An ontology for clinical questions about the contents of patient notes

ObjectiveMany studies have been completed on question classification in the open domain, however only limited work focuses on the medical domain. As well, to the best of our knowledge, most of these medical question classifications were designed for literature based question and answering systems. This paper focuses on a new direction, which is to design a novel question processing and classification model for answering clinical questions applied to electronic patient notes.MethodsThere are four main steps in the work. Firstly, a relatively large set of clinical questions was collected from staff in an Intensive Care Unit. Then, a clinical question taxonomy was designed for question and answering purposes. Subsequently an annotation guideline was created and used to annotate the question set. Finally, a multilayer classification model was built to classify the clinical questions.ResultsThrough the initial classification experiments, we realized that the general features cannot contribute to high performance of a minimum classifier (a small data set with multiple classes). Thus, an automatic knowledge discovery and knowledge reuse process was designed to boost the performance by extracting and expanding the specific features of the questions. In the evaluation, the results show around 90% accuracy can be achieved in the answerable subclass classification and generic question templates classification. On the other hand, the machine learning method does not perform well at identifying the category of unanswerable questions, due to the asymmetric distribution.ConclusionsIn this paper, a comprehensive study on clinical questions has been completed. A major outcome of this work is the multilayer classification model. It serves as a major component of a patient records based clinical question and answering system as our studies continue. As well, the question collections can be reused by the research community to improve the efficiency of their own question and answering systems.

Graphical abstractFigure optionsDownload full-size imageDownload high-quality image (187 K)Download as PowerPoint slideHighlights► Focusing on questions about patient condition, a clinical question corpus was built. ► A clinical question taxonomy and a set of generic question templates were designed. ► A multi-layer question classification model was developed as a major component of QA. ► By introducing automatic feature expansion, the minimum classification was improved.