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.

Authority and stratification in the Bahamas: The quest for legitimacy

This longitudinal study provides a detailed description of the transition in the Bahamas from British colony to independent country. It analyzes the ongoing process of legitimation and delegitimation of Bahamian political parties and of the transfer of authority from the white minority to the black majority. It is a story of social and political struggles that take place within the quarter century following World War II. These struggles are analyzed within a theoretical framework which focuses on the meaning of symbols used to support claims to authority, and/or which function to delegitimize alternative claims. Specifically, this study looks at the delegitimization of the institutions of colonialism and the concurrent profession of symbols to support both independence and a fully enfranchised democracy in the Bahamas. ^ The research methodology includes an extensive analysis of official British colonial documents, private governmental dispatches, and contemporaneous newspaper articles. The sources were primarily the Public Records Office of Great Britain; the Archives of the Bahamas; and the Institute for Social and Economic Research, University of the West Indies. Secondary literature on civil rights, political science, religion, Black Nationalism, corruption, social theory, and popular culture was studied. Two hundred days of participant observation, spread over seven years of study, resulted in notes from which information was gleaned. During that time, seventeen open-ended interviews with a cross section of Bahamians (male and female, black and white) who lived through this period were recorded, information from which was also incorporated. ^ A detailed description of the socio-historical process, and an analysis of data, demonstrates how the black majority's desire for political representation, and future independence, pressured Great Britain to come into line with the desires of the majority of Bahamians. The symbolic universe that had historically divided white from black now urged dramatic social and political change. ^ The documents and testimonials studied demonstrate how symbols and symbolic events supported and/or undercut the claims to legitimacy proffered by different groups in the Bahamas in their respective attempts to solidify their social and political position within the society. ^