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Terminology in the Medical Domain

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Title: Terminology in the Medical Domain


1
Terminology in the Medical Domain
  • Harold Solbrig
  • 3M Health Information Systems
  • hrsolbrig_at_wpmail.code3.com

2
Outline
  • What is a terminology?
  • Medical terminologies - 100,000 ft. intro
  • Medical Terminologies - Issues
  • Possible Synergies between NCITS/L8 and Medical
    Terminologies.

3
What is a terminology?
  • The lexicon of a special subject language
    reflects the organisational characteristics of
    the discipline by tending to provide as many
    lexical units as there are concepts
  • Juan C. Sager, A Practical Course in Terminology
    Processing. John Benjamins, 1990

4
What is a terminology?
  • The items which are characterised by special
    reference within a discipline are the terms of
    the discipline, and collectively they form its
    terminology those which function in general
    reference over a variety of sublanguages are
    simply called words, and their totality the
    vocabulary.
  • Juan C. Sager. A Practical Course in Terminology
    Processing

5
What is a terminology?
  • Subject field - Section of human knowledge, the
    border lines which are defined from a
    purpose-related point of view.
  • Special language - Linguistic subsystem, intended
    for unambiguous communication in a particular
    subject field using a terminology and other
    linguistic means.
  • ISO 1087 (1990) Terminology - Vocabulary

6
What is a terminology?
  • System of concepts - Structured set of concepts
    established according to the relations between
    them, each concept being determined by its
    position in this set.
  • Term - Designation of a defined concept in a
    special language by a linguistic expression.
  • Terminology - Set of terms representing the
    system of concepts of a particular subject field.
  • ISO 1087 (1990) Terminology - Vocabulary

7
What is a terminology?
  • Key characteristics
  • Set of terms, definitions and relationships for a
    (relatively) non-ambiguous partitioning of the
    conceptual space of a specialized subject area or
    discipline.
  • NOT necessarily related to computerized data
    processing (or even data processing, period)

8
Related Terms
  • Nomenclature
  • A system of terms which is elaborated according
    to pre-established naming rules.
  • Plants
  • Animals
  • Chemical compounds
  • ...
  • ISO 1087 (1990) Terminology - Vocabulary

9
Related Terms
  • Thesaurus
  • a terminological control device used in
    translating from the natural language of
    documents, indexers, or users into a more
    constrained system language.
  • A controlled and dynamic vocabulary of
    semantically and generically related terms which
    covers a specific domain of knowledge
  • ISO 2788 (1974) Guidelines for the establishment
    and development of monolingual thesauri

10
Related Terms
  • Coding System
  • A coding system shall be a combination of a
    system of concepts a terminology (rubrics) a
    set of code values at least one coding scheme to
    relate the codes to the concepts or the terms.
  • CEN ENV 12264 1995 (MoSe)
  • Medical informatics - Categorial structures of
    systems of concepts - Model for representation of
    semantics

11
Related Terms
  • Taxonomy
  • A terminological system whose system of concepts
    is structured by generic relations
  • only.
  • CEN ENV 12264 1995 (MoSe)
  • Medical informatics - Categorial structures of
    systems of concepts - Model for representation of
    semantics

12
Why Terminology?
CONCEPT
CONCEPT
Symbolises
Refers To
Refers To
Symbolises
ROSE
ROSE
Stands For
Stands For
Designation
Designation
Referent
Rose(2) 1 a Websters Collegiate Dictionary Tenth
Edition
Rose(2) 1 a Websters Collegiate Dictionary Tenth
Edition
13
Medical Terminologies
  • Health care and medicine consists a set of
    specialized disciplines. It has been reasonably
    standardized (at least in the Western world) to
    the point that the conceptual space(s) of the
    discipline are (somewhat) well agreed upon.

14
Medical Terminologies
  • Terminologies exist for many areas
  • Disease classification
  • Diagnosis
  • Anatomy
  • Procedures
  • Pathology
  • Pharmacy
  • Laboratory
  • Interventions
  • ...

15
Medical Terminologies
  • Terminologies exist for different (and possibly
    conflicting) purposes
  • Classification and Statistics Gathering
  • Billing, Auditing and Reimbursement
  • Recording Clinical Information and Findings
  • Automated Decision Support
  • ...

16
A Classification of Medical Terminologies
  • First Generation terminological systems
  • Typically targeted for paper based information
    systems (not IT-enabled)
  • Simple hierarchies and organization
  • Expensive to maintain and reuse
  • Angelo Rossi Mori, et. al. Standards to support
    development of terminological systems for
    healthcare telematics.

17
A Classification of Medical Terminologies
  • Second Generation terminological systems
  • Compositional systems, based on a categorial
    structure (semantic categories, semantic links
    associations between categories)
  • Dynamic organization, systematic description of a
    subject field
  • Flexible and extensible
  • Limited semantic based processing

18
A Classification of Medical Terminologies
  • Third Generation terminological systems
  • Based on a formal model (a set of symbols and a
    set of formal rules)
  • Dynamic w/ multiple hierarchies
  • Content and updates are formally validated
  • Complete semantic based processing (behavior is
    independent of names)

19
Medical Terminologies
  • Some more common medical terminologies
  • International Classification of Diseases (ICD-9,
    ICD-9-CM, ICD-10, ...)
  • Current Procedural Terminology (CPT-4)
  • Systemized Nomenclature of Human and Veterinary
    Medicine (SNOMED)
  • National Drug Codes (NDC)
  • World Health Organization Adverse Drug Reaction
    Terminology
  • Logical Observations Identifiers, Names and Codes
    (LOINC)
  • Nursing Interventions Classification (NIC)
  • Nursing Outcomes Classification (NOC)
  • Universal Medical Device Nomenclature System
    (UMDNS )
  • Medical Dictionary for Regulatory Activities
    (MeDRA)
  • Health Care Financing Administration Common
    Procedure Coding Scheme (HCPCS)

20
Medical Terminologies
  • Current Unification efforts
  • Unified Medical Language System
  • Metathesaurus
  • Semantic Network
  • SNOMED-RT (Reference Terminology)

21
Medical Terminologies
  • Current Unification Efforts
  • UK Clinical Codes (Read)
  • GALEN

22
Medical Terminologies
  • Current Unification Efforts

UMLS
Galen
SMOMED-RT
UK Clinical Codes
23
Medical TerminologiesStandards Bodies
  • ASTM E.31.01 Controlled Vocabularies for
    Healthcare Informatics
  • Standardize existing High Level principles for
    the contents and structure of Controlled Health
    Vocabularies.
  • Develop a description and comparison of existing
    formalisms for health concept representation.
  • Develop a standard formalism for Controlled
    Health Vocabularies.
  • Work toward a standard model for vocabulary
    evolution, maintenance, and distribution.
  • Work to develop mechanisms to facilitate
    international use of common underlying formal
    structures for Controlled Health Vocabularies

24
Medical TerminologiesSome Standardization Efforts
  • ISO TC/215 Working Group 3 - Health Concept
    Representation
  • Terminology of terminology

25
Medical TerminologiesStandards Bodies
  • CEN TC/251 WGII
  • The semantic organisation of information so as to
    make it of practical use in the domains of
    healthcare informatics. The actual work items
    focuses on interrelationships of concepts and on
    structures for concepts systems.
  • Terms, Concepts and the interrelationship of
    concepts
  • Structures for concepts systems including those
    for multi-axial coding schemes
  • Guidelines for the production of coding systems
    and knowledge bases.

26
Medical TerminologiesSome Standards Bodies
  • HL7 Vocabulary Technical Committee
  • Scope To identify, organize and maintain coded
    vocabulary terms used in HL7 messages.

27
Medical TerminologiesSome Standards Bodies
  • Healthcare Informatics Standards Board
  • Vocabularies and code sets ad-hoc working group
  • Focus on code set inventory and education

28
Medical Terminologies Some Issues
  • Harmonization of the terminology of terminology
  • ISO TC37 - Terminology (terms definitions)
  • ISO TC46 - Documentation (thesaurus)
  • ISO TC69 - Statistics
  • ISO/IEC JTC1 - Informatics
  • CEN TC/251 - Medical Informatics

29
Medical Terminology Some Issues
  • Semantics of associations
  • O-O analysis, data-bases and programming -
    implementation oriented
  • RM/ODP - ISO/IEC ISO/IEC 10165-7
  • Concept analysis/description logies
  • CSMF, etc - ISO/IEC 9007, 14481
  • Traditional terminologists
  • linguistically oriented theories

30
Medical Terminology Some Issues
  • ROI and pricing structure
  • Does creating a code mean that you own the
    concept?
  • How do we encourage development of rigorous
    terminologies without making them too expensive
    to use?

31
Medical TerminologySome Issues
  • A coding scheme for coding schemes (bootstrap
    issue)
  • ICD-9? I9? IC9? SNOMED? SMD? ISMarc?
  • CEN TC/251 1068 (Registration of Coding Schemes)
    - superceded by ISO 7826
  • ISO 7826 (Identification and Registration of
    Coding Schemes) - broken
  • NCITS/L8 - Not currently in scope

32
Medical TerminologiesSome Issues
  • The relationship of terminologies to metadata
  • Structure issues
  • Patient Gender F
  • Patient Gender F Y Patient Gender M N
  • Tag Gender Value F
  • Transformation and binding issues
  • How do the two relate on the meta level?

33
Medical Terminology Direction
Terminologies and Coding Schemes
Metadata
34
NCITS/L8 Directions
Terminologies and Coding Schemes
Metadata
35
Some Possible Points of Cooperation
  • Medical Terminologies
  • Body of knowledge and research on terminological
    structure and content
  • Medical Terminology itself
  • Research and practical experience in
    terminology/metadata integration
  • Galen (Alan Rector, et. al.)
  • CEN TC/251 PT-27 (Angelo Rossi-Mori, et. al)
  • HL7 (Stan Huff, et. al.)

36
Some Possible Points of Cooperation
  • NCITS/L8
  • X3.285 Metadata Model
  • Value Domains work
  • Registry models and implementations
  • Ties with XML/RDF
  • ???

37
A Few ReferencesBooks
  • Juan C. Sager - A Practical Course in Terminology
    Processing. 1990, John Benjamins Publishing
  • C.K. Ogden, I.A. Richards - The Meaning of
    Meaning 1923 - (republished) Harcourt, Brace
    World, Inc.
  • John Sowa - Conceptual Structures Information
    Processing in Mind and Machine. 1984
    Addison-Wesley
  • Umberto Eco - Semiotics and the Philosophy of
    Language. 1984. Indiana University Press
  • George Lakoff - Women, Fire and Dangerous Things
    - What Categories Reveal about the Mind. 1987.
    University of Chicago Press

38
A Few ReferencesURLs
  • ASTM E.31 Home Page
  • http//www.astm.org/COMMIT/e-31.htmsponsor
  • CEN TC/251 Home Page
  • http//www.centc251.org/
  • HL7 Home Page
  • http//www.hl7.org/
  • Angelo Rossi-Moris Terminology Home Page
  • http//gift.irmkant.rm.cnr.it/termhome.htm
  • The Duke medical standards home page
  • http//www.mcis.duke.edu/standards/guide.htm

39
Other Publications
  • Proceedings of IMIA WG6 - Conference on Natural
    Language and Medical Concept Representation
  • CG Chute, RH Baud, JJ Cimino, VL Patel, AL
    Rector, Guest Editors. Methods of Information in
    Medicine 199837(4-5)311-575. Special Issue on
    Coding and Language Processing
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