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The Medical Entities Dictionary
Columbia University
Department of Biomedical Informatics
The Medical Entities Dictionary
K#1 = 4.2K#1 = 3.3
K#2 = 3.2
K#1 = 3.0
Retrieving Results Individually
K#1
K#2
K#3 = 2.6
K#3
K#1 = 4.2K#1 = 3.3
K#2 = 3.2
K#1 = 3.0
Retrieving Results by Class
K#1
K#2
K
K#3
K#3 = 2.6
What is in the MED?
• Sunquest lab terms
• Cerner lab terms
• Digimedix drugs
• Cerner Drugs
• Sunquest Radiology
• ICD9-based problem list terms
• Other applications
• Knowledge terms
How Big is the MED?
• Concept-based (77,500)• Multiple hierarchy (115,000)• Synonyms (180,000)• Translations (125,000)• Semantic links (270,000)• Attributes (175,000)
MED Structure
MedicalEntity
PlasmaGlucose
Test
LaboratorySpecimen
PlasmaSpecimen
AnatomicSubstance
Plasma Substance
Sampled
Part of
Has S
pecimen
Substance Measured
LaboratoryProcedure
CHEM-7
LaboratoryTest
Event
DiagnosticProcedure
Substance
BioactiveSubstance
Glucose
Chemical
Carbo-hydrate
Using the MED• Translation
– What is the ICD9 Code for …?– What is the display name for …?– What is the aggregation class for …?
• Translation Tables
• Class-based questions– Is Altace an antihypertensive?– What are all the antibiotics?
• Knowledge queries– What are the pharmaceutic ingredients of…?
Using the MED
MED QueryMEDTranslation
TableInterfaceEngine
WebCIS
DecisionSupport
The MED and Messaging
AncillarySystem
LocalCodes
MEDCodes
ClinicalData
Repository
OtherSubscribers
Interface EngineTranslation
Table
Case Study: Aggregation for C2000
• Labs have multiple codes for the same tests
• C2000 displays tests in spreadsheets (“buttons”)
• One code per column per button
• Unrecognized codes go into “Miscellaneous”
• Labs are always adding new tests and not telling
• How do we keep the C2000 buttons current?
C2000 Buttons in the MED
The “Lytes” Button
Intravascular Sodium Tests
C2000 Buttons in the MED
Querying for Button Parts
Querying for Button Parts
Operationalizing C2000 Aggregation
• Translation from lab code to MED code is done by interface engine
• Aggregation from MED code to C2000 button column (“Intravascular …”) is done by interface engine
• New lab tests that fall into existing columns are automatically aggregated
• New lab tests that don’t fall into existing columns can be identified before ending up in “Miscellaneous”
Translations with the MED
Gentamicin
InjectableGentamicin
Gentamicn Sensitivity
Test
SerumGentamicin
Level
GentamicinToxicity
EtiologyMeasures
Sensitivity
Substance Measured Has ingredient
is-a
IntravascularGentamicin
TestsSummaryReports
DecisionRule
ExpertSystem
DrugInformation
The MED and Eclipsys
• Capturing data from ancillary systems
• Aggregation for summary reporting
• Keeping terminologies up to date (e.g., for order entry)
• Class-based decision rules
• Multiple hierarchies allowed
• Linking to on-line resources