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At least 433 records · Page 24Linked to original sources
PubMed2005

Genestrace: phenomic knowledge discovery via structured terminology.

The era of applied genomic medicine is quickly approaching accompanied by the increasing availability of detailed genetic information. Understanding the genetic etiology behind complex, multi-gene diseases remains an important challenge. In order to uncover the putative genetic etiology of complex diseases, we designed a method that explores the relationships between two major terminological and ontological resources: the Unified Medical Language System (UMLS) and the Gene Ontology (GO). The UMLS has a mainly clinical emphasis; Gene Ontology has become the standard for biological annotations of genes and gene products. Using statistical and semantic relationships within and between the two resources, we are able to infer relationships between disease concepts in the UMLS and gene products annotated using GO and its associated databases. We validated our inferences by comparing them to the known gene-disease relationships, as defined in the Online Mendelian Inheritance in Man's morbidmap (OMIM). The proof-of-concept methods presented here are unique in that they bypass the ambiguity of the direct extraction of gene or disease term from MEDLINE. Additionally, our methods provide direct links to clinically significant diseases through established terminologies or ontologies. The preliminary results presented here indicate the potential utility of exploiting the existing, manually curated relationships in biomedical resources as a tool for the discovery of potentially valuable new gene-disease relationships.

Computational Biology↗
PubMed2006

SNOMED-CT: The advanced terminology and coding system for eHealth.

A clinical terminology is essential for Electronic Health records. It represents clinical information input into clinical IT systems by clinicians in a machine-readable manner. Use of a Clinical Terminology, implemented within a clinical information system, will enable the delivery of many patient health benefits including electronic clinical decision support, disease screening and enhanced patient safety. For example, it will help reduce medication-prescribing errors, which are currently known to kill or injure many citizens. It will also reduce clinical administration effort and the overall costs of healthcare.

Computer Communication Networks↗
PubMed2006

Intelligent semantic interoperability: Integrating knowledge, terminology and information models to support stroke care.

INTRODUCTION: Electronic patient record (EPR) systems for the continuity of care for stroke patient are under development. These systems are based on standards such as for clinical practice, vocabularies, and the HL7 information model. PROBLEM STATEMENT: In order to achieve intelligent semantic interoperability, knowledge about evidence based patient care, vocabulary and information models need to be integrated. METHODOLOGY: A format was developed in which the clinical knowledge, clinical terminology, and standard information models are integrated as specification for the technical implementation of electronic health systems and electronic messages. This format is verified by clinicians and technicians. RESULTS: The document structure consists of meta-information such as version control and changes, purpose of the clinical content, evidence from the literature, variables and values, terminology used, guidelines for application and interpretation, HL7 message models, coding, and technical data specification. Further, XML message excerpts, archetypes and screen designs are developed from these documents to facilitate implementation. CONCLUSION: The combination of these aspects in one document creates valuable content for intelligent semantic interoperability by means of development of messages and systems.

Continuity of Patient Care↗
PubMed1995

Applying a controlled medical terminology to a distributed, production clinical information system.

To maximize the value of computerized medical records systems, an organizing structure is needed. That structure can be provided by a controlled medical terminology (CMT). At Columbia-Presbyterian Medical Center, we have been employing a controlled medical terminology, our Medical Entities Dictionary (MED), to mediate the storage and retrieval of patient data and enable decision support applications. This paper describes how the MED is actually used for data management in our distributed clinical information systems environment. Our system tools which access the MED for production purposes facilitate the mapping of terms from many sources to a uniform representation of concepts and also return information about the relationships between concepts. Applications which access a CMT for production purposes should be optimized for performance in high volume settings, fault tolerant, synchronizable, extensible, portable, and maintainable. We briefly describe our system architecture and then demonstrate how we utilize the MED for translation and semantic information as data is moved into and out of our patient database. We discuss our current tools and present a preview of the next generation of applications which will manage access to the MED for our production systems.

Computer Communication Networks↗
PubMed2004

A survey of clinical productivity and current procedural terminology (CPT) coding patterns of pediatric hematologist/oncologists.

BACKGROUND: Subspecialty-specific normative values for clinical productivity of practicing pediatric hematologist/oncologists have not been well established. This information could be a useful adjunct in administrative decision-making in areas such as necessary levels of physician staffing and development of compensation plans. METHODS: Current procedural terminology (CPT) coding information was obtained from 27 pediatric hematology/oncology groups. Clinical productivity was assessed by overall number of patient encounters and the total number of physician work relative value units (RVU) as defined by the resource-based relative value scale. The average physician productivity within each individual program was calculated. To determine uniformity of CPT coding, an additional survey solicited mock patient encounter documentation and CPT coding for a simple clinical vignette. RESULTS: A broad range of clinical productivity was observed for both numbers of patient encounters and RVU. Evaluation of the CPT coding data of the surveyed groups revealed differences in usage of certain evaluation and management (E/M) codes and procedural and specimen interpretation codes. Within individual categories of E/M service codes, a wide variation in assigned CPT code levels was also observed. This observation was supported by differences in the E/M coding for the clinical vignette. CONCLUSIONS: Assessment and tracking of physician productivity can provide useful information for the administrative management of pediatric hematology/oncology programs. Caution must be exercised, however, when making productivity comparisons with other subspecialties or even between pediatric hematology/oncology programs. Such comparisons should take into account the number of patient encounters, characteristics of E/M coding patterns, the use of physician extenders, as well as overall RVU production.

Current Procedural Terminology↗
PubMed2007

Invited review: Amino acid bioavailability and digestibility in pig feed ingredients: terminology and application.

In this review, the terminology that is used to describe the bioavailability and ileal digestibility of AA in pig feed ingredients is defined. Aspects of the methodology to establish bioavailability and ileal digestibility values also are discussed, and recommendations about the use of these values are provided. Two main factors can contribute to differences between bioavailability and ileal digestibility of AA. First, some AA, such as Lys, may be absorbed in chemical complexes that preclude their use for metabolism. Second, fermentation in the upper gut may result in a net loss or gain of AA to the animal. In addition, dietary effects on the efficiency of using bioavailable AA intake for tissue growth or milk production should be considered and may be attributed to endogenous AA losses in the hindgut and the metabolic costs associated with endogenous gut protein synthesis and losses. Ileal digestibility values may be expressed as apparent ileal digestibility (AID), standardized ileal digestibility (SID), or true ileal digestibility (TID). These terms are used to specify how ileal endogenous AA losses are reflected in digestibility values. Ileal endogenous AA losses may be separated into basal losses, which are not influenced by feed ingredient composition, and specific losses, which are induced by feed ingredient characteristics such as levels and types of fiber and antinutritional factors. Values for AID are established when total ileal outflow of AA (i.e., the sum of endogenous losses and nondigested dietary AA) is related to dietary AA intake. A concern with the use of AID values is that these are not additive in mixtures of feed ingredients. This concern may be overcome by correcting AID values for defined basal endogenous losses of AA, which yields SID values. Furthermore, if the AID values are corrected for basal and specific endogenous losses, then values for TID are calculated. However, reliable procedures to routinely measure specific endogenous losses are not yet available. It is recommended that basal ileal endogenous losses of AA should be measured in digestibility experiments using a defined protein-free diet and that these losses are reported with observed AID and SID values. It is suggested that SID values should be used for feed formulation, at least until more information on TID values becomes available.

Amino Acids↗
PubMed2002

Expert agreement in Current Procedural Terminology evaluation and management coding.

BACKGROUND: Available data suggest that physicians are accurate in approximately 55% of Current Procedural Terminology (CPT) evaluation and management (E/M) coding for their services. This accuracy is relative to observers' or auditors' assigned codes for these services, a group that has not been studied for their consistency in application of the CPT E/M coding guidelines. The purpose of this study was to determine the level of agreement of certified coding specialists in their application of CPT E/M coding guidelines. METHODS: Three hundred certified professional coding specialists randomly selected from the active membership of the American Health Information Management Association were sent 6 hypothetical progress notes of office visits along with a demographic survey. The study group assigned CPT E/M codes to each of the progress notes and completed the demographic survey. RESULTS: Coding specialists agreed on the CPT E/M codes for 57% of these 6 cases. The level of agreement for the individual cases ranged from 50% to 71%. Relative to the most common or consensus code, undercoding of established patients occurred more commonly than overcoding. In contrast, for new patient progress notes, overcoding relative to the consensus code was more common than undercoding. CONCLUSIONS: There is substantial disagreement among coding specialists in application of the CPT E/M coding guidelines. The results of this study are similar to results of prior studies assessing physician coding accuracy, suggesting that the CPT coding guidelines are too complex and subjective to be applied consistently by coding specialists or physicians.

Adult↗
PubMed1991

Standardizing neck dissection terminology. Official report of the Academy's Committee for Head and Neck Surgery and Oncology.

The emergence of the multitude of modified techniques for neck dissection procedure has resulted in a nomenclature system that is nonuniform. To eliminate potential misinterpretation, overlap, and lack of standardization, the Academy's Committee for Head and Neck Surgery and Oncology, with input from the Education Committee of the American Society of Head and Neck Surgery, has developed a classification system for these procedures. This has now been adopted by the American Academy of Otolaryngology-Head and Neck Surgery. The classification is based on the following concepts: (1) radical neck dissection is the fundamental procedure with which all other neck dissections are compared, (2) modified radical neck dissection denotes preservation of one or more nonlymphatic structure(s), (3) selective neck dissection denotes preservation of one or more group(s) of lymph nodes, and (4) extended radical neck dissection denotes removal of one or more additional lymphatic and/or nonlymphatic structure(s). Adherence to the principles of this classification system to describe neck dissection techniques should provide an improved method of communication. Furthermore, the system provides a rational framework on which subsequent terminology can be added.

Head and Neck Neoplasms↗
PubMed1997

Terminology of developmental abnormalities in common laboratory mammals (version 1).

This paper presents the first version of an internationally-developed glossary of terms for structural developmental abnormalities in common laboratory animals. The glossary is put forward by the International Federation of Teratology Societies (IFTS) Committee on International Harmonization of Nomenclature in Developmental Toxicology, and represents considerable progress toward harmonization of terminology in this area. The purpose of this effort is to provide a common vocabulary that will reduce confusion and ambiguity in the description of developmental effects, particularly in submissions to regulatory agencies worldwide. The glossary contains a primary term or phrase, a definition of the abnormality, and notes, where appropriate. Selected synonyms or related terms, which reflect a similar or closely related concept, are noted. Nonpreferred terms are indicated where their usage may be incorrect. Modifying terms used repeatedly in the glossary (e.g., absent, branched) are listed and defined separately, instead of repeating their definitions for each observation. Syndrome names are generally excluded from the glossary, but are listed separately in an appendix. The glossary is organized into broad sections for external, visceral, and skeletal observations, then subdivided into regions, structures, or organs in a general overall head to tail sequence. Numbering is sequential, and not in any regional or hierarchical order. Uses and misuses of the glossary are discussed. Comments, questions, suggestions, and additions from practitioners in the field of developmental toxicology are welcomed on the organization of the glossary as well as on the specific terms and definitions. Updates of the glossary are planned based on the comments received.

Animals↗
PubMed2000

Terminology of the prostate and related structures.

The various studies of J.E. McNeal (1968ndash;1977) established with precision the different sites of predilection for prostatic carcinomas, benign prostatic hypertrophy (BPH), and inflammation, making the division of the prostate into right, left, and middle lobes and isthmus inadequate for their description. Unfortunately, his positional terms for the sites (peripheral, central, transition, and preprostatic) are not based on the usual parameters and cannot be directly related to those of other workers. Nevertheless, the International Federation of Associations of Anatomists' Federative Committee on Anatomical Terminology has made recommendations in Terminologia Anatomica, based on his findings but modified to take some account of those of Tisell and Salander (1975 Scand J Urol Nephrol 1975 9:185-191). The use of the term lobe is confined to the right and left lobes and the variable middle lobe. The term lobule is used for the subdivisions, which are named from the anatomical position. Thus each side has a superomedial, an anteromedial, an inferoposterior, and an inferolateral lobule. Also necessary to describe a site of predilection is a peri-urethral gland zone. In ultrasound diagnosis, the trapezoid area is important: its upper limit is the rectoperinealis, its anterior limit is the intermediate part of the urethra, its lower limit is the anoperinealis, and its posterior limit is the anorectal junction. Confusion at the bladder neck is resolved by recognizing that the position of the internal urethral orifice varies with functional state of the bladder: while it is filling the orifice lies above the base of the prostate; when voiding begins, the orifice descends to the base of the prostate; between the filling internal orifice and the emptying internal orifice is the bladder neck part of the urethra.

Diagnosis, Differential↗
PubMed1989

Multilocular cyst of the kidney (cystic nephroma) and cystic, partially differentiated nephroblastoma. Terminology and criteria for diagnosis.

The entities commonly known as multi-locular cyst of the kidney (MLC) and cystic partially differentiated nephroblastoma (CPDN) were reviewed, based on material in the National Wilms' Tumor Study Pathology Center. The authors recommend several modifications of existing terminology and definitional criteria for these lesions. Because MLC probably represents a neoplastic lesion, the designation "cystic nephroma" (CN) is preferred. This term should be used only for predominantly cystic tumors composed entirely of differentiated tissues, without blastema or other embryonal elements. The designation CPDN should be applied to predominantly cystic lesions, lacking nodular solid regions, in which blastemal or other embryonal cells are present in the septa of the cysts. Solid Wilms' tumor with multifocal cystic change should be distinguished from CPDN. Five cases of CN and 18 cases of CPDN were reviewed. No CN, for which follow-up data was available, showed aggressive behavior. Only one case of CPDN underwent local recurrence, and there were no metastases. In general, nephrectomy alone appears to be adequate therapy for CPDN, but regular monitoring by noninvasive techniques would seem advisable.

Adolescent↗
PubMed1992

Recommendations for modification of terminology of neuroblastic tumors and prognostic significance of Shimada classification. A clinicopathologic study of 213 cases from the Pediatric Oncology Group.

To develop consistency in terminology and pathologic criteria, the authors reviewed the literature and 213 cases of neuroblastic tumors (NT) registered with Pediatric Oncology Group (POG) protocols 8104 and 8441. The patients were given standardized therapy stratified according to POG stage and patient age, and four or more histologic sections of primary tumor resected before therapy were available in each of these 213 cases. All stages were represented. The recommended nomenclature combines conventional terms and criteria with those used by Bove and McAdams and Shimada et al. The main features of the recommended nomenclature are as follows: (1) the terms neuroblastoma (NB) and ganglioneuroblastoma (GNB) are retained instead of stroma-poor NB and stroma-rich NB, recommended by Shimada et al.; (2) undifferentiated NB is considered a subtype separate from poorly differentiated NB; and (3) the term GNB is used only when there is a predominant ganglioneuromatous component admixed with the minor neuroblastomatous component. With the use of these criteria and terms, the Shimada classification was determined in the 213 cases. The results showed that, even after stratification for age, POG stage, and primary site, there is a statistically significant difference in survival rate between favorable histologic and unfavorable histologic prognostic subgroups. The authors recommend that definitive prognostic categorization of an NT according to Shimada classification should be done only when adequate histologic material is available from a primary tumor resected before any other therapy. Categorization done on histologic material from small biopsy specimens, previously treated primary tumors, or metastatic sites should be considered tentative.

Child, Preschool↗
PubMed2004

Confusing dinosaurs with mammals: tetrapod phylogenetics and anatomical terminology in the world of homology.

At present, three different systems of anatomical nomenclature are available to researchers describing new tetrapod taxa: a nonstandardized traditional system erected in part by Sir Richard Owen and subsequently elaborated by Alfred Romer; a standardized system created for avians, the Nomina Anatomica Avium (NAA); and a standardized system for extant (crown-group) mammals, the Nomina Anatomica Veterinaria (NAV). Conserved homologous structures widely distributed within the Tetrapoda are often granted different names in each system. The recent shift toward a phylogenetic system based on homology requires a concomitant shift toward a single nomenclatural system also based on both evolutionary and functional morphological homology. Standardized terms employed in the NAA and NAV should be perpetuated as far as possible basally in their respective phylogenies. Thus, NAA terms apply to nonavian archosaurs (or even all diapsids) and NAV terms apply to noncrown-group mammals and more basal synapsids. Taxa equally distant from both avians and crown-group mammals may maintain the traditional nonstandardized terminology until a universal anatomical nomenclature for all tetrapods is constructed.

Anatomy↗
PubMed1995

The terminology of early development: history, concepts, and current usage.

The meaning of some terms used in describing the development of embryos is discussed in the light of their historical origin and current usage. Attention is focused on the terminology associated with the early development of animals, particularly that concerned with gastrulation and germ layer theory. It is suggested that terms linked with outdated concepts are not always appropriate for, and unless defined with care may limit, our appreciation of the significance of subsequent observation and experiment. Recommendations are made concerning the use of the terms mesoblast, mesoderm, and mesenchyme.

Animals↗
PubMed1984

Terminology and anatomy of angulated coronary arteriography.

Angulated views in coronary arteriography have been increasingly utilized because of their superiority in demonstrating lesions not well seen in standard right and left oblique projections. The importance of these angulated views has been repeatedly demonstrated. It is the purpose of this article to review some basic coronary anatomy angulation terminology, and then to describe the particular advantages of the angulated views in coronary arteriography. Illustrations of these particular views of both coronary systems will be provided.

Angiography↗
PubMed2003

A new terminology for describing left and right ventricular conduction abnormalities.

The words we use to describe a medical condition should match our knowledge of it. Unfortunately, at times, the words we used long ago persist after new knowledge of the subject has become apparent; so it is with left and right ventricular conduction system abnormalities. The words left or right bundle-branch block no longer reflect our knowledge of the condition. Accordingly, this essay describes a new terminology that more accurately describes the numerous abnormalities that compose left and right ventricular conduction system block as well as their numerous subsets. A brief account of the cardiac conditions associated with the conduction defects is also presented.

Bundle-Branch Block↗
PubMed2006

Billing effectively with the new health and behavior current procedural terminology codes in primary care and specialty clinics.

The health and behavior current procedural terminology (CPT) codes introduced in 2003 have gained nationwide acceptance through Medicare and limited acceptance through third party payers. The codes facilitate accurate description and quantification of behavioral medicine services within a primary care or specialty clinic setting. The author reviews their appropriate utilization to enhance reimbursement and facilitate development of self-sustaining behavioral medicine programs. Information is provided on increased use and reimbursement of codes within psychology. Future directions for continued advocacy, increased acceptance, training, and research are discussed.

Behavioral Medicine↗
PubMed1979

Comprehensive schemata on the histology of the liver with consequences in terminology.

New schemata of the liver are presented to discuss the combination of the three kinds of liver lobules known until today in a chalk-talk-manner. Terminology is also discussed. Further investigations are needed involving the construction and the vascular pattern of compound lobules of the three individial lobules of the liver in different species.

Liver↗