A study of EMR-based medical knowledge network and its applications

Comput Methods Programs Biomed. 2017 May:143:13-23. doi: 10.1016/j.cmpb.2017.02.016. Epub 2017 Feb 23.

Abstract

Background and objective: Electronic medical records (EMRs) contain an amount of medical knowledge which can be used for clinical decision support. We attempt to integrate this medical knowledge into a complex network, and then implement a diagnosis model based on this network.

Methods: The dataset of our study contains 992 records which are uniformly sampled from different departments of the hospital. In order to integrate the knowledge of these records, an EMR-based medical knowledge network (EMKN) is constructed. This network takes medical entities as nodes, and co-occurrence relationships between the two entities as edges. Selected properties of this network are analyzed. To make use of this network, a basic diagnosis model is implemented. Seven hundred records are randomly selected to re-construct the network, and the remaining 292 records are used as test records. The vector space model is applied to illustrate the relationships between diseases and symptoms. Because there may exist more than one actual disease in a record, the recall rate of the first ten results, and the average precision are adopted as evaluation measures.

Results: Compared with a random network of the same size, this network has a similar average length but a much higher clustering coefficient. Additionally, it can be observed that there are direct correlations between the community structure and the real department classes in the hospital. For the diagnosis model, the vector space model using disease as a base obtains the best result. At least one accurate disease can be obtained in 73.27% of the records in the first ten results.

Conclusion: We constructed an EMR-based medical knowledge network by extracting the medical entities. This network has the small-world and scale-free properties. Moreover, the community structure showed that entities in the same department have a tendency to be self-aggregated. Based on this network, a diagnosis model was proposed. This model uses only the symptoms as inputs and is not restricted to a specific disease. The experiments conducted demonstrated that EMKN is a simple and universal technique to integrate different medical knowledge from EMRs, and can be used for clinical decision support.

Keywords: Complex network; Electronic medical record; Knowledge representation; Medical knowledge network.

MeSH terms

  • China
  • Cluster Analysis
  • Databases, Factual
  • Decision Support Systems, Clinical*
  • Diagnosis, Computer-Assisted / methods*
  • Electronic Health Records*
  • Humans
  • Knowledge Bases*
  • Medical Informatics
  • Models, Statistical
  • Poisson Distribution
  • Reproducibility of Results