Modeling electronic discharge summaries as a simple temporal constraint satisfaction problem. Academic Article uri icon

Overview

MeSH

  • Algorithms
  • Humans
  • Models, Theoretical
  • Time

MeSH Major

  • Medical Records Systems, Computerized
  • Patient Discharge

abstract

  • To model the temporal information contained in medical narrative reports as a simple temporal constraint satisfaction problem. A constraint satisfaction problem is defined by time points and constraints (inequalities between points). A time interval comprises a pair of points and a constraint. Five complete electronic discharge summaries and paragraphs from 226 other discharge summaries were studied. Medical events were represented as intervals, and assertions about events were represented as constraints. Through a consensus process, a set of encoding procedures and a list of issues related to encoding were generated. Instances of temporal disjunction and contradiction and distribution of temporal constraints were used. An average of 95 medical events (range, 46-151) and 234 temporal assertions (range, 118-388) were identified per complete discharge summary. Nondefinitional assertions were explicit (36%) or implicit (64%) and absolute (17%), qualitative (72%), or metric (11%). Implicit assertions were based on domain knowledge and assumptions, e.g., the section of the report determined the ordering of events. Issues included linking events, intermittence, periodicity, granularity, vagueness, ambiguity, uncertainty, and plans. ions such as intermittence were not represented explicitly. The temporal network was sparse: Only 0.80% (range, 0.42%-1.38%) of possible constraints were instantiated. No instances of discontinuous temporal disjunction were found in the complete summaries or the 226 paragraphs. One instance of temporal contradiction was found (intrareport rate of 0.2 with a 95% confidence interval of 0.005-1.114). A simple temporal constraint satisfaction problem appears sufficient to represent most temporal assertions in discharge summaries and may be useful for encoding electronic medical records.

publication date

  • January 2005
  • February 2005

has subject area

  • Algorithms
  • Humans
  • Medical Records Systems, Computerized
  • Models, Theoretical
  • Patient Discharge
  • Time

Research

keywords

  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC543827

Digital Object Identifier (DOI)

  • 10.1197/jamia.M1623

PubMed ID

  • 15492038

Additional Document Info

start page

  • 55

end page

  • 63

volume

  • 12

number

  • 1