title: Automated classification of limb fractures from free-text radiology reports using a clinician-informed gazetteer methodology.
abstract: BACKGROUND
  Timely diagnosis and reporting of patient symptoms in hospital emergency departments (ED) is a critical component of health services delivery. However, due to dispersed information resources and a vast amount of manual processing of unstructured information, accurate point-of-care diagnosis is often difficult.
  
  
  OBJECTIVE
  The aim of this research is to report initial experimental evaluation of a clinician-informed automated method for the issue of initial misdiagnoses associated with delayed receipt of unstructured radiology reports.
  
  
  METHODS
  A method was developed that resembles clinical reasoning for identifying limb abnormalities. The method consists of a gazetteer of keywords related to radiological findings; the method classifies an X-ray report as abnormal if it contains evidence contained in the gazetteer. A set of 99 narrative reports of radiological findings was sourced from a tertiary hospital. Reports were manually assessed by two clinicians and discrepancies were validated by a third expert ED clinician; the final manual classification generated by the expert ED clinician was used as ground truth to empirically evaluate the approach.
  
  
  RESULTS
  The automated method that attempts to individuate limb abnormalities by searching for keywords expressed by clinicians achieved an F-measure of 0.80 and an accuracy of 0.80.
  
  
  CONCLUSIONS
  While the automated clinician-driven method achieved promising performances, a number of avenues for improvement were identified using advanced natural language processing (NLP) and machine learning techniques.
authors.affiliation: The Australian e-Health Research Centre, Brisbane, CSIRO.
authors.forename: Amol
authors.initials: A
authors.lastname: Wagholikar
authors.forename: Guido
authors.initials: G
authors.lastname: Zuccon
authors.forename: Anthony
authors.initials: A
authors.lastname: Nguyen
authors.forename: Kevin
authors.initials: K
authors.lastname: Chu
authors.forename: Shane
authors.initials: S
authors.lastname: Martin
authors.forename: Kim
authors.initials: K
authors.lastname: Lai
authors.forename: Jaimi
authors.initials: J
authors.lastname: Greenslade
keywords: Limb fractures; classification; emergency department; machine learning; radiology reports; rule-based method