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Methods Inf Med 1997; 36(03): 163-171
DOI: 10.1055/s-0038-1636826
Original Article
Schattauer GmbH

A Generalized Language for Platform-Independent Structured Reporting

C. E. Kahn Jr.
1   Section of Information and Decision Sciences, Department of Radiology, Medical College of Wisconsin, Milwaukee WI, USA
› Author AffiliationsSupported in part by grants from The Whitaker Foundation (Biomedical Engineering Research Grant to C.E.K.) and the National Library of Medicine (USPHS grant LM05705 to the Medical College of Wisconsin). The author thanks Phiem N. Huynh and Kurt J. Pfeifer for research assistance; James Lowe, David Grosse, and Ondrej Zoltan for computer systems support; and Douglas S. Bell, M.D., for critical review of the manuscript.
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Publication History

Publication Date:
17 February 2018 (online)

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Structured reporting systems allow health-care workers to record observations using predetermined data elements and formats. The author developed the Data-entry and Reporting Markup Language (DRML) to provide a generalized representational language for describing concepts to be included in structured reporting applications. DRML is based on the Standard Generalized Markup Language (SGML), an internationally accepted standard for document interchange. The use of DRML is demonstrated with the SPIDER system, which uses public-domain Internet technology for structured data entry and reporting. SPIDER uses DRML documents to create structured data-entry forms, outline-format textual reports, and datasets for analysis of aggregate results. Applications of DRML include its use in radiology results reporting and a health status questionnaire. DRML allows system designers to create a wide variety of clinical reporting applications and survey instruments, and helps overcome some of the limitations seen in earlier structured reporting systems.

Keywords

Computer-based Patient Records - Structured Data Entry - Reporting - Standards - SGML - World Wide Web - Knowledge Representation
 

  • REFERENCES

  • 1 Dick RS, Steen EB. eds. The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, DC: National Academy Press; 1991
    Search in Google Scholar
  • 2 Shortliffe EH, Barnett GO. Medical data: their acquisition, storage, and use. In: Shortliffe EH, Perrault L, Wiederhold G, Fagan L. eds. Medical Informatics: Computer Applications in Health Care. Reading MA: Addison-Wesley; 1990: 37-69.
    Search in Google Scholar
  • 3 Kuhn K, Gaus W, Wechsler JG. et al. Structured reporting of medical findings: evaluation of a system in gastroenterology. Meth Inform Med 1992; 31: 268-74.
    PubMedSearch in Google Scholar
  • 4 Bell DS, Greenes RA. Evaluation of Ultra-STAR: performance of a collaborative structured data entry system. In: Ozbolt JG. ed. Proceedings of the 18th Annual Symposium on Computer Applications in Medical Care. Philadelphia: Hanley-Belfus; 1994: 216-21.
    Search in Google Scholar
  • 5 Campbell KE, Wieckert K, Fagan LM, Musen MA. A computer-based tool for generation of progress notes. In: Safran C. ed. Proceedings of the 17th Annual Symposium on Computer Applications in Medical Care. New York: McGraw-Hill, Inc; 1993: 284-8.
    Search in Google Scholar
  • 6 Kuhn K, Zemmler T, Reichert M, Rosner D, Baumiller O, Knapp H. An integrated knowledge-based system to guide the physician during structured reporting. Meth Inform Med 1994; 33: 417-22.
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 Hall P, Mellner C, Danielsson T. J5 – a data processing system for medical information. Meth Inform Med 1967; 06: 1-6.
    PubMedSearch in Google Scholar
  • 8 Pendergrass HP, Greenes RA, Barnett GO, Poitras JW, Pappalardo AN, Marble CW. An on-line computer facility for systematized input of radiology reports. Radiology 1969; 92: 709-13.
    CrossrefPubMedSearch in Google Scholar
  • 9 Greenes RA, Barnett GO, Klein SW, Rob-bins A, Prior R. Recording, retrieval and review of medical data by physician-computer interaction. N Engl J Med 1970; 282: 307-15.
    CrossrefPubMedSearch in Google Scholar
  • 10 Wheeler PS, Simborg DW, Gitlin JN. The Johns Hopkins Radiology Reporting System. Radiology 1976; 119: 315-9.
    CrossrefPubMedSearch in Google Scholar
  • 11 Leeming BW, Simon M, Jackson JD, Horowitz GL, Bleich HL. Advances in radiologic reporting with computerized language information processing (CLIP). Radiology 1979; 133: 349-53.
    CrossrefPubMedSearch in Google Scholar
  • 12 Clayton PD, Ostler DB, Gennaro JL, Beatty SS, Frederick PR. A radiology reporting system based on most likely diagnoses. Corn-put Biomed Res 1980; 13: 258-70.
    PubMedSearch in Google Scholar
  • 13 Greenes RA. OBUS: a measurement, calculation, reporting, filing and retrieval computer system for obstetrical ultrasound examinations. Radiology 1982; 144: 879-83.
    CrossrefPubMedSearch in Google Scholar
  • 14 Bernauer J, Gumrich K, Kutz S, Lindner P, Pretschner DP. An interactive report generator for bone scan studies. In: Clayton PD. ed. Proceedings of the 15th Annual Symposium on Computer Applications in Medical Care. New York: McGraw-Hill; 1991: 858-60.
    Search in Google Scholar
  • 15 Kuhn K, Zemmler T, Reichert M, Heinlein C, Roesner D. Structured data collection and knowledge-based user guidance for abdominal ultrasound reporting. In: Safran C. ed. Proceedings of the 17th Annual Symposium of Computer Applications in Medical Care. New York: McGraw-Hill; 1993: 311-5.
    Search in Google Scholar
  • 16 Bell DS, Greenes RA, Doubilet P. Form-based clinical input from a structured vocabulary: Initial application in ultrasound reporting. In: Frisse ME. ed. Proceedings of the 16th Annual Symposium on Computer Applications in Medical Care. New York: McGraw-Hill; 1992: 789-90.
    Search in Google Scholar
  • 17 International Standards Organization. ISO 8879:1986 Information processing – Text and office systems – Standard Generalized Markup Language (SGML). Geneva: International Standards Organization; 1986
    Search in Google Scholar
  • 18 Goldfarb CF. The SGML Handbook. Oxford: Clarendon Press; 1990
    Search in Google Scholar
  • 19 Van Herwijnen E. Practical SGML. 2nd ed.). Boston: Kluwer Academic Publishers; 1994
    Search in Google Scholar
  • 20 Lindberg DAB, Humpreys BL, McCray AT. The Unified Medical Language System. Meth Inform Med 1993; 32: 281-91.
    PubMedSearch in Google Scholar
  • 21 American College of Radiology. Index for Radiological Diagnoses (rev. 3 ed). Reston, VA: American College of Radiology; 1986
    Search in Google Scholar
  • 22 Kahn Jr CE, Wang K, Bell DS. Structured entry of radiology reports using World Wide Web technology. RadioGraphics 1996; 16: 683-91.
    CrossrefPubMedSearch in Google Scholar
  • 23 Bemers-Lee T, Cailliau R, Luotonen A, Nielsen HF, Secret A. The World-Wide Web. Comm ACM 1994; 37: 76-82.
    PubMedSearch in Google Scholar
  • 24 Schatz BR, Hardin JB. NCSA Mosaic and the World Wide Web: global hypermedia protocols for the Internet. Science 1994; 265: 895-901.
    CrossrefPubMedSearch in Google Scholar
  • 25 Richardson ML. A World-Wide Web radiology teaching file server on the Internet. AJR 1995; 164: 479-83.
    CrossrefPubMedSearch in Google Scholar
  • 26 Kahn Jr CE. CHORUS: a computer-based radiology handbook for international collaboration via the World Wide Web. Radio-Graphics 1995; 15: 963-70.
    CrossrefPubMedSearch in Google Scholar
  • 27 Cimino JJ, Socratous SA, Clayton PD. Internet as clinical information system: application development using the World Wide Web. J Am Med Informatics Assoc 1995; 02: 273-84.
    CrossrefPubMedSearch in Google Scholar
  • 28 Lowe HJ, Lomax EC, Polonkey SE. The World Wide Web: a review of an emerging Internet-based technology for the distribution of biomedical information. J Am Med Informatics Assoc 1996; 03: 1-14.
    CrossrefPubMedSearch in Google Scholar
  • 29 Bell DS, Kahn Jr CE. Assessing health status via the World Wide Web. In: Cimino J. ed. Proceedings of the AMIA Annual Fall Symposium. Philadelphia: Hanley & Belfus; 1996: 338-42.
    Search in Google Scholar
  • 30 Kahn Jr CE, Anderson GM. Case-based reasoning and imaging procedure selection. Invest Radiol 1994; 29: 643-7.
    CrossrefPubMedSearch in Google Scholar
  • 31 Doubilet P, Greenes RA, Bell DS, Dichter MS, Benson CB, Fener EF. Computer-based reporting of US examinations: a time-and money-saving alternative to dictating. Radiology 1995; 197: 160 (abstract).
    PubMedSearch in Google Scholar
  • 32 Essin DJ. Intelligent processing of loosely structured documents as a strategy for organizing electronic health care records. Meth Inform Med 1993; 32: 265-8.
    PubMedSearch in Google Scholar
  • 33 Essin DJ, Lincoln TL. An information model for medical events. In: Ozbolt JP. ed. Proceedings of the 18th Annual Symposium on Computer Applications in Medical Care. Philadelphia: Hanley & Belfus; 1994: 509-13.
    Search in Google Scholar
  • 34 Evans DA, Cimino JJ, Hersh WR, Huff SM, Bell DS. Toward a medical-concept representation language. The Canon Group. J Am Med Informatics Assoc 1994; 01: 207-17.
    CrossrefPubMedSearch in Google Scholar
  • 35 Bell DS, Pattison-Gordon E, Greenes RA. Experiments in concept modeling for radiographic image reports. J Am Med Informatics Assoc 1994; 01: 249-62.
    CrossrefPubMedSearch in Google Scholar
  • 36 Campbell KE, Das AK, Musen MA. A logical foundation for representation of clinical data. J Am Med Informatics Assoc 1994; 01: 218-32.
    CrossrefPubMedSearch in Google Scholar
  • 37 Moorman PW, van Ginneken AM, van der Lei J, van Bemmel JH. A model for structured data entry based on explicit descrip-tional knowledge. Meth Inform Med 1994; 33: 454-63.
    PubMedSearch in Google Scholar
  • 38 Bell DS, Pattison-Gordon E, Greenes RA, Kahn Jr CE. A conceptual-graph framework for structured reporting in radiology: application in pelvic ultrasound and breast imaging. In: Boehme JM, Rowberg AH, Wolfman NT. eds. Computer Applications to Assist Radiology. Carlsbad, CA: Symposia Foundation; 1994: 261-4.
    Search in Google Scholar
  • 39 Moorman PW, van Ginneken AM, Siersema PD, van der Lei J, van Bemmel JH. Evaluation of reporting based on descriptional knowledge. J Am Med Informatics Assoc 1995; 02: 365-73.
    CrossrefPubMedSearch in Google Scholar
  • 40 The Java™ language: a white paper. Mountain View, CA: Sun Microsystems; 1995
  • 41 Huynh PN, Kahn Jr CE. Structured entry of medical data using SGML, Java, and the World Wide Web. AMIA 1996 Spring Congress Abstract Book. Bethesda, MD: American Medical Informatics Association; 1996: 100 (abstract).
    Search in Google Scholar
  • 42 Poon AD, Fagan LM, Shortliffe EH. The PEN-Ivory project: exploring user-interface design for the selection of items from large controlled vocabularies of medicine. J Am Med Informatics Assoc 1996; 03: 168-83.
    CrossrefPubMedSearch in Google Scholar