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PubMed2006

Alimentary tract mucositis in cancer patients: impact of terminology and assessment on research and clinical practice.

BACKGROUND AND SIGNIFICANCE: The field of terminology and assessment of oral and gastrointestinal mucosal injury caused by high-dose cancer therapies in cancer patients has undergone important evolution in recent years. The advances are important for several clinical and research reasons. These reasons include improved patient management and design and conduct of clinical trials based on molecularly targeted therapies. For several decades leading up to the 1980s, terminology was characterized by varying use of "mucositis" and "stomatitis" to describe oral mucosal inflammatory changes and ulceration caused by cancer treatments. In addition, oral mucositis was viewed principally as an epithelial event and one that likely did not intersect with causative mechanisms associated with gastrointestinal mucositis. The term "stomatitis" was directed to oral toxicities and seemed to isolate these conditions from parallel events occurring throughout the alimentary tract and potentially other tissues as well. These perspectives and varying use of these terms resulted in several dilemmas, including (1) difficulty in accurately reporting incidence and severity of oral mucositis and, (2) an under-appreciation of potential significance of alimentary tract mucosal toxicity relative to overall course of therapy, patient quality of life, and in some cases, survivorship. These and related components of the model relative to mucositis have undergone strategic shifts over the past 15 years. A 1989 National Institutes of Health Consensus Development Conference targeted oral mucositis research as one of the key areas for investigation relative to causation, clinical impact, and potential links with other complications in cancer patients. Research in this area over the past 15 years has evolved such that oral and gastrointestinal mucositis are now appropriately framed as a continuum of pathobiologic changes over time, with clinical impact that may well contribute to overall symptom clustering in selected patient cohorts. OBJECTIVES: This paper will review history, current status, and new research directions associated with terminology and assessment of mucosal injury in cancer patients in the context described above.

Bibliometrics↗
PubMed1995

Cesarean delivery: a reconsideration of terminology.

The terminology we employ influences our perceptions. Thus, we believe in reviewing terminology regularly. The term "cesarean section" should be abandoned. A medical procedure is rarely named after a historic figure, and almost never after an ancient Roman law. Cesarean section has recently been amended to cesarean birth; however, the term is still inadequate. The word "hysterotomy" more appropriately describes the procedure we regularly perform. The adjectives used to describe cesarean birth should also be reevaluated. If we are to keep the term "classical" for the original fundal vertical uterine incision, then the other designations of hysterotomy should retain the same architectural context. Contemporary hysterotomy should be used in reference to a low transverse cesarean. Neoclassical hysterotomy might be used to describe the low vertical procedure. Transitional hysterotomy may be an appropriate term for the "hockey stick" or "J" incision. Cesarean delivery best describes a postmortem cesarean. Vaginal birth after cesarean (VBAC) is inappropriate because a vaginal birth after a cesarean section would not occur if cesarean section refers to a perimortem procedure. Vaginal birth after hysterotomy should be substituted for VBAC. Such revision of our terminology will keep obstetrics at the forefront of medical science and bring us most efficiently into the 21st century.

Cesarean Section↗
PubMed2026

2026 International Society for the Study of Vulvovaginal Disease terminology for vulvar intraepithelial neoplasia and squamous intraepithelial lesions.

The 2026 International Society for the Study of Vulvovaginal Disease terminology for vulvar intraepithelial neoplasia and squamous intraepithelial lesion requires p16 and p53 immunohistochemistry for classification into human papillomavirus-associated or human papillomavirus-independent disease. p16 and p53 are tumor suppressor proteins; block positive p16 staining is a surrogate marker for genomic integration of oncogenic human papillomavirus, while null or overexpressed p53 staining correlates with TP53 mutation. Human papillomavirus-associated and human papillomavirus-independent vulvar intraepithelial neoplasia represent 2 distinct entities with different diagnostic considerations, treatments, surveillance strategies, and prognoses. The designation of 'neoplasia' vs 'lesion' reflects biological behavior, with neoplasia signifying an established risk of progression to cancer. Human papillomavirus-associated disease maintains a 2-tier nomenclature: human papillomavirus-associated vulvar intraepithelial neoplasia for precursors to vulvar squamous cell carcinoma vs low-grade squamous intraepithelial lesion and condyloma for transient human papillomavirus manifestations. While human papillomavirus-associated vulvar intraepithelial neoplasia is preferred, high-grade squamous intraepithelial lesion is retained as acceptable in some settings to maintain consistency with nomenclature for analogous lesions across the lower genital tract. Human papillomavirus-independent disease almost always arises from longstanding lichen sclerosus. The updated terminology for human papillomavirus-independent precursors to squamous cell carcinoma is human papillomavirus-independent vulvar intraepithelial neoplasia, subcategorized as p53 mutant or p53 wild type. Verrucous vulvar intraepithelial neoplasia is a subtype of p53 wild type human papillomavirus-independent vulvar intraepithelial neoplasia and the usual precursor to verrucous carcinoma. Vulvar aberrant maturation encompasses human papillomavirus-independent lesions of uncertain neoplastic potential arising in lichen sclerosus that raise concern for but are not diagnostic of human papillomavirus-independent vulvar intraepithelial neoplasia. Collaboration between clinicians and pathologists is essential to achieve accurate diagnosis, optimal individualized treatment, and consistent application of this terminology in practice and research.

Humans↗
PubMed2005

Description logic-based methods for auditing frame-based medical terminological systems.

OBJECTIVE: Medical terminological systems (TSs) play an increasingly important role in health care by supporting recording, retrieval and analysis of patient information. As the size and complexity of TSs are growing, the need arises for means to audit them, i.e. verify and maintain (logical) consistency and (semantic) correctness of their contents. This is not only important for the management of TSs but also for providing their users with confidence about the reliability of their contents. Formal methods have the potential to play an important role in the audit of TSs, although there are few empirical studies to assess the benefits of using these methods. METHODS AND MATERIAL: In this paper we propose a method based on description logics (DLs) for the audit of TSs. This method is based on the migration of the medical TS from a frame-based representation to a DL-based one. Our method is characterized by a process in which initially stringent assumptions are made about concept definitions. The assumptions allow the detection of concepts and relations that might comprise a source of logical inconsistency. If the assumptions hold then definitions are to be altered to eliminate the inconsistency, otherwise the assumptions are revised. RESULTS: In order to demonstrate the utility of the approach in a real-world case study we audit a TS in the intensive care domain and discuss decisions pertaining to building DL-based representations. This case study demonstrates that certain types of inconsistencies can indeed be detected by applying the method to a medical terminological system. CONCLUSION: The added value of the method described in this paper is that it provides a means to evaluate the compliance to a number of common modeling principles in a formal manner. The proposed method reveals potential modeling inconsistencies, helping to audit and (if possible) improve the medical TS. In this way, it contributes to providing confidence in the contents of the terminological system.

Algorithms↗
PubMed2005

Building medical ontologies by terminology extraction from texts: an experiment for the intensive care units.

In many medical fields, maintenance, comparison and aggregation of unambiguous terminologies go through formal specialized clinical terminologies: ontologies. We describe a methodology to build medical ontology from textual reports using a natural language processing tool, the SYNTEX software. The methodology is illustrated in the surgical intensive care medical domain. We have tested the possibility for an expert to build a sizeable ontology in a reasonable time. The quality of the ontology has been evaluated according to its capacity to cover the ICD-10 terminology in the field. Finally, the methodology itself is discussed.

Humans↗
PubMed2004

Borderline ovarian tumors: diverse contemporary viewpoints on terminology and diagnostic criteria with illustrative images.

The National Cancer Institute sponsored a Borderline Ovarian Tumor Workshop held in August 2003 in Bethesda, MD. This report was developed from discussions at the Workshop. The participants acknowledged several areas of disagreement on basic terminology issues and agreed that a glossary with example images would help clarify many commonly misunderstood issues. This report defines terminology used in the pathological description of borderline tumors and their variants, and illustrates examples of each of the most common entities. It also addresses controversial aspects of the definitions and issues involving specimen handling and reporting. For those issues where there is disagreement, the terminology and diagnostic approaches reflecting the differing views are presented.

Cystadenocarcinoma↗
PubMed2005

Developing terminology for documenting perioperative nursing interventions.

OBJECTIVE: To develop terminology for documenting perioperative nursing interventions. METHOD: Nursing documentation of 250 patients was explored by content analysis. The study was conducted to validate further the Perioperative Nursing Data Set (PNDS) in Finland. The data included 3442 terms that were clustered into 104 nursing interventions. A Delphi-panel (N=5) evaluated the relevance of each term on a scale from 1 to 4. The structure of each nursing intervention was checked to meet the minimum requirements of the ISO reference terminology model for nursing action concepts. Finally, the nursing interventions were compared with the original PNDS-interventions. RESULTS: The Delphi-panel accepted 98 nursing interventions with Content Validity Index from 0.88 to 1.0. Of the 133 nursing interventions in the PNDS, 60% (n=80) were covered by nursing interventions identified in this study. A notable portion of the nursing interventions related to preventive aspects of perioperative care and the patients' coping with perioperative experience. CONCLUSION: The findings supported the need for cross-cultural validation of a nursing language prior to clinical implementation. The ISO reference terminology model is recommended as framework in constructing concepts for nursing interventions in a regular form.

Delphi Technique↗
PubMedDate not supplied

Development and evaluation of a terminology-based electronic nursing record system.

The present study was conducted to develop and evaluate a terminology-based electronic nursing record system. The narrative nursing notes of 63 obstetric patients collected over 395 hospital days were decomposed and cross-mapped with the Korean version of the beta version of the International Classification for Nursing Practice (ICNP). The terminology-based nursing record system was developed with a terminology server to manage nursing concepts and nursing phrases, and a user application system to document nursing notes. The system was evaluated in two Korean hospitals by 20 nurses documenting nursing notes of 57 patients. Patterns were found in nursing notes reflecting the nursing process. A total of 14,727 phrases were used for documenting nursing notes, with these phrases consisting of 237 unique phrases. Among the 259 unique nursing concepts extracted from the 237 unique phrases, 103 concepts (39.8%) did not map onto the ICNP. The users were able to find nursing phrases with a success rate of 89.4%. The mean time required for documentation at each input session decreased significantly from 276 to 158 s as the users became more experienced.

Computational Biology↗
PubMedDate not supplied

Evaluation of the draft international standard for a reference terminology model for nursing actions.

PURPOSE: The purpose of this study was to evaluate the draft ISO reference terminology model (RTM) for nursing actions. Nursing RTM models attempt to include concepts that are universally represented in nursing documentation to improve the depiction of nursing practice in computerized systems. METHOD: Content analysis was used to decompose interventions into words and phrases, which were then mapped to the six model categories used to represent nursing actions in the draft ISO RTM. The decomposition of interventions was applied to nurses' documentation of pain interventions entered into a clinical information system. FINDINGS: Consistent with the ISO standard requirements, all (100.00%) of the interventions contained an word or phrase and a < >. Additional findings are discussed in relation to earlier studies of terminology models. CONCLUSIONS: It is recommended that terminology and information system developers consider this model in their ongoing system development, evaluation, maintenance, and revisions. Further evaluation of the ISO RTM for nursing will contribute to the goals of this specific model and the harmonization and integration with other health care models.

Computational Biology↗
PubMedDate not supplied

Using nurses' natural language entries to build a concept-oriented terminology for patients' chief complaints in the emergency department.

Information about the chief complaint (CC), also known as the patient's reason for seeking emergency care, is critical for patient prioritization for treatment and determination of patient flow through the emergency department (ED). Triage nurses document the CC at the start of the ED visit, and the data are increasingly available in electronic form. Despite the clinical and operational significance of the CC to the ED, there is no standard CC terminology. We propose the construction of concept-oriented nursing terminologies from the actual language used by experts. We use text analysis to extract CC concepts from triage nurses' natural language entries. Our methodology for building the nursing terminology utilizes natural language processing techniques and the Unified Medical Language System.

Computational Biology↗
PubMedDate not supplied

The Nursing Terminology Summit Conferences: a case study of successful collaboration for change.

The Nursing Terminology Summit, a series of invitational conferences and ongoing collaboration, has played both initiating and contributing roles to bring about a second-order change in the development and integration of standards for nursing terminology. What factors enabled this success? What factors made change difficult? This paper examines the structure and process of the Nursing Terminology Summit using concepts, principles, theories, and strategies identified in Lorenzi and Riley [Organizational Aspects of Health Informatics: Managing Technological Change, Springer, 1995]. As a case study, this critical analysis offers practical lessons for informaticians in managing change across disciplinary, organizational, and national boundaries.

Computational Biology↗
PubMed2001

Macular translocation: unifying concepts, terminology, and classification.

PURPOSE: To describe some unifying concepts, terminology, and classification of macular translocation so as to facilitate communication within the scientific community. METHODS: A panel of ophthalmologists with expertise in macular translocation reviewed available data and developed some unifying concepts, terminology, and classification of macular translocation. RESULTS: Macular translocation may be defined as any surgery that has a primary goal of relocating the central neurosensory retina or fovea intraoperatively or postoperatively specifically for the management of macular disease. It may be classified according to the size of the retinotomy and, where applicable, the technique of chorioscleral shortening used. The direction of macular translocation is denoted by the movement of the neurosensory macula relative to the underlying tissues. Effective macular translocation may be defined as successful intraoperative or postoperative relocation of the fovea overlying a subfoveal lesion to an area outside the border of the lesion. The concepts of minimum desired translocation and median postoperative foveal displacement can give some useful idea of the likelihood of effective macular translocation before surgery. CONCLUSIONS: Use of a common standardized terminology for macular translocation will facilitate communication within the scientific community and enhance further research in this area. However, the definitions, terms, classification, and concepts concerning macular translocation are likely to continue to evolve as macular translocation undergoes further modifications and refinements.

Humans↗
PubMed1998

Operational terminology for stimulus exposure (SE) conditioning.

Nomenclature for simple types of learning is ambiguous and incomplete, as even commonly used terms such as 'habituation' and 'sensitization' are not applied consistently. One problem is a failure to distinguish between operational and theoretical constructs linguistically. Operational terminology for reporting behavioural results should be different from the language used in the discussion of learning theory. Thus, systematic operational terminology for simple types of conditioning is proposed. The most general category, stimulus exposure (SE) conditioning, is learning by exposure to a stimulus or to multiple stimuli where explicit inter-stimulus contingencies or instrumental reinforcers are not a part of training. Subtypes of SE conditioning are distinguished by the number of different stimuli used during training, by the method used to assess learning, and by the relationship between training stimuli and the assessment method. These categories include 'alteractive', 'iterative', 'heterostimic', and 'multistimic' conditioning. Learned responses are also categorized as reduction, enhancement, or transformation. SE conditioning categories combine with response terminology in phrases such as 'iterative reduction', which is a decrease in the response to a stimulus due to repeated presentation of that stimulus.

Animals↗
PubMed2004

The Birmingham Eye Trauma Terminology system (BETT).

PURPOSE: To evaluate the international eye injury scene and design a standardized terminology for mechanical eye injuries. METHODS: Surveys of practicing ophthalmologists and an extensive review of the international ocular trauma literature. Development of the Birmingham Trauma Terminology (BETT) using a logic-based approach. RESULTS: BETT always uses the entire globe as the tissue of reference. Its well-defined terms encompass all types of mechanical eye injury. A one-to-one relationship exists between terms and clinical conditions. CONCLUSION: BETT provides an unambiguous, consistent, simple, and comprehensive system to describe any type of mechanical globe trauma. Endorsed by several societies and peer-reviewed journals as the standardized international language of ocular traumatology, BETT is expected to become the preferred terminology for categorizing eye injuries in daily clinical practice.

Eye Injuries↗
PubMed1999

Terminology: semantics of postorthodontic treatment changes in the dentition.

Correct terminology eliminates confusion in communication between clinicians, as well as between clinician and patient. Long-term stability seems to be an elusive goal, because the terminology in this respect eludes to the various changes occurring in the posttreatment dentition. However, a stable orthodontic result can be achieved when the physiologic changes that naturally occur in the dentition are considered as part of the long-term result. Standardization of terminology is therefore important.

Humans↗
PubMed1998

[Numeric terminology of erythrocyte blood group antigens].

Since the discovery of the first human blood groups, the terminology for erythrocyte blood group antigens has evolved and become inconsistent. In some cases, a single letter is used (eg, A/B, E/e), in some others a symbol with a superscript to denote allelic products is used (eg, Fya/Fyb, Jka/Jkb) while in still others, a numerical notation is used (eg, Fy3, Lu4, K11). Even within the same blood group system, antigens have been named by different terminology (eg, K/k, Kpa/Kpb, K11/K17) and the same antigen was given different names in different laboratories. Therefore a necessary alternative 'popular' terminology was suggested by the ISBT (International Society of Blood Transfusion) Working Party; In its last monograph, published in 1995 and reviewed in 1996, erythrocyte blood group antigens are classified into 23 systems, 5 collections and 2 series. The Working Party also suggested guidelines for establishing new blood group systems and including new specificities into the nomenclature.

Blood Group Antigens↗
PubMed2002

An evaluation of the usefulness of two terminology models for integrating nursing diagnosis concepts into SNOMED Clinical Terms.

OBJECTIVES: We evaluated the usefulness of two models for integrating nursing diagnosis concepts into SNOMED Clinical Terms (CT). METHODS: First, we dissected nursing diagnosis term phrases from two source terminologies (North American Nursing Diagnosis Association Taxonomy 1 (NANDA) and Omaha System) into the semantic categories of the European Committee for Standardization (CEN) categorical structure and ISO reference terminology model (RTM). Second, we critically analyzed the similarities between the semantic links in the CEN and ISO models and the semantic links used to formally define diagnostic concepts in SNOMED CT. RESULTS: Our findings demonstrated that focus, bearer/subject of information, and judgment were present in 100% of the NANDA and Omaha term phrases. The Omaha term phrases contained no additional descriptors beyond those considered mandatory in the CEN and ISO models. The comparison among the semantic links showed that SNOMED CT currently contains all but one of the semantic links needed to model the two source terminologies for integration. In conclusion, our findings support the potential utility of the CEN and ISO models for integrating nursing diagnostic concepts into SNOMED CT.

Classification↗