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Elsevier Content Enrichment Center (CEC) Smart Content for Clinical Practice: EMMeT and ClinicalKey NFAIS Annual Conference 2013 February 25, 2013 Helen Parr Moran Vice President, Smart Content Elsevier Operations, CEC [email protected] About Elsevier Elsevier is the largest Science, Technical and Medical (STM) Publisher in the world. In the area of Health Sciences, Elsevier publishes leading brands including The Lancet, Braunwald’s Heart Disease, Gray’s Anatomy, as well as leading online clinical support tools and products including ClinicalKey, Mosby’s Nursing Consult and Gold Standard Drug Database. The Content Enrichment Center (CEC) in Elsevier Operations has more than 25 years of experience in creating and maintaining terminologies for use in manual and automated Abstracting and Indexing (A&I). Current taxonomies include EMTREE, Genetree, Geotree, and EMMeT and support products in a wide range of domains, such as life sciences, medicine, chemistry, pharmacology, and engineering. Copyright © 2013 Elsevier, Inc. | All Rights Reserved The Challenge Copyright © 2013 Elsevier, Inc. | All Rights Reserved The Challenge: Getting doctors the right information to make the best decisions and provide the best clinical care The Physician’s Dilemma Copyright © 2013 Elsevier, Inc. | All Rights Reserved No current offering delivers on all three components doctors need in a medical information product ClinicalKey Complements Physician Workflows Patient Care Management Workflows 1 Collateral Workflows 2 • Conferences/ society meetings • Reading current literature Diagnosis Create Care Plan 3 Treatment Medical Treatment Keeping Current Surgical Treatment Procedures Sharing Information • Patient specific information • Case presentation (within dept) After-Treatment Care Plan • Presentation to other bodies (eg, treatment committees, drug committees, etc.) Patient Education & Compliance Copyright © 2013 Elsevier, Inc. | All Rights Reserved • External presentations (grand rounds, association presentations, etc) The Approach: Smart Content Copyright © 2013 Elsevier, Inc. | All Rights Reserved Taxonomy-Powered Content = Smart Content Content with applied taxonomy Content with structured XML Copyright © 2013 Elsevier, Inc. | All Rights Reserved Copyright 2011 Outsell Gilbane Services, Inc. http://www.outsellinc.com http://gilbane.com/xml/2009/11/what-is-smart-content.html#ixzz0hnuRhaBc Role of Smart Content Smart Content is Infrastructure Product Development & Enhancement • • • More accurate search results Faceted navigation Improved content discoverability Content Analytics • • • Greater insights into what we publish Identification of co-occurring terms Link to related external content & data Personalization • • • Individual content recommendations Targeted individual marketing Contextual advertising Editorial Productivity • • Copyright © 2013 Elsevier, Inc. | All Rights Reserved Flexible product types – new collections, image banks, etc. Increased speed to market ClinicalKey Workflow Copyright © 2013 Elsevier, Inc. | All Rights Reserved Introducing EMMeT (Elsevier Merged Medical Taxonomy) Parent Terms • • • • Breast Disorders Cancer of the Thorax Mammary Neoplasms More…. 2 Medical Name Malignant Neoplasm of the Breast Consumer Friendly Name Breast Cancer Synonyms Malignant Tumor of Breast Malignant Breast Neoplasm Breast Ca Codes ICD9 – 174.9 MeSH – D001943 SNOMED-CT – 190121004 Semantic Type/Group Neoplastic Process/Disease Children Terms • • • • • Breast Lump, Nipple Retraction, ….. Diagnostic Procedures Mammography, Breast Biopsy, ….. Semantic Relationships 1 3 Breast Sarcoma Familial Breast Cancer Malignant lymphoma of the Breast Malignant Neoplasm of the breast outer quadrant More… Copyright © 2012 Elsevier, Inc. | All Rights Reserved Symptoms Treatment Procedures 4 Chemotherapy, Mastectomy, …. Medications Tamoxifen, Doxorubicin, ….. Risk Factors Family History, Genetics, Predisposition, …. Prevention Screening, Preemptive Mastectomy, …. Complications Metastatic Cancer, …. Automated Indexing: Weighted Tags for Better Search Article-level SMART Content tags help confirm relevance and provide a topical overview about a piece of content. Paragraph-level SMART Content tags uncover highly-relevant information not necessarily evident from the title or abstract alone. Copyright © 2013 Elsevier, Inc. | All Rights Reserved Testing Quality: Multipronged QA 1. Technical Test Set • Validate the field selection and delivery format 2. Representative Gold Test • Establish recall, precision, and harmonic mean versus a manually tagged set of content 3. Query Set • Compare product results with expected results from established search queries 4. Search Logs • Analyze search logs for candidate terms and noise 5. Linguistic Intelligence (NLP) Use Cases • Test language parsing by rules engine using test cases (e.g., hepatitis B/C) Semantic Enrichment Poll Is your organization semantically enriching your content? 1. Yes 2. Not yet, but we’re working on it 3. No 4. Don’t know Copyright © 2013 Elsevier, Inc. | All Rights Reserved Smart Content In Action: ClinicalKey Copyright © 2013 Elsevier, Inc. | All Rights Reserved EMMeT Powered Auto-Suggest Copyright © 2012 Elsevier, Inc. | All Rights Reserved Speed to Answer: Content Filters & Previews Workflow: Presentation Maker, Reading List & Saved Searches User Response Copyright © 2013 Elsevier, Inc. | All Rights Reserved Smart Content for Doctors = Clinically Relevant Search Actual Use-Case: Non-invasive cardiologist wants the latest information on the use of biomarker guided therapy in treating congestive heart failure. He enters search term: •BNP guided therapy in CHF Clinical Search Results Search BNP guided therapy for CHF TM • 1 relevant result, last updated in 2009 • 310,000 results—mostly news summaries • Requires Google Scholar to produce a sublist of journal articles • 10 results in reverse chronological order, burying several key papers • 2nd result is an unwanted editorial comment • Result set misses several key publications due to lack of term expansion and acronym confusion *Based on an actual case study. Search conducted in March 2011. Google is a trademark of Google Inc. ClinicalKey: Finding the Needle in the Clinical Haystack • 128 results • Results from various 12 content types appear in rank order based on their currency and clinical impact • 1st four results are journals citing the most relevant and current studies • Highly relevant and current content from various information sources: • Clinical Trials • Books • First Consult What’s Next? Copyright © 2013 Elsevier, Inc. | All Rights Reserved Internationalization: French EMMeT (FrEMMeT) BETA Copyright © 2013 Elsevier, Inc. | All Rights Reserved Curation: Smart Collection Tool & Specialty Collections Copyright © 2012 Elsevier, Inc. | All Rights Reserved Questions? Helen Moran Vice President, Smart Content Elsevier Operations, CEC [email protected] Copyright © 2013 Elsevier, Inc. | All Rights Reserved