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Laura Slaughter

Semantic Relationships in Health Consumer Questions and Physicians Answers: A Basis for Representing Medical Knowledge for Concept Exploration Interfaces
Laura Slaughter
Advisors: Dagobert Soergel, Marilyn Domas White

This dissertation is concerned with the representation of medical knowledge in health consumers questions and physician-provided answers. It has implications for the design of user interfaces that improve health consumers ability to define their information problem and understand retrieved results. The underlying semantics of health consumers questions and physicians answers were analyzed as a basis for 1) understanding questioning behavior and answering patterns and 2) constructing a frame-based representation system for expressing semantic relationships in health-related questions and answers (or potential answers).

The primary research question involved the identification and analysis of semantic relationships in medically-oriented consumer questions and answers from Ask-an-Expert Web sites. Using the semantic relationships within the Unified Medical Language System (UMLS) Semantic Network as a starting point, this work used an iterative approach of analyzing and comparing semantic relationships in question-answer pairs as a basis for constructing an inventory of semantic relationships that evolved from instances in actual text rather than introspection. The results suggested important modifications to the UMLS Semantic Network, including clarifying the definitions and structure of the original UMLS relationships and introducing new semantic relationships.

A total of 509 semantic relationship instances were identified in twelve question-answer pairs (97 in the questions, 334 in the answers, 78 implied between question and answer concepts). Certain relationship categories were seen more often in questions than in answers and vice versa. Health consumers, for example, often use temporal semantic relationships in explaining their information need. A taxonomy of question types (Graessers) was used to get a broad overview of the questions asked by consumers. The semantic relationships from questions were analyzed with respect to question type to appraise how the two might be used in conjunction with one another. Regarding the answering strategy of physicians, a direct match between the semantic relationships in the question and those in the answer occurred in only half of the question-answer pairs analyzed. All answers contained expansions of one or more question concepts . These concept expansions used many relationship types such as TREATS and RESULTS_IN.
Clients came primarily from the poorer segment of the community. Their major problem was a need for child support, through suing errant fathers in court or applying for subsistence payments. Most clients' problems had not been solved after one year, indicating slow and unresponsive bureaucracies at referral agencies.

Literacy was absent in the information transfer process described. Although the volunteers and most clients were literate, printed matter was not part of their everyday life, and not the means they used to find information. Conclusions emphasize the need for local involvement in planning rural services, the importance of appropriate introduction of a service to a community, the need for adequate training programs that assist intermediaries in dealing with challenges they will face, and the need for abundant quantities of printed information to be available at the beginning, so that it becomes a normal part of the information process.