, AMIA.

[17]  Timothy B. Patrick,et al.  Comparing frequency of word occurrences in abstracts and texts using two stop word lists , 2001, AMIA.

[18]  C. Langlotz RadLex: a new method for indexing online educational materials. , 2006, Radiographics : a review publication of the Radiological Society of North America, Inc.

[19]  R. Khorasani,et al.  Critical finding capture in the impression section of radiology reports. , 2011, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[20]  Carol Friedman,et al.  Research Paper: A General Natural-language Text Processor for Clinical Radiology , 1994, J. Am. Medical Informatics Assoc..

[21]  Julius Cuong Pham,et al.  Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998-2007. , 2010, JAMA.

[22]  Mark S. Tuttle,et al.  NCI Thesaurus: Using Science-Based Terminology to Integrate Cancer Research Results , 2004, MedInfo.

[23]  William R. Hersh,et al.  Evaluation of biomedical text-mining systems: Lessons learned from information retrieval , 2005, Briefings Bioinform..

[24]  D. Lindberg,et al.  Unified Medical Language System , 2020, Definitions.

[25]  Clement J. McDonald,et al.  Automated Extraction and Normalization of Findings from Cancer-Related Free-Text Radiology Reports , 2003, AMIA.

[26]  S. Mani,et al.  Extracting and integrating data from entire electronic health records for detecting colorectal cancer cases. , 2011, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[27]  Jesse M. Pines,et al.  Trends in the Rates of Radiography Use and Important Diagnoses in Emergency Department Patients With Abdominal Pain , 2009, Medical care.

[28]  D. M. Titterington,et al.  Neural Networks: A Review from a Statistical Perspective , 1994 .

[29]  F B ROGERS,et al.  Medical Subject Headings , 1948, Nature.

[30]  Lucila Ohno-Machado,et al.  Natural language processing: an introduction , 2011, J. Am. Medical Informatics Assoc..

[31]  Christopher G Chute,et al.  Discovering peripheral arterial disease cases from radiology notes using natural language processing. , 2010, AMIA ... Annual Symposium proceedings. AMIA Symposium.