Discourse structures in medical reports--watch out! The generation of referentially coherent and valid text knowledge bases in the MEDSYNDIKATE system.

The automatic analysis of medical narratives currently suffers from neglecting text structure phenomena such as referential relations between discourse units. This has unwarranted effects on the descriptional adequacy of medical knowledge bases automatically generated from texts. The resulting representation bias can be characterized in terms of incomplete, artificially fragmented and referentially invalid knowledge structures. We focus here on four basic types of textual reference relations, viz. pronominal and nominal anaphora, textual ellipsis and metonymy and show how to deal with them in an adequate text parsing device. Since the types of reference relations we discuss show an increasing dependence on conceptual background knowledge, we stress the need for formally grounded, expressive conceptual representation systems for medical knowledge. Our suggestions are based on experience with MEDSYNDIKATE, a medical text knowledge acquisition system designed to properly deal with various sorts of discourse structure phenomena.