Abstract

BackgroundTraditionally text mention normalization corpora have normalized concepts to single ontology identifiers (“pre-coordinated concepts”). Less frequently, normalization corpora have used concepts with multiple identifiers (“post-coordinated concepts”) but the additional identifiers have been restricted to a defined set of relationships to the core concept. This approach limits the ability of the normalization process to express semantic meaning. We generated a freely available corpus using post-coordinated concepts without a defined set of relationships that we term “compositional concepts” to evaluate their use in clinical text.MethodsWe annotated 5397 disorder mentions from the ShARe corpus to SNOMED CT that were previously normalized as “CUI-less” in the “SemEval-2015 Task 14” shared task because they lacked a pre-coordinated mapping. Unlike the previous normalization method, we do not restrict concept mappings to a particular set of the Unified Medical Language System (UMLS) semantic types and allow normalization to occur to multiple UMLS Concept Unique Identifiers (CUIs). We computed annotator agreement and assessed semantic coverage with this method.ResultsWe generated the largest clinical text normalization corpus to date with mappings to multiple identifiers and made it freely available. All but 8 of the 5397 disorder mentions were normalized using this methodology. Annotator agreement ranged from 52.4% using the strictest metric (exact matching) to 78.2% using a hierarchical agreement that measures the overlap of shared ancestral nodes.ConclusionOur results provide evidence that compositional concepts can increase semantic coverage in clinical text. To our knowledge we provide the first freely available corpus of compositional concept annotation in clinical text.

Highlights

  • Text mention normalization corpora have normalized concepts to single ontology identifiers (“pre-coordinated concepts”)

  • “no bowel wall thickening” would be counted as “Single” in Table 6 since only the identifier for “Thickened” was directly annotated; the anatomical Concept Unique Identifiers (CUIs) and negative polarity were already present in the linked SEMEVAL2015 attribute annotations

  • Limitations We have shown that annotating text from discharge summaries with compositional concepts from SNOMED CT is possible with high levels of annotator agreement

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Summary

Introduction

Text mention normalization corpora have normalized concepts to single ontology identifiers (“pre-coordinated concepts”). Normalization corpora have used concepts with multiple identifiers (“post-coordinated concepts”) but the additional identifiers have been restricted to a defined set of relationships to the core concept. This approach limits the ability of the normalization process to express semantic meaning. Post-coordinated concepts have been used by medical ontological systems such as GALEN [1] and SNOMED CT [2] to elucidate a broader range of concepts than is possible with pre-coordinated systems [3, 4] using descriptive logic This methodology relies on a restricted set of pre-defined semantic relationships to avoid or min-. Earlier work [8] comparing normalization between different SNOMED CT encoding groups that applied post-coordination to normalize text mentions in case report forms failed to find any statistically significant semantic agreement

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