View
221
Download
0
Category
Tags:
Preview:
Citation preview
Defining the Need for a Controlled Vocabulary
• Recording primary clinical information
• Multipurpose (re-use)
• Sharing data
• Maintenance
1: Content
• Must seek to be provide breadth and depth
• Atoms versus molecules
• A formal methodology is needed
• Structure must not limit size
2: Concept Orientation
• Concepts, not terms
• One meaning (nonvague)
• No more than one meaning (nonambiguous)
• Higher-level ambiguous
• One concept per meaning (nonredundant)
• May have multiple context-dependent meanings
3: Concept Permanence
• Old concepts can't be deleted
• Example: non-A-non-B hepatitis
• Names can be changed as long as meaning doesn't change (retronyms)
• Example: transvenous pacemaker
4: Nonsemantic Concept Identifiers
• Don't use the name
• Don't use a code that will run out of room
• Don't use a hierarchical code
• Meaningless integer (+/- check digit)
5: Polyhierarchy
• Needed for tree walking
• Needed for inferencing
• Needed for "essence"
• Example: diseases of the liver which also involve the kidney
6: Formal Definitions
• Support understanding
• Support maintenance
• Structured and controlled (not narrative)
• Represented through relationships within the vocabulary
• Defintional versus assertional knowledge
• Additional effort minimal and will pay off
7: Reject "Not Elsewhere Classified"
• Can never have a formal definition
• Vocabulary changes induce semantic drift
8: Multiple Granularities
• Different levels for different purposes
• Uncertainty is allowed, imprecision is not
• We must be precise about our uncertainty
9: Multiple Consistent Views
• Multiple views for multiple purposes
• Must not lead to inconsistency
10: Representing Context
• Needed: a grammar to show usage
• "What is sensible to say"
• Consider modeling "events"
Controlled Medical Vocabulary
Definitional Knowledge(how concepts define each other)
Body Site
Joint
is -a
Finding
JointSwelling
PathologicFunction
Swelling
is -a is -a
Right Kneeis -a
has-abnormality
has-site
Controlled Medical Vocabulary
Definitional Knowledge(how concepts define each other)
Assertional Knowledge(how concepts combine)
Body Site
Body Site Findingmodifies
Joint
is -a
Finding
JointSwelling
PathologicFunction
Swelling
is -a is -a
Right Kneeis -a
has-abnormality
has-site
Controlled Medical Vocabulary
Definitional Knowledge(how concepts define each other)
Assertional Knowledge(how concepts combine)
Contextual Knowledge(how concepts are used)
Body Site
Body Site FindingFinding Physical Exam
ProgressNote
HospitalAdmission
part-of
part -of
part-of
modifies
Joint
is -a
Finding
JointSwelling
PathologicFunction
Swelling
is -a is -a
Right Kneeis -a
has-abnormality
has-site
Electronic Medical Record
Controlled Medical Vocabulary
Definitional Knowledge(how concepts define each other)
Assertional Knowledge(how concepts combine)
Contextual Knowledge(how concepts are used)
Body Site
Body Site FindingFinding Physical Exam
ProgressNote
HospitalAdmission
part-of
part -of
part-of
modifies
Hospital Admission
Progress Note
Progress Note
Progress Note
Physical Exam
[Joint Swelling [Right Knee]]
Joint
is -a
Finding
JointSwelling
PathologicFunction
Swelling
is -a is -a
Right Kneeis -a
has-abnormality
has-site
11: Graceful Evolution
• Will always need to fix mistakes
• Medical knowledge will grow
• Bad reasons
• Good reasons
11: Graceful Evolution
• Bad reasons:
- Redundancy
- Major name changes
- Code reuse
- Changed codes
11: Graceful Evolution
• Good reasons:
- Simple addition
- Refinement
- Precoordination
- Disambiguation
- Obsolescence
- Discovered redundancy
- Minor name changes
12: Recognize Redundancy
• Synonyms are good• Redundant concepts are bad• Redundant expressions are inevitable• Example:
- Year 1: "Pneumonia", "Left Lower Lobe"
- Year 2: "Left Lower Lobe Pneumonia"
12: Recognize Redundancy
Left Lower Lobe Pneumonia is-a: Pneumonia
Pneumonia
Finding
Left Lower Lobe
12: Recognize Redundancy
Left Lower Lobe Pneumonia is-a: Pneumonia has-site: Left Lower Lobe
Pneumonia
Finding
Left Lower Lobe
12: Recognize Redundancy
Left Lower Lobe Pneumonia is-a: Pneumonia has-site: Left Lower Lobe participates-in: Finding
Pneumonia
Finding
Left Lower Lobe
12: Recognize Redundancy
Left Lower Lobe Pneumonia is-a: Pneumonia has-site: Left Lower Lobe participates-in: Finding
Pneumonia
Finding
Left Lower Lobe
What's Here Today?
1: Content
4: Nonsemantic Concept Identifiers
8: Multiple Granularities
10: Multiple Consistent Views
What May Be Here Soon?
2: Concept Orientation
3: Concept Permanence
5: Polyhierarchy
6: Formal Definitions
7: Reject "Not Elsewhere Classified"
Recommended