Characteristics of Finnish and Swedish intensive care nursing narratives: a comparative analysis to support the development of clinical language technologies

BackgroundFree text is helpful for entering information into electronic health records, but reusing it is a challenge. The need for language technology for processing Finnish and Swedish healthcare text is therefore evident; however, Finnish and Swedish are linguistically very dissimilar. In this paper we present a comparison of characteristics in Finnish and Swedish free-text nursing narratives from intensive care. This creates a framework for characterising and comparing clinical text and lays the groundwork for developing clinical language technologies.MethodsOur material included daily nursing narratives from one intensive care unit in Finland and one in Sweden. Inclusion criteria for patients were an inpatient period of least five days and an age of at least 16 years. We performed a comparative analysis as part of a collaborative effort between Finnish- and Swedish-speaking healthcare and language technology professionals that included both qualitative and quantitative aspects. The qualitative analysis addressed the content and structure of three average-sized health records from each country. In the quantitative analysis 514 Finnish and 379 Swedish health records were studied using various language technology tools.ResultsAlthough the two languages are not closely related, nursing narratives in Finland and Sweden had many properties in common. Both made use of specialised jargon and their content was very similar. However, many of these characteristics were challenging regarding development of language technology to support producing and using clinical documentation.ConclusionsThe way Finnish and Swedish intensive care nursing was documented, was not country or language dependent, but shared a common context, principles and structural features and even similar vocabulary elements. Technology solutions are therefore likely to be applicable to a wider range of natural languages, but they need linguistic tailoring.AvailabilityThe Finnish and Swedish data can be found at: http://www.dsv.su.se/hexanord/data/.

[1]  P. Frank,et al.  Boston Studies in the Philosophy of Science , 1968 .

[2]  Klaus Krippendorff,et al.  Content Analysis: An Introduction to Its Methodology , 1980 .

[3]  Z. Harris,et al.  Book Reviews: The Form of Information in Science: Analysis of an Immunology Sublanguage , 1989, CL.

[4]  Fred D. Davis Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology , 1989, MIS Q..

[5]  Douglas Biber,et al.  Using Register-Diversified Corpora for General Language Studies , 1993, Comput. Linguistics.

[6]  Matthew B. Miles,et al.  Qualitative Data Analysis: An Expanded Sourcebook , 1994 .

[7]  A. Ehrenberg,et al.  Nursing documentation in patient records: experience of the use of the VIPS model. , 1996, Journal of advanced nursing.

[8]  Dennis Reil Forum. , 1996, Environmental health perspectives.

[9]  A. Egol Guidelines for intensive care unit admission, discharge, and triage , 1999 .

[10]  Christian Lovis,et al.  Power of expression in the electronic patient record: structured data or narrative text? , 2000, Int. J. Medical Informatics.

[11]  Martin Gellerstam,et al.  The Bank of Swedish , 2000, LREC.

[12]  S. Salanterä,et al.  Developing an instrument to measure and describe clinical decision making in different nursing fields. , 2002, Journal of professional nursing : official journal of the American Association of Colleges of Nursing.

[13]  M. Haupt,et al.  Guidelines on critical care services and personnel: Recommendations based on a system of categorization of three levels of care* , 2003, Critical care medicine.

[14]  Ricky K. Taira,et al.  Automatic Section Segmentation of Medical Reports , 2003, AMIA.

[15]  Oili Karkkainen,et al.  Evaluation of patient records as part of developing a nursing care classification. , 2003, Journal of clinical nursing.

[16]  Ola Knutsson,et al.  A Robust Shallow Parser for Swedish , 2003 .

[17]  Hsiu-Fang Hsieh,et al.  Three Approaches to Qualitative Content Analysis , 2005, Qualitative health research.

[18]  R. Hellesø Information handling in the nursing discharge note. , 2006, Journal of clinical nursing.

[19]  Aree Cheevakasemsook,et al.  The study of nursing documentation complexities. , 2006, International journal of nursing practice.

[20]  Christopher G. Chute,et al.  Developing a corpus of clinical notes manually annotated for part-of-speech , 2006, Int. J. Medical Informatics.

[21]  Kaarina Tanttu,et al.  Nationally standardized electronic nursing documentation in Finland by the year 2007. , 2006, Studies in health technology and informatics.

[22]  Suzanne Bakken,et al.  Toward the Creation of an Ontology for Nursing Document Sections: Mapping Section Headings to the LOINC Semantic Model , 2006, AMIA.

[23]  Alla Keselman,et al.  Beyond Surface Characteristics: A New Health Text-Specific Readability Measurement , 2007, AMIA.

[24]  Jeremy Jancsary,et al.  Revealing the Structure of Medical Dictations with Conditional Random Fields , 2008, EMNLP.

[25]  Hanna Suominen Machine Learning and Clinical Text. Supporting Health Information Flow , 2009 .

[26]  H. Dalianis,et al.  The Stockholm EPR Corpus – Characteristics and Some Initial Findings , 2009 .

[27]  Kaija Saranto,et al.  Models, Standards and Structures of Nursing Documentation in European Countries , 2009, Nursing Informatics.

[28]  Hercules Dalianis Proceedings of the NAACL HLT 2010 Second Louhi Workshop on Text and Data Mining of Health Documents , 2010 .

[29]  Heljä Lundgrén-Laine,et al.  Characteristics and Analysis of Finnish and Swedish Clinical Intensive Care Nursing Narratives , 2010, Louhi@NAACL-HLT.