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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Team IRLabDAIICT at ShARe/CLEF eHealth 2014 Task 3: User-centered Information Retrieval system for Clinical Documents</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Harsh Thakkar</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Ganesh Iyer</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Kesha Shah</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Prasenjit Majumder</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>IR Lab, DA-IICT</institution>
          ,
          <addr-line>Gandhinagar, Gujarat, India harsh9t</addr-line>
        </aff>
      </contrib-group>
      <fpage>248</fpage>
      <lpage>259</lpage>
      <abstract>
        <p>In this paper we, Team IRLabDAIICT, describe our participation in the ShARe/CLEF ehealth 2014 task 3: Information Retrieval for addressing questions related to patients health based on clinical reports. We submitted a total of six runs out of the seven in this years task. In our approach we focus on examining the relevance between the documents and user generated query by conducting experiments through query analysis. Our major challenge is to bridge the conceptual gap between the user-generated queries (in-formal query) to biomedical speci c terminology (formal query). We incorporate the MeSH (Medical Subject Headings) library , which is a medical thesaurus mapping layman terms to medical synonym terms in order to target the concept matching problem. We use blind relevance feedback model for relevance feedback and query-likelihood model for query expansion which performed the best in the experiments conducted by us. The retrieval system is evaluated based on various parameters as: mean average precision, precision (P@5), precision (P@10), NDCG@5 and NDCG@10, with P@10 and NDCG@10 being the primary and secondary evaluation measures. The experiments were conducted on the gigantic 43:6 GB ShARe/CLEF 2013 Task 3 dataset harvested using (a) EU-FP7 Khresmoi project and and (b) a new 2014 set of English general realistic public queries based on the discharge summary contents. We have obtained the highest result in our baseline run (run 1), with compared to our other ve runs, which is 0.706 as declared by ShARe/CLEF organizing committee. We further propose to incorporate a machine learning based retrieval algorithm prediction model for further exploration.</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>-</title>
      <p>
        With the increase in awareness amongst people regarding health issues, a dire
need for expanding the horizons of research on medical document retrieval has
become mandatory these days. Patients now want answers to their health
problems on the touch of a nger. Discharge summaries obtained from the
physicians has attracted a lot of attention from patients. Thus, the concept of health
information retrieval has become more popular[
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]. The main challenge in this
area is to answer the patients questions[
        <xref ref-type="bibr" rid="ref2">2</xref>
        ] in a format which is
understandable by the layman (i.e. the user/patient). The medical prescriptions and
discharge summaries are written in professional medical terminology which makes
no sense to the end user (patient). Taking this challenge as an opportunity the
ShARe/CLEF (Cross Lingual Evaluation Forum) started an eHealth Task in
year 2013, with a goal to develop such a system by attracting the young
researchers from various organizations and universities of the world of computer
science and biological domain and present a common platform for conducting
the research. The ShARe/CLEF (Cross Lingual Evaluation Forum) community
addressed this problem by initiating the eHealth Tasks from 2013[
        <xref ref-type="bibr" rid="ref3">3</xref>
        ] with a goal
to evaluate systems that support laypeople in searching for and understanding
their health information.
      </p>
      <p>
        This ShARe/CLEF challenge ehealth 2014[
        <xref ref-type="bibr" rid="ref4">4</xref>
        ] comprises three tasks1. The
speci c use case considered is as follows: before leaving the hospital, a patient
receives a discharge summary. This describes the diagnosis and the treatment
that they received in the hospital. The rst task considered in CLEF eHealth
2014[
        <xref ref-type="bibr" rid="ref4">4</xref>
        ] aims at delivering a visualization of the medical information extracted
from the discharge summaries in manner which is conceivable by layman. While
the second task requires normalization and expansion of abbreviations and
acronyms present in the discharge summaries. The use case then postulates that,
given the discharge summaries and the diagnosed disorders, patients often have
questions regarding their health condition[
        <xref ref-type="bibr" rid="ref5">5</xref>
        ]. The goal of the third task[
        <xref ref-type="bibr" rid="ref6 ref7">6,
7</xref>
        ] is to provide valuable and relevant documents to patients, by developing a
user-centered[
        <xref ref-type="bibr" rid="ref2">2</xref>
        ] or context-based[
        <xref ref-type="bibr" rid="ref8">8</xref>
        ] health information retrieval system so as to
satisfy their health-related information needs.
      </p>
      <p>In order to aid the evaluation process of the systems involved in task 3,
the task organizers have provided us with the potential user queries and their
relevant judgments which have been obtained from medical professionals and an
enormous dataset consisting of a variety of health and biomedical documents. As
is common in evaluation of information retrieval (IR), the test collection consists
of documents, queries, and corresponding relevance judgments.</p>
      <p>
        This paper describes our participation in Task 3 of 2014 ShARe/CLEF
eHealth[
        <xref ref-type="bibr" rid="ref4">4</xref>
        ] Evaluation Lab. This paper is organized as follows: Section 2,
discusses the collection of documents provided in the corpus, its characteristics,
relevance assessment of the documents and guidelines for the submission of
results. Section 3, presents the description of our proposed user-centered health
information retrieval system. Section 4, discusses the conducted experimental
runs and the analysis of harvested results. Section 5, concludes the paper with
authors comments and future work.
2
      </p>
    </sec>
    <sec id="sec-2">
      <title>Corpus</title>
      <p>
        The corpus provided by ShARe/CLEF organizers[
        <xref ref-type="bibr" rid="ref6">6</xref>
        ] consists of a distributed
medical web crawl of a large collection of les containing the documents from
      </p>
      <sec id="sec-2-1">
        <title>1 (http://clefehealth2014.dcu.ie/</title>
        <p>the EU-FP7 Khresmoi (http://khresmoi.eu/) project's 2012 medical documents.
This dataset consists of 1.6 million English documents covering a wide set of
medical topics. This collection is prepared from a variety of sources (online)
sources, including Health on the Net Foundation2 certi ed websites, as well as
well-known medical sites and databases (e.g. Genetics Home Reference,
ClinicalTrial.gov, Diagnosia3)</p>
        <p>The corpus is divided into eight archive les (zip les) named part number.zip.
the size of the corpus is 6.3 GB compressed and about 43.6 GB uncompressed.
This collection is the processed version of crawled documents after eliminating
out the very small documents and correction of some errors in mark-up (i.e.
applying Jsoup functions) from the original crawl. This document collection of
CLEF eHealth 2014 Task 3 is split into a group of .dat les. Each of the .dat
les in this collection contains the web crawl for one domain (where a domain is
de ned to be the root URL).</p>
        <p>The format of the data in the .dat les is described below: Each .dat le
contains a collection of web pages and metadata (data about data i.e. keywords),
where the data for one web page is organized as follows:
1. a unique identi er (#UID) for a web page in this document collection,
2. the date of crawl in the form YYYYMM (#DATE),
3. the URL (#URL) to the original web page, and
4. the raw HTML content (#CONTENT) of the web page
This crawled dataset is a result of work by: Health on the Net Foundation (HON),
Switzerland and University of Applied Sciences Western Switzerland (HES-SO),
Switzerland.
2.1</p>
        <sec id="sec-2-1-1">
          <title>Relevance assessment</title>
          <p>The information provided by the ShARe/CLEF on the relevance assessment is
as follows:
{ The o cial training query and result set for eHealth Task 3 consists of 5
queries and corresponding result set generated from manual relevance
assessment (by medical professionals) on a shallow pool.
{ Relevance assessments for these 5 training queries were formed based on
pooled sets generated using the Vector Space Model and Okapi BM25.
{ Pooled sets were created by taking the top 30 ranked documents returned
by the two retrieval models with duplicates removed.
{ Relevance is provided on a 2-point-scale: Non relevant (0); Relevant (1), and
on a 4-point scale: Non relevant (0); on topic, but unreliable (1); somewhat
relevant (2); highly relevant (3).</p>
        </sec>
      </sec>
      <sec id="sec-2-2">
        <title>2 http://www.healthonnet.org 3 http://www.diagnosia.com/</title>
        <p>
          A sample query from the o cial 5 training queries[
          <xref ref-type="bibr" rid="ref6">6</xref>
          ] is shown below for
reference:
&lt;topic&gt;
&lt;id&gt;QTRAIN2014.1&lt;/id&gt;
&lt;title&gt;MRSA and wound infection&lt;/title&gt;
&lt;desc&gt;What is MRSA infection and is it dangerous?
&lt;/desc&gt;
&lt;profile&gt;This 60 year old lady has had coronary artery bypass grafting
surgery and during recovery her wound has been infected. She wants to
know how dangerous her infection is, where she got it and if she can
be infected again with it.
&lt;/profile&gt;
&lt;narr&gt;Documents should contain information about sternal wound infection
by MRSA. They should describe the causes and the complications.
&lt;/narr&gt;
&lt;/topic&gt;
2.2
        </p>
        <sec id="sec-2-2-1">
          <title>Submission guidelines</title>
          <p>
            The guidelines stated for submission of the results of task 3 are as follows:
Participants are asked to submit up to seven ranked runs for the English (EN)
queries in Task 3. The runs to be submitted are described as following:
1. Run 1 (mandatory) is a baseline: only title and description in the query can
be used, and no external resource (including discharge summary[
            <xref ref-type="bibr" rid="ref5">5</xref>
            ], corpora,
ontology, etc.) can be used.
2. Runs 2-4 (optional) any experiment WITH the discharge summaries.
3. Runs 5-7 (optional) any experiment WITHOUT the discharge summaries.
          </p>
          <p>One of the runs from 2-4 and one from 5-7 must use the IR technique in
Run 1 as a baseline. The idea being to allow analysis of the impact of discharge
summaries/other techniques on the performance of the baseline Run 1.</p>
          <p>The optional runs must be ranked in order of priority (for Runs 2-4, 2 is the
highest priority; for Runs 5-7, 5 is the highest priority).
3
3.1</p>
        </sec>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>Retrieval system</title>
      <sec id="sec-3-1">
        <title>System overview</title>
        <p>The gure 1 represents the block diagram of our proposed retrieval system. First
we pre-process the dataset provided. We rst convert the data of the collection to
standard TREC format which is acceptable by Indri4. Indri is a software product
of lemur for building indexing and retrieval systems based on language models.
Then this pre-processed data goes through subsequent language processing steps
as stemming (using porter-stemmer), stop-word removal (using a mixture of
standard English and free medical dictionary comprising of 4000 medical words).
Thus the data provided was rst cleaned for the next (indexing) process.
4 Indri - Online at http://www.lemurproject.org/indri.php</p>
        <p>Indexing: In the rst phase, Indexing is done on the cleaned and
formatted document set using Indri with parameters including tokenizing, stop-word
removal and stemming. For stop-word removal, we have used the PubMed list
of stop-words5. Stanford Porter stemmer is used for stemming during indexing.</p>
        <p>
          Query expansion: In the second phase, for query expansion stop-word
removal from the same PubMed list which is used during indexing is used.
Spellchecking is also performed on the query terms. Two dictionaries are used for
spell checking and correcting, one is the general English (US) dictionary used
in enchant and the second dictionary is speci cally for medical domain.6 Blind
relevance feedback is also used to re-rank the documents. We use Metamap[
          <xref ref-type="bibr" rid="ref9">9</xref>
          ] to
integrate MeSH7 to extract medical nomenclature of layman terms, used in the
subsequent runs 6 and 7 for query expansion. MeSH (stands for Medical Subject
5 Free Medical Dictionary at http://www.ncbi.nlm.nih.gov/books/NBK3827/table
/pubmedhelp.T43/
6 http://www.essex1.com/people/cates/free.htm
7 MeSH - Online at www.ncbi.nlm.nih.gov/mesh
Headings) is the NLM controlled vocabulary thesaurus used for indexing articles
for PubMed. MeSH is used to map the query from a textual base (layman
representation) to a concept base (medical terminology). Runs 6 and 7 are based
on MeSH.
        </p>
        <p>We make use of discharge summaries provided from the ShARe/CLEF ehealth
task 2 dataset in runs 2 and 3 for the task of query expansion. We obtain the
relevant discharge summary le for the user query from the documents indexed
previously. Further, we extract medical terms from the tags like fMajor Surgical or
Invasive Procedure, Past Medical History, Past Surgical History, Chief
Complaint, Discharge Diagnosisg from the information (clinical analysis data
consisting of various other tags) provided in that speci c discharge summary
le. We use a combination of the the words extracted from user query and the
discharge summaries with a ratio of 4:1 (i.e. 0.8 weightage is given to words
extracted from user query whereas 0.2 weightage is given to those extracted
from discharge summaries). Thus, we employ an alternative approach to using
medical thesaurus is employed in our retrieval system.</p>
        <p>Documents retrieval: In the third phase, scoring of documents is done
for each query. The scores were calculated by running query on three retrieval
models namely Okapi, tf-idf and Query Likelihood model. Okapi and tf-idf are
non-language based models whereas Query Likelihood is language based model.
However, after evaluating the lab results on last years test queries we decided
discard the tf-idf runs due to its poor performance. The tf-idf model was reported
to perform even worse than the okapi model. Hence, we have not compiled the
tf-idf statistics in this report.</p>
        <p>Thus we submitted six successful runs to the task which consists of okapi,
MeSH and query-likelihood (baseline run).</p>
        <p>
          Query-likelihood model The Query-likelihood is a language based model[
          <xref ref-type="bibr" rid="ref10">10</xref>
          ].
Using this, we construct from each document in the collection a language model
Md. Our goal is to rank documents d by P (djq), where the probability of a
document is interpreted as the likelihood[
          <xref ref-type="bibr" rid="ref11">11</xref>
          ] that it is relevant to the query.
Using Bayes rule, we have P (djq) = P (qjd) P (d)=P (q)
        </p>
        <p>Since the probability of the query P(q) is the same for all documents, this can
be ignored. Further, it is typical to assume that the probability of documents is
uniform. Thus, P(d) is also ignored. Hence, P (djq) = P (qjd).</p>
        <p>Documents are then ranked by the probability that a query is observed as a
random sample from the document model. The multinomial unigram language
model is commonly used to achieve this. We have:
Where the multinomial coe cient is :</p>
        <p>P (qjMd) = Kq Y P (tjMd)tft;q</p>
        <p>t V
Kq = Lq!=(tft1;q!tft2;q!:::tftM;q!)
(1)
(2)
In practice the multinomial co-e cient is usually removed from the calculation.
The calculation is repeated for all documents to create a ranking of all documents
in the document collection.</p>
        <p>
          Okapi model We make use of the famous Okapi Model[
          <xref ref-type="bibr" rid="ref11 ref12">12, 11</xref>
          ]. The weighting
based documents score is calculated as in below formulae:
        </p>
        <p>RSVd = X log
t q</p>
        <p>N
dft
:
k1((1</p>
        <p>(k1 + 1)tfd
b) + b(Ld=Lave)) + tfd
:
(k3 + 1)tftq
k3 + tftq
score(D; Q) =
n
X IDF (qi)
i=1</p>
        <p>f (qi; D):(k1 + 1)
f (qi; D) + k1:(1</p>
        <p>b + b: ajvDgdjl )
IDF (qi) = log</p>
        <p>N</p>
        <p>n(qi) + 0:5
n(qi) + 0:5
(3)
(4)
(5)</p>
        <p>Here, tf is term's frequency in the document.
qtf is term's frequency in the query,
N is the total number of documents in the collection,
df is document frequency that contains the term,
dl is the document length (in bytes) and
avdl is the average document length.</p>
        <p>This formula has three components: The rst is the idf part which re ects
the discriminative power of each word. Second part is tf component which is the
number of documents in which that particular term is encountered. The value
of tf generally increases, but reaches an asymptotic limit. This implies that
whether a term appears a 100 times or a 1000 times the function will weight it
almost the same. Also, there is a correction for document weight. If a document
is short, the tf for all its words is increased; if a document is long the tf for all
its words is decreased. The count of each word is measured with respect to the
document of average length in the collection. The third part is qtf component.
If a word in the query appears more times than another it should be weighted
higher.
3.3</p>
      </sec>
      <sec id="sec-3-2">
        <title>Experiments and results</title>
        <p>Submitted Runs We submitted six of the seven runs in the task that are
described as follows.</p>
      </sec>
      <sec id="sec-3-3">
        <title>Run Query</title>
        <p>Likelihood
1 X
2 X
3
5
6
7</p>
        <p>X
X
X</p>
      </sec>
      <sec id="sec-3-4">
        <title>MeSH Okapi Discharge Summary summaries</title>
        <p>X
X
X</p>
        <p>X
X
mandatory Baseline run
optional run WITH discharge
summary 1
optional run WITH discharge
summary 2
optional run WITHOUT
discharge summary 1
optional run WITHOUT
discharge summary 2
optional run WITHOUT
discharge summary 3
1. RUN 1: the rst run is the system baseline run. In this run we use only the
primitive blind relevance feedback mechanism for query feedback and
querylikelihood model for query expansion. Use of external libraries and resources
is exempted from in this run.
2. RUN 2: Run 2 and 3 are the runs WITH Discharge summaries. In run
2 we use the combination of query-likelihood model and discharge
summaries, text extracted from fMajor Surgical or Invasive Procedure,
Past Medical History, Past Surgical History, Chief Complaint, Discharge
Diagnosisg tags, for query expansion and document retrieval processes
respectively. The medical words are extracted from discharge summaries and
incorporated with the word set obtained by query-likelihood model using a
special weight function. The words obtained from the query are given
prominent weightage (0.7) while the words extracted from discharge summaries are
given lesser weightage (0.3).
3. RUN 3: It is a variant of run 2, in which okapi model is introduced for
retrieval process along-with discharge summaries for query expansion .
4. RUN 5: Run 5 through 7 is the runs WITHOUT Discharge summaries.</p>
        <p>Run 5 make use of the Okapi model along with blind relevance feedback for
retrieving documents.
5. RUN 6: we used the Query Likelihood model for retrieving documents. We
also used MeSH for query expansion. Medical concepts are identi ed using
MetaMap and their synonyms were used for query expansion following the
same weighting strategy as with discharge summaries.
6. RUN 7: we used the Okapi model for retrieval along with MeSH for query
expansion.</p>
        <p>We discuss the o cial ndings released by ShARe/CLEF organizing
committee in the following section along with their analysis.</p>
      </sec>
    </sec>
    <sec id="sec-4">
      <title>4 O cial results and Discussion</title>
      <p>The precision at 10 (P@10) and normalized discounted cumulative gain were
selected as the primary and secondary evaluation parameters for ehealth task 3
2014. Figure 2 shows the results of the submitted six runs. Figure 4 shows the
variance in the performance of the six runs. It is clear from gure 2 that run 1
(baseline) is the best run yielding the highest values followed by run 2, 6 and 5
respectively. Whereas run 7 is the least performing run followed by run 3. It is
observed that the best performing models are the query-likelihood model and its
duo combination with discharge summaries or MeSH. Whereas the trio (i.e. the
combination of query-likelihood, okapi and Mesh or discharge summaries) shows
a drastic fall in the performance of the system. This is caused by the caching of
irrelevant words extracted from the di erent texts. We observe that the query
length is increased by leaps and bounds in the trio with respect to that in the
duo. Thus, in the case of medical text retrieval, extensive use of keywords does
not guarantee higher performance. Instead it suppresses the more relevant words
and increases the vagueness in the query. It also observed from the comparison
result of the runs 2 and 3 (with discharge summaries) that the use of combination
of the okapi model and discharge summaries do not show any improvement over
the baseline run rather a 12% downfall of the system performance. Whereas the
combination of query-likelihood and discharge summaries preserves the system
performance when compared to the baseline run.</p>
      <sec id="sec-4-1">
        <title>Query-wise comparison of the baseline run:</title>
        <p>Figure 3 shows the query wise performance graph of the participating teams
in the ehealth task 3 2014. Figure 4 is computed based on these given results
for each run. For the baseline run it is observed that our system out-performs
other systems in queries 2, 8, 9, 15, 17, 28, 32 and 36 respectively. On the other
hand, our baseline system lags in queries 11, 22, 24, 26, 30, 34, 38, 44, 48,and
50 respectively. Figure 4 shows the query wise performance of other ve runs. It
is clear from the above gures that the query-likelihood model out-performs the
okapi model in run 2 and run 6 as compared to in run 3 and run 5.
5</p>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>Conclusion &amp; Future work</title>
      <p>The nature of query varies from being very precise to being extremely vague.
The model selected for a speci c query type performs in accordance with the
nature of the query. For the medical text retrieval task it is clear that the
querylikelihood model works the best so far than the other models like okapi and tf-idf.
We carried out experiments with the tf-idf model in the lab tests but its results
were poor than that of the okapi model and thus were later excluded from the
Fig. 4. Comparison of performance variance between the six runs of ehealth task 3
2014.
submitted runs (as mentioned in section 3.2). Hence, it can be concluded that
tfidf is not a suitable model for medical document information retrieval. Moreover,
there is a need for developing a mechanism through which the deployment of
these models could be predicted beforehand. By judging the nature of the query
from the text, we can incorporate which model or which combination of models
to use.</p>
      <p>Keeping the current constraints in mind, we propose to develop a machine
learning based retrieval algorithm prediction model for predicting query
performance based on the features extracted from the query as future work. The
features comprise of various factors like the combination of keywords/terms used
in the query, length of query, query similarity score and etc. Incorporating such
a mechanism promises to improve the evaluation score of our system by a factor
of 8-10 %.
6</p>
    </sec>
    <sec id="sec-6">
      <title>Acknowledgments</title>
      <p>We would like to specially thank and acknowledge our faculty advisor Prof.
Prasenjit Majumder for being around to provide quality inputs for the system.
We would also like to convey our regards to the ShARe/CLEF team for
organizing the eHealth Task enabling teams like ours to participate and give us a
chance to contribute to the community to the best of our abilities.</p>
    </sec>
  </body>
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