Information Discovery on Electronic Health Records Using Authority Flow Techniques

Background As the use of electronic health records (EHRs) becomes more widespread, so does the need to search and provide effective information discovery within them. Querying by keyword has emerged as one of the most effective paradigms for searching. Most work in this area is based on traditional Information Retrieval (IR) techniques, where each document is compared individually against the query. We compare the effectiveness of two fundamentally different techniques for keyword search of EHRs. Methods We built two ranking systems. The traditional BM25 system exploits the EHRs' content without regard to association among entities within. The Clinical ObjectRank (CO) system exploits the entities' associations in EHRs using an authority-flow algorithm to discover the most relevant entities. BM25 and CO were deployed on an EHR dataset of the cardiovascular division of Miami Children's Hospital. Using sequences of keywords as queries, sensitivity and specificity were measured by two physicians for a set of 11 queries related to congenital cardiac disease. Results Our pilot evaluation showed that CO outperforms BM25 in terms of sensitivity (65% vs. 38%) by 71% on average, while maintaining the specificity (64% vs. 61%). The evaluation was done by two physicians. Conclusions Authority-flow techniques can greatly improve the detection of relevant information in EHRs and hence deserve further study.

Attributes of Identity Document Credibility: A Synthesis of Expert Knowledge

In broad terms — including a thief's use of existing credit card, bank, or other accounts — the number of identity fraud victims in the United States ranges 9-10 million per year, or roughly 4% of the US adult population. The average annual theft per stolen identity was estimated at $6,383 in 2006, up approximately 22% from $5,248 in 2003; an increase in estimated total theft from $53.2 billion in 2003 to $56.6 billion in 2006. About three million Americans each year fall victim to the worst kind of identity fraud: new account fraud. Names, Social Security numbers, dates of birth, and other data are acquired fraudulently from the issuing organization, or from the victim then these data are used to create fraudulent identity documents. In turn, these are presented to other organizations as evidence of identity, used to open new lines of credit, secure loans, “flip” property, or otherwise turn a profit in a victim's name. This is much more time consuming — and typically more costly — to repair than fraudulent use of existing accounts. This research borrows from well-established theoretical backgrounds, in an effort to answer the question – what is it that makes identity documents credible? Most importantly, identification of the components of credibility draws upon personal construct psychology, the underpinning for the repertory grid technique, a form of structured interviewing that arrives at a description of the interviewee’s constructs on a given topic, such as credibility of identity documents. This represents substantial contribution to theory, being the first research to use the repertory grid technique to elicit from experts, their mental constructs used to evaluate credibility of different types of identity documents reviewed in the course of opening new accounts. The research identified twenty-one characteristics, different ones of which are present on different types of identity documents. Expert evaluations of these documents in different scenarios suggest that visual characteristics are most important for a physical document, while authenticated personal data are most important for a digital document.