title: Preparing a collection of radiology examinations for distribution and retrieval.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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/).
authors.affiliation: Staff Scientist, Lister Hill National Center for Biomedical Communications National Library of Medicine, National Institutes of Health Bldg. 38A, Room 10S-1022, 8600 Rockville Pike MSC-3824 Bethesda, MD 20894, USA ddemner@mail.nih.gov.
authors.forename: Dina
authors.initials: D
authors.lastname: Demner-Fushman
authors.affiliation: Assistant Professor, Director of Informatics, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Marc D
authors.initials: MD
authors.lastname: Kohli
authors.affiliation: Associate Professor, Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Marc B
authors.initials: MB
authors.lastname: Rosenman
authors.affiliation: Computer Science Branch, Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA.
authors.forename: Sonya E
authors.initials: SE
authors.lastname: Shooshan
authors.affiliation: Computer Science Branch, Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA.
authors.forename: Laritza
authors.initials: L
authors.lastname: Rodriguez
authors.affiliation: Staff Scientist, Communications Engineering Branch, Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA.
authors.forename: Sameer
authors.initials: S
authors.lastname: Antani
authors.affiliation: Branch Chief, Communications Engineering Branch, Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA.
authors.forename: George R
authors.initials: GR
authors.lastname: Thoma
authors.affiliation: Director, Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA.
authors.forename: Clement J
authors.initials: CJ
authors.lastname: McDonald
mesh_terms: D000068240:Data Anonymization; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods*; D013902:Radiography, Thoracic; D011873:Radiology Information Systems
keywords: abstracting and indexing; biometric identification; information storage and retrieval; medical records; radiography