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Dissertation Information for Catherine Arnott Smith

NAME:
- Catherine Arnott Smith

DEGREE:
- Ph.D.

DISCIPLINE:
- Library and Information Science

SCHOOL:
- University of Pittsburgh (USA) (2002)

ADVISORS:
- Ellen Detlefsen
- Henry Lowe

COMMITTEE MEMBERS:
- Hong Xu
- Edie Rasmussen
- J. Clement Harrison

MPACT Status: Fully Complete

Title: The clinical document architecture: XML semantic markup for enhanced clinical information retrieval

Abstract: Purpose . It is proposed that retrieval of clinical documents is facilitated and enhanced when these records conform to a semantic markup structure, specifically that proposed in HL7's Clinical Document Architecture (CDA) model. Hypothesis I: that tagging document elements will result in enhanced retrieval; Hypothesis II: that tagging document elements will result in a difference in relevance scores of two different question tasks.

Setting/subjects . Ten subjects with varying clinical experience, nine males and one female; 6 were fellows, 2 residents, 1 graduate of medical school beginning residency, and 1 an attending physician/faculty member. Three specialized in internal medicine, two in family medicine, and one each in infectious diseases, geriatrics, and medical informatics; two indicated they did not have a specialization. All were located at the University of Pittsburgh Medical Center.

Methodology . Crossover information retrieval study in which subjects served as their own controls; the document base consisted of 1000 deidentified clinical documents of 8 commonly occurring types in the MARS (Medical Archival Record) System in use at the University of Pittsburgh Medical Center.

Results . Hypothesis I was not supported. No statistically significant differences were found between the control (339.5 seconds ± 287.8) and treatment conditions (400 seconds ± 311.9) in mean time elapsed or the mean number of records in the final result set (control, 4.1 ± 7.8; treatment, 5.2 ± 10.5). However, tasks performed in the tagged treatment condition required a mean number of more steps in the search sequence to a degree that was statistically significant (control, 3.6 ± 2.9; treatment, 21.2 ± 13.2). Differences in precision were additionally investigated. The treatment condition tasks had a statistically significant lower rate of mean precision (control, .92 ± .231; treatment, .79 ± .383). Hypothesis II was also not supported. There was no statistically significant difference between the means of relevance of Type I and Type II questions tasks (Type I, .72 ± .388; Type II, .67 ± .345).

Discussion . The implications of this experiment are primarily for the development of the data model. Inadequacy of existing section headings--labels--for representation of clinical content may account for these negative results. Complex tag sets cannot ultimately resolve problems of unstandardized structure; the lack of structure is itself a significant limitation.

MPACT Scores for Catherine Arnott Smith

A = 0
C = 3
A+C = 3
T = 0
G = 0
W = 0
TD = 0
TA = 0
calculated 2014-03-08 19:20:56

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