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DOI: 10.3414/ME09-01-0057
Construction of an Interface Terminology on SNOMED CT
Generic Approach and Its Application in Intensive CarePublikationsverlauf
received:
29. Juni 2009
accepted:
03. März 2010
Publikationsdatum:
17. Januar 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035037/201004/lookinside/thumbnails/10-3414-me09-01-0057-1.jpg)
Summary
Objective: To provide a generic approach for developing a domain-specific interface terminology on SNOMED CT and to apply this approach to the domain of intensive care.
Methods: The process of developing an interface terminology on SNOMED CT can be regarded as six sequential phases: domain analysis, mapping from the domain concepts to SNOMED CT concepts, creating the SNOMED CT subset guided by the mapping, extending the subset with non-covered concepts, constraining the subset by removing irrelevant content, and deploying the subset in a terminology server.
Results: The APACHE IV classification, a standard in the intensive care with 445 diagnostic categories, served as the starting point for designing the interface terminology. The majority (89.2%) of the diagnostic categories from APACHE IV could be mapped to SNOMED CT concepts and for the remaining concepts a partial match was identified. The resulting initial set of mapped concepts consisted of 404 SNOMED CT concepts. This set could be extended to 83,125 concepts if all taxonomic children of these concepts were included. Also including all concepts that are referred to in the definition of other concepts lead to a subset of 233,782 concepts. An evaluation of the interface terminology should reveal what level of detail in the subset is suitable for the intensive care domain and whether parts need further constraining. In the final phase, the interface terminology is implemented in the intensive care in a locally developed terminology server to collect the reasons for intensive care admission.
Conclusions: We provide a structure for the process of identifying a domain-specific interface terminology on SNOMED CT. We use this approach to design an interface terminology on SNOMED CT for the intensive care domain. This work is of value for other researchers who intend to build a domain-specific interface terminology on SNOMED CT.
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References
- 1 de Keizer NF, Abu-Hanna A, Zwetsloot-Schonk JH. Understanding terminological systems. I: Terminology and typology. Methods Inf Med 2000; 39 (01) 16-21.
- 2 German E, Leibowitz A, Shahar Y. An architecture for linking medical decision-support applications to clinical databases and its evaluation. J Biomed Inform 2009; 42 (02) 203-218.
- 3 Rosenbloom ST, Miller RA, Johnson KB, Elkin PL, Brown SH. A Model for Evaluating Interface Terminologies. J Am Med Inform Assoc 2008; 15 (01) 65-76.
- 4 Brown SH, Husser CS, Wahner-Roedler D, Bailey S, Nugent L, Porter K, Bauer BA, Elkin PL. Using SNOMED CT as a reference terminology to cross map two highly pre-coordinated classification systems. Medinfo 2007; 12 Pt (01) 636-639.
- 5 World Health Organization.. International classification of diseases, manual of the international statistical classification of diseases, injuries and causes of death. 9th revision. 1977
- 6 Imel M, Campbell JR. Mapping from a Clinical Terminology to a Classification. AHIMA’s 75th Anniversary National Convention and Exhibit Proceedings 2003
- 7 Young JD, Goldfrad C, Rowan K. Development and testing of a hierarchical method to code the reason for admission to intensive care units: the ICNARC Coding Method. Intensive Care National Audit & Research Centre. Br J Anaesth 2001; 87 (04) 543-548.
- 8 Rosenbloom ST, Miller RA, Johnson KB, Elkin PL, Brown SH. Interface terminologies: facilitating direct entry of clinical data into electronic health record systems. J Am Med Inform Assoc 2006; 13 (03) 277-288.
- 9 Spackman KA, Campbell KE, Cote RA. SNOMED RT: a reference terminology for health care. Proc AMIA Annu Fall Symp 1997 pp 640-644.
- 10 Richesson RL, Andrews JE, Krischer JP. Use of SNOMED CT to Represent Clinical Research Data: A Semantic Characterization of Data Items on Case Report Forms in Vasculitis Research. J Am Med Inform Assoc 2006; 13 (05) 536-546.
- 11 Elevitch FR. SNOMED CT: electronic health record enhances anesthesia patient safety. AANA J 2005; 73 (05) 361-366.
- 12 Brown SH, Elkin PL, Bauer BA, Wahner-Roedler D, Husser CS, Temesgen Z, Hardenbrook SP, Fielstein EM, Rosenbloom ST. SNOMED CT: utility for a general medical evaluation template. AMIA Annu Symp Proc 2006 pp 101-105.
- 13 Campbell JR. Semantic features of an enterprise interface terminology for SNOMED RT. Medinfo 2001; 10 Pt (01) 82-85.
- 14 Asbeh N, Peleg M, Schertz M. Creating Consistent Diagnoses List for Developmental Disorders Using UMLS, Next generation information technologies and systems. Lecture notes in computer science. Berlin/Heidelberg: Springer; 2006. 4032 pp 333-336.
- 15 Lopez-Osornio A, Luna D, Gambarte ML, Gomez A, Reynoso G, de Quiros FG. Creation of a local interface terminology to SNOMED CT. Medinfo 2007; 12 Pt (01) 765-769.
- 16 Patrick J, Wang Y, Budd P, Rector A, Brandt S, Rogers BJ, Herkes R, Ryan A, Vazirnezhad B. Developing SNOMED CT Subsets from Clinical Notes for Intensive Care Service. 7th Annual HINZ Conference and Exhibitions Rotorua, New Zealand: 2008
- 17 Seidenberg J, Rector A. Web ontology segmentation: Analysis, classification and use. In: 5th International World Wide Web Conference 2006. Available at: http://www.co-ode.org/resources/papers/seidenberg-www2006.pdf. Last accessed: September 2009
- 18 The International Health Terminology Standards Development Organisation. Available at: http://www.ihtsdo.org/our-standards/snomed-ct. Last accessed: September 2009
- 19 SNOMED Clinical Terms® Technical Implementation Guide.. The International Health Terminology Standards Development Organisation. January 2008
- 20 SNOMED Clinical Terms® Technical Reference Guide.. The International Health Terminology Standards Development Organisation. January 2008
- 21 SNOMED Clinical Terms Editorial Guidelines, Content Inclusion Principles and Process, The International Health Terminology Standards Development Organisation. May 2008
- 22 Castro AG, Rocca-Serra P, Stevens R, Taylor C, Nashar K, Ragan MA, Sansone SA. The use of concept maps during knowledge elicitation in ontology development processes – the nutrigenomics use case. BMC Bioinformatics 2006; 7: 267.
- 23 Cimino JJ. From data to knowledge through concept-oriented terminologies: experience with the Medical Entities Dictionary. J Am Med Inform Assoc 2000; 7 (03) 288-297.
- 24 Ryan A, Patrick J, Herkes R. Introduction of enhancement technologies into the intensive care service. Royal Prince Alfred Hospital, Sydney. HIM J 2008; 37 (01) 40-45.
- 25 Vikstrom A, Skaner Y, Strender LE, Nilsson GH. Mapping the categories of the Swedish primary health care version of ICD-10 to SNOMED CT concepts: rule development and intercoder reliability in a mapping trial. BMC Med Inform Decis Mak 2007; 7: 9.
- 26 Min Z, Baofen D, Weeber M, van Ginneken AM. Mapping OpenSDE domain models to SNOMED CT Applied to the domain of cardiovascular disease. Methods Inf Med 2006; 45 (01) 4-9.
- 27 Wang Y, Patrick J, Miller G, O’Halloran J. Linguistic mapping of Terminologies to SNOMED CT. First European Conference on SNOMED CT organised by the Network of Excellence Semantic Mining. 2006 Avaialable at: http://www.hiww.org/smcs2006/proceedings/6WangSMCS2006final.pdf. Last accessed: September 2009
- 28 Wilson PS. What mapping and modeling means to the HIM professional. Perspect Health Inf Manag 2007; 4: 2.
- 29 Rosenbloom ST, Brown SH, Froehling D, Bauer BA, Wahner-Roedler DL, Gregg WM, Elkin PL. Using SNOMED CT to represent two interface terminologies. J Am Med Inform Assoc 2009; 16 (01) 81-88.
- 30 Wang Y, Patrick J, Miller G, O’Hallaran J. A computational linguistics motivated mapping of ICPC-2 PLUS to SNOMED CT. BMC Med Inform Decis Mak 2008; 8 (01) S5.
- 31 Noy NF, Musen MA. Specifying ontology views by traversal. In: International Semantic Web Conference. 2004. pp 713-725. Available at: http://www.stanford.edu/~natalya/papers/traversalViews-SW.pdf. Last accessed: September 2009
- 32 Wasserman H, Wang J. An applied evaluation of SNOMED CT as a clinical vocabulary for the computerized diagnosis and problem list. AMIA Annu Symp Proc 2003 pp 699-703.
- 33 Chute CG, Elkin PL, Sherertz DD, Tuttle MS. Desiderata for a clinical terminology server. Proc AMIA Symp 1999 pp 42-46.
- 34 Zimmerman JE, Kramer AA, McNair DS, Malila FM. Acute Physiology and Chronic Health Evaluation (APACHE) IV: Hospital mortality assessment for today’s critically ill patients. Crit Care Med 2006; 34 (05) 1297-1310.
- 35 DesHarnais SI, Forthman MT, Homa-Lowry JM, Wooster LD. Risk-adjusted quality outcome measures: indexes for benchmarking rates of mortality, complications, and readmissions. Qual Manag Health Care 1997; 5 (02) 80-87.
- 36 Lilford R, Mohammed MA, Spiegelhalter D, Thomson R. Use and misuse of process and outcome data in managing performance of acute medical care: avoiding institutional stigma. Lancet 2004; 363 9415 1147-1154.
- 37 SNOMED Clinical Terms® User Guide.. The International Health Terminology Standards Development Organisation. January 2008
- 38 Cornet R, Prins AK. An architecture for standardized terminology services by wrapping and integration of existing applications. AMIA Annu Symp Proc 2003 pp 180-184.
- 39 Cornet R, Schulz S. Relationship Groups in SNOMED CT. Stud Health Technol Inform 2009; 150: 223-227.
- 40 Mapoles J, Smith CS, Brian Levy JC. Strategies for Updating Terminology Mappings and Subsets using SNOMED CT®. Proceedings of the 3rd international conference on Knowledge Representation in Medicine (KR-MED): Representing and sharing knowledge using SNOMED. 2008
- 41 Spackman KA. Rates of change in a large clinical terminology: three years experience with SNOMED Clinical Terms. AMIA Annu Symp Proc 2005 pp 714-718.
- 42 Wade G, Rosenbloom ST. The impact of SNOMED CT revisions on a mapped interface terminology: Terminology development and implementation issues. J Biomed Inform 2009
- 43 SNOMED Clinical Terms® Reference Set Specification.. International Healthcare Terminology Standards Development Organisation. January 2008
- 44 Bakhshi-Raiez F, Cornet R, de Keizer NF. Development and application of a framework for maintenance of medical terminological systems. J Am Med Inform Assoc 2008; 15 (05) 687-700.
- 45 Cimino JJ, Patel VL, Kushniruk AW. Studying the human-computer-terminology interface. J Am Med Inform Assoc 2001; 8 (02) 163-173.
- 46 Kushniruk A, Patel V, Cimino JJ, Barrows RA. Cognitive evaluation of the user interface and vocabulary of an outpatient information system. Proc AMIA Annu Fall Symp 1996 pp 22-26.