A session from SemTech SF in June 2012 Abstract: As access to a richer set of knowledge and research continues to be critical to the healthcare community, the users of healthcare and life science solutions are demanding the same level of discoverability, integration, and innovation from their professional tools that they enjoy in their personal applications. Through the Smart Content initiative Elsevier seeks to semantically enrich its diverse offerings of health sciences content to both improve the performance of existing online resources as well as to enable the creation of the next generation of digital products. In this session, Alan Yagoda will discuss Elsevier’s efforts in developing Smart Content capabilities to power a new portfolio of strategic product offerings. The journey into smarter search and discovery resulted in a new infrastructure with a rich set of semantic capabilities include the development of a standardized medical taxonomy called EMMeT (Elsevier’s Merged Medical Taxonomy), indexing and content enrichment, and linked data services.

1. Elsevier Health Sciences
Smart Content Drives Smart Applications
The Future Of Using Knowledge In Healthcare
SemTechBiz 2012 Conference Alan Yagoda
June 5, 2012 VP, Business Technology
a.yagoda@elsevier.com
@alanyagoda

2. About Elsevier
Elsevier is the largest Science, Technical and Medical
Publisher in the world. In the area of Health Sciences,
Elsevier publishes leading brands including The Lancet,
Braunwald’s Heart Disease, Gray’s Anatomy, and the Netter
Atlases among others. In addition, Elsevier produces leading
online clinical support tools and products including:
• MD Consult
• Procedures Consult
• Mosby’s Nursing Consult
• CPMRC Nursing Care Plans
• Gold Standard Drug Database
• MEDai Analytics for Managed Care Plans
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3. The Challenge

4. The Challenge: Getting doctors the right information to make
the best decisions and provide the best clinical care
Trusted:
Authoritative medical and surgical content from Elsevier.
Comprehensive:
Integrated Medline and 3rd party journal content.
Speed To Answer:
Fast discoverability of the most relevant answers and
more intuitive searching.
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5. Introducing
Smart Content
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6. Taxonomy-Powered Content = Smart Content
Content
with
applied
taxonomy
Content
today
with
structured
XML
Copyright 2011 Outsell Gilbane Services, Inc.
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http://www.outsellinc.com
http://gilbane.com/xml/2009/11/what-is-smart-content.html#ixzz0hnuRhaBc

7. Smart Content At Elsevier
Smart Content Applications
Better discovery through
semantic search & navigation
Linked data from
• Faceted search & browse
partners and the Web
• Ontology-driven navigation
• Task-specific results
• Personalized/localized results
• Question answering"
• Link to evidenced-based content
Text Better understanding through
analysis and visualization
Entities, • Tag clouds
Elsevier concepts • Heatmaps"
content Tables and • Streamgraphs"
• Scatterplots"
relationships • Time series
• Animations
Images
New knowledge through
aggregation and synthesis
• Topic pages
Elsevier • Social network maps
knowledge • Geolocation maps
organization
• Data mashups"
systems • Text mining reports
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8. Making Smart Content Work in the Clinical Setting
Clinical
Clinical
Trials
Journals
Summaries
Guidelines
Procedural
Drug
Info
Pa3ent
Ed
Books
Videos
Elsevier Merged Medical Taxonomy (EMMeT)
250K+
Core
Clinical
Concepts
EMMeT
Concept
Mapping
Elsevier
1M+
Synonyms
Custom
1M+
Hierarchical
Rela3onships
1M+
Ontological
Rela3onships
UMLS
•
Vast
amounts
of
content
made
easily
discoverable
•
Specialty-­‐specific
naviga9on
•
Dynamic
clinical
summary
crea9on
•
Meaningful
related
content
recommenda9ons
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9. Introducing EMMeT (Elsevier Merged Medical Taxonomy)
Parent Terms
• Breast Disorders 2
• Cancer of the Thorax
• Mammary Neoplasms
• More….
Symptoms Breast Lump, Nipple Retraction, …..
Medical Name
Diagnostic
Malignant Neoplasm of the Breast Mammography, Breast Biopsy, …..
Procedures
Consumer Friendly Name
Breast Cancer
Synonyms 1 4
Malignant Tumor of Breast Treatment
Chemotherapy, Mastectomy, ….
Malignant Breast Neoplasm Procedures
Semantic Relationships
Breast Ca
Codes
ICD9 – 174.9
MeSH – D001943 Medications Tamoxifen, Doxorubicin, …..
SNOMED-CT – 190121004
Semantic Type/Group
Neoplastic Process/Disease
Risk Factors Family History, Genetics, Predisposition, ….
Children Terms
• Breast Sarcoma
3 Prevention Screening, Preemptive Mastectomy, ….
• Familial Breast Cancer
• Malignant lymphoma of the Breast
• Malignant Neoplasm of the breast outer
quadrant Complications Metastatic Cancer, ….
• More…
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10. 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.
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11. Search & Discovery:
ClinicalKey
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12. EMMeT Powered Auto-Suggest
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13. Speed to Answer: Most relevant preview

14. Linked Data Repository
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15. Linked Data Repository (LDR): Warehouse for
Smart Content Enhancements
Evaluation and management of delirium in • Service that provides a rich semantic layer
hospitalized older patients
Delirium is common in hospitalized older patients and
on top of content and enables search and
may be a symptom of a medical emergency, such as Title discovery of metadata
hypoxia or hypoglycemia. It is characterized by an acute
change in cognition and attention, although the
Disease may be subtle and usually fluctuate
symptoms • Transforms content into data to allow
throughout the day. This heterogeneous syndrome
requires prompt recognition and evaluation, because the exploration of Elsevier-wide knowledge
underlying medical condition may be life threatening. base
Risk factors for delirium include visual impairment,
previous cognitive impairment, severe illness, and an
elevated blood urea nitrogen/serum creatinine ratio.
Interventions that have been shown to reduce the
• Opens up discovery and utility of content
Clinical finding
incidence of delirium in at-risk hospitalized patients beyond searchable documents
include repeated reorientation of the patient to person
and place, promotion of good sleep hygiene, early
mobilization, correction of dehydration, and the • Extends Elsevier extracted knowledge by
minimization of unnecessary noise and stimuli. The
treatment of delirium centers on the identification and
Drugs
interlinking data with other related sources
management of the medical condition that triggered the of content from partners and the web
delirious state. Nonpharmacologic interventions may be
beneficial, but antipsychotic agents may be needed when
the cause is nonspecific and other interventions do not
sufficiently control symptoms such as severe agitation or • Optimized for high-volume read-write of
psychosis. Although delirium is a temporary condition, it RDF data
Source
may persist for several months in the most vulnerable
patients. Patient outcomes at one year include a higher
mortality rate and a lower level of functioning compared • Provide service layer APIs for ease of
with age-matched control patients. Copyright © 2008
American Academy of Family Physicians. integration 15
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16. Represent Enhancements and Vocabularies In RDF
Satellites
Creation of Satellite Standards
• Linked data compliant RDF representing metadata objects
• Leverage common namespaces from dct, pav, rdf, skos
• Taxonomies in SKOS to enhance portability in the linked data world
• Subject tagging against a vocabulary representing extracted
knowledge LDR
• Concept URIs that can be equated to URIs in linked data
Delivery Infrastructure
• Product-specific indexes generating RDF “Smart Tags”
• Data pipeline transformations for building semantic warehouse
• Exposed through linked data delivery services
Example RDF Statements
 Tags from a taxonomy for a given document
 Document sections relevant to a given concept
 Document sections providing answers to a given question
 Genes mentioned in a given document
 Documents supporting or disputing conclusions of a given document
 Concepts in the areas of expertise for a given author
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17. LDR Semantic Infrastructure
Linked Data Linked Data Loader (REST)
Data
Space
Services
Vocab &
Annotation
Annota3on
Linked
Data
Satellites
Satellites
Satellites
3rd
Party
RDF
Vocab
Asset
Data
Satellites
Smart Content Indexing Pipeline
Linked
Data
Pipeline
Services
(Hadoop)
AWS Cloud Management
EMMeT Vocabulary
SKOS
Semantic
RDF Validation
Ontology Svcs
Genera3on
Interlinking
Reasoning
Transform
Network
N-Quads
Extract
JSON
…
Tagging
and
Indexing
Content
Elsevier
Services
(Concepts,
Chapters,
Ar3cles,
Guidelines,etc)
RDF
Genera3on
Discovery Services (Semantic Knowledgebase)
3rd
Party
Content
Content
Ins3t.
Amazon MongoDB SOLR/ Virtuoso
S3 NoSQL SIREn Triplestore
Product-specific
Smart Content Access & Admin &
Atom Feed Analytics
Search Index Entitlements Monitoring
Discovery Svc Ontology
SPARQL Alerts
API (REST) Service
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18. Elsevier Smart Content In Action
Applications powered by Smart Content:
– Semantic search for practitioners and medical researchers
– Expose medical taxonomies in SKOS
– Crossref collaboration of scholarly publishers and funding agencies
– Lancet application mashups on specialty health topics
– Sciverse applications
– Clinical Decision Support Drug Research
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19. LDR
API
Access
To
Ar4cle
Metadata
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20. Trend Analysis Of Special Health Topics
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21. Comprehensive Drug Research
• Moving world-class content online to Point of Care.
• Extracted knowledge is linked for further enrichment.
• Information is condensed, immediate and actionable.
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22. Linking Patient Data To Evidence-Based Research
-­‐
Discover
knowledge
from
research
relevant
to
a
pa3ent
profile
-­‐
Alerts
on
FDA
Announcements.
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23. SciVerse Widgets Powered by Smart Content
Article search on ScienceDirect results in related
specialty content recommendations available from
The Lancet Journal.
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24. Smart content is a bridge to the future of publishing
• Smart content allows publishers to create new products
and services through structuring content for better
discovery, insight and utility
– The value is in the structure
– Creating that structure is hard work
– The kind of hard work that publishers have
traditionally focused on
• New consumer Internet businesses are using open
source software and the cloud to add structure to content
today… quickly and on the cheap
• Publishers and societies both large and small can use
the same techniques to follow suit
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25. Thank you.
Alan Yagoda
a.yagoda@elsevier.com
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