CC BY-NC-ND 4.0 · Methods Inf Med
DOI: 10.1055/a-2039-3773
Original Article

An Alternative Application of Natural Language Processing to Express a Characteristic Feature of Diseases in Japanese Medical Records

Yoshinori Yamanouchi
1   Department of Medical Information Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
Taishi Nakamura
1   Department of Medical Information Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
Tokunori Ikeda
2   Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Sojo University, Nishi-ku, Kumamoto, Japan
Koichiro Usuku
1   Department of Medical Information Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
› Author Affiliations
Funding This study was supported by Bristol-Myers Squibb Foundation Grants Number 41762123 (to TN) and an endowment fund of the department – Project Number 147100001k.


Background Owing to the linguistic situation, Japanese natural language processing (NLP) requires morphological analyses for word segmentation using dictionary techniques.

Objective We aimed to clarify whether it can be substituted with an open-end discovery-based NLP (OD-NLP), which does not use any dictionary techniques.

Methods Clinical texts at the first medical visit were collected for comparison of OD-NLP with word dictionary-based-NLP (WD-NLP). Topics were generated in each document using a topic model, which later corresponded to the respective diseases determined in International Statistical Classification of Diseases and Related Health Problems 10 revision. The prediction accuracy and expressivity of each disease were examined in equivalent number of entities/words after filtration with either term frequency and inverse document frequency (TF-IDF) or dominance value (DMV).

Results In documents from 10,520 observed patients, 169,913 entities and 44,758 words were segmented using OD-NLP and WD-NLP, simultaneously. Without filtering, accuracy and recall levels were low, and there was no difference in the harmonic mean of the F-measure between NLPs. However, physicians reported OD-NLP contained more meaningful words than WD-NLP. When datasets were created in an equivalent number of entities/words with TF-IDF, F-measure in OD-NLP was higher than WD-NLP at lower thresholds. When the threshold increased, the number of datasets created decreased, resulting in increased values of F-measure, although the differences disappeared. Two datasets near the maximum threshold showing differences in F-measure were examined whether their topics were associated with diseases. The results showed that more diseases were found in OD-NLP at lower thresholds, indicating that the topics described characteristics of diseases. The superiority remained as much as that of TF-IDF when filtration was changed to DMV.

Conclusion The current findings prefer the use of OD-NLP to express characteristics of diseases from Japanese clinical texts and may help in the construction of document summaries and retrieval in clinical settings.

Authors' Contribution

YY designed the study and retrieved a series of data under the supervision by TN and KU. YY and TI performed a statistical analysis of collected data. TN and KU helped make the overall study design and conceptualized interpretations and criticisms. YY and TN drafted the manuscript and it was critically revised by TN, TI, and KU. The final manuscript was approved by all authors.

Supplementary Material

Publication History

Received: 17 October 2021

Accepted: 13 April 2022

Accepted Manuscript online:
21 February 2023

Article published online:
04 April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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