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What is an Event? Domain Constraints for Temporal Analysis of Chief Complaints and Triage Notes

Stephanie Haas, Debbie Travers, Anna Waller and Jacob Kramer-Duffield

(Submission #54)


Summary

In this paper we present preliminary results of a study of events represented in portions of the Emergency Department (ED) patient record. An advantage to working in such a specific domain is that we can use domain knowledge to reveal events that are not explicitly mentioned in the record. In addition, domain assumptions and constraints can be used to identify or clarify temporal characteristics of events, allowing more precise placement on an event timeline.

When a patient visits the ED, the triage nurse asks what the problem is. Information about the reason the patient came to the ED is recorded in the chief complaint (CC) and triage note (TN) fields of the patient record, along with the date and time (timestamp) of the visit. A timeline of these events would aid clinicians in understanding what occurred prior to the patient's visit, and also allow analysis of patterns of events such as symptoms across patients. We define several types of events that appear in these fields, including symptom events, reporting events and visit events. Examples illustrate how assumptions and constraints can be exploited to provide a richer event timeline than one based just on explicitly mentioned events. Future work includes refinement of event type definitions and validation of the resulting timelines with domain experts.

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