An experiment comparing lexical and statistical methods for extracting MeSH terms from clinical free text

Objective: A primary goal of the University of Pittsburgh's 1930-94 UMLS-sponsored effort was to develop and evaluate PostDoc (a lexical indexing system) and Finder (a statistical indexing system) comparatively, and then in combination as a hybrid system. Each system takes as input a portion of the free text from a narrative part of a patient's electronic medical record and returns a list of suggested MeSH terms to use in formulating a Medline search that includes concepts in the text. This paper describes the systems and reports an evaluation. The intent is for this evaluation to serve as a step toward the eventual realization of systems that assist healthcare personnel in using the electronic medical record to construct patient-specific searches of Medline. Design: The authors tested the performances of PostDoc, Finder, and a hybrid system, using text taken from randomly selected clinical records, which were stratified to include six radiology reports, six pathology reports, and six discharge summaries. They identified concepts in the clinical records that might conceivably be used in performing a patient-specific Medline search. Each system was given the free text of each record as an input. The extent to which a system-derived list of MeSH terms captured the relevant concepts in these documents was determined based on blinded assessments by the authors. Results: PostDoc output a mean of approximately 19 MeSH terms per report, which included about 40% of the relevant report concepts. Finder output a mean of approximately 57 terms per report and captured about 45% of the relevant report concepts. A hybrid system captured approximately 66% of the relevant concepts and output about 71 terms per report. Conclusion: The outputs of PostDoc and Finder are complementary in capturing MeSH terms from clinical free text. The results suggest possible approaches to reduce the number of terms output while maintaining the percentage of terms captured, including the use of UMLS semantic types to constrain the output list to contain only clinically relevant MeSH terms.