U.S. patent application number 10/846255 was filed with the patent office on 2005-05-26 for system and method for generating a report using a knowledge base.
Invention is credited to Agarwal, Deepak, Cotton, Peter B., Divinsky, Aaron, Odlivak, Andrew, Pearson, Philip, Shapiro, Marc.
Application Number | 20050114283 10/846255 |
Document ID | / |
Family ID | 33476833 |
Filed Date | 2005-05-26 |
United States Patent
Application |
20050114283 |
Kind Code |
A1 |
Pearson, Philip ; et
al. |
May 26, 2005 |
System and method for generating a report using a knowledge
base
Abstract
A method and system for assisting a user in generating a report
regarding a procedure such as a medical procedure. A first display
region provides a hierarchical menu of available keywords from a
knowledge base. A second display region provides a hierarchical
menu of particular keywords that have been selected by the user. A
third display region provides a report from a sentence that was
generated by populating a sentence model based on the selected
keywords. The sentence can be edited by selecting a keyword from
the sentence, then selecting a replacement keyword from the first
display region. A grammar engine corrects the grammar of the
sentence based on user settings for the keywords.
Inventors: |
Pearson, Philip; (Sea Cliff,
NY) ; Odlivak, Andrew; (Oakdale, NY) ;
Shapiro, Marc; (Dix Hills, NY) ; Agarwal, Deepak;
(Hicksville, NY) ; Divinsky, Aaron; (Sayville,
NY) ; Cotton, Peter B.; (Mt. Pleasant, SC) |
Correspondence
Address: |
SCULLY SCOTT MURPHY & PRESSER, PC
400 GARDEN CITY PLAZA
SUITE 300
GARDEN CITY
NY
11530
US
|
Family ID: |
33476833 |
Appl. No.: |
10/846255 |
Filed: |
May 14, 2004 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60471349 |
May 16, 2003 |
|
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|
Current U.S.
Class: |
706/50 ;
704/1 |
Current CPC
Class: |
G16H 10/60 20180101;
H04N 2005/2255 20130101; G16H 10/40 20180101; G16H 40/20 20180101;
G16H 15/00 20180101; G06Q 10/10 20130101; H04N 5/232939
20180801 |
Class at
Publication: |
706/050 ;
704/001 |
International
Class: |
G06F 017/20; G06F
007/00; G06F 017/30; G06N 005/02; G06F 017/00 |
Claims
What is claimed is:
1. A method for generating a report regarding a procedure,
comprising: displaying available keywords from a knowledge base on
a first display region of a user interface; receiving, via the user
interface, at least one user command selecting at least one of the
available keywords from the first display region; displaying the at
least one of the available keywords on a second display region of
the user interface, responsive to the selection thereof by the at
least one user command; populating a sentence model according to
the at least one of the available keywords to provide a populated
sentence; and displaying the populated sentence on a third display
region of the user interface.
2. The method of claim 1, wherein: the populating the sentcnce
model comprises selecting the sentence model from among a plurality
of available sentence models according to the at least one of the
available keywords.
3. The method of claim 1, farther comprising: editing the populated
sentence by: (a) receiving, via the user interface, at least one
user command selecting the at least one of the available keywords
in the populated sentence, and at least one user command selecting
another of the available keywords from the first display region,
and (b) re-populating the sentence model using the another of the
available keywords in place of the at least one of the available
keywords.
4. The method of claim 1, wherein: the displaying the populated
sentence comprises displaying the populated sentence with the at
least one of the available keywords highlighted therein.
5. The method of claim 1, wherein: the populating the sentence
model comprises providing static text in at least one text
placeholder.
6. The method of claim 1, wherein: the populating the sentence
model comprises providing a specified property value in at least
one node placeholder.
7. The method of claim 1, wherein: the populating the sentence
model comprises generating text in the at least one sentence that
depends on the value of a property.
8. The method of claim 1, wherein: the receiving comprises
receiving, via the user interface, at least one user command
selecting a plurality of the available keywords from the first
display region; the populating the sentence model comprises
populating the sentence model according to the plurality of the
available keywords to provide the populated sentence; and the
sentence model comprises a summary sentence model in which fewer
than all of the plurality of the available keywords are used.
9. The method of claim 1, wherein: the rccciving comprises
receiving, via the user interface, at least one user command
selecting a plurality of the available keywords from the first
display region; the populating the sentence model comprises
populating the sentence model according to the plurality of the
available keywords to provide the populated sentence; and the
sentence model comprises a normal sentence model in which all of
the plurality of the available keywords are used.
10. The method of claim 1, further comprising: receiving, via the
user interface, at lest one user command setting a grammatical
property of the at least one of the available keywords; analyzing a
grammar of the at least one populated sentence based on the
grammatical property.
11. The method of claim 1, wherein: the displaying the available
keywords comprises displaying the available keywords on the first
display region organized according to at least one hierarchical
menu wherein related keywords are child keywords of a parent
keyword.
12. The method of claim 11, wherein: the receiving comprises
receiving, via the user interface, at least one user command
selecting a plurality of the available keywords from the first
display region; and the displaying the at least one of the
available keywords comprises displaying the plurality of the
available keywords on the second display region organized according
to at least one hierarchical menu in accordance with the at least
one hierarchical menu in the first display region.
13. The method of claim 11, wherein: the child keywords qualify the
parent keyword.
14. The method of claim 1, wherein: the receiving comprises
receiving, via the user interface, a shortcut command for selecting
multiple keywords at a time from the available keywords.
15. The method of claim 1, further comprising: receiving at least
one user command for maintaining the knowledge base.
16. The method of claim 15, wherein: the at least one user command
for maintaining the knowledge base comprises at least one user
command for adding a keyword to the knowledge base.
17. The method of claim 15, wherein: the at least one user command
for maintaining the knowledge base comprises at least one user
command for editing properties of the at least one of the available
keywords.
18. The method of claim 15, wherein: the at least one user command
for maintaining the knowledge base comprises at least one user
command for associating a billing code with the at least one of the
available keywords.
19. The method of claim 15, wherein: the at least one user command
for maintaining the knowledge base comprises at least one user
command for at least one of creating and editing the sentence
model.
20. The method of claim 15, wherein: the at least one user command
for maintaining the knowledge base comprises at least one user
command for at least one of adding and editing a trigger for the at
least one of the available keywords.
21. The method of claim 1, further comprising: displaying at least
one image obtained from the procedure in a fourth display region of
the user interface.
22. A method for providing keywords for generating a report
regarding a procedure, comprising: providing respective keywords
for use in the report; associating each of the respective keywords
with a respective classification in a hierarchically arranged tree
structure of classifications; associating respective properties
with the respective keywords; and defining, based on the respective
properties, a set of allowable values for a group of the respective
keywords; wherein the group of the respective keywords are
related.
23. The method of claim 22, wherein: the group of the respective
keywords which are related are associated with the same
classification.
24. The method of claim 22, wherein: the group of the respective
keywords which are related inherit from the same
classification.
25. The method of claim 22, further comprising: displaying the
available keywords on a first display region of a user interface
organized in a first tree structure that is based on the
hierarchically arranged tree structure of classifications;
receiving, via the user interface, at least one user command
selecting at least one of the available keywords from the first
tree structure; displaying the at least one of the available
keywords on a second display region of the user interface,
responsive to the receiving, in a second tree structure that is
based on the first tree structure.
26. The method of claim 22, further comprising: populating a
sentence model according to the at least one of the available
keywords to provide a populated sentence; and displaying the
populated sentence on the user interface.
27. The method of claim 22, further comprising: querying a database
containing the keywords based on at least one of the respective
classifications.
28. A user interface for assisting a user in generating a report
regarding a procedure, comprising: a first display region
displaying available keywords from a knowledge base; wherein the
user provides at least one user command selccting at least one of
the available keywords from the first display region; a second
display region displaying the at least one of the available
keywords responsive to the selection thereof by the at least one
user command; and a third display region displaying a populated
sentence that is provided by populating a sentence model according
to the at least one of the available keywords.
29. A program storage device tangibly embodying a program of
instructions executable by a machine to perform a method for
providing keywords for generating a report regarding a procedure,
the method comprising: providing respective keywords for use in the
report; associating each of the respective keywords with a
respective classification in a hierarchically arranged tree
structure of classifications; associating respective properties
with the respective keywords; and defining, based on the respective
properties, a set of allowable values for a group of the respective
keywords; wherein the group of the respective keywords are related.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. provisional
patent application No. 60/471,349, filed May 16, 2003, entitled
"System And Method For Endoscope Management" (docket No. P16531),
and incorporated herein by reference.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The invention relates generally to a system and method for
generating a report using a knowledge base and, more specifically,
to generating a report using sentence models that are automatically
populated with keywords selected by a user. The invention is
illustrated in the context of a medical procedure such as an
endoscopic examination.
[0004] 2. Description of the Related Art
[0005] Computerized word processing applications have gained
widespread use since they allow a user to prepare and manipulate
documents in electronic form. Moreover, various applications have
been developed to assist users in specific industries in developing
reports and other documents. For example, some voice-activated
systems use a dictionary developed from scanning published reports
to choose a term that most closely matches a spoken word. The
spoken words of the user are then converted to text to produce a
report. Other systems allow the user to enter information for a
report via various prompts and menus. The system then generates a
report based on the entered information.
[0006] However, such approaches are problematic since the terms are
not presented in a uniform sentence structure. Moreover, the terms
are not classified in a way that improves understanding and data
mining capabilities. Similarly, various other features and benefits
have also been lacking in the known systems.
BRIEF SUMMARY OF THE INVENTION
[0007] To overcome these and other deficiencies in the prior art,
the present invention provides a system and method for generating a
report using a knowledge base.
[0008] In a particular aspect of the invention, a method is
provided for generating a report regarding a procedure. The method
includes: (a) displaying available keywords from a knowledge base
on a first display region of a user interface, (b) receiving, via
the user interface, at least one user command selecting at least
one of the available keywords from the first display region, (c)
displaying the at least one of the available keywords on a second
display region of the user interface, responsive to the selection
thereof by the at least one user command, (d) populating a sentence
model according to the at least one of the available keywords to
provide a populated sentence, and (e) displaying the populated
sentence on a third display region of the user interface.
[0009] In another aspect of the invention, a method for providing
keywords for generating a report regarding a procedure includes:
(a) providing respective keywords for use in the report, (b)
associating each of the respective keywords with a respective
classification in a hierarchically arranged tree structure of
classifications, (c) associating respective properties with the
respective keywords, and (d) defining, based on the respective
properties, a set of allowable values for a group of the respective
keywords, where the group of the respective keywords are
related
[0010] A related user interface and program storage device are also
provided.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011] These and other features, benefits and advantages of the
present invention will become apparent by reference to the
following text and figures, with like reference numbers referring
to like structures across the views, wherein:
[0012] FIG. 1 illustrates an overview of a report-generating system
according to the invention;
[0013] FIG. 2 illustrates a Registration and Scheduling clinical
flow;
[0014] FIG. 3 illustrates a Pre-Procedure clinical flow;
[0015] FIG. 4 illustrates a Procedure clinical flow;
[0016] FIG. 5 illustrates a Post-Procedure clinical flow;
[0017] FIG. 6 illustrates a Home tab of a user interface;
[0018] FIG. 7 illustrates a Patient File tab of a user
interface;
[0019] FIG. 8 illustrates a Registration tab of a user
interface;
[0020] FIG. 9 illustrates a Pre Procedure tab of a user
interface;
[0021] FIG. 10 illustrates a Procedure tab of a user interface;
[0022] FIG. 11 illustrates a Post-Procedure tab of a user
interface;
[0023] FIG. 12 illustrates an Analysis tab of a user interface;
[0024] FIG. 13 illustrates an Admin tab of a user interface;
[0025] FIG. 14 illustrates a Pre-Procedure Lexicon interface;
[0026] FIG. 15 illustrates a Lexicon user interface for selecting
indications of GI symptoms for a patient;
[0027] FIG. 16 illustrates a Lexicon interface that shows the
selected keyword "heartburn";
[0028] FIG. 17 illustrates a Lexicon interface that shows a keyword
"severity" in expanded form; FIG. 18 illustrates a Lexicon
interface that shows a selected keyword "severe";
[0029] FIG. 19 illustrates a Lexicon interface that shows a user
input value "6" as a selected keyword;
[0030] FIG. 20 illustrates an interface with a list of billing
codes;
[0031] FIG. 21 illustrates a Lexicon interface in the
Post-Procedure tab;
[0032] FIG. 22 illustrates an interface for selecting a Procedure
Note Template under the Post-Procedure tab;
[0033] FIG. 23 illustrates a Procedure Note interface;
[0034] FIG. 24 illustrates an interface for selecting a Procedure
Note Template under the Admin tab;
[0035] FIG. 25 illustrates a class diagram of the Concept Layer of
the knowledge base;
[0036] FIG. 26 illustrates a class diagram of the Data Layer of the
knowledge base;
[0037] FIG. 27 illustrates a class diagram of the Sentence Model
infrastructure of the knowledge base;
[0038] FIG. 28 illustrates a class diagram of the View Layer of the
knowledge base;
[0039] FIG. 29 illustrates a user interface for adding a keyword to
the knowledge base;
[0040] FIG. 30 illustrates a user interface for adding a property
definition to the knowledge base;
[0041] FIG. 31 illustrates a user interface for editing a keyword
in the knowledge base;
[0042] FIG. 32 illustrates a user interface for editing properties
of a keyword in the knowledge base;
[0043] FIG. 33 illustrates a user interface for adding properties
of a keyword in the knowledge base;
[0044] FIG. 34 illustrates a user interface for adding and editing
codes in the knowledge base;
[0045] FIG. 35 illustrates a user interface for adding and editing
sentence models in the knowledge base;
[0046] FIG. 36 illustrates a user interface for adding a condition
in a sentence model in the knowledge base;
[0047] FIG. 37 illustrates a user interface for adding and editing
triggers in the knowledge base;
[0048] FIG. 38 illustrates a user interface for adding a keyword
item to a menu in a view;
[0049] FIG. 39 illustrates a user interface for adding a menu in
the knowledge base;
[0050] FIG. 40 illustrates a user interface for creating a shortcut
in the knowledge base;
[0051] FIG. 41 illustrates a user interface for editing a shortcut
in the knowledge base; and
[0052] FIG. 42 illustrates user interfaces for a grammar
engine.
DETAILED DESCRIPTION OF THE INVENTION
[0053] Overview of the System
[0054] FIG. 1 illustrates an overview of a report-generating system
according to the invention. In one possible aspect, the invention
involves a web-browser based clinical information management system
that automates a medical lab such as an endoscopy lab by managing
patient examination data at different phases of patient care,
including the capture of images, data and written Procedure Notes,
and further, the generation of medical records and procedure
reports. The system may include an endoscopic workstation 110, a
Mavigraph printer 112, RGB monitor 114 and processor 116. The user
provides inputs to the workstation 110 via keyboard, mouse, voice
interface, or the like. The workstation may be coupled with a web
browser interface that provides the necessary information to
perform exams, and facilitates for users of endoscopic equipment,
e.g., physicians, nurses or clinicians, the efficient capture,
management, organization and presentation of endoscopic images and
patient and examination data.
[0055] The workflow processes associated with this aspect of the
system are flexible enough to support small endoscopic practices in
addition to endoscopic departments within large healthcare
institutions.
[0056] The system may function as a stand-alone system including
memory for storing patient data and image information. The system
may also include a server 140 and database element 145 that may be
connected via a gateway application to various "external" systems
such as a hospital information system where the gateway facilitates
the transfer of healthcare information between the system and other
applications. Patient information stored in the system may be
downloaded to external systems (e.g., a legacy system) via a
gateway interface. The workstation 110 may communicate with the
server 140 via the Internet 170 or other network, such as a LAN or
intranet. The workstation 110 may also communicate with a fax
server 160, for instance, for faxing reports via a fax modem 162.
Generally, software instructions, including firmware and microcode,
may be stored in any type of program storage device or devices,
also referred to as computer-readable media. The software is
executed by a processor in a known manner to achieve the
functionality described herein.
[0057] In a particular aspect, the system includes an Image
Management function enabling a user to annotate, label, import,
export, and enhance the quality of images, including the ability to
manage, record, and export live video clips. Further to this is an
"auto-masking" feature that automatically selects an appropriate
video mask based on a particular endoscope device being utilized by
the health care practitioner.
[0058] In another particular aspect, the system includes a medical
terminology "Knowledge Base" (KB) comprising keywords relating to
the procedure, e.g., such as gastrointestinal, endoscopic and
bronchoscopic terminology keywords. The keywords are captured via a
graphical user interface (GUI) before, during, and/or after a
procedure. The keywords are made available for labeling images
captured during an examination to be used in reports,
auto-populating appropriate sections of a report such as a
Procedure Note, described further below, based on patient history,
and building Procedure Note templates or models to auto-populate
sections of information. The system also facilitates the use of
custom terms that apply to a specific department or location. Thus,
for example, during an exam, a user may select KB terms for a
procedure via a common user interface, which is employed wherever
the user needs to locate or extract keywords. This also provides a
consistent way to select and use terminology.
[0059] Clinical Flow
[0060] FIGS. 2-5 illustrate clinical flow diagrams that describe
the most common activities associated with the system and their
relationship in time in the context of one possible application of
the invention. Clinical flow is based on patient flow, which
relates to how a patient is processed before, during, and after an
endoscopic procedure. The overall flow across all lifecycle stages
starts with an exam request and ends with the generation of a
Procedure Note, the release of the patient, and the generation of a
set of related reports. User roles are represented as horizontal
bands.
[0061] The registration and scheduling clinical flow 200 of FIG. 2
includes a collection of all the information necessary to set up a
visit. It is initiated through an exam request made by either the
patient, a surrogate for the patient, or a referring physician. The
nurse and physician share the activity of preparing prep
instructions and medical advice for the patient.
[0062] The Pre-Procedure clinical flow 300 of FIG. 3 starts with
the arrival of the patient at the endoscopy facility and addresses
all administrative and medical activities necessary to prepare the
patient for the exam.
[0063] The Procedure clinical flow 400 of FIG. 4 depicts the actual
examination that takes place during the Procedure lifecycle stage.
The system is used to capture images, record vital signs, and
administer medications during this stage.
[0064] The Post-Procedure clinical flow 500 of FIG. 5 depicts the
activities that take place after the completion of an exam. These
activities include a nurse continuing to monitor the patient's
recovery, a nurse completing discharge instructions, releasing the
patient, and preparing billing code reports, and a physician
reviewing and editing the analysis of an exam by generating a
Procedure Note. A physician signs the Procedure Note when it is
complete. Afterward, management reports, patient recall requests,
and referral letters can be created and distributed.
[0065] User Interface
[0066] The invention is next described in connection with a user
interface that allow the user to select different features under
different tabs.
[0067] I. Home tab 600 (FIG. 6). The Home tab is the default home
page, and is pre-defined for each role. However, the user can
modify the page to suit the user's needs. The following are the
most common tasks that can be performed in the Home tab. Access to
these tasks is based on the user's role. For example, if the user
logs into the application as a scheduler, then the user would not
see the Sign Reports menu option, since that option is reserved for
the physician role.
[0068] 1) Scheduled Exams--used to view a list of scheduled exams
and create a new visit and exam.
[0069] 2) Create a New Visit--allows the user to schedule a new
visit for a patient.
[0070] 3) Pending Items--used to view all of the pending tasks. The
user can also select one or more pending items and close them.
[0071] 4) Pathology Status--used to view the status of outstanding
pathology requests or search the database for an existing record.
The user can also edit or delete existing pathology records. When a
pathology record is deleted, all of the specimens associated with
that record are deleted.
[0072] 5) Unsigned Reports--an attending physician can use the
Unsigned Reports screen to view and sign unsigned Procedure
Notes.
[0073] 6) Sign Reports--A system administrator can use the Sign
Reports screen to view unsigned Procedure Notes for a specific
physician and mark them as signed.
[0074] 7) Carbon Copies--When the user distributes a document to a
medical provider, clinical staff, or contact via email, a
notification is sent to the recipients that a document is available
for them in the system. Recipients can then log on to the system
and view a list of documents on the Carbon Copies screen.
[0075] 8) ICU Synchronization--when the user performs an exam in
ICU (Image Capture) mode, the user's imaging station is not
connected to the network server. When the user finishes the exam,
the user must upload images and data from the workstation to the
server repository. When the workstation is re-connected to the
network, a series of simple commands will upload the data and
images captured during the exam. After the data is uploaded, the
user uses the ICU Synchronization option to synchronize images and
data.
[0076] 9) Recall Letters--used to recall a patient for another
examination. The user can use this option to add an item to the
Recall Letter Queue to remind a patient of a follow-up
examination.
[0077] 10) System Log -Allows the system administrator to view
errors and messages generated by the application.
[0078] II. Patient File tab 700 (FIG. 7)--allows a user to capture
information specific to the individual patient. This tab is used to
record a patient's demographic information; a patient's medical
alerts, GI/pulmonary, medication, family, and social history
information, and view a summary of the patient information.
[0079] III. Registration tab 800 (FIG. 8). This tab is used to: (a)
create and modify visit and/or exam information; (b) view past,
current, or future schedules; (c) assign resources for an
examination including procedure rooms and equipment; and (d)
distribute registration documents.
[0080] III. Pre-Procedure tab 900 (FIG. 9). This tab is used to:
(a) record care plan information for a specific visit; (b) record
medical alert information; (c) record GI, pulmonary, family, and
social history information, (d) manage physical examination,
patient assessment, and physician check information, (e) manage
prep status information for the patient; (f) manage consent
information for a visit; (g) capture vital signs and medications
administered before the examination; (h) display a summary of
selected Pre-Procedure information and capture nurse handoff
information; and (i) distribute Pre-Procedure documents.
[0081] IV. The Procedure Tab 1000 (FIG. 10). This tab is used to:
(a) capture images during an endoscopic procedure; (b) record live
video clips; (c) record scope time used during an examination; (d)
view images and Procedure Notes from a previous exam; (e) print
images for an exam on a laser jet or a Mavigraph printer; (f)
record nurse administration information; (g) record accessories and
equipment used during an examination; (h) generate pathology
requests; (i) capture vital signs and medications administered
during the examination; and (j) distribute procedure documents.
[0082] V. The Post Procedure Tab 1100 (FIG. 11)--After an
examination is completed, this tab is used to perform
post-procedural tasks. These tasks include synchronizing images in
the ICU mode, monitoring a patient's vital sign and medication
information, managing captured images, and writing Procedure Notes.
Images from a current procedure, e.g., image 1 and image 2, and
from a prior procedure, e.g., image 3, image 4, and image 5, can be
displayed together for comparison. This tab is used to: (a) record
patient recovery information; (b) manage images captured during an
exam; (c) label, annotate, enhance, and print images; (d) import
and export images to and from the current examination; (e) manage
video clips recorded during an examination; (f) write and sign
Procedure Notes; (g) capture patient recall information; (h) assess
performance of a trainee participating in an examination; (i)
capture patient survey information; (j) distribute Post-Procedure
documents; and (k) perform ICU synchronization.
[0083] VI. The Analysis Tab 1200 (FIG. 12)--used to generate
redefined template-based management reports to satisfy end-user
administrative reporting requirements related to patient, procedure
and facility management, efficiency analysis, and resource
utilization. This tab is used to generate: (a) Continuous Quality
Improvement (CQI) reports; (b) efficiency reports; (c) equipment
analysis reports; (d) procedure analysis reports; and (e)
administration reports.
[0084] VII. The Admin Tab 1300 (FIG. 13)--used to perform
administrator tasks and ensure the efficiency and security of the
system. The system can be customized based on the needs and
requirements of the facility, physician, and clinical staff. This
tab is used to: (a) maintain system data (such as Patient ID type
and department information); (b) maintain application resource data
(such as clinical staff and contact information); (c) perform
system configuration (such as configure Mavigraph printer and video
settings); (d) customize how the application will flow and generate
information (for example, changing the order and location of menus
within the application and editing or creating templates/models
that are used to create Procedure Notes); (e) customize
user-defined fields (such as other patient information and other
visit information); (f) control access to or within the application
(such as user and role maintenance); and (g) maintain equipment
used during the procedure.
[0085] Knowledge Base
[0086] The Knowledge Base (KB) is a terminology database that
contains terms related to the specific procedure. For example, the
KB may be a medical terminology database that includes
gastrointestinal, endoscopic and bronchoscopic terminology in one
possible application. The KB can be extended to other medical and
non-medical applications by using the appropriate terminology. For
example, the knowledge base may be used for any application where
standardized terminology is desired. This may include applications
for producing reports in various industries, such as financial
services, insurance, legal services, real estate and so forth.
[0087] The KB contains concepts (terms), keywords (terms used in a
specific context), sentence models and views (menus and keyword
items). Keywords are the medical terms that are the basic building
blocks of the KB. When the user selects a keyword from a menu of
available keywords, it appears in a list of selected keywords or
terms. Moreover, keywords are organized in menus. For example, a
"size" menu type could contain the keywords "small", "medium", and
"large". Furthermore, a menu can be configured to be single-select,
unique, or multi-select.
[0088] Generally, the user can use the KB to: (a) capture keywords
before, during, or after a procedure; (b) label images captured
during an examination to be used in reports; (c) auto-populate
appropriate sections of a Procedure Note based on patient history;
and (d) build Procedure Note templates/models to auto-populate
sections of information.
[0089] During an exam, the user can select KB terms for a
procedure. The KB features a common user interface, which is
employed wherever the user needs to locate or extract keywords.
This also provides a consistent way for the user to select and use
terminology. The KB also facilitates the use of custom terms that
apply to a specific department or location.
[0090] Lexicon Function
[0091] A Lexicon function is used to select terms from the KB. The
Lexicon arranges the KB content into different report sections,
based on Phases of Care. The user can click a tab to see the KB
terms associated with the report section. A facility determines
which report sections should be available in the Lexicon screen for
a phase of care. A system administrator can make a report section
available to appropriate phases of care in the Admin tab.
[0092] Each tab or report section in the Lexicon screen may contain
two panes or display regions. As described further below, the right
hand side pane displays a KB view and contains all the available
terms of the KB arranged in a logical tree. Typically, only a
portion of the tree is visible at a time. The user can navigate the
tree to view different portions of it. The left hand side pane
contains the selected terms. When the user picks or selects an
available term from the right hand side pane, it is copied to the
left hand side pane, which displays the selected terms, thus
allowing the user to logically building a comprehensive description
of the exam. The user uses these selected terms along with other
exam data collected during various phases of care to generate
Procedure Notes, e.g., reports, and other exam related
documents.
[0093] Detailed Discussion
[0094] Lexicon Function--Pre-Procedure
[0095] FIG. 14 illustrates an example of the Pre-Procedure Lexicon
screen or interface 1400. The user can use the Lexicon function to
select terms from the KB and to record procedure related
information of the exam. The Lexicon arranges the KB content into
different report sections for the Pre-Procedure, including
indications, unplanned events and billing codes. These report
sections appear as tabs in the Lexicon screen 1400. To reach this
interface, the Pre-Procedure tab is selected, and the menu item
"Lexicon" is selected from the far left hand side of the interface.
Furthermore, under the Lexicon function, the "Indications" tab has
been selected, so the term "Indications" appears at the top of the
left hand pane or second display region 1410.
[0096] The right-hand pane or first display region 1420 of the
interface 1400 displays the available terms in the KB in a
hierarchical tree or menu 1425. Generally, there is insufficient
room to display all terms at the same time. Instead, the user can
view branches of the tree 1425 in an expanded view by clicking on a
"+" icon, or in a contracted view by clicking on a "-" icon. The
branches of a node of the tree may contain related keywords that
qualify the concept of the parent node keyword. For example, in the
tree 1425, the keyword "severity" includes branches for keywords
"mild", "moderate" and "severe" that describe the degree of
severity of the patient's symptoms. Keywords at lower levels of the
tree thus can be provided to qualify the keywords at the higher
levels.
[0097] In one example approach, the keywords in the tree 1425 are
organized into menus in which the physician might organize the
indications or symptoms of a patient. These menus may include,
e.g., GI or gastrointestinal symptoms, airway symptoms, test
results, imaging results, surveillance, treatment of established
disease, systemic disorders, follow up, diagnostic sampling, and
protocol study. Under each keyword, further qualifying terms can be
viewed by expanding the tree. The interface 1400 relates to GI
symptoms, and the portion of the tree 1425 shown relates to the
indication "abdominal pain". Multiple menus of indications can be
selected by the user together or in turn.
[0098] The second display region 1410 contains a tree 1415 with the
keywords that the user has selected from the KB terms in the
display region 1420. Generally, when the user selects an available
term from the first display region 1420, it is copied to the second
display region 1410 to logically build a comprehensive description,
e.g., of the patient's symptoms, or of the subsequent exam results.
For example, in the tree 1415, the indications of diarrhea, weight
loss, abdominal pain and heartburn have been selected along with
various keywords for detailing each indication. The following
discussion explains how the keyword "heartburn" in the tree 1415 is
selected by the user.
[0099] FIG. 15 illustrates an example lexicon user interface 1500
for selecting indications of GI symptoms for a patient. In the
first display region 1420, the various GI symptoms are provided as
branches of a tree 1525 in which the keyword "GI symptoms" is a
parent node. The user has expanded the tree under the keyword GI
symptoms to reveal the next lower level of keywords, e.g.,
abdominal pain, bloating, etc. The second display region 1410
indicates that the user has not yet selected any GI symptoms.
[0100] The user, such as a physician, obtains information regarding
the GI symptoms of a patient such as by interviewing the patient.
The user learns that the patient is experiencing heartburn. The
user then selects the keyword "heartburn" from the tree 1525 in the
first display region 1420, e.g., by clicking on "heartburn" with a
pointing device such as mouse. The keyword "heartburn" is then
copied to the second display region 1410 as a first indication. See
the interface 1600 of FIG. 16, which shows the selected keyword
"heartburn" displayed in the tree 1615 in the second display region
1410. Other indications such as diarrhea, weight loss and abdominal
pain, as provided in the tree 1415 of FIG. 14, may similarly be
selected from the tree 1525 to build a lexicon of selected keywords
in the second display region 1410.
[0101] Moreover, each keyword may be further detailed when
selected. For example, when the keyword "heartburn" is selected
from the tree 1525 in the first display region 1420, as shown in
FIG. 15, the first display region 1420 may be updated to display
the tree 1625, in which various additional details appear as
branches or child nodes of the selected keyword. For example, as
shown in FIG. 16, the tree 1625 displays keywords for detailing the
severity, frequency, duration, length of last episode, precipitants
and relief factors regarding the heartburn. Note that these same
keywords may be used for detailing the other indications, such as
diarrhea, weight loss and abdominal pain. Keywords that are
specific to a particular indication may also be used for detailing
the indication.
[0102] Furthermore, each of the keywords in the tree 1625 may be
expanded to provide further detailing keywords. For example, the
user may expand the node "severity" in the tree 1625 by clicking on
the "+" sign next to "severity". The result is the tree 1725 in the
interface 1700 of FIG. 17, where the keywords "mild", "moderate"
and "severe" allow the user to detail the severity of the
heartburn. Note that the term "heartburn" is highlighted in the
tree 1615, indicating to the user that any further selection from
the first display region 1420 will provide details regarding the
heartburn. If other indications such as weight loss and abdominal
pain were present in the tree 1615, each indication could be
highlighted in turn by the user to allow the user to enter the
associated details in turn.
[0103] Referring to the tree 1725, assume the user selects the
child keyword "severe" under the parent keyword "severity". As
shown in the tree 1815 in the interface 1800 of FIG. 18, the term
"severe" is copied to the second display region 1410 and provided
as a branch of the term "heartburn". As a further example, assume
the user proceeds to detail the frequency of the heartburn. To do
this, the user expands the keyword "frequency` in the tree 1625 to
reveal options such as "constantly", "specify number of times per
day", "specify number of times per week", "specify number of times
per month", and "specify number of times per year". The user may
select "specify number of times per day", which causes a pop-up
window to be displayed requesting that the user enter a number. The
user enters "6" in an Enter Number field if the patient was feeling
heartburn six times a day. The user then clicks OK to save the
entry. The interface is then updated so that the number "6" appears
in the tree 1915 in the interface 1900 of FIG. 19 under the keyword
"heartburn". Alternatively, the interface may display "6 times per
day".
[0104] The process as detailed above may be repeated for the
different indications to arrive at the interface 1400 of FIG. 14.
Note that the hierarchical relationship of the keywords in the tree
of available keywords is maintained in the tree of selected
keywords. Essentially, the tree of selected keywords is a subset of
the tree of available keywords. Advantageously, this allows the
context of a keyword to be understood by the user. Also, note that
the "specify" keywords prompt the user for a specific entry, e.g.,
as text or a numerical entry. It is also possible for the numerical
values or ranges of values to be provided as keywords in the tree
of available keywords.
[0105] Generally, the menu or tree of available keywords in the KB
can be configured to single-select, unique, or multi-select. A
single-select menu allows the user to select one keyword at a time.
For example, in the tree 1425 of FIG. 14, the keyword "severity" is
classified as a single-select menu, so the user can select only one
qualifier from the available qualifiers, such as mild, moderate or
severe. In a unique menu, once the user selects a keyword, the user
cannot select the keyword again. For example, the GI Symptoms menu
1525 of FIG. 15 is unique, and the user selects "heartburn" as the
first symptom. If the user tries to selects this keyword again from
the tree 1525, the keyword "heartburn" in the tree 1615 of FIG. 16
is highlighted to indicate that it has already been selected.
[0106] A multi-select menu allows the user to select multiple
keywords at a time. The user can even select all the keywords in a
multi-select menu. For example, if the GI symptoms menu in the tree
1525 of FIG. 15 is classified as a multi-select menu, the user may
select multiple symptoms such as diarrhea, weight loss, abdominal
pain and heartburn at the same time. For example, the user may
select multiple terms by clicking on each term with a mouse while
holding down the <Ctrl> key on the keyboard. Each selected
symptom appears at the same hierarchical level of the tree 1415 of
FIG. 14.
[0107] Views are collections of menus and their associated keywords
organized within a tree-structure. The user can use views to
navigate through the KB and select appropriate medical terms or
keywords. For example, the interface 1400 of FIG. 14 illustrates a
collection of menus and keywords or a View in the Lexicon screen.
To access the Lexicon screen, the user navigates to the
Pre-Procedure tab, selects an exam, and selects the "Lexicon"
option from the far left hand menu. The Lexicon screen 1400 may
contain the following tools to assist the user in navigating the
interface. Any appropriate icon design may be used.
1 Tool: Purpose: Generate Generate sentences from selected
keywords. Active only Report in the Procedure Note screen (The
Post-Procedure tab). Move Up Move keyword up in the selected terms
hierarchy. Move Down Move keyword down in the selected terms
hierarchy. Code Generate billing codes based on keyword selection.
Add KB Item Add a new keyword to the Knowledge Base or available
terms (the right side pane). Next Take the user to the previous
multi-select menu one level up in the selected terms (the left side
pane). Previous Take the user one level up in the selected terms
(the left side pane). Delete KB Item Delete a keyword from the
selected terms (the left side pane).
[0108] As mentioned, to select a clinical term for a particular
report section (tab), the user clicks on a keyword from the list of
available keywords in the first display region 1420, and the
selected keyword is copied to the second display region 1410.
However, this arrangement of the display regions is an example
only. It is possible to have the available and selected keywords
displayed in various other configurations. For example, the
available keywords may be displayed on a top display region while
the selected keywords are in a bottom display region. In another
possible approach, the selected keywords are displayed in a window
that is overlaid on a window that displays the available keywords.
It is also possible to use multiple display screens, where, e.g.,
the available and selected keywords are displayed on different
screens. Various other configurations are possible based on the
available display technologies.
[0109] Under the "unplanned events" tab of the interface 1400 of
FIG. 14, a window may be provided that allows the user to type in
details of such an event, or keywords describing the event may be
selected from the first display region 1420. For example, an
unplanned event during an endoscopic procedure may include
bleeding. The location and extent of bleeding can thus be
detailed.
[0110] Under the "codes" tab, the user can associate billing codes
with selected keywords for billing purposes. The user accesses the
Lexicon screen and selects a keyword with which to associate the
billing code. The user clicks the Code icon, and a Select Billing
Codes window is displayed. The user clicks Code Set, and the Code
Sets window is displayed. The user searches for a billing code from
this window. The user selects a type of code set from the Code Set
dropdown list. The user enters the number of the code that is being
searched for in the Number field. The user enters a description of
the code in the Description field. The used clicks Go, and a list
of billing codes based on the search criteria is displayed. If no
search criteria are entered, all the billing codes from the
selected code set are displayed. FIG. 20 illustrates an interface
2000 with a list of billing codes from the ICD-9 (International
Classification of Diseases) Diagnostic Code Set. The user clicks a
billing code to select it. To select multiple billing codes, the
user presses and holds the <Ctrl> key and selects the billing
codes.
[0111] Lexicon Function--Post-Procedure
[0112] FIG. 21 illustrates an example of the Lexicon screen 2100 in
the Post-Procedure tab. In the Post-Procedure phase, the physician
or other user uses the Lexicon function to record findings from
performing a procedure. These report sections appear as tabs in the
Lexicon screen 2100 labeled as: indications, procedure, findings,
medication, unplanned events, recommendation, summary and codes.
FIG. 21 illustrates the Findings tab. To access the Lexicon screen,
the user navigates to the Post-Procedure tab, selects an exam, and
selects the Lexicon option from the far left hand menu. The Lexicon
interface for Post-Procedure is analogous to that for Pre-Procedure
(FIG. 14).
[0113] The Post-Procedure Lexicon screen may contain icons for
tools as discussed above in connection with the Pre-Procedure
lexicon function. Moreover, as with the Pre-Procedure case, a
Lexicon menu for Post-Procedure can be configured as single-select,
unique, or multi-select.
[0114] To select a clinical term for a particular report section
(tab), the user clicks on a keyword from the list of available
keywords. The selected keyword is copied to the left side of screen
or other separate display region. For example, assume the user
finds a small polyp in the stomach in the patient during the
endoscopic procedure, specifically on the anterior wall of the
antrum. To document this finding, the user may perform the
following steps:
[0115] (a) Access the Lexicon screen.
[0116] (b) Select the Findings report section tab. The display
region 1420 provides a tree where a parent node is for the keyword
"organs" (not shown).
[0117] (b) Click the +(plus) sign next to "organs" to expand it,
revealing branch nodes for specific organs such as the stomach,
duodenum, etc.
[0118] (c) Select "stomach" from the first display region 1420.
This causes the tree 2115 (FIG. 21) to be updated with the keyword
"stomach", and for the first display region 1420 to display
branches including "stomach findings" under the parent node
"stomach" (not shown).
[0119] (d) Click the + (plus) sign next to "stomach findings" to
expand it. This causes the first display region 1420 to display
branches of "stomach findings", including "polyps" (not shown).
Note that it is not necessary to update the tree 2115 with the
keyword "stomach findings" since it is self-evident that the
findings that are subsequently detailed are stomach findings.
[0120] (e) Select "polyp" from the first display region 1420. This
causes the tree 2115 to be updated with the keyword "polyp" as a
child branch of the keyword "stomach". The first display region
1420 is updated to display a tree that is similar to the tree 2125,
except that the keywords are unexpanded. The keywords in the tree
2125, e.g., fundus site. body site, antrum site, other stomach
site, etc., are child branches of the keyword "polyp".
[0121] (f) Click the + (plus) sign next to "antrum site" in the
tree 2125 to expand it, revealing the child branches of anterior
wall, posteriori wall, greater curvature and lesser curvature.
[0122] (g) Select "anterior wall of the antrum" from the tree 2125.
This causes the tree 2115 to be updated with the keyword "anterior
wall of the antrum" as a first branch of the keyword "polyp".
[0123] (h) Click the + (plus) sign next to "size of polyp" to
expand it, revealing the branches for diminutive, small, medium,
and specify size (mm) in the tree 2125.
[0124] (i) Select "small" from the tree 2125 This causes the tree
2115 to be updated with the keyword "small" as a second child
branch of the keyword "polyp". Again, note that the hierarchical
relationship of the available keywords is maintained in the tree
2115 for the selected keywords.
[0125] (j) Click Save.
[0126] The system further allows the user to enter custom
information. If the user does not find a keyword in the available
KB terms, the user can specify a term using a keyword that begins
with "specify" (such as "specify size to enter a size", "specify
finding to enter a finding", etc.) to add a term. For example, if
the user does not find the size that the user wants to specify for
the "size of polyp", the user can specify a different size. To
specify a different size in millimeters (mm), for instance, the
user can perform the following:
[0127] (a) Click the "specify size (mm)" option in the tree 2125 to
display a Specify Size (mm) window as a pop up window with a text
field.
[0128] (b) Enter a value in the Enter Value text field, e.g.,
"23".
[0129] (c) Click OK. The size of the polyp then appears in the left
side tree 2115. For example, in the tree 2115, the entry "23 mm" or
"size of polyp 23 mm" may appear in place of the keyword
"small".
[0130] (d) Click Save.
[0131] Procedure Notes
[0132] The Procedure Notes task may be accessed from the
Post-Procedure tab of the interface to prepare Procedure Notes
regarding a procedure performed on a patient. A Procedure Note may
include documented information about a specific exam. It can be
used to document findings, diagnosis, medications, recommendations,
and other information such as past diagnosis. Generally, the
Procedure Note function can be used to: (a) manage images, (b) view
information such as images and Procedure Notes for other exams, (c)
select terms from the Knowledge Base tree, (d) generate report
text, (e) select billing codes, (f) sign a note, (g) generate
different versions of a note, (h) discard a note, and (i) delete a
note.
[0133] The user selects a template/model to use the Procedure Note
function. The system administrator creates a Procedure Note
template/model based on the manner in which either a facility or a
physician wants to display captured information in a document. FIG.
22 illustrates a Select Procedure Note Template screen 2250 in the
Post-Procedure screen 2000. To select a template, the user does the
following: (a) access the Post-Procedure screen 2200, (b) select an
exam, (c) select "Procedure Note" from the far left hand menu,
causing the Select Procedure Note Template screen 2250 to be
displayed, e.g., as a pop up window, (d) search for the Procedure
Note template based on facility and/or physician names, (e) click
Go, causing a list of resulting Procedure Note templates to be
displayed, and (f) select a particular template to view the
Procedure Note screen 2300 of FIG. 23. In the example provided, a
template entitled "Standard--Bronch" is available to assist the
user in generating a Procedure note for a bronchoscopy
procedure.
[0134] Referring to FIG. 23, a first display region 2364 may
provide a tree 2365 of available KB keywords as discussed in
connection with the first display region 1420 of the Lexicon screen
1400 (FIG. 14). Similarly, a second display region 2362 may provide
a tree 2363 of selected keywords as discussed in connection with
the second display region 1410 of the Lexicon screen 1400. A third
display region 2340 provides a Procedure Note Builder for editing
and generate reports such as Procedure Notes. A fourth display
region 2320 provides an Image Strip section 2320 for managing
images for the current exam. Example images for the current exam
are displayed at the left side of the section 2320 as "image 1" and
"image 2".
[0135] The user can use the Images section 2320 in a similar manner
as the Image Management screen. The Images section 2320 may contain
tools for the following functions: (a) delete selected images from
the current exam, (b) delete all unlabeled images from the current
exam, (c) mark selected images for printing, (d) unmark the
selected image for printing, (e) view larger image, (f) label all
selected images from the current exam, (g) delete the label from
all selected images from the current exam, (h) associate findings,
(i) disassociate findings, (j) show or hide menu and (k) show or
hide strip.
[0136] The Procedure Note function can be used to view images and
Procedure Notes for other exams associated with the selected
patient. The following tools may be used to view other exam
information: (a) view large image, (b) view the Procedure Note for
the other exam, and (c) close the other exam image window. To view
images for another exam, the user accesses the Procedure Note
screen, and selects an exam from the Other Exam dropdown list 2322.
Images for the selected exam are displayed on the right side of the
Images section 2320.
[0137] To view Procedure Notes for another exam, the user selects
the exam from the Other Exam dropdown list 2322, and clicks the
View the Procedure Note icon to display the Procedure Note for the
other selected exam in a new window.
[0138] The Procedure Note function can also be used to select KB
keywords for an examination. The first display region 2364 is used
to select keywords as discussed above in connection with the
Lexicon function. When the user is done selecting keywords, the
user clicks the Generate Report icon, discussed in connection with
the tools above, to generate a report in the third display region
2340, which is the report section of the interface 2300. The
Generate Report icon is activated if the user makes changes to the
selected keywords. Moreover, if any of the selected keywords are
associated with a sentence model, the sentence is generated and
populated with the keywords in the displayed report within the
specific Report Section.
[0139] The third display region 2340 may include predefined
sections corresponding to the tabs in the Lexicon screen 2100 of
FIG. 21, e.g., introduction, indications, procedure, findings,
medication, unplanned events, recommendations, summary and codes.
The user may build a lexicon for one or more of the sections as
discussed above. As the lexicons are developed, one or more
sentence models are selected from a number of available sentence
models. The selected sentence models are populated using the
selected keywords and predefined or static text, as discussed
further below.
[0140] In the Findings section of the third display region 2340, a
Use Organ Labels feature may be set to Yes for the exam type, in
which case the sentences for findings are prefixed with the name of
the organ. For example, assume there was a finding of "polyp" in
"stomach". Moreover, the polyp is further detailed by the user
selecting the keyword "antrum site" and the branch keyword thereof
"anterior wall of the antrum", the keyword "polyp qualifier" and
the branch keyword thereof "broad based", and the keyword "size of
polyp" and the branch keyword thereof "small". These keywords are
indicated in the tree 2363 in the second display region 2362. The
sentence model in the report might appear as: "Stomach: A small,
broad-based polyp was found arising from the anterior wall of the
antrum. (2)". Here, the notation "(2)" denotes a corresponding
image in the Images section 2320 associated with the finding, e.g.,
image 2. When a sentence for a finding is generated, and there is
an image associated with the finding, the image number may be
provided at the end of the finding.
[0141] Also in the third display region 2340, a sentence model is
populated to describe findings regarding a second organ, the
esophagus. As indicated in the tree of selected keywords 2363, the
user has found food in the esophagus. The food is characterized as
being a trace amount, in a location described as the upper third of
the esophagus, and the presence of the food is attributed to a
motor disorder in the patient. Specifically, after building the
lexicon of terms to describe the Findings in the tree 2363, the
user clicks the Generate Report icon, and the sentence is
generated. The sentence might appear as: "Esophagus: Trace of food
was found in the upper third of the esophagus, due to motor
disorder."
[0142] Similarly, a Recommendation may appear as the sentence:
"Start a low fat diet" based, e.g., on one or more keywords
selected by the user under the Recommendation tab. Other example
recommendations include "admit for observation", "consult
radiologist", and so forth.
[0143] The sentence models advantageously allow the user to quickly
generate reports using standard terminology and sentence
structures. Moreover, the generated sentences can be easily edited
by substituting one keyword in place of another. For example, under
Procedure in the third display region 2340, the user may wish to
change "The views were excellent" to "The views were good". To
achieve, this, the user highlights the word "excellent" in the
sentence. In response, the display region 2362 is updated to show
the portion of the tree 2363 in which the selected keyword
"excellent" is located. The keyword "excellent" may appear
highlighted in the tree 2363. Additionally, the display region 2364
is similarly updated to show the portion of the keyword tree 2365
in which the keyword "excellent" is located. Moreover, in the tree
2365, "excellent" will appear with other related keywords such as
"poor", "fair" and "good", which are branches of the same parent
node, such as "quality". The keyword "quality" may in turn be a
branch of a parent node "views", for instance. To replace the
keyword "excellent" with the keyword "good", the user selects
"good" from the tree 2365. The tree 2363 is then updated with the
keyword "good" replacing "excellent". Next, the user clicks the
Generate Report icon to re-populate the sentence model with "good"
in place of "excellent".
[0144] Similarly, a sentence can be edited by adding or deleting a
keyword. For example, the user may wish to change "A small,
broad-based polyp was found . . . " to "A broad-based polyp was
found . . . " To achieve this, the user highlights "small" in the
sentence and clicks on a delete icon. To add a keyword, the user
selects the additional keyword from the tree of available keywords
2365. The keyword is then copied to the tree of selected keywords
2363 and shown in the appropriate hierarchical position in the
tree. The user then clicks the Generate Report icon to re-populated
the sentence in the third display region 2340. For example, the
user may select the additional keyword "small" from the tree 2364
to change the sentence "A broad-based polyp was found . . . " to "A
small, broad-based polyp was found . . . "
[0145] This keyword editing feature is very powerful since it
allows the user to modify the report to correct erroneous entries,
or to modify entries based on further findings or change in
judgment, for instance.
[0146] The example sentence models discussed above are normal
sentence models since they read as complete sentences rather than
as sentence fragments. A normal sentence model also typically
incorporates all of the selected keywords associated with the
report section. However, it is also possible to associate a keyword
in the KB with a summary sentence model. If a selected template has
a Summary section and a selected keyword has a summary sentence
model, the summary sentence for the keyword appears in the Summary
section. For example, if the user finds a polyp in the stomach, the
summary sentence might be: "Diagnosis--polyp". Thus, a report can
include both normal and summary sentences.
[0147] The Procedure Note function can further be used to select
relevant billing codes for the exam. If a keyword has a billing
code associated with it, the user would see all billing codes and
descriptions associated with the keyword when clicking the Code
icon. Relevant billing codes associated with a keyword can be
selected for the current exam as discussed previously
[0148] To save a Procedure Note, the user accesses the Procedure
Note screen and clicks Save. The user can sign a Procedure Note if
the Procedure Note text is generated. In one approach, only
attending physicians for the examination can sign the Procedure
Note. If the Validate & Sign Procedure Note settings are set to
Yes, the user will be asked to validate the user ID and password.
Signing a note will lock the report from further editing. To sign a
report, the user accesses the Procedure Note screen and clicks
Sign. Signing a Procedure Note updates a patient's past procedure,
past diagnosis, and past surgeries record.
[0149] In situations where the user makes changes to an existing
Procedure Note and wants to apply those changes to future Procedure
Notes, the user saves the modified Procedure Note as a template for
generating future Procedure Notes. To save a Procedure Note as
template, the user accesses the Procedure Note screen, clicks Save
As, assigns a name to the template, selects either a facility or
physician name to assign an owner to the template, and clicks
Save.
[0150] Once a Procedure Note is signed, it is locked and cannot be
edited. To make any changes to an existing, signed Procedure Note,
the user can create a new version of the Procedure Note. The new
version of the Procedure Note is an exact copy of the current
signed Procedure Note, without regenerating any sentences or
updating any database fields. To generate a new version, the user
accesses the Procedure Note screen and clicks New.
[0151] Discarded Procedure Notes are stored in a Discard Bin, where
they can be viewed but not restored. To discard a Procedure Note,
the user accesses the Procedure Note screen, makes sure the
Procedure Note is signed, clicks Discard, and clicks Yes.
[0152] To delete a Procedure Note, the user accesses the Procedure
Note screen, makes sure the Procedure Note is not signed, clicks
Delete, and clicks OK.
[0153] Maintaining the Knowledge Base
[0154] A system administrator is responsible for maintaining the
Knowledge Base by adding new keywords, sentence models, and menu
structures.
[0155] Report Sections are used to generate Procedure Notes for a
specific exam type. When the user creates a Procedure Note
template, the user can choose to include a few or all the report
sections in it. The user can also assign these report sections to a
phase of care and then use them in the Lexicon screen as tabs to
record data. The user can create, modify, and delete report
sections from the Report Section List screen. Examples of report
sections include: introduction, indications, procedure, findings,
medication, unplanned events, recommendation, summary, and billing
codes.
[0156] A Phase of Care function can be used to assign specific
report sections to a phase of care, namely Registration,
Pre-Procedure, Procedure, and Post-Procedure.
[0157] To create a Procedure Note template for an exam type, the
user uses the Report Template function. To access the Report
Template screen, the user navigates to the Admin tab, and selects
Customization from the left menu. Available customization options
are displayed. The user selects Report Template from the left menu,
and the Select Procedure Note Template screen is displayed (FIG.
24). To search for a Procedure Note template/model, the user
accesses the Select Procedure Note Template screen, selects an exam
type, facility, or physician, and clicks Go. A list of Procedure
note templates is displayed, based on the search criteria.
[0158] Knowledge Base Framework
[0159] The KB provides a controlled vocabulary for reporting
results, e.g., of medical examinations and procedures. Discussed
below are the three structural layers of the KB, an overview of the
use of the KB base by the end user while creating Procedure Notes,
the use of selected terms for query purposes, and an interface to
maintain the KB.
[0160] The KB includes three main layers: Concept Layer, Data Layer
and View Layer. The Concept Layer represents a dictionary from
which individual words can be selected to build a more complicated
grammar. The Data Layer represents the data that describes the
Concepts in greater detail. The View Layer organizes the Keywords
into groups of terms in a tree structure connected by menus. The
view is the primary way for the user to navigate through the
knowledge base to select the appropriate medical terms for a given
examination type.
[0161] In the following discussion, class diagrams are provided
according to the Unified Modeling Language (UML). As is known,
class diagrams describe the static structure of a system. Classes
represent an abstraction of entities with common characteristics.
Classes are illustrated with rectangles divided into portions. The
name of the class is in the top portion, and the attributes of the
class are in the middle portion. Write operations may be provided
in the bottom portion.
[0162] Moreover, associations represent the relationships between
classes. Multiplicity or cardinality notations are indicated near
the ends of an association. These symbols indicate the number of
instances of one class linked to one instance of the other class,
as follows: (a) "1" denotes no more than one, (b) "0 . . . 1"
denotes zero or one, (c) "*" denotes many, (d) "0 . . . *" denotes
zero or many, and (e) "1 . . . *" denotes one or many. A filled
diamond represents a composition relationship, denoting a strong
ownership between a "whole" class and a "part" class. A hollow
diamond represents a simple aggregation relationship, in which the
whole class plays a more important role than the part class, but
the two classes are not dependent on each other. The diamond end in
both a composition and aggregation relationship points toward the
whole class or the aggregate.
[0163] Concept Layer (The Dictionary)
[0164] FIG. 25 illustrates a conceptual class diagram 2500 of the
Concept Layer. The classes are "Concept" and "LUI" (Lexical Unique
Identifier). There are one or many instances of "LUI" linked to one
instance of "Concept". Also, there is a composition relationship
between "Concept" and "LUI".
[0165] The Concept Layer defines the concepts that can exist in the
KB. Concepts are given a textual representation and classified
according to the dictionary definition of the concept within this
layer. The Concept Layer acts much like a dictionary, defining
meanings of concepts, whereas the rest of the knowledge base is
more like an encyclopedia, defining concept usage.
[0166] Concepts are unique objects within the KB that represent the
data that does not change regardless of the context in which the
data is used. For example, the word "mass" is defined as a unified
body of matter with no specific shape. It may also be defined as a
large but nonspecific amount or number. These would be two separate
concepts within the KB because they have different meanings.
However, a mass within the esophagus and a mass within the colon
would be the same concept because they are both a unified body of
matter with no specific shape. As discussed further below, this
approach advantageously allows accurate querying of indications,
findings and other data obtained via the system, which
distinguishes when the same word is used in different contexts.
Concepts have no inherent relationship to any other concepts within
the KB.
[0167] LUIs represent a specific version of text that represents a
Concept. When the text for a Concept changes, a new LUI is created
so that the Concept can still be referred to by its old name. For
example, a user of the KB may choose to change the name of the
Concept "mass" to "tumor" due to personal preference. In this case,
all references to that Concept will have the text of "tumor" unless
the specific LUI for "mass" is used.
[0168] LUIs are used to "lock" the text of a signed Procedure Note.
When a Procedure Note is signed, the application traverses the tree
of selected terms and stores the LUIs of the concepts at the time
of signing. When the signed report is later amended, the selected
items refer to the text that was present at the time of signing
until that item is modified at which time the newest LUI is used.
The LUI infrastructure could also be extended to accommodate other
features where the textual representation of a concept needs to
change without the underlying meaning being affected, e.g., for
internationalization and synonym support.
[0169] Data Layer
[0170] FIG. 26 illustrates a conceptual class diagram 2600 of the
Data Layer. The Data Layer represents all the knowledge that is
contained within the KB. The Data Layer allows the application to
understand what a concept means in the context of the KB. The Data
Layer can be thought of as an encyclopedia of knowledge as apposed
to the Concept Layer, which is a dictionary. For instance, while
the dictionary definition of "mass" might be quite simple, an
encyclopedia entry for mass could talk about all the different
causes for, and descriptions of, a mass/tumor.
[0171] Keywords are Concepts that have a defined set of properties.
Unlike Concepts, Keywords are linked with other Keywords to define
a specific use of a Concept. For example, sample data for a Concept
called Mass may include a classification as an
Entity/ConceptualEntity/PatientProblem/Fin-
ding/ImagingFinding/ProtrudingLesions. The use of the "/" in this
notation denote that the item following the "/" is a subclass of
the item preceding the "/". For example, Conceptual Entity is a
subclass of Entity, PatientProblem is a subclass of Conceptual
Entity, and so forth.
[0172] Classifications represent the semantics of Concepts. Through
Classifications, Concepts are given a meaning. Classifications are
constructed in a hierarchy much like a taxonomic classification of
organisms. Taxonomy is the scientific discipline of categorizing
various species of organisms into conveniently sized groups,
referred to as taxa, which share common, identifiable traits. In
one possible implementation, the root of the hierarchy is a
classification called Entity, from which all other classifications
are derived. The hierarchy is structured so that more specific
classifications are lower in the hierarchy. For example, under the
root classification of Entity there are two classifications;
Physical Object and Conceptual Entity. If a Concept is classified
as a Physical Object, like a chair for example, we know that that
Concept exists in the physical world and could, for example, be
measured. Alternatively if a Concept is classified as a Conceptual
Entity, for example, occupation, we know this is not a physical
thing and could not be held or touched. For example, with the above
approach, the user could formulate a search of the KB to find all
patients who had neoplasms. The KB would return patients that had
tumors and polyps because both Concepts are classified as
neoplasms.
[0173] Properties define the set of allowable values for a group of
related keywords. A keyword can have any number of properties that
are made up of a homogenous list of keywords that all share the
same classification or inherit from the same classification. For
example, the property Location on Mass has a classification of
BodyLocation; this means that any keyword that is also classified
as BodyLocation or something derived from BodyLocation, such as
Organ, can be assigned as an allowable value to the property. The
following table indicates sample properties, classifications and
values for the keyword "mass."
2 Keyword - Mass Property Classification Values Location
Entity/PhysicalObject/ esophagus, stomach, AnatomicalStructure/
duodenum, distance from entry AnatomicalForm/BodyLocation
Appearance Entity/ConceptualEntity/ nodular, ulcerated, friable,
FindingModifier/VisualAppearance firm, frond-like/villous,
fungating, infiltrative, polypoid, submucosal, smooth Bleeding
Entity/ConceptualEntity/ oozing, spurting, not bleeding,
FindingModifier/Bleeding bleeding on contact Circumferential
Entity/ConceptualEntity/ <25%, 25-49%, 50-74%, 75-99%,
QuantitativeConcept/Size specify Narrowing Entity/ConceptualEntity/
Extrinsic, intrinsic, uncertain, QuantitativeConcept nodular,
friable, firm, ulcerated, infiltrative, submucosal, smooth
Obstructing Entity/ConceptualEntity/ Possible, mild, moderate,
severe QuantitativeConcept Size Entity/ConceptualEntity/
diminutive, small, medium, large, QuantitativeConcept/Size measured
(cm), measured (mm) Stigmata Entity/ConceptualEntity/ adherent
clot, loose clot, spot, visible FindingModier/Bleeding vessel, no
bleeding stigmata
[0174] FIG. 27 illustrates a conceptual class diagram 2700 of the
Sentence Model infrastructure. Sentences define the prose that will
be generated for a given set of keyword selections. A sentence
model may include up to four different types of placeholders. Text
placeholders are used to add static text to the sentence model.
Node-placeholders are used as a placeholder for any value of the
property specified in the placeholder. Conditional-placeholders are
used to generate text that depends on the value or values of a
property or properties, respectively, in the sentence model.
Trigger-placeholders are used to put the keyword that this sentence
model is associated with into the sentence. Moreover, a keyword may
be associated with a summary sentence model and/or a normal
sentence model. The summary sentence model is used specifically in
the summary report section.
[0175] The following code illustrates example sentence models. In
the examples, text-placeholders are represented surrounded by angle
brackets (<>), node-placeholders are represented surrounded
by square brackets ([ ]), trigger-placeholders are displayed all in
uppercase, and conditional-placeholders are surrounded by curly
braces ({ }).
EXAMPLE 1
Finding
[0176] <There was a> [Size] [Mass Appearance] TUMOR/MASS
<present> {IF ([site]==(distance cm from teeth)) "at" else
"in the" } [Site] {IF ([site]!=(whole esophagus) AND
[site]!=(Distance cm from teeth) AND [site]==(ANY)) "of the
esophagus" ELSE ""} {IF ([site]==(Distance cm from teeth)) "from
the entry site" ELSE ""}<.>
[0177] The trigger-placeholder "TUMOR/MASS" indicates that the
particular sentence model will be populated and displayed on the
user interface, such as on the Procedure Note Builder display
region 2340 (FIG. 23), when the user selects the keyword
"TUMOR/MASS" from the available keywords and clicks the Generate
Report icon. The node placeholders [Size] and [Mass Appearance]
will be populated by the respective keywords selected by the user
for those concepts. For example, [Size] and [Mass Appearance] may
be populated by the keywords "large" and "rounded", respectively.
Moreover, note that various conditional statements are used to in
the example code above to adjust the grammar of the sentence
depending on the keywords selected by the user to characterize the
finding. For example, if the "site" is described by a distance in
cm from the teeth, the sentence will state: "There was a large
rounded tumor/mass present at 10 cm from the teeth". If the site is
described by something other than a distance in cm from the teeth,
e.g., the site is described as being the esophagus, the sentence
will state: "There was a large rounded tumor/mass present in the
esophagus". The sentence models thus account for the different ways
in which information can be provided by the user for the same
findings, for instance.
EXAMPLE 2
Medication
[0178] <Start> CIPROFLOXACIN [dose][route] {IF
([frequency]==(qpm)) "every evening" ELSE ""} {IF
([frequency]==(q12 h)) "every twelve (12) hours" ELSE ""} {IF
([duration]==(ANY) "for" ELSE "" } [duration]<.>
[0179] The trigger-placeholder "CIPROFLOXACIN" indicates that the
particular sentence model will be populated and displayed on the
user interface, such as on the Procedure Note Builder screen region
2340 (FIG. 23), when the user selects the keyword "CIPROFLOXACIN"
from the available keywords and clicks the Generate Report icon.
The node placeholders [dose] and [route] will be populated by the
respective keywords selected by the user for those concepts. For
example, [dose] and [route] may be populated by the keywords "IV"
and "2 mg", respectively. Again, note that various conditional
statements are used to adjust the grammar of the sentence depending
on the keywords selected by the user to characterize the finding.
For example, if the "frequency" is described by 12-hour period
(variable "q12 h"), the sentence will state: "Start CIPROFLOXACIN
IV 2 mg every twelve (12) hours."
[0180] Triggers are used to signal the application that some action
must be taken when the triggering keyword is selected. There are
two forms of triggers that can be assigned to a keyword: Education
and Recall. An education trigger is used to signal the system that
a particular document should be queued for printing when the
keyword is selected. A recall trigger is used to generate an item
in a recall queue for a patient when the keyword is selected.
[0181] Codes are used to associate external codes to a keyword in
the KB, primarily for billing. Any number of Codes can be assigned
to a keyword. Codes are assigned to a Keyword from a code set,
which is the universe of all possible codes for a given code set
type.
[0182] View Layer
[0183] FIG. 28 illustrates a class diagram 2800 of the View Layer.
Items are Keywords that appear within a View. Items are grouped
into menus when they are inserted into a view. Menus are used to
group related items together within a view. Shortcuts are stored
selections that will be expanded when selected. Shortcuts are named
entities that have their own menu structure. A shortcut menu
appears under the parent of the highest-level menu for the
shortcut.
[0184] Using the Knowledge Base
[0185] Procedure Note Data
[0186] When terms are selected from a view and associated with an
examination, a reference to the keywords, not the terms, is saved.
The references are stored in an ordered tree based on the order in
which the terms are selected from the view.
[0187] Queries
[0188] The reference data associated with the examination will be
open to queries. The query can look at either the concepts or
keywords associated with the examination. For example to find all
patients that had a finding of mass in the esophagus, the query
could be: findings.mass.location=esop- hagus. To find all patients
that had a finding of mass in the esophagus greater than 2 cm, the
query could be: findings.mass.location=esophagus and
findings.mass.size>2 cm. To find all patients that had a
confirmed diagnosis of cancer in the esophagus, the query could be:
diagnosis.(concept.classification=cancer).location=esophagus and
diagnosis.(concept.classification=cancer).certainty=confirmed.
Thus, the invention allows advanced data mining techniques from a
database of patient information. Other techniques that simply
search a database by keyword yield less accurate results. For
instance, a search for the word "mass" in a database with such
techniques might yield a finding stating that "no mass was found"
as well as other tangential or irrelevant results.
[0189] Maintaining the Knowledge Base
[0190] Generally, the KB can be tailored to the user's specific
needs. In one possible approach, a complete baseline KB is defined
by the developer of the system to enable users such as physicians
to immediately use the system. The users can subsequently fine-tune
the system to meet their specific needs after gaining experience
with the system by employing the following maintenance
features.
[0191] FIG. 29 illustrates a user interface for adding a keyword to
the KB. The KB maintenance user interface 2900 may include a number
of tools, including: add menu/term, edit menu/term, add concept,
edit concept, add property definition, edit property, remove, copy,
past, move up, move down, create shortcut, edit sentence, edit
codes and triggers.
[0192] In a pop up window 2920, the user enters a new concept named
"stomach" in a field 2924. A classification tree 2922 indicates
that the classification of the concept is under "organ". The user
can navigate the tree 2922 by clicking on the desired
classification. The higher-level classifications in the tree are
also shown, up to the top-level classification "Entity". The user
can also enter a plural term for the concept, and a description of
the concept, via the window 2920. A classification description is
also provided in a grayed out manner to indicate that it cannot be
edited. In the display region 2905 of the interface 2900, the
classification tree is repeated. A display region 2910 indicates
that "esophagus" and "duodenum" are concepts that are related to
"stomach" since they are all members of the classification "organ".
The user can check a "specify" checkbox 2925 so that the user is
prompted to enter a value to replace the keyword when the report is
generated. The data type specified by the drop down menu 2930
determines whether the user is allowed to enter a text or numeric
value. Note that the keyword "stomach" is also defined for a
certain exam type, e.g., EGD, and for a report section, e.g.,
Findings. The user can also adjust these factors.
[0193] FIG. 30 illustrates a user interface for adding a property
definition to the knowledge base. The user interface 3000 includes
a display region 3005 indicating that the property definition is
for the classification of "body location".
[0194] FIG. 31 illustrates a user interface 3100 for editing a
keyword in the knowledge base. A tree 3120 indicates that the user
has selected the keyword "ulcer". The concept "ulcer" is presented
in a grayed out manner to indicate it cannot be edited. The
sentence name can be edited if desired. If the keyword is a
"specify" type item that prompts the user for a value, the check
box 3125 will be checked, and the user will be allowed to determine
its data type with the drop down menu 3130.
[0195] FIG. 32 illustrates a user interface 3200 for editing
properties of a keyword in the knowledge base. The keyword tree
3120 is the same as shown in FIG. 31. A display region 3210 allows
the user to edit the properties of a keyword, such as "size". The
classification of the keyword is identified as a quantitative
concept. The user selects one or more keywords for the quantitative
concept from a pop up window 3230. The selected keywords are then
copied to a display region 3220 as available values for detailing
the property of "size". The user may check a checkbox 3225 to
indicate that a value for size is required to be entered by the
user, e.g., when reporting the findings of a procedure.
[0196] FIG. 33 illustrates a user interface 3300 for assigning
properties to a keyword in the knowledge base. The user selects a
classification from the Select Class tree. A display region 3340
indicates the properties available in the selected class, and a
user may choose a property to assign to the keyword. In window
3310, the user may create a new property by assigning it to a
classification.
[0197] FIG. 34 illustrates a user interface 3400 for adding and
editing codes in the knowledge base. The keywords are provided in
the tree 3410. A pop up window 3430 allows the user to select codes
such as for billing. For example, the user may choose a code set
from a drop down menu, and one or more individual codes. A display
region 3420 displays the selected codes.
[0198] FIG. 35 illustrates a user interface 3500 for adding and
editing sentence models in the knowledge base. The tree 341 0 is
the same as in FIG. 34. The keywords in the tree 3410 that trigger
a sentence model may be highlighted, e.g., in bold font. A display
region 3520 provides the sentence model for the normal or full
sentence, while the display region 3530 provides the summary
sentence model. The placeholder terms in brackets may be
highlighted in yellow, for instance. The pop up window 3540
indicates the available nodes that the user may choose to insert
into the sentence model.
[0199] FIG. 36 illustrates a user interface 3600 for adding a
condition in a sentence model in the knowledge base. For example,
the user may desire to add a conditional placeholder to the
sentence model in the display region 3520. To do this, the user
positions the cursor to a location in the sentence model in which
the conditional placeholder is to be added, and clicks on the
"conditional" icon, causing the window 3630 to pop up. The window
3630 allows the user to define a condition, operator, and values.
The user also defines the text that is to be entered in the
sentence model depending on whether or not the condition is met.
The user can click on an icon 3635 to cause a window 3640 to pop up
that display values from which to select. Once the user defines the
conditions, corresponding code, such as in the C language, is
generated in the sentence model. The example sentence model in the
display region 3620 is simplified. In practice, detailed sentence
models contain several conditional statements to account, e.g., for
variations in the way a finding can be described, the level of
detail, grammatical concerns and so forth.
[0200] FIG. 37 illustrates a user interface 3700 for adding and
editing triggers in the knowledge base. As mentioned previously,
selected keywords may trigger an action such as printing a document
or scheduling a patient recall. For instance, the user may select
the keyword "polyp" from the keyword tree 3705. In a display region
3710, the user checks a check box 3720 to set an education trigger.
Additionally, a document is selected from a drop down menu 3725 to
identify a relevant document to provide to the patient. The
document may be printed and handed to the patient during the
patient's examination, mailed to the patient's home, or emailed to
the patient, for instance. Another checkbox sets a recall reminder
for a given number of days, weeks or months, based on a second drop
down list. A follow-up examination may be scheduled based on the
recall.
[0201] FIG. 38 illustrates a user interface 3800 for adding a
keyword item to a menu in a view. The user selects a menu such as
"colon findings" in the tree 3810, then selects from a menu of
available terms in a list 3820, after selecting a classification in
region 3830 to display a list of available keywords in the selected
classification.
[0202] FIG. 39 illustrates a user interface 3900 for adding a menu
in the knowledge base. The user selects a keyword, e.g., "normal",
from the tree 3910, for which the menu is to be provided. Assume
the user desires to add a menu for "rectal sites" under "normal" in
the tree 3910. To do this, the user types in the menu name in a
display region 3920. Other factors, such as menu type, can also be
defined.
[0203] FIG. 40 illustrates a user interface 4000 for creating a
shortcut in the knowledge base. With this feature, the user can
select multiple keywords at a time, which is desirable when the
same group of keywords is selected over and over, e.g., for
different patients. The user provides pre text 4025 for the report,
which appears prior to the selected keywords, and post text 4030,
which appears after the selected keywords. When the user selects
the multiple keywords from the tree 4010, a sentence model is
populated to provide a preview 4035 of the resulting sentence.
[0204] FIG. 41 illustrates a user interface 4100 for editing a
shortcut in the knowledge base. The shortcut named "Std Meds" was
created using the interface 4000 of FIG. 40. The keyword
"Shortcuts" appears in the tree 4110 along with the specific
shortcut "Std Meds". The user can quickly generate the report in
the display region 4120 by selecting the keyword "Std Meds".
[0205] Grammar Engine
[0206] As discussed, the user may automatically generate a report
from selected keywords by clicking on the Generate Report icon.
Furthermore, a grammar checking routine or grammar engine may be
used to correct or optimize the grammar in the populated sentences.
The grammar engine may be run automatically when a sentence is
populated. Various grammar engines, including those known in the
art, may be used.
[0207] A grammar engine can be helpful for various reasons, such as
ensuring that the verb and subject of a sentence agree, providing
correct punctuation and capitalization, and ensuring that singular
and plural nouns are properly modified. In one possible approach, a
grammar engine includes three main components. First, a
part-of-speech tagger assigns a part of speech (POS) tag to each
word or word component (e.g., noun or verb) in the generated
sentence. Second, a lexical analyzer is run to break the sentence
into grammatical components, phrases, and clauses. The final
portion updates the sentence with the necessary corrections.
[0208] Each keyword in the KB may be assigned a primary tag by
default that identifies the most likely grammatical characteristic
of the keyword in the domain in which it is used. Tags for other
allowable grammatical characteristic may also be provided. Tags may
also be provided for the words in a sentence that are not keywords,
such as static text. Example grammatical characteristics identify a
word as being, e.g., an adjective, singular noun, plural noun,
adverb and so forth. The tag may be a two-letter codeword, for
instance.
[0209] FIG. 42 illustrates user interfaces for a grammar engine. In
accordance with a further aspect of the invention, user interfaces
may be provided that allow a user to set grammatical
characteristics, and view existing characteristics, for keywords or
groups of keywords in the KB for use by a grammar engine. This
allows the user to tailor the system to the user's preferences and
needs, as well as to gain a better understanding of the operation
of the grammar engine. A first interface 4200 allows the user to
search a dictionary of terms. "Dilated bile duct" is an example.
The interface indicates that the term has been assigned to the
grammatical characteristic or category of NN, denoting a singular
noun. The user then clicks on "edit" to edit the dictionary entry
definition. A user interface 4220 provides the name of the entry
and the base word, e.g., "duct". The user can use check boxes, drop
down menus and other widgets to set the grammatical characteristics
of the entry. For example, the part of speech can be changed by
clicking on the "edit" button, thereby causing the user interface
4240 to appear. The interface 4240 provides a list of available
grammatical characteristics on the left hand display region 4242
and the one or more assigned characteristics on the right hand
display region 4244. The user can assign an available
characteristic by clicking on the characteristic in the display
region 4242 and clicking on the right-pointing arrow. Similarly,
the user can delete an assigned characteristic by clicking on the
characteristic in the display region 4244 and clicking on the
left-pointing arrow. When multiple characteristics are assigned,
the user designates one of them as a primary characteristic by
selecting the characteristic and clicking on the "primary" button
in the display region 4244.
[0210] The invention has been described herein with reference to
particular exemplary embodiments. Certain alterations and
modifications may be apparent to those skilled in the art, without
departing from the scope of the invention. The exemplary
embodiments are meant to be illustrative, not limiting of the scope
of the invention, which is defined by the appended claims.
* * * * *