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Methods and reagents is a unique monthly column that highlights current discussions in the newsgroup blonet.molbio.methds-reagnts, available on the internet. This month's column reviews a recent debate held over the present sense and antisense terminology when referring to DNA. For details on how to partake in the newsgroup, see the accompanying box.
OBJECTIVES: We present in this article experiments on multi-language information extraction and access in the medical domain. For such applications, multilingual terminology plays a crucial role when working on specialized languages and specific domains. MATERIAL AND METHODS: We propose firstly a method for enriching multilingual thesauri which extracts new terms from parallel corpora, and secondly, a new approach for bilingual lexicon extraction from comparable corpora, which uses a bilingual thesaurus as a pivot. We illustrate their use in multi-language information retrieval (English/German) in the medical domains. RESULTS: Our experiments show that these automatically extracted bilingual lexicons are accurate enough (85% precision for term extraction) for semi-automatically enriching mono- or bi-lingual thesauri such as the universal medical language system, and that their use in cross-language information retrieval significantly improves the retrieval performance (from 22 to 40% average precision) and clearly outperforms existing bilingual lexicon resources (both general lexicons and specialized ones). CONCLUSION: We show in this paper first that bilingual lexicon extraction from parallel corpora in the medical domain could lead to accurate, specialized lexicons, which can be used to help enrich existing thesauri and second that bilingual lexicons extracted from comparable corpora outperform general bilingual resources for cross-language information retrieval.
To address deficiencies in Current Procedural Terminology (CPT) codes that describe many of the clinical services offered to patients, several physicians in the blood and marrow transplantation and apheresis field joined with a coalition including the American Society of Hematology, American Society for Blood and Marrow Transplantation, American Association of Blood Banks, American Society of Clinical Oncology, American Society for Apheresis, National Marrow Donor Program, and American Red Cross to collaborate in addressing these deficiencies by designing new CPT codes. The CPT editorial panel approved 18 new or revised codes. All these codes were given permanent or temporary value by the relative value unit update committee, but not all values were approved by the Centers for Medicare & Medicaid Services (CMS), in particular, the cell-processing codes and the unrelated donor search code. Further discussions addressing these concerns are under way with the CMS. Use of these new codes allows apheresis and transplant centers to charge appropriately for these services. This will help transplant center contracts with CPT codes, with payers more specifically describing services offered to these patients. In turn, this will give better justification for payment. This may allow certain payments for services to increase and help transplant centers better allocate revenue from fixed global case rate payments. Details about the individual codes and their approval process are reviewed in this article.
In the rapidly developing field of photobiology as it relates to solar ultraviolet radiation (UVR), there is a need as never before to ensure that definitions and terminology are current, correct, and standard. This article provides a basic definition of UVR; a review of correct UVR radiometric symbols, units, and nomenclature; defines extraterrestrial and terrestrial solar UVR; and reviews the measurement of biologically effective dose of solar UVR in humans.
The use of the term 'infertility' and related terms in reproductive medicine is reviewed. Current terminology is found to be ambiguous, confusing, and misleading. We recommend that the fertility investigation report of a couple should consist of statements concerning description, diagnosis, and prognosis. The description concerns the duration of nonpregnancy before consulting the clinician. A system for prognostic grading is proposed. The fertility investigation report forms the basis for further action, including the possibility of waiting with treatment in case of almost normal or only slightly reduced fertility. The use of the terms 'infertility', 'subfertility', and 'fecundity' is not necessary, and it is recommended to avoid them.
Although terminology in reproductive medicine is currently imprecise, it will not be easy to develop a consensus for a new approach to describing couples with difficulty achieving pregnancy.
The International Committee Monitoring Assisted Reproductive Technologies (ICMART) is an independent international nonprofit organization that has taken a leading role in the development, collection, and dissemination of worldwide data on assisted reproductive technology (ART). Information on availability, efficacy, and safety is provided to health professionals, health authorities, and the public. The glossary facilitates dissemination of ART data through a set of agreed-upon definitions, as seen in the most recent World Report on ART. It provides a conceptual framework for further international terminology and data development of ART.
Coding and payment methodology for physician professional services has been standardized through the introduction of the Current Procedural Terminology, which is maintained by the American Medical Association. The codes contained within this dataset are used by health care professionals to describe their services to payers. Inherent in the development of the procedural codes, the Resource Based Relative Value Scale Update Committee recommends physician work relative value units and practice expense and professional liability inputs to the Center for Medicare and Medicaid Services. This article provides an overview of the processes in place that permit regular updates in physician payment continually to be updated.
Natural language processing (NLP) systems have demonstrated utility in parsing narrative texts for purposes such as surveillance and decision support. However, there has been little work related to NLP of nursing narratives. The purpose of this study was to compare the semantic categories of a NLP system (Medical Language Extraction and Encoding [MedLEE] system) with the semantic domains, categories, and attributes of the International Standards Organization (ISO) reference terminology models for nursing diagnoses and nursing actions. All but two MedLEE diagnosis and procedure-related semantic categories mapped to ISO models. In some instances, we found exact correspondence between the semantic structures of MedLEE and the ISO models. In other situations (e.g. aspects of Site or Location), the ISO model was not as granular as MedLEE. For clinical procedure and non-invasive examination, two ISO nursing action model components (Action and Target) mapped to a single MedLEE semantic category. The ISO models are applicable to NLP of nursing narratives. However, the ISO models require additional specification of selected semantic categories for the abstract semantic domains in order to achieve the objective of using NLP to parse and encode data from nursing narratives. Our analysis also suggests areas for extension of MedLEE particularly in regard to represent nursing actions.
INTRODUCTION: Problem lists summarize an aspect of the patient's medical history and provide an important way to implement entry points for clinical pathways and guideline-oriented care. However, in order to automate processes based on problem lists, the use of controlled vocabularies is required. We developed a methodology to extract a collection of standardized problem-related terms from medical documents entered in free text by physicians. METHODS: We extracted a corpus of sentences describing problems from a randomized selection of admission notes collected at the University Hospitals of Geneva. Theses sentences underwent manual and automatic normalization processes, and a statistical clustering, in order to build a set of terms. RESULTS: We obtained 17,805 sentences from 5000 admission notes. We refined them into 1546 terms, 88.6% of which could be related to a relevant problem statement. DISCUSSION: A clinically relevant problems terminology was derived from clinical admission notes in free-text using a few methodical steps with a reasonable investment of human resources. Such an approach will ease the development and the use of problem lists better suited to user needs.
BACKGROUND AND OBJECTIVE: To determine the accuracy of recently introduced International Classification of Diseases Ninth Revision (ICD-9) procedure and Current Procedural Terminology (CPT) codes designed for injection or infusion of thrombolytic agents. MATERIALS AND METHODS: We determined the accuracy of ICD-9 procedure code 99.10 and CPT codes 37201, 37202 for use of thrombolysis in ischemic stroke by comparing procedure codes of University Hospital discharge data with a concurrent prospective registry. RESULTS: Of the 369 ischemic stroke patients, 49 (13.3%) received either intravenous and/or intraarterial thrombolysis. The sensitivity and specificity for ICD-9 procedure code 99.10 was 55% and 98% and CPT procedure code 37201 and 37202 was 49% and 99%. Identification by either ICD-9 codes or CPT codes yielded a high sensitivity and specificity of 82% and 98%. CONCLUSIONS: The use of ICD-9 and CPT codes alone may underestimate the use of thrombolytics using national and regional database. Best results are achieved when a combination of ICD-9 and CPT codes are used to identify the use of thrombolytics.
It is widely accepted that the medical terminology has its roots in ancient Greek and Latin. Greek words have been used not only in the field of medicine but also in every day language for many centuries. The aim of this article is to provide an abbreviated guide to the etymology and the meaning of Greek words used in the medical literature today, emphasizing on the field of pediatric surgery. Thus, the term paediatric is constructed from the words paedion, meaning "child", and iatriki, meaning "medicine", literally, "medicine for children." Surgery, however, is not a Greek word. The corresponding Greek term is chirourgiki, derived from cheir and ergon, that is, "hand and action," meaning the action made by hands. This term is also found in the French and German medical literature as chirourgie and chirurgie, respectively. Some general terms in surgery are also of Greek origin. The word trauma has been transferred into the English literature without modification and comes from the verb diatitreno, meaning to "penetrate." Other such terms include diagnosis, from the verb diagignosko, meaning to "discriminate"; symptom, from the verb sympipto, that is, "to coinside"; and the adjectives clinical and clinic, from the noun klini, meaning "bed." Focusing on special fields of pediatric surgery, the etymology and the meaning of Greek words used in the medical literature will be shown and analyzed.
Magnetic resonance imaging (MRI) is now a recognized method of imaging the breast. Unfortunately, there is lack of standardization in the MRI terminology used to characterize the appearance of breast lesions. Moreover, cases of mixed histologies are often imaged. We retrospectively identified cases of pure high-grade ductal carcinoma in situ (DCIS) using the recently introduced breast MRI lexicon and characterized the lesions in order to try and identify features that might distinguish high-grade DCIS from invasive disease. Five-year review of our institution's database revealed 637 patients underwent gadolinium-enhanced breast MRI examination. Twenty patients had histologically proven pure high-grade DCIS. After excluding patients with previous chemotherapy or inadequate MRI examination, 13 patients were analyzed and compared to the 13 most recent cases of pure invasive breast carcinoma. The morphological and dynamic features were then compared. High-grade DCIS cases were significantly more likely to show focal branching pattern (P=.03) and to have an irregular contour (P=.03), compared with invasive disease. Although of marginal statistical significance, DCIS lesions are more likely to have a lower morphological score than invasive carcinoma (P=.06), whilst the latter is more likely to show ring enhancement (P=.07). Use of breast MRI for staging at our institution shows that pure DCIS and pure invasive cancers are both rare entities. Despite the relatively limited numbers, we identified features that would help to differentiate high-grade DCIS from invasive carcinoma on MRI.
Patients with chronic heart failure can be divided into 2 broad categories: systolic heart failure and diastolic heart failure. There are significant differences in demographics, prognosis, left ventricular structure, as well as systolic and diastolic function between these 2 groups of patients. The purpose of this presentation is to define the terminology used to describe these 2 broad categories of heart failure and to characterize the functional measurements that constitute their pathophysiological mechanisms.
This article presents a standard system of terminology recently approved by the International Continence Society, the American Urogynecologic Society, and the Society of Gynecologic Surgeons for the description of female pelvic organ prolapse and pelvic floor dysfunction. An objective site-specific system for describing, quantitating, and staging pelvic support in women is included. It has been developed to enhance both clinical and academic communication regarding individual patients and populations of patients. Clinicians and researchers caring for women with pelvic organ prolapse and pelvic floor dysfunction are encouraged to learn and use the system.
PURPOSE: Orbital venous anomalies and lymphangiomas have been generally classified on morphologic grounds. However, conflicting concepts of these lesions have hampered scientific dialogue and confused clinicians, with occasionally serious consequences for patients. As a step toward uniform nomenclature and better communication, a consensus on the terminology of orbital vascular malformations was sought among the members of the Orbital Society. METHODS: A classification of orbital vascular malformations based on their hemodynamic relationships, as revealed by clinical and imaging features, was presented, discussed, and adopted at the 1998 Annual Meeting of the Orbital Society. A consensus statement was drafted and distributed to all members. The statement was then modified in accordance with members' responses, which included minor stylistic recommendations but no substantive dissent. RESULTS: Orbital vascular malformations may be classified according to their hemodynamic relationships as no flow, venous flow, and arterial flow lesions. Assignment to each group is based on pertinent clinical and imaging criteria. Mixed forms with both venous and no flow components are grouped within the venous flow category to emphasize the clinical importance of that relationship. CONCLUSIONS: A hemodynamic classification of orbital vascular malformations emphasizes features most germane to their management. It should reduce the clinical confusion resulting from purely morphologic differentiation. Widely accepted definitions may allow a better comparison of therapeutic protocols for these troublesome lesions.
The function of language is communication, but accurate communication is impossible unless the language is mutually understood. In an extensive review of the literature of conjoined twins, considerable difficulty was encountered in interpreting the variations in nomenclature--the designation of the different types of union as well as the identification of the individual twins and their anatomic relationship to one another. For example, the term thoracopagus often includes twins with either one or two hearts; the former rarely (if ever) is capable of surviving, but the latter often do survive. Labeling them as thoracopagus and omphalopagus, respectively, will permit more meaningful comparison between the two types. A simple, logical system of terminology is proposed.
The terms death (as an irreversible occurrence), necrosis and apoptosis are well defined and generally accepted in cell biology. Procedures and terminology related to estimation of different forms of cell mortality are, however, less clear and exact. Evaluation of the rate of mortality is important for numerous biological processes such as growth, atrophy, regeneration and neoplasia. Procedures used for assessing cell mortality include: 1. dye exclusion tests which were shown to be inadequate in apoptosis; 2. release of radioactive markers, also inadequate, as they occur also in life during shedding of membranes and cleavage of cell parts; 3. morphological and histochemical procedures which show only relatively late changes (autolysis) in cells which have not yet been completely obliterated; 4. absence of synthetic activities, which do not necessarily indicate death (e.g. mature erythrocytes); 5. colony forming capacity in cultures, which are considered by most authors as the most useful tests for assessing the effects of cytotoxic treatments. These tests do not, however, assess viability, but rather reproductive capacity. In all these tests, delayed changes in vitality can be determined by repeated or continuous testing. The following new terms are proposed and related to presently available tests. Aposchisis--for cleavage of cell parts not necessarily associated with cell death. N-mortality--for necrosis type of mortality estimated by the dye exclusion tests. A-mortality--for apoptosis type of mortality, which cannot be directly estimated at present. Acarpy--for loss of reproductive capacity of cells which is assessed by the colony forming tests.