ShareThisSALT LAKE CITY - If Jackson Pollock had worked on whiteboards, his art might have looked something like the piece hanging on the wall of Matthew Samore's office.
The board is a jumbled mess of colors, figures and lines. But underneath the dry-erase abstract is order -- or the potential for it.
Samore is part of a team of U.S. Department of Veterans Affairs researchers using a combination of medical expertise, computer science and social research techniques to extract information from millions of clinical notes. The goal is to identify patterns in symptoms that might help physicians treat veterans of the wars in Iraq and Afghanistan whose conditions are otherwise unexplainable.
As have generations of combatants before them, thousands of veterans have returned from the nation's ongoing wars with medical conditions unexplained by current epidemiological science, including gastrointestinal problems, respiratory illness, blood disease and skin rashes.
Until recently, however, researchers interested in reviewing the medical records for similarities among groups of veterans were mostly limited to reviewing the records from their own hospitals.
Researchers have long coveted the enormous cache of medical records held by the VA -- an early adopter of digital record-keeping technology and the largest health system in the nation. But concerns about privacy have long limited who could access the VA records kept at four regional data warehouses.
The solution, according to Samora and other researchers, is VINCI -- the Veterans' Informatics and Computing Infrastructure -- which provides researchers with a secure, virtual working environment in which they can use data derived from VA patient records.
The Salt Lake City-based initiative, which is operating on a research and technology budget of about $4.7 million this year, currently supports more than 20 projects, including Samore's study. Similarly elaborate studies completed without access to the records could cost millions each.
The system, in which researchers are able to access the data and the analysis tools behind a firewall, is intended to prevent the loss or misuse of confidential patient information.
"The VA is absolutely adamant about protecting the information in those records," said VINCI program manager Tori Barrett.
Barrett said that researchers are only permitted to access and work with the data within VINCI's virtual environment, a process intended to help prevent data breaches-- such as the 2006 theft of a laptop computer that contained the sensitive data on nearly 30 million veterans.
But even once he could access the data in a secure environment, Samore had a problem:
"Doctors don't like recording information about their patients by clicking boxes," Samore said. "They prefer the expressivity of narration. They want to be able to describe their patients' conditions. But people on the data collections side don't like that, because they can't easily analyze it."
Samore and his fellow researchers will use the older technique of content analysis and a field of computer science known as natural language processing. They hope to convert physicians' narratives into structured data. What patterns will be revealed from the millions of key words identified in the study is anyone's guess.
And Samore is reluctant to promise quick answers.
After all, it has taken 40 years for science to link some veterans' symptoms to exposure to Agent Orange in Vietnam, and research on other illnesses possibly linked to the toxic contaminant continues today. Researchers trying to understand the causes of Gulf War Illness -- which began appearing in veterans of the first war in Iraq in 1991 -- are also finding it difficult to tie symptoms to specific origins.
"Trying to disentangle causes from symptoms and symptoms from causes is tough," he said. "What caused what? It's not something that always has a clear cut answer. From a researcher's standpoint, that can be very frustrating."
But the closer researchers can come to answers, Samore said, the closer veterans can get to better care. "And that, of course, is the goal."
(E-mail reporter Matthew D. LaPlante at mlaplante(at)sltrib.com. For other stories, visit www.scrippsnews.com.)
(Distributed by Scripps Howard News Service, www.scrippsnews.com.)
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