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Reference terminology for therapeutic goals: a new approach.

Participants at the Nursing Terminology Summit Conference 2002 developed proposed terminology models and information models for findings, goals, and outcomes and described the relationships among these concepts. At Vanderbilt University the author has dissected items in a controlled vocabulary of goals in accordance with the terminology model for findings. The concept-based dissections are linked to pre-coordinated phrases in a relational database, providing unambiguous definitions of clinical expressions and enabling concept-oriented searching of the terms database and of the goal achievement database.

Databases as Topic↗

Embryonic stem cell research: terminological ambiguity may lead to legal obscurity.

National regulation on embryonic stem cell research in the European Union is ambiguous, due to a lack of consistent scientific terminology as exemplified by the Dutch Embryos Act. To force a breakthrough in this ethically dubious research topic, a more careful use of terminology would be in the interest of both the scientific community and the lawmakers, in order to avoid terminology becoming associated with research or applications for which it is inappropriate. Therefore I will first clarify the technological possibilities in an age of biological control. Secondly, we will critically analyse the statements of the European Convention on Human Rights and Biomedicine concerning embryo research and cloning. The Convention prohibits human reproductive cloning but does not take a clear position on so-called therapeutic cloning. Finally, we will give an overview of the most recent legislative initiatives within the European Union on this matter.

Cloning, Organism↗

NCI Thesaurus: using science-based terminology to integrate cancer research results.

Cancer researchers need to be able to organize and report their results in a way that others can find, build upon, and relate to the specific clinical conditions of individual patients. NCI Thesaurus is a description logic terminology based on current science that helps individuals and software applications connect and organize the results of cancer research, e.g., by disease and underlying biology. Currently containing some 34,000 concepts--covering chemicals, drugs and other therapies, diseases, genes and gene products, anatomy, organisms, animal models, techniques, biologic processes, and administrative categories--NCI Thesaurus serves applications and the Web from a terminology server. As a scalable, formal terminology, the deployed Thesaurus, and associated applications and interfaces, are a model for some of the standards required for the NHII (National Health Information Infrastructure) and the Semantic Web.

Computer Systems↗

The specification of a frame-based medical terminological system in Protégé.

A medical terminological system (TS) is essentially a representation of concepts, attributes and relationships pertaining to medical terms. Although the requirements and structures of TSs have enjoyed some attention in the literature, the actual implementation of TSs consisted so far of ad-hoc approaches starting from scratch. Recently, Protégé has been suggested as a software environment for the development of knowledge-based systems. In Protégé various component types interact, and knowledge can be represented at various levels. This paper investigates how to specify a frame-based TS in Protégé and demonstrates this in a specific application in the intensive care. Our approach is characterized by the utilization of a conceptual framework for understanding TSs and mapping its components onto Protégé constructs. This results in specifications of knowledge components for the implementation of terminological systems. The significance of the work stems from the generality of the specifications, thus facilitating the principled design and development of terminological systems in various medical domains

Artificial Intelligence↗

Logical support for terminological modeling.

Terminological modeling, in particular in medical domains, is difficult and has enjoyed growing attention over the recent past. In practice, logical reasoning can play a fundamental role to support the modeling process. Nevertheless, the development of the logical tools is usually driven by computational or theoretical criteria rather than by the direct needs of a modeler. In this paper we attempt to shift this balance and discuss a number of logical reasoning services to support the modeler of a (medical) terminology to construct a formally sound, complete and concise terminology. This modeling support is logical as it is based on reasoning services with respect to formally defined semantics. Practical results of this systematic discussion are formal definitions of several new reasoning tasks.

Information Science↗

A terminological and ontological analysis of the NCI Thesaurus.

OBJECTIVE: The National Cancer Institute Thesaurus is described by its authors as "a biomedical vocabulary that provides consistent, unambiguous codes and definitions for concepts used in cancer research" and which "exhibits ontology-like properties in its construction and use". We performed a qualitative analysis of the Thesaurus in order to assess its conformity with principles of good practice in terminology and ontology design. MATERIALS AND METHODS: We used both the on-line browsable version of the Thesaurus and its OWL-representation (version 04.08b, released on August 2, 2004), measuring each in light of the requirements put forward in relevant ISO terminology standards and in light of ontological principles advanced in the recent literature. RESULTS: We found many mistakes and inconsistencies with respect to the term-formation principles used, the underlying knowledge representation system, and missing or inappropriately assigned verbal and formal definitions. CONCLUSION: Version 04.08b of the NCI Thesaurus suffers from the same broad range of problems that have been observed in other biomedical terminologies. For its further development, we recommend the use of a more principled approach that allows the Thesaurus to be tested not just for internal consistency but also for its degree of correspondence to that part of reality which it is designed to represent.

Computational Biology↗

[Current colposcopic terminology. Successes and limitations].

Colposcopy is nowadays a habitual tool applied to the routine gynecological exploration. The terminology for the normal and abnormal colposcopic findings has changed according with the time and the new knowledge about the low genital tract diseases. Gynecologists must be aware of this terminology for a correct application in diagnosis, therapeutics and papers on findings and results. It is necessary that the whole medical community around the world applies the same terminology in order to have a better communication.

Colposcopy↗

Clinical terminology support for a national ambulatory practice outcomes research network.

The Medical Quality Improvement Consortium (MQIC) is a nationwide collaboration of 74 healthcare delivery systems, consisting of 3755 clinicians, who contribute de-identified clinical data from the same commercial electronic medical record (EMR) for quality reporting, outcomes research and clinical research in public health and practice benchmarking. Despite the existence of a common, centrally-managed, shared terminology for core concepts (medications, problem lists, observation names), a substantial "back-end" information management process is required to ensure terminology and data harmonization for creating multi-facility clinically-acceptable queries and comparable results. We describe the information architecture created to support terminology harmonization across this data-sharing consortium and discuss the implications for large scale data sharing envisioned by proponents for the national adoption of ambulatory EMR systems.

Ambulatory Care Information Systems↗

Representing lexical components of medical terminologies in OWL.

Medical Terminologies play a vital role in clinical data capture, reporting, information integration, indexing and retrieval. The Web Ontology language (OWL) provides an opportunity for the medical community to leverage the capabilities of OWL semantics and tools to build formal, sound and consistent medical terminologies, and to provide a standard web accessible medium for inter-operability,access and reuse. One of the tasks facing the medical community today is to represent the extensive terminology content that already exists into this new medium. This paper addresses one aspect of this challenge - how to incorporate multilingual, structured lexical information such as definitions, synonyms, usage notes, etc. into the OWL ontology model in a standardized, consistent and useful fashion.

Internet↗

Managing caries in the 21st century: today's terminology to treat yesterday's disease.

BACKGROUND: For more than a century, dentistry has been treating the disease of dental caries largely by restoring teeth. Research in the microbiological and chemical mechanisms of the caries process over the past two decades suggests a fundamental rethinking of solely using this type of treatment approach. METHODS: A clinician's understanding of how the field has advanced has been impeded by the inconsistent use of dental terminology. This article will focus on defining dental caries and its related terms. CONCLUSIONS: The term "caries," although used very liberally in the field, should be further defined in its context of use to avoid confusion, until which time an accepted international terminology system is developed. PRACTICE IMPLICATIONS: Reducing or eliminating ambiguity in terminology used in managing dental caries is the first step in consistent diagnosis, detection, and finally treatment.

Communicable Diseases↗

Features of standardized nursing terminology sets in Japan.

UNLABELLED: This paper reports the features and relationships between standardizes nursing terminology sets used in Japan. First, we analyzed the common parts in five standardized nursing terminology sets: the Japan Nursing Practice Standard Master (JNPSM) that includes the names of nursing activities and is built by the Medical Information Center Development Center (MEDIS-DC); the labels of the Japan Classification of Nursing Practice (JCNP), built by the term advisory committee in the Japan Academy of Nursing Science; the labels of the International Classification for Nursing Practice (ICNP) translated to Japanese; the labels, domain names, and class names of the North American Nursing Diagnosis Association (NANDA) Nursing Diagnoses 2003-2004 translated to Japanese; and the terms included in the labels of Nursing Interventions Classification (NIC) translated to Japanese. Then we compared them with terms in a thesaurus dictionary, the Bunrui Goihyo, that contains general Japanese words and is built by the National Institute for Japanese Language. THE RESULTS: 1) the level of interchangeability between four standardized nursing terminology sets is quite low; 2) abbreviations and katakana words are frequently used to express nursing activities; 3) general Japanese words are usually used to express the status or situation of patients.

Humans↗

Different use of medical terminology and culture-specific models of disease affecting communication between Xhosaspeaking patients and English-speaking doctors at a South African paediatric teaching hospital.

BACKGROUND: Language and cultural differences between patients and health care providers may have adverse health consequences. Red Cross War Memorial Children's Hospital is a paediatric teaching hospital in Cape Town where staff communicate mainly in English or Afrikaans, while many patients speak Xhosa as their first language. OBJECTIVES: To examine whether differences in the definitions of common respiratory medical terminology by patients and doctors cause miscommunication and to explore culture-specific models if used by parents in their definitions. DESIGN: In-depth, semi-structured interviews were conducted with three speech communities, viz. 8 English-speaking doctors and 33 Xhosa-speaking parents, educated to grade 12 level or less and recruited from two areas in the hospital, the short-stay ward (Xhosa s-s) and the allergy clinic (Xhosa allergy). The sum of both groups of Xhosa-speaking patients are referred to as 'Xhosa all'. Definitions were elicited for common respiratory terminology in both Xhosa and English. Contrastive linguistic analysis was used to identify the semantic properties for each group in order to condense the groups' definitions into representative 'core definitions'. Differences in the definitions of terminology were identified and words were classified as concordant (used in the same way) or discordant (used in different ways) by the three speech communities. RESULTS: Parents experience difficulty in understanding terms used by doctors and words in common use were understood differently by these two groups. Most Xhosa words were not in the doctors' vocabulary, and some common English words were not in the parents' vocabulary. Where words were in the vocabulary of both groups, significant differences existed in the number and range of definitions, with many clinically significant discordances of definition being apparent. Some common examples relevant to paediatric respiratory problems are presented. Three culture-specific explanatory models of respiratory illness, ingqele, xakaxa and idliso, are illustrated.

Child↗

[Terminology problems in medical thermography].

The paper is devoted to some problems of medico-technical terminology of clinical thermography. A short historical review of stages of the discovery of infrared rays and their medical application was given. An analysis of a number of terms is based on the rules of medical terminology and state standards. An obligatory use in literature of correct terms, mainly of the Greek and Latin origin, is proposed. Commonly used terms on the basis of modern anatomical terminology are recommended for thermogram description.

Humans↗

Static film/screen imaging terminology: the need to standardize.

The lack of standardization of static film/screen imaging terminology causes confusion among people working in the field of radiology. The research presented in this article compares terminology used by a variety of radiology professionals, basic reference texts, and film companies. A survey was developed and distributed, in which 96% of the participants indicated they saw a definite need to standardize static film/screen imaging terminology.

Humans↗

[Terminology and classification problems in relation to vulvar pathology].

The aim of this paper is to update the physicians (gynecologists, dermatologists and pathologists) on the evolution of vulvar disease terminologies. In doing that the authors illustrate briefly the fundamental steps which led to present classifications of the International Society for the Study of Vulvar Disease (ISSVD). The classification of "non neoplastic epithelial disorders" together with that of "intraepithelial alterations" are illustrated and compared with the terminologies previously employed. The last ISSVD definition of "superficially invasive carcinoma" of the vulva is also presented and discussed. The authors concluded that even if all these ISSVD classifications represent an important effort for reaching a common language for a better international exchange of different experiences, nevertheless an improvement of these terminologies is still requested.

Female↗

A revised terminology for recording surgical findings of the mitral valve.

The existing terminology for the various structures of the mitral valve are diverse and numerous. With the resurgence of interest in reparative procedures for mitral valve disease, it becomes imperative to have a unified terminology which would convey precise connotations in recording the pathology as well as the corrective procedures applied. In an effort to suggest a commonly acceptable nomenclature, we reviewed the available terminology and propose a simple system which will fulfil the needs of recording the intraoperative observations of the pathology of each valve and the manouveres carried out to correct them by the surgeon. This involves designating all structures anterior to the intercommissural line as "anterior" or "A" and those posterior as "posterior" or "P". The structures, as observed by the surgeon through a standard left atriotomy, to the left of the line dropped perpendicular to the middle of the aortic curtain will be designated by the numeral "1" and those to the right "2". The chords will be termed in groups based on their point of insertion, irrespective of whether they are inserted to the free edge or the ventricular surface of the leaflet. The anterior leaflet chords will further be subdivided based on their relation to the stay chords. We hope that this system of naming the structures would provide a unified method of reporting intraoperative findings of mitral valve disease.

Heart Valve Diseases↗

Terminology of the thalamus and its representation in a part-whole relation.

In stereotaxic neurosurgery, a variety of operative procedures focus on thalamic targets. The nomenclature of thalamic nuclei and subnuclei, however, has not yet been settled. In clinical and laboratory environments several terminologies coexist. This is an obstacle to both communication and a better understanding of recent electrophysiological findings. In the late 1980s, the application of new histochemical and immunohistochemical methods led to a deeper insight into existing correlationships between the nomenclatures. As a uniform terminology of the thalamus is still lacking, we created a knowledge-based system (THALAMUS) which gives a comprehensible survey about the most important terminologies. The different nomenclatures are related to each other by organizing them in a component-integral relation. This part-whole relation contains both the knowledge on the subdivisions of the thalamus as well as the knowledge on the correlations between the various nomenclatures.

Animals↗

Premalignant and early malignant lesions in the gastrointestinal tract: definitions, terminology, and problems.

The definition of a "premalignant" lesion is discussed, together with its relationship to dysplastic change. The definition and description of dysplasia are given. Systems for grading dysplasia are set out, and the clinical implications of these changes are discussed. Although the "dysplasia terminology" in current use remains the gold standard for clinical practice, a series of more recent developments, including the discovery of flat and depressed adenomas, the possibility of de novo carcinoma throughout the gastrointestinal tract, as well as advances in molecular biology, raise the question of whether this terminology will be adequate in future. Other terminologies exist that provide an alternative viewpoint, but none is satisfactory.

Gastrointestinal Neoplasms↗