Preparing a collection of radiology examinations for distribution and retrieval
Preparing a collection of radiology examinations for distribution and retrieval
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DOI：
10.1093/jamia/ocv080
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发表时间：
2016-03-01
影响因子：
6.4
通讯作者：
McDonald, Clement J.
中科院分区：
文献类型：
--
作者：
Demner-Fushman, Dina;Kohli, Marc D.;McDonald, Clement J.
目的临床文献的二次利用在临床知识的发现、研究方法的发展和教育方面发挥着越来越重要的作用。促进临床文献收藏的二次利用的一个重要步骤是方便地访问代表收藏内容的描述和样本。本文提出了一种开发放射学检查集合的方法，包括图像和放射科医生的叙述报告，并使它们在可搜索的数据库中公开可用。材料和方法作者收集了来自印第安纳州患者护理网络的3996份放射学报告和来自医院图片存档系统的8121张相关图像。图像和报告自动去识别，然后人工验证自动去识别。作者对报告的关键发现进行了编码，并经验性地评估了手工编码对检索的好处。结果对叙事的自动去认同是积极的，以使一些发现无法解释为代价，达到100%的准确率。自动去识别图像并不是那么完美。3996例患者中2例（0.05%）的图像显示受保护的健康信息。手工编码结果提高了检索精度。结论严格的去标识化方法可以将所有标识符从放射学报告文本中去除。DICOM图像去识别不删除所有识别信息，需要特别注意从胶片扫描的图像。在放射科医师叙述报告中添加手动编码，显著提高了检索到的临床文档的相关性。去识别的印第安纳胸部x光片集可从国家医学图书馆（http://openi.nlm.nih.gov/）搜索和下载。
Objective Clinical documents made available for secondary use play an increasingly important role in discovery of clinical knowledge, development of research methods, and education. An important step in facilitating secondary use of clinical document collections is easy access to descriptions and samples that represent the content of the collections. This paper presents an approach to developing a collection of radiology examinations, including both the images and radiologist narrative reports, and making them publicly available in a searchable database.Materials and Methods The authors collected 3996 radiology reports from the Indiana Network for Patient Care and 8121 associated images from the hospitals' picture archiving systems. The images and reports were de-identified automatically and then the automatic de-identification was manually verified. The authors coded the key findings of the reports and empirically assessed the benefits of manual coding on retrieval.Results The automatic de-identification of the narrative was aggressive and achieved 100% precision at the cost of rendering a few findings uninterpretable. Automatic de-identification of images was not quite as perfect. Images for two of 3996 patients (0.05%) showed protected health information. Manual encoding of findings improved retrieval precision.Conclusion Stringent de-identification methods can remove all identifiers from text radiology reports. DICOM de-identification of images does not remove all identifying information and needs special attention to images scanned from film. Adding manual coding to the radiologist narrative reports significantly improved relevancy of the retrieved clinical documents. The de-identified Indiana chest X-ray collection is available for searching and downloading from the National Library of Medicine (http://openi.nlm.nih.gov/).