Determining word sequence variation patterns in clinical documents using multiple sequence alignment.

Sentences and phrases that represent a certain meaning often exhibit patterns of variation where they differ from a basic structural form by one or two words. We present an algorithm that utilizes multiple sequence alignments (MSAs) to generate a representation of groups of phrases that possess the same semantic meaning but also share in common the same basic word sequence structure. The MSA enables the determination not only of the words that compose the basic word sequence, but also of the locations within the structure that exhibit variation. The algorithm can be utilized to generate patterns of text sequences that can be used as the basis for a pattern-based classifier, as a starting point to bootstrap the pattern building process for a regular expression-based classifiers, or serve to reveal the variation characteristics of sentences and phrases within a particular domain.

A methodology to integrate clinical data for the efficient assessment of brain-tumor patients.

Careful examination of the medical record of brain-tumor patients can be an overwhelming task for the neuroradiologist. The number of clinical documents alone may approach 100 for a patient that has a 3-year-old brain tumor. The neuroradiologist's evaluation of a patient's brain tumor involves examining the current imaging exam and checking for previous imaging exams that may occur pre- or post-treatment. The goal of this research is to develop an effective method to review all of the pertinent patient information from the medical record. We have designed and developed a medical system that incorporates Hospital Information Systems, Radiology Information Systems, and Picture Archiving and Communications Systems information. Our research improves clinical review of patient's data by organizing image display, removing unnecessary documents, and mining for key clinical scenarios that are important in the assessment and care of brain-tumor patients.

Workflow management of HIS/RIS textual documents with PACS image studies for neuroradiology.

Reviewing brain tumor patients' complete medical record is a daunting task for any clinician. In current practice, the radiologist examines the most recent documents and then dictates an assessment of the patient's condition based on a review of the most current imaging study and compared with the most recent previous image study. Occasionally, the radiologist searches other clinical documents when more precise detail is needed. The purpose of this research is to develop effective methods to review all of the pertinent information in a patient medical record incorporating HIS (Hospital Information Systems), RIS (Radiology Information Systems) and PACS (Picture Archiving and Communications Systems) information in three distinct ways: filtering the document worklist for pertinent clinical data, identification of key clusters of clinical information, and an automatic hanging protocol that displays the MR images for optimal image comparison.

DataServer: an infrastructure to support evidence-based radiology.

Following a requirements analysis for development of an information infrastructure supporting evidence-based radiology, the objective of this study was the development of a data gateway to support flexible access to the totality of a patient's electronic medical records through a single, uniform representation, regardless of the underlying data sources (eg, hospital information systems [HIS], radiology information systems [RIS], picture archiving and communication systems [PACS]). XML-based (eXtensible Markup Language) technologies were employed to create an application framework permitting querying of different clinical databases. The contents of different data sources were represented by using XML. On the basis of these representations, users can specify queries. The system transforms the XML queries into a query format understood by the specific databases, processes the query, and transforms the results back into an XML format. XML results can then be transformed in accordance to different data-formatting standards. Access to several different data sources, including HIS, RIS, and PACS, has been accomplished with this framework. The extensible nature of the XML data gateway enables data sources to be readily added. The framework also provides a means by which data can be systematically de-identified to protect patient confidentiality, thus supporting research endeavors.

Evaluation of layer decomposition for multiframe quantitative coronary angiography.

Multiframe quantitative coronary angiography is typically performed by averaging measurements of artery diameter over multiple frames. This approach reduces errors attributable to random noise but may not reduce systematic errors caused by background structures, nonlinear system response, and motion blur. We attempt to reduce these sources of error by decomposing the image sequence into moving layers, one of which includes the artery. We embed simulated arteries into clinical angiographic sequences so that the true vessel dimensions are known accurately. The measurement tasks are minimum diameter, geometric percent stenosis, and densitometric percent stenosis. We compare measurements for single and multiple raw images, single images with fixed mask subtraction, single and multiple images with layered background subtraction, and time-averaged layer images. We find that both multiframe averaging and layer decomposition significantly improve geometric and densitometric accuracy compared with single-frame measurements. The best results were obtained by averaging measurements from multiple frames of layered background-subtracted images.

Structured reporting in neuroradiology.

We have developed a system to structure free-text neuroradiology reports using a natural language processing program and formatted the output into the digital image and communication in medicine (DICOM) standard for structured reporting (SR). DICOM SR formats the correspondence of pertinent diagnostic images to the radiologist's dictated report of clinical findings. In addition, DICOM SR allows the information to be organized into a tree structure. Individual nodes of the tree can contain individual items or lists. Structuring the content of free-text information allows the creation of hierarchies with defined relationships between the concepts contained within the report.