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MedEx: Medical ExpertPowered by a Context Targeted Search EngineBeltran, LopeSarmiento, JaybeeTorrecampo, DanielleAdviser: De Guzman, Achilles1AbstractThe system is an XML-based Dynamic Context Targeted Search Engine that can search existing records in a database relevant to the given record. Its dynamic in the sense that it can be deployed in any domain (police records, case records, etc)MedEx is an application where the system is deployed, which is in the medical record field.2INTRODUCTIONAnd so it begins3

Before, medical records were kept inside folders and file cabinetsThanks to technology, most medical records today are stored in computer databases

4Picture this:

A typical barrio setting5Consult a medical record database from other hospitals via the internet!

6GoalDevelop a system to allow easy cross-referencing with other existing records in the database.System Format and DomainSearch EngineContext Filtering/Classification of DataSummary and Ranking of Results

7LITERATURE REVIEWShed light on the unknown8Medical Record FormatMost records follow the SOAP format: [1]Subjective - Story / SymptomsObjective - ObservationAssessment - Assumption/DiagnosisPlan of actionMore reliable records contain a final pathological diagnosis

[1] Soap notes. medical assistant net . advanced medical assistant custom web design. http://www.medicalassistant.net/soap note.htm, 2009.9Context Filtering10Context FilteringKWiC algorithmSynonymyUMLSExtracting the most relevant data11KeyWord in Context (KWiC)Extraction of keywords within the contextattempts to find the segments that maximize the number of medical terms and other keywords (a kind of keyword diversity, including synonyms). [2][2] A. Gaudinat et. al, Health search engine with e-document analysis for reliable search results, International Journal of Medical Informatics (2006) 75, 7385

12SynonymyFor each medical term, there are equivalent words or "synonyms". Different people fill up the medical records, making them seem different or unrelated to each other. However, the diagnosis/symptom/etc. that a record has may actually be similar to another record that uses different terminology. This calls for a scheme to relate keywords and their synonyms.

13UMLS MetathesaurusUnified Medical Language System (UMLS) [3]The US National Library of Medicine (NLM), by creating UMLS Knowledge Sources, made it easier for medical software to be developed. MetamorphoSys is the UMLS installation wizard and Metathesaurus customization tool included in each UMLS release. It installs one or more of the UMLS Knowledge Sources and enables one to create customized Metathesaurus subsets. The Metathesaurus contains more than 100 vocabularies related to medicine. It also has multi-lingual support.

[3] http://www.nlm.nih.gov

UMLSKS14Search Engine15XML-based Search EngineMore dynamicXML widely used standard for data representation and exchangeEasy to structure datahierarchical, partly ordered, and pervasively cross-linkedThe more the data, the more accurate the results

16XQUERYShorthand for XML Query LanguageUsed for querying XML dataHandles XML natively and, thus, is able to process and manipulate HTML webpages [4]Like PHP and JavascriptCan store query results in a variable where you can query againStructure query

[4] Ghislain Fourny, Markus Pilman, Daniela Florescu, Donald Kossmann, Tim Kraska, Darin McBeath: XQuery in the Browser. WWW 2009, Madrid, Spain.17eXist Native XML DatabaseeXist is an open source, native XML database [5]Java-basedCore: XqueryDatabase of X filesServerSearch engine-likeApache Lucene included99% XQTS (XQuery Testing Score)

[5]Meier, Wolfgang. "eXist-db Open Source Native XML Database." eXist-db Open Source Native XML Database. 2009. SourceForge.net, Web. 8 Mar 2010. .18DeliveryAJAXShorthand for Asynchronous Javascript and XML. [6]Uses the following technologies:XHTML and CSS for presentation.Document Object Model (DOM) for dynamic display and interaction.XML and XSLT for data manipulation.xmlHttpRequest for asynchronous data retrieval.Javascript for connecting all the above together.

[6] Negrino, Tom, and Dori Smith. Javascript and AJAX for the Web, Sixth Edition. 6th ed. Berkeley. Pearson Education Limited, 2007.

AJAXAllows asynchronous user interaction with the application. [7]

[7] Garret, Jesse James. "Ajax: A New Approach to Web Applications". Adaptive Path. 5 Mar. 2010 The YUI LibraryYUI stands for Yahoo! User Interfacea set of utilities and controls, written with JavaScript and CSS, for building richly interactive web applicationsUses techniques such as AJAX.proven, scalable, fast, and robust [8]

[8]"YUI Library." Yahoo! Developer Network. 2010. Yahoo! Inc., Web. 3 Mar 2010. . PROBLEM STATEMENTA puzzle waiting to be solved23Problem StatementDevelop a dynamic search engine system that can deliver an accurate, relevant results.Apply it in the medical record domain where given an input medical record, the system will deliver relevant medical records.Relevancy is based on the structure of the content model (eg. Sequence of symptoms)Summarization the results24MethodologyTrial and error, an effort to bring the answer to light25MethodologyFormat ParsingContent/Data ClassificationSearch EngineDeliveryDiagram

Format ParserFormat file: XMLOutput: XHTML tagsDynamic generation of fieldsContent/Data Classification and FilteringInput from forms are passed as parameters to the controllerThe controller passes the processed data to the search engine.Stopwords articles like a, the, an Search EngineKeywords from the filter are used to generate a query based on the content. (Lucene module query)Results are records in the form of XML sequences where arrange according to the most relevant recordStored in HTTP Session.RankingUses Apache Lucene (inclusive in eXist)Boost configurationDeliveryOutput: XHTML file stored in XQLAJAX framework via YUITabbed viewLayout ManagerYahoo.util.Connect.asyncRequest xmlhttprequestData TableAnimationResultsWhat comes out of experimentationGiven a Medical Record

Related Records

34Search SpeedSearch Speed given an amount of records in the database (One Field Search)

Search Speed

Search Speed given an amount of records in the database (All Field Search)Search Speed

Search Speed given an amount of records found in the search RelevancyExperiment:Remove a random recordUse the removed record for searchingSee the results if its relatedResults:All the top ranked records are similar to the diagnoses of the input recordSimilar plans, operations, complaints are found with little differencesConclusionAnd it draws to a closeThe dynamic feature of the system was made successfully with the help of XQuery using a format le to generate input sections and to pass format parameters.The more relevant keywords and phrases extracted from the input, the results are more accurately relevant as shown in the results.The more records are stored in the database, the more accurate the results since more data will support the relevancy of the results.Using the summary reports of each search, we can assume that the highest percentage of the same assessment is said to be the most relevant data to be crossed referenced.It is indeed helpful by using the system as a supporting structure for search engines across other domains.RecommendationsSo much more in storeUse more algorithms to extract accurate keywords in the input data. Structure and arrangement of extracted keywords may help in determining its relevancy. Some context models are not based from its keywords but in its structure.Field Search ConstraintAn Installer for those who wish to use the system for developing their own programsIndex creatorUMLS feature of serial coding may help in eliminating synonymity.EndThe credit is not all ours