Improving Consumer Understanding of Medical Text: Development and Validation of a New SubSimplify Algorithm to Automatically Generate Term Explanations in English and Spanish
AffiliationUniv Arizona, Dept Linguist
Univ Arizona, Dept Spanish & Portuguese
Univ Arizona, Mel & Enid Zuckerman Coll Publ Hlth, Hlth Promot Sci Div
MetadataShow full item record
PublisherJMIR PUBLICATIONS, INC
CitationKloehn N, Leroy G, Kauchak D, Gu Y, Colina S, Yuan NP, Revere D Improving Consumer Understanding of Medical Text: Development and Validation of a New SubSimplify Algorithm to Automatically Generate Term Explanations in English and Spanish J Med Internet Res 2018;20(8):e10779 URL: http://www.jmir.org/2018/8/e10779 DOI: 10.2196/10779 PMID: 30072361 PMCID: 6096166
Rights© Nicholas Kloehn, Gondy Leroy, David Kauchak, Yang Gu, Sonia Colina, Nicole P Yuan, Debra Revere. Originally published in the Journal of Medical Internet Research. This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at email@example.com.
AbstractBackground: While health literacy is important for people to maintain good health and manage diseases, medical educational texts are often written beyond the reading level of the average individual. To mitigate this disconnect, text simplification research provides methods to increase readability and, therefore, comprehension. One method of text simplification is to isolate particularly difficult terms within a document and replace them with easier synonyms (lexical simplification) or an explanation in plain language (semantic simplification). Unfortunately, existing dictionaries are seldom complete, and consequently, resources for many difficult terms are unavailable. This is the case for English and Spanish resources. Objective: Our objective was to automatically generate explanations for difficult terms in both English and Spanish when they are not covered by existing resources. The system we present combines existing resources for explanation generation using a novel algorithm (SubSimplify) to create additional explanations. Methods: SubSimplify uses word-level parsing techniques and specialized medical affix dictionaries to identify the morphological units of a term and then source their definitions. While the underlying resources are different, Sub Simplify applies the same principles in both languages. To evaluate our approach, we used term familiarity to identify difficult terms in English and Spanish and then generated explanations for them. For each language, we extracted 400 difficult terms from two different article types (General and Medical topics) balanced for frequency. For English terms, we compared SubSimplify's explanation with the explanations from the Consumer Health Vocabulary, WordNet Synonyms and Summaries, as well as Word Embedding Vector (WEV) synonyms. For Spanish terms, we compared the explanation to WordNet Summaries and WEV Embedding synonyms. We evaluated quality, coverage, and usefulness for the simplification provided for each term. Quality is the average score from two subject experts on a 1-4 Likert scale (two per language) for the synonyms or explanations provided by the source. Coverage is the number of terms for which a source could provide an explanation Usefulness is the same expert score, however, with a 0 assigned when no explanations or synonyms were available for a term. Results: SubSimplify resulted in quality scores of 1.64 for English (P<.001) and 1.49 for Spanish (P<.001), which were lower than those of existing resources (Consumer Health Vocabulary [CHV]= 2.81). However, in coverage, SubSimplify outperforms all existing written resources, increasing the coverage from 53.0% to 80.5% in English and from 20.8% to 90.8% in Spanish. (P<.001). This result means that the usefulness score of Sub Simplify (1.32; (P<.001) is greater than that of most existing resources (eg, CHV = 0.169). Conclusions: Our approach is intended as an additional resource to existing, manually created resources. It greatly increases the number of difficult terms for which an easier alternative can be made available, resulting in greater actual usefulness.
NoteOpen access article.
VersionFinal published version
SponsorsNational Library of Medicine of the National Institutes of Health [R01LM011975]
Except where otherwise noted, this item's license is described as © Nicholas Kloehn, Gondy Leroy, David Kauchak, Yang Gu, Sonia Colina, Nicole P Yuan, Debra Revere. Originally published in the Journal of Medical Internet Research. This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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