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Automatically Identifying Health Outcome Information in MEDLINE Records
Understanding the effect of a given intervention on the patient's health outcome is one of the key elements in providing optimalpatient care. This study presents a methodology for automatic identification of outcomes-related information in medical text and evaluates its potential in satisfying clinical information needs related to health care outcomes. An annotation scheme based onan evidence-based medicine model for critical appraisal of evidence was developed and used to annotate 633 MEDLINE citations.Textual, structural, and meta-information features essential to outcome identification were learned from the created collectionand used to develop an automatic system. Accuracy of automatic outcome identification was assessed in an intrinsic evaluationand in an extrinsic evaluation, in which ranking of MEDLINE search results obtained using PubMed Clinical Queries relied on identified outcome statements. The accuracy and positive predictive value of outcome identification were calculated. Effectiveness ofthe outcome-based ranking was measured using mean average precision and precision at rank 10. Automatic outcome identificationachieved 88% to 93% accuracy. The positive predictive value of individual sentences identified as outcomes ranged from 30% to37%. Outcome-based ranking improved retrieval accuracy, tripling mean average precision and achieving 389% improvement in precision at rank 10. Preliminary results in outcome-based document ranking show potential validity of the evidence-based medicine-model approach in timely delivery of information critical to clinical decision support at the point of service.