Using Semantic Text Similarity calculation for question matching in a rheumatoid arthritis question-answering system
Original Article

Using Semantic Text Similarity calculation for question matching in a rheumatoid arthritis question-answering system

Meiting Li1^, Xifeng Shen1^, Yuanyuan Sun1^, Weining Zhang1^, Jiale Nan1^, Jia’an Zhu2, Dongping Gao1^

1Institute of Medical Information, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; 2Department of Ultrasound, Peking University People’s Hospital, Beijing, China

Contributions: (I) Conception and design: D Gao; (II) Administrative support: D Gao, J Zhu; (III) Provision of study materials or patients: J Zhu; (IV) Collection and assembly of data: M Li, X Shen, Y Sun, W Zhang, J Nan; (V) Data analysis and interpretation: M Li, X Shen, Y Sun, W Zhang, J Nan; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

^ORCID: Meiting Li, 0000-0003-1555-7728; Xifeng Shen, 0000-0003-3446-6741; Yuanyuan Sun, 0000-0001-7894-865X; Weining Zhang, 0000-0003-2326-9400; Jiale Nan, 0000-0002-0577-4510; Dongping Gao, 0000-0002-8699-8195.

Correspondence to: Dongping Gao. Institute of Medical Information, Chinese Academy of Medical Sciences, Peking Union Medical College, No. 3 Yabao Road, Chaoyang District, Beijing, China. Email:

Background: When users inquire about knowledge in a certain field using the internet, the intelligent question-answering system based on frequently asked questions (FAQs) provides numerous concise and accurate answers that have been manually verified. However, there are few specific question-answering systems for chronic diseases, such as rheumatoid arthritis, and the related technology to construct a question-answering system about chronic diseases is not sufficiently mature.

Methods: Our research embedded the classification information of the question into the sentence vector based on the bidirectional encoder representations from transformers (BERT) language model. First of all, we calculated the similarity using edit distance to recall the candidate set of similar questions. Then, we took advantage of the BERT pretraining model to map the sentence information to the corresponding embedding representation. Finally, each dimensional feature of the sentence was obtained by passing a sentence vector through the multihead attention layer and the fully connected feedforward layer. The features that were stitched and fused were used for the semantic similarity calculation.

Results: Our improved model achieved a Top-1 precision of 0.551, Top-3 precision of 0.767, and Top-5 precision of 0.813 on 176 testing question sentences. In the analysis of the actual application effect of the model, we found that our model performed well in understanding the actual intention of users.

Conclusions: Our deep learning model takes into account the background and classifications of questions and combines the efficiency of deep learning technology and the comprehensibility of semantics. The model enables the deep meaning of the user’s question to be better understood by the intelligent question answering system, and answers that are more relevant to the original query are provided.

Keywords: Intelligent question-answering system; Semantic Text Similarity (STS); rheumatoid arthritis; classification; deep learning

Submitted Jul 18, 2022. Accepted for publication Jan 26, 2023. Published online Mar 15, 2023.

doi: 10.21037/qims-22-749


An increasing number of people are using the internet to look up health information. For example, patients with rheumatoid arthritis disease may be interested in the duration of joint symptoms and effective long-acting medicines. Traditional search engines often return too many relevant web pages or data items, which makes it difficult for the required information to be located quickly and accurately (1). An intelligent question-answering system based on frequently asked questions (FAQs) can enable users to ask questions in their natural language. It returns short and accurate results, enhancing users’ information acquisition experience.

According to epidemiological reports, as of 2019, the number of patients with rheumatoid arthritis in China reached more than 6 million, with about one-tenth of these being severe cases (2). From the perspective of the user experience, an automatic question-answering system has long been an area of intense research interest in the field of information retrieval. However, the current question-answering system for specific fields has yet to be perfected, especially in the medical specialty field.

Semantic Text Similarity (STS) refers to the degree of a match between two texts. STS has a wide range of applications in many fields of natural language processing tasks, such as text summarization generation, question-answering systems, plagiarism detection, duplicate checking, and similar content recommendations. The present study aimed to evaluate STS calculation for questions of the FAQ-based question-answering system to make improvements that apply to the field of rheumatoid arthritis disease. In the Chinese language, many synonyms, acronyms, negative words, and complex and diverse sentence structures increase the difficulty of calculation. Due to the short length of the question, the absence of context, and the diversity and complexity of users’ questions, a Chinese language question-answering system has certain requirements for its accuracy and reasoning ability. Presently, the related research in the field of Chinese question answering is not mature.

Traditional Chinese Semantic Textual Similarity algorithms use a number of methods. The keyword-based method extracts and analyzes the word frequency and part-of-speech information in a sentence (3). The method based on semantic dependence analyzes the deep syntactic structure by analyzing the dependence relationship between the core words of the sentence and other components (4). The method based on semantic analysis calculates the similarity of the words in the sentence using a constructed semantic knowledge base to calculate the similarity value of the whole sentence (5). However, the difficulty of this method lies in the improvement and expansion of some words. The method based on edit distance counts the number of editing operations required to transform two sentences into the same sentence, including addition, deletion, and modification (6).

Many previous studies have researched how to obtain the similarity of two texts. Albitar et al. (7) used the term frequency-inverse document frequency (TF-IDF) method to measure the similarity between texts and used the results as the prediction standard for text classification. Ormerod et al. (8) applied linear decoding and Representational Similarity Analysis (RSA) to measure the semantic similarity signal in intermediate token representations of 5 popular transformer models, with predictions producing a correlation of 0.87 with ground-truth similarity scores compared with the state-of-the-art correlation of 0.9. These included the bidirectional encoder representations from transformers (BERT)-Large (9), 3 variants of BERT that were fine-tuned on text from the clinical domain, and XLNet-Large (10). The 3 BERT variants were BioBERT (11), ClinicalBERT (1-13), and discharge summary BERT (DS BERT) (12-13). Chinese scholars have developed many methods based on semantic considerations. Li et al. (14) presented an approach to compute the similarity and relevance between words based on two kinds of language resources: CiLin (15) and HowNet (16). Yu et al. (17) proposed a method to calculate the similarity of question sentences based on the keyword vector space method and semantic conception vector space method. Cui et al. (18) further considered the distance and order of words, proposed a new method, and applied it to the network question-answering system. Xiong et al. (19) put forward a calculation method for the community question-answering system based on a latent Dirichlet allocation (LDA) model, which separately calculated from the statistical information, semantic information, and topic information of the question sentence, comprehensively obtaining the overall similarity.

Many experts have carried out research on STS based using deep learning. Mahmoud (20) used a convolutional neural network to detect the semantic relevance between suspicious text and source text documents using the open-source Arabic corpus (21). The results showed that the accuracy and recall rates were better compared with those achieved with the TF-IDF method based on statistics and a method based on word correlations. Wu et al. (22) integrated the BERT and boosted tree models and proved the effectiveness of the ensemble through a correlation analysis. With the ensemble of the two types of models, the F1 score reached 0.90825, which was 3.88% higher than that of the optimal single model. Li et al. (23) proposed a combined method based on knowledge-based conceptualization and a transformer encoder that could more effectively capture the semantics of short texts, which was found to be useful in experiments and could be applied to a variety of applications, such as short-text information retrieval and short-text classification.

Most of the current similarity calculation techniques based on deep learning seek to improve performance by changing the model structure, which can often improve the accuracy of the similarity calculation results with a small amount of data. However, achieving a high level of accuracy is not the only challenge. In practical applications, only by thoroughly understanding the user’s question and their questioning intention can we better answer the user’s query and provide the answer that the user actually needs. Rather than using literal matching, our method can circumvent the drawbacks of literal understanding and matching while understanding deep user needs. The question answering system built in our research not only gives users answers to specific questions, but also enables intelligent understanding.

Our results indicated a strong correlation between the effect of STS calculation of Chinese sentences and the analysis of text structure and the concept of words. This finding suggests that the characteristics of the calculation method and its applicability in a specific field should be fully considered when calculating STS.


The application of our method in the working process of the question-answering system is shown in Figure 1. First, we used the edit distance method to calculate similarity to recall a set of 20 question sentences in the FAQ. Then, we calculated the similarity between the candidate question set and the question and sorted them from largest to smallest. Finally, we selected the answer corresponding to the largest similarity question as the result.

Figure 1 Flowchart depicting the workflow of the answer extraction of this question-answering system. FAQ, frequently asked question.

The edit distance is a commonly used distance measurement method that has been widely used in the field of text similarity calculation. We used this method to determine the approximate scope of candidate questions in order to improve search efficiency. This method refers to the minimum number of operations required to convert one string to another. The operations include the following: add, which adds a character; delete, which deletes a character; and modify, which modifies a character. The edit distance directly and literally reflects the degree of difference between two texts; that is, the more similar the two texts are, the smaller the edit distance. The main idea of the edit distance technique is to construct a matrix d[m+1, n+1], where m and n are the lengths of the texts d1 and d2, respectively, and then calculate ED(d1,d2) = d[m+1, n+1], where ED(d1,d2) is the edit distance between d1 and d2.

The formula of the edit distance algorithm is as follows:



First, the matrix is initialized with values 0…n in the first row and 0...m in the first column, and then each character from 1 to m in d1 is compared with each character from 1 to n in d2. The comparison formula is shown in Eq. [2]. When d1 or d2 is 0, the edit distance is the length of another nonzero text; when d1i and d2j are equal, the edit distance is the edit distance d[i-1,j-1] of the previous character of the current character; when d1i and d2j are not equal, the edit distance takes the minimum value of three cases.

The edit distance approach only calculates the similarity from the literal text and does not combine the semantic features for further judgment. Question recall based on edit distance can only obtain a set of candidate questions, and the similarity value needs to be calculated in combination with a transformer for deep learning.


Sentence vectorization is an important step in the process of sentence feature extraction. With the development of word vector technology, sentence information can be mapped into vectors, as is done with static word vectors word2vec (24) and glove (25). For BERT (9), the transformer is the core module, and it can solve the long-distance dependency problem caused by the traditional recurrent neural network (RNN) model and can be calculated in parallel to improve computational efficiency. The structure of BERT is shown in Figure 2.

Figure 2 The structure of bidirectional encoder representation from the transformer. E, the vector transformed from each question; T, the implicit output state; Trm, transformer encoding module.

The training process of BERT is divided into the pretraining and fine-tuning stages. In the pretraining stage, we used the BERT pretraining model provided by the Harbin Institute of Technology (26). Questions related to rheumatoid arthritis were used in the fine-tuning stage. Questions in a question-answering system are typical short texts. Due to the lack of context information, short text without rich background information is more likely to produce ambiguity and be difficult to understand. Therefore, we added a layer of sentence classification information into the BERT embedding layer, which was developed in advance according to the basic information of questions under the supervision of professional doctors. Finally, the BERT embedding layer consisted of token embedding, segment embedding, position embedding, and classification embedding (Figure 3). Token embedding recorded the information of each word; sentence embedding recorded the overall information of the sentence; position embedding used the sine and cosine functions to encode the position of the word, and the position information of the word was encoded into a feature matrix; and classification embedding integrated the semantic information of sentences into the generation of vectors. The model converts each word xi in the input sentence sequence X=(x1,x2,...,xt,...,xn) into the embedding vector ei and output, which obtains the embedding representation E = (e1,e2,...,et,...,en) of the sentence X.

Figure 3 Four input vector representations of BERT. CLS, a classifier token; SEP, a sentence separator; BERT, bidirectional encoder representation from transformers.

Specifically, the combination of embedding layers is as follows.

Token embedding

In this layer, each character is converted into a 768-dimensional vector. Before the conversion, two special tokens (CLS) (classification) and (SEP) (separation) are added to the beginning and end of the sentence text, which are regarded as signs of dividing the sentence.

Segment embedding

In the similarity calculation task, the input is a concatenated sentence pair. In this layer, there are only two vector representations. For the position of the first sentence, the value is assigned to 0; the position of the second sentence is assigned to 1.

Position embedding

The position of the characters is critical for the meaning sentences written in Chinese.

The transformer has a different structure from RNN and cannot use the order information of words. Therefore, the position information of the words is encoded in the manner shown in Eq. [3] and Eq. [4]:



pos represents the position of the character in the sentence, dmodel is the dimension of the vector, and i is the position of the vector. The position relation of subsequent characters relative to the current character can be obtained through this position encoding, which is beneficial to expressing the semantic relation.

Classification embedding

We input the sentence pair into the original BERT model to obtain the CLS vector of the sentence. The classification information of sentences obtained with one-hot encoding is passed through an embedding layer and added to (CLS) to obtain the final representation vector.

After the above process, the four different vector representations are averaged to synthesize a vector representation with a batch size of 768, which is the input of the transformer encoder part.

The BERT pretraining model is a 2-stage model. The first stage is a language pretraining model, which employs a masked language model and next sentence prediction to capture the textual representation at the word and sentence level.

Specifically, 15% of the token locations are randomly selected for masking, and 80% of these 15% locations use (MASK) tokens, 10% use any other random token, and the last 10% keep the original token unchanged. The training process of the next sentence prediction task is that for example sentences A and B, there is a 50% probability that B is similar to A, and the other 50% probability is irrelevant. In this study, in the second stage of BERT, we used the prediction result of the next sentence prediction task as the calculation result of the similarity of the two questions and continuously adjusted a large number of parameters in the BERT network through the backpropagation mechanism to minimize the loss function. The loss function used in the training phase of this article is shown in Eq. [5], where F represents the true label, sj represents the probability, and T represents the total.



The encoder of the transformer is composed of 6 identical stacked basic layers, each of which contain two sublayers: the multihead attention layer that uses the three matrices of Q, K, and V for the calculation of the attention mechanism and the fully connected feedforward layer that introduces nonlinearity and transforms the output space of the attention layer to increase the model’s characterization ability. After the addition of the multihead attention layer and fully connected feedforward layer, residual connection and normalization layers are added, respectively, to standardize the optimized space and accelerate the convergence process, preventing problems such as the disappearance of gradients.

The function of the multihead attention layer is to enable the encoder to fully integrate the context information when extracting each position feature, thereby capturing the internal structure information of the input text. First, this part decomposes the information contained in the input source text into a series of key-value pairs (key, value). Next, the degree of correlation between each query and each key is calculated to obtain the value corresponding to each key in each source text. Finally, the value is weighted and summed to obtain the final attention value. Essentially, attention is the weighted summation of the value of the elements in the source, and the query and key are used to calculate the weight coefficient of the corresponding value. The calculation process is shown in Figure 4. The first stage involves calculating the weight coefficient based on query and key, and the second stage involves normalizing the original score of the first stage using softmax, as shown in Eq. [6] (27). The calculation idea for the entire text is as follows: Attention(query,source)=i=1lxsimilarity(query,keyi)valuei.


Figure 4 The calculation process is divided into the 3 stages. *, the matrix used in the calculation.

where ai is the attention weight vector, and Lx is the length. The third stage involves performing a weighted summation of the value according to the weight coefficients normalized in the second stage. The calculation process of the three stages is shown in Figure 4 (25).

The calculation formula is shown in Eq. [7]. Three vectors, Q, K, and V, are calculated through model learning: the Q vector represents the current character, the K vector represents each character in the context, and the vector V represents the relationship of the target word and each context. In the calculation, the weight expressed by the similarity between the Q vector and each K vector is weighted and then fused with the V vector. The scaling factor dimk is used to achieve softmax normalization, making the model more stable during training.


The process of calculating the scaled dot-product of the query and key is also the process of focusing. The focus of important information is reflected in the weight coefficient, which represents the importance of the information and corresponds to value. Specifically, multihead attention combines and linearly transforms the enhanced semantic vectors of each word in the sentence in different semantic spaces to obtain a final enhanced semantic vector with the same length as the original word vector, which is the result of the multihead attention layer. The calculation formula is shown in Eq. [8] and Eq. [9] (28). Multihead attention correlates different attention results to obtain contextual semantic information from multiple dimensions, which reflects the relevance and importance of different characters to a certain extent and obtain richer semantic feature expression.



WiQ,WiK,andWiVRdmodel×dk represent the weight matrix Q, K, and V of the i-th head (i=1,2,……,h, h=12), h represents the number of attention, and dmodel is the dimension of the element vector, dk = dv = dmodel/h. Each attention captures the information of a subspace in the question, and the multihead attention value is obtained by splicing h attention heads through matrix WORdmodel×dmodel.

The second sublayer of the encoder’s basic structure is the fully connected feedforward layer, which was composed of a rectified linear activation function (ReLU) activation function layer and the linear function layer. The overall formula is expressed as follows: FFN(x) = max(0,xW1+b1)W2+b2. Here, W1 and W2 are two trainable weight matrices, b1 and b2 are the 2 offset vectors, and x is the input of the activation function.

Attention imitates the activity mechanism of the human brain. In the question sentence “What are the symptoms of rheumatoid arthritis in the active period?”, “in the active period” and “symptoms” are highly correlated. To answer this question about “symptoms,” the limiting condition of “in the active period” must be taken into consideration. The attention mechanism is used to distinguish the effects of different parts of the input on the output.


We conducted our experiments on two models: a baseline model and an improved baseline model. The specific experimental environment settings are shown in Table 1. The experimental data were divided into the training, validation, and test sets according in a ratio of 8:1:1.

Table 1

Experiment environment configuration

Experiment environment Configuration
Operating system Ubuntu16.04
CPU Intel(R) Xeon(R) CPU E5-2603 v4 at 1.70 GHz
Random access memory 32 G
Development language Python
Development framework PyTorch

CPU, central processing unit; GPU, graphic processing unit; NVIDIA GeForce GTX 1080, video card product of NVIDIA.

Data set

There is no public question-pair corpus in the field of rheumatoid arthritis disease. Therefore, we first built a question-answering corpus for rheumatoid arthritis. We manually classified the resulting interrogative sentences according to the meaning of the question sentences and the characteristics of the disease. We first searched for relevant questions and corresponding answers with “rheumatoid arthritis” on several well-known Chinese question and answering websites and then marked the similarity of the questions. We labeled questions with similar meanings or the same category as similar and the rest as dissimilar. We treated questions with the same answer requirements as similar. All of our work was conducted under the supervision of professional sonographers, following the actual clinical situation and the actual needs of patients, and the questions and classification were professional and authoritative. Since our research is still in progress, the code and data have not yet been released, we will consider sharing these after we complete our research. The final question classification is shown in Table 2.

Table 2

Classification information of questions

Number Primary classification Secondary classification Tertiary classification
1 Disease profile Awareness of disease Concept
Hazards and effects
Influence factor
Epidemiology Basic statistical indicators
Prone population
2 Pathogeny and predisposing factors Pathogeny Disease causes
Causes of accompanying other symptoms or illnesses
Causes of symptoms
Predisposing or aggravating factors Predisposing or aggravating factors
3 Diagnosis and evaluation of disease Symptoms Symptoms of the disease itself
Symptoms associated with other symptoms or diseases
Diagnostic criteria Diagnostic indicators
Differential diagnosis
Active diagnosis
Means of inspection and inspection Laboratory inspections
Physical examinations
Imageological examinations
Other examinations
4 Treatment principles and protocols Principle of treatment Principle of treatment
Therapeutic schedule Drug therapy
Operative treatment
Other therapeutic substances
Folk prescription
Treatment of symptoms Treatment of symptoms
Treatment of accompanying other symptoms or diseases Treatment of accompanying other symptoms or diseases
Traditional Chinese medicine therapy Traditional Chinese medicine therapy
Naturopathy Naturopathy
5 Matters needing attention Disease control considerations Disease control strategy
Other matters needing attention Dietary contraindications and dietary recommendations
Exercise and movement patterns
Matters needing attention merged with other diseases and symptoms
Nursing methods
6 Prognosis Prognostic effect Prognostic effect
Prognostic factors Prognostic factors
7 Precaution Disease prevention Disease prevention
Symptoms of prevention Symptoms of prevention
8 Others Economics Expenditure
Health insurance
Medical establishment Hospital

For each question in the question-answering pairs, 5 dissimilar questions and 1 similar question with their corresponding category information were randomly selected. This was used for the training set data input to the model. Each sentence corresponded to 6 pieces of data, including 5 wrong answers and 1 correct answer. The validation set was constructed in the same way as the training set. For each piece of test data, the top 100 pieces of data were selected in descending order according to the edit distance of all questions that were paired with the question and answer pair. Then, their similarity to these 100 questions was calculated in the prediction stage.


We evaluated the effect of the question and answer system from the following aspects: accuracy, comprehensiveness, the speed of the system to return answers, and the fluency of answer sentences, which should be concise and conform to the characteristics of natural language.

We used two ways to measure the performance of our question-answering system.

First, precision indicated whether the result returned was what we expected. We checked the precision of the top 1, 3, and 5 answers. Mean reciprocal rank (MRR) indicated the average of reciprocal ranks of the desired items, which was computed as the sum reciprocal of all the correct answers, and rank (q) was the position of the first correct answer in the returned list. The results are shown in Tables 3,4. In addition to the basic BERT model, we also improved several classic BERT variant models, including robustly optimized bidirectional encoder representations from transformers approach (RoBerta); a LITE bidirectional encoder representations from transformers (ALbert), and MLM as correction bidirectional encoder representations from transformers (MacBert). It should be noted here that the ratio of positive and negative samples was fixed at 1:5, the learning rate of experiments was performed for 1e-7, and the batch size was 32.


Table 3

Performance of the baseline and improved models

Model MRR Top-5 precision Top-3 precision Top-1 precision
Berta_Baseline_model 0.562 0.676 0.614 0.500
Bert_Improved_model 0.660 0.813 0.767 0.551
RoBertab-base-Baseline_model 0.306 0.489 0.307 0.188
RoBerta-base-Improved_model 0.517 0.653 0.580 0.420
RoBerta-large-Baseline_model 0.252 0.386 0.284 0.153
RoBerta-large-Improved_model 0.342 0.534 0.426 0.210
ALbertc-large-Baseline_model 0.719 0.852 0.801 0.614
ALbert-large-Improved_model 0.712 0.865 0.831 0.588
ALbert-xlarge-Baseline_model 0.571 0.761 0.665 0.432
ALbert-xlarge-Improved_model 0.622 0.807 0.756 0.483
MacBertd-base-Baseline-model 0.722 0.858 0.830 0.608
MacBert-base-Improved-model 0.739 0.863 0.807 0.636
MacBert-large-Baseline-model 0.618 0.863 0.795 0.438
MacBert-large-Improved-model 0.705 0.841 0.818 0.591

aBert, bidirectional encoder representations from transformers; bRoBerta, robustly optimized bidirectional encoder representations from transformers approach; cALbert, A LITE bidirectional encoder representations from transformers; dMacBert, MLM as correction bidirectional encoder representations from transformers; MRR, mean reciprocal rank.

Table 4

Performance of the baseline and improved models based on question classification

Classification Model MRR Top-5 precision Top-3 precision Top-1 precision
Laboratory inspections Baseline 0.889 0.889 0.889 0.889
Improved 1.0 1.0 1.0 1.0
Drug therapy Baseline 0.440 0.563 0.500 0.375
Improved 0.573 0.688 0.688 0.5
Dietary contraindications and dietary recommendations Baseline 0.7 0.7 0.7 0.7
Improved 0.733 0.9 0.9 0.6
Principle of treatment Baseline 0.341 0.6 0.367 0.233
Improved 0.831 0.933 0.9 0.767
Traditional Chinese medicine therapy Baseline 0.6 0.6 0.6 0.6
Improved 0.75 1.0 0.8 0.6
Exercise and movement patterns Baseline 0.333 0.167 0.0 0.0
Improved 0.5 0.5 0.5 0.5
Symptoms of the disease itself Baseline 0.659 0.818 0.727 0.545
Improved 0.727 0.909 0.909 0.545
Disease prevention Baseline 0.452 0.714 0.714 0.286
Improved 0.524 0.857 0.857 0.286
Classification Baseline 0.733 1.0 1.0 0.6
Improved 0.8 0.8 0.8 0.8
Cure Baseline 0.567 0.75 0.625 0.5
Improved 0.588 0.875 0.75 0.375
Nursing methods Baseline 0.417 0.5 0.5 0.333
Improved 0.806 1.0 1.0 0.667
Disease control strategy Baseline 0.875 1.0 1.0 0.75
Improved 1.0 1.0 1.0 1.0

MRR, mean reciprocal rank.

Second, we chose several representative sentences as examples to compare the calculation effects of the baseline and improved model. The sorted sentences in the top 3 and the corresponding similarity values returned by the baseline model and the improved model are shown in Table 5. The baseline model tended to match literally, such as asking “类风湿关节炎可以采用免疫治疗吗?” (“Can rheumatoid arthritis be treated with immunotherapy?”), for which the baseline model matches, “类风湿关节炎可以打疫苗吗?” (“Can rheumatoid arthritis be vaccinated against?”) and “类风湿关节炎可以做沙疗吗?” (“Can I do sand therapy?”). We considered that the users’ needs were the treatments of rheumatoid arthritis and knowledge about whether immunotherapy was one of them. Therefore, we matched the question “类风湿关节炎要怎么治疗最好”? (“How best to treat rheumatoid arthritis?”). The answers returned to users were common treatments for rheumatoid arthritis, not other vaccine-related issues.

Table 5

Similarity calculation results of example sentences

Examples Sorting of the returned results of the baseline model Similarity scores for the baseline model Sorting of the returned results of the improved model Similarity scores for the improved model
膝盖类风湿关节炎能打玻璃酸钠吗? Can rheumatoid arthritis be treated with sodium hyaluronate injection in the knee? 类风湿关节炎能根治吗? Can rheumatoid arthritis be curative? 0.0072 类风湿关节炎要怎么治疗最好? What is the best treatment for rheumatoid arthritis? 0.8960
类风湿关节炎早期能治好吗? Can inchoate rheumatoid arthritis be cured? 0.0057 类风湿关节炎需要注意什么? What are the precautions for patients with rheumatoid arthritis? 0.8877
类风湿关节炎会好吗!能怀孕吗? Can rheumatoid arthritis be cured? Can the patient become pregnant? 0.0051 类风湿关节炎有哪些症状? What are the symptoms of rheumatoid arthritis? 0.8869
类风湿关节炎可以采用免疫治疗吗? Can rheumatoid arthritis be treated with immunotherapy? 类风湿关节炎可以打疫苗吗? Can rheumatoid arthritis be vaccinated against? 0.3141 类风湿关节炎要怎么治疗最好 What is the best treatment for rheumatoid arthritis? 0.9053
类风湿关节炎可以做沙疗吗? Can rheumatoid arthritis be treated with sand therapy? 0.1713 类风湿关节炎的治疗药物有什么危害? What are the dangers of rheumatoid arthritis medications? 0.9016
类风湿关节炎能根治吗? Can rheumatoid arthritis be curative? 0.1211 严重类风湿关节炎怎么治疗? How to treat patients with severe rheumatoid arthritis? 0.8896
类风湿因子71,能确诊是类风湿关节炎吗? Rheumatoid factor value is 71; can you be sure it is rheumatoid arthritis? 类风湿关节炎能根治吗? Can rheumatoid arthritis be curative? 0.0249 类风湿因子阳性是类风湿关节炎吗? Can a positive rheumatoid factor diagnose rheumatoid arthritis? 0.9170
类风湿关节炎会好吗!能怀孕吗? Can rheumatoid arthritis be cured? Can the patient become pregnant? 0.0130 如何诊断类风湿性关节炎? How to diagnose rheumatoid arthritis? 0.9160
如果有类风湿关节炎,现吃药可以怀孕吗? Can I get pregnant if I have rheumatoid arthritis while taking medicine? 0.00978 什么是类风湿关节炎? What is rheumatoid arthritis disease? 0.9156
类风湿关节炎如何进行康复训练? How do patients with rheumatoid arthritis undergo rehabilitation? 如何诊断类风湿性关节炎? How to diagnose rheumatoid arthritis? 0.4063 类风湿关节炎怎样运动? How do patients with rheumatoid arthritis exercise? 0.8945
类风湿关节炎应该如何预防How to prevent rheumatoid arthritis? 0.0779 类风湿关节炎要怎么治疗最好? What is the best treatment for rheumatoid arthritis? 0.1376
类风湿关节炎如何医治,怎么预防? How to treat and prevent rheumatoid arthritis? 0.0711 类风湿关节炎预后如何? What is the prognosis for rheumatoid arthritis? 0.0339
怎么治好类风湿关节炎? How to cure rheumatoid arthritis? 如何诊断类风湿性关节炎? How to diagnose rheumatoid arthritis? 0.9422 类风湿关节炎要怎么治疗最好? What is the best treatment for rheumatoid arthritis? 0.9066
类风湿关节炎诊断, 怎么治疗? How is rheumatoid arthritis diagnosed and treated? 0.8995 严重类风湿关节炎怎么治疗? How to treat patients with severe rheumatoid arthritis? 0.8860
怎么治疗类风湿关节炎的肾损害? How to treat kidney damage caused by rheumatoid arthritis? 0.7161 什么是类风湿关节炎? What is rheumatoid arthritis disease? 0.8669


Due to the limitations of technology and knowledge, our question-answering system based on FAQs had some limitations. First, our study did not consider the relevance of semantic understanding in complex multiround question answering. Second, as user problems become more complex and diverse and people’s knowledge of a certain fields becomes more complete, the use and maintenance of the question-answering system will become more difficult. Zhou et al. (29) proposed for the first time that the upper and lower questions of the question are also particularly important in the limited field. When the question is incomplete, it is necessary to combine the previous question for a joint semantic understanding, especially in the field of chronic medical diseases. For example, some user questions will add time and context restrictions to describe their symptoms. Questions about how to distinguish these subtle differences and return answers in a targeted manner are the key issues that our intelligent question answering system will aim to solve in its next stage. In the future, an important research direction to consider is the content of sentences and adding more and broader disease information to the similarity calculation method. Mining deeper semantic information of questions can provide more relevant analytical dimensions for the similarity calculation model.


We have researched and improved the text similarity technology of the FAQ-based intelligent question-answering system, which involves the comprehension and analysis of the content and form of users’ questions using natural language processing technology to provide answers described in natural language. STS calculation techniques are key techniques for retrieving and displaying answers to such question answering systems.. Most of the current similarity calculation techniques based on deep learning seek to improve performance by changing the model structure, but the semantic information of the question is also an important part of the calculation result that must be considered. Our research additionally considers the classification information of the question, which can effectively limit the range of questions and answers, making the returned answer as close as possible to the users’ query needs and improving the efficiency of the question-answering system. For example, for the question: “手指痛一定是类风湿关节炎吗”? (“Is finger pain necessarily rheumatoid arthritis?”), this study classified it as being related to the diagnosis of rheumatoid arthritis because we believe that patients need information related to the diagnosis of the disease. However, the top 5 classifications of similar sentences given by the baseline model were the following: concept, matters needing attention merging other diseases and symptoms, the principle of treatment, operative treatment, and a cure.


Funding: This work was supported by the National Key Research and Development Program of China (No. 2020AAA0104905) and the National Natural Science Foundation of China (No. 82071930).


Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at The authors report that this work was supported by the National Key Research and Development Program of China (No. 2020AAA0104905) and the National Natural Science Foundation of China (No. 82071930). The authors have no other conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. There were no participants in this study, and no ethics approval and informed consent form were required.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See:


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Cite this article as: Li M, Shen X, Sun Y, Zhang W, Nan J, Zhu J, Gao D. Using Semantic Text Similarity calculation for question matching in a rheumatoid arthritis question-answering system. Quant Imaging Med Surg 2023;13(4):2183-2196. doi: 10.21037/qims-22-749

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