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Building medical ontologies based on terminology extraction from texts: an experimentation in pneumology.

Pathologies and acts are classified in thesauri to help physicians to code their activity. In practice, the use of thesauri is not sufficient to reduce variability in coding and thesauri do not fit computer processing. We think the automation of the coding task requires a conceptual modelling of medical items: an ontology. Our objective is to help pneumologists code acts and diagnoses with a software that represents medical knowledge by an ontology of the concerned specialty. The main research hypothesis is to apply natural language processing tools to corpora to develop the resources needed to build the ontology. In this paper, our objective is twofold: we have to build the ontology of pneumology and we want to develop a methodology for the knowledge engineer to build various types of medical ontologies based on terminology extraction from texts.

Humans↗

Valuing neurosurgery services: part II. The interdependence of Current Procedural Terminology and federal Medicare payment policy.

Current Procedural Terminology (CPT) policies for coding of medical procedures and services are adopted by the American Medical Association CPT editorial panel. Since institution of the Medicare Fee Schedule in 1992, the Medicare budget neutrality rule has strongly influenced CPT policies for the coding of additions or modifications. The Centers for Medicare and Medicaid Services Medicare program policies, particularly payment limits, influence code modification strategies and CPT editorial panel processes.

Fee Schedules↗

The history of the plant embryo. Terminology and visualization from ancient until modern times.

Since ancient times comparisons between embryonic forms of humans, animals, and plants are known. In deciphering a plant embryo and its development, one applied a specific zoomorphic terminology. Until the 17th century naturalists who studied plants were inspired by the concepts of ancient natural philosophy. Since then plant embryos are visualized by drawings and diagrammatic sketches. In the 18th century the embryo became an important issue in debates concerning theories of generation and the analogy between animal egg and vegetable seed was emphasized. Due to the cell theory and refined microscopic techniques around 1850 botanists described the 'plant embryo' as an aggregate of cells. The 20th century profited of further technical improvements, e.g. microphotography, SEM, and plant tissue culture. The spell of the word embryo integrated morphological and morphogenetic data in botany and served as a code to decipher botanic forms. The paper presents a short history of the concept of 'plant embryo' and focuses on its distinct meanings over centuries, supported by different images.

Embryology↗

Methods for evaluation of medical terminological systems--a literature review and a case study.

OBJECTIVES: The usability of terminological systems (TSs) strongly depends on the coverage and correctness of their content. The objective of this study was to create a literature overview of aspects related to the content of TSs and of methods for the evaluation of the content of TSs. The extent to which these methods overlap or complement each other is investigated. METHODS: We reviewed literature and composed definitions for aspects of the evaluation of the content of TSs. Of the methods described in literature three were selected: 1) Concept matching in which two samples of concepts representing a) documentation of reasons for admission in daily care practice and b) aggregation of patient groups for research, are looked up in the TS in order to assess its coverage; 2) Formal algorithmic evaluation in which reasoning on the formally represented content is used to detect inconsistencies; and 3) Expert review in which a random sample of concepts are checked for incorrect and incomplete terms and relations. These evaluation methods were applied in a case study on the locally developed TS DICE (Diagnoses for Intensive Care Evaluation). RESULTS: None of the applied methods covered all the aspects of the content of a TS. The results of concept matching differed for the two use cases (63% vs. 52% perfect matches). Expert review revealed many more errors and incompleteness than formal algorithmic evaluation. CONCLUSIONS: To evaluate the content of a TS, using a combination of evaluation methods is preferable. Different representative samples, reflecting the uses of TSs, lead to different results for concept matching. Expert review appears to be very valuable, but time consuming. Formal algorithmic evaluation has the potential to decrease the workload of human reviewers but detects only logical inconsistencies. Further research is required to exploit the potentials of formal algorithmic evaluation.

Evaluation Studies as Topic↗

[Discussion on the usage of terminology of some parasites and parasitic diseases].

According to the International Code of Zoological Nomenclature and the Standardized Nomenclature of Animal Parasitic Diseases (SNOAPAD), and considering the new advances in parasitology, the usage of the terminology of some parasites and parasitic diseases (such as Trichinella and trichinellosis, filariae and filariasis, Echinococcus and echinococcosis, etc.) was discussed.

Animals↗

Evaluation of documents that integrate knowledge, terminology and information models.

Healthcare depends on evidence for practice and for electronic exchange of clinical patient information. To standardize the information that is being exchanged we created a format for describing care related information: a care information model. This model integrates knowledge, terminology and an information model. During a meeting between experts on nursing, standards and electronic patient records we evaluated the format of the care information model by use of an evaluation form and a group discussion. In general, the experts were enthusiastic about the format of the care information model. However they missed specific information about the purpose of the documents, and clarity on copyright issues. In addition, detailed comments on the existing structure and suggestions for additional categories were given. Also, experts suggested representing the integration in both HL7 message model format and in OpenEHR archetype format to allow different implementations of the same intelligence. From this we can conclude that the combination of these aspects in one document creates a valuable content for development of messages and systems. However, some adjustments are needed.

Evaluation Studies as Topic↗

Enriching medical terminologies: an approach based on aligned corpora.

Medical terminologies such as those in the UMLS are never exhaustive and there is a constant need to enrich them, especially in terms of multilinguality. We present a methodology to acquire new French translations of English medical terms based on word alignment in a parallel corpus - i.e. pairing of corresponding words. We automatically collected a 27.7-million-word parallel, English-French corpus. Based on a first 1.3-million-word extract of this corpus, we detected 10,171 candidate French translations of English medical terms from MeSH and SNOMED, among which 3,807 are new translations of English MeSH terms.

France↗

Mapping of the WHO-ART terminology on Snomed CT to improve grouping of related adverse drug reactions.

The WHO-ART and MedDRA terminologies used for coding adverse drug reactions (ADR) do not provide formal definitions of terms. In order to improve groupings, we propose to map ADR terms to equivalent Snomed CT concepts through UMLS Metathesaurus. We performed such mappings on WHO-ART terms and can automatically classify them using a description logic definition expressing their synonymies. Our gold standard was a set of 13 MedDRA special search categories restricted to ADR terms available in WHO-ART. The overlapping of the groupings within the new structure of WHO-ART on the manually built MedDRA search categories showed a 71% success rate. We plan to improve our method in order to retrieve associative relations between WHO-ART terms.

Adverse Drug Reaction Reporting Systems↗

An Ontology driven collaborative development for biomedical terminologies: from the French CCAM to the Australian ICHI coding system.

The CCAM French coding system of clinical procedures was developed between 1994 and 2004 using, in parallel, a traditional domain expert's consensus method on one hand, and advanced methodologies of ontology driven semantic representation and multilingual generation on the other hand. These advanced methodologies were applied under the framework of an European Union collaborative research project named GALEN and produced a new generation of biomedical terminology. Following the interest in several countries and in WHO, the GALEN network has tested the application of the ontology driven tools to the existing reduced Australian ICHI coding system for interventions presently under investigation by WHO to check its ability and appropriateness to become the reference international coding system for procedures. The initial results are presented and discussed in terms of feasibility and quality assurance for sharing and maintaining consistent medical knowledge and allowing diversity in linguistic expressiveness of end users.

Australia↗

A patient care workstation based on user centred design and a formal theory of medical terminology: PEN&PAD and the SMK formalism.

The PEN & PAD clinical workstation is for use by clinicians for direct patient care. It is based on a highly structured and detailed medical record but is intended to be simple and intuitive to use, allowing clinicians to summarise and view information in many ways, and quickly enter information through structured forms. It also provides mechanisms for tailoring the system to individual users without compromising its overall integrity. This has been achieved by following a process of user centred design and by developing a novel formalism, Structured Meta Knowledge, to represent the terminological knowledge, the medical record, and pragmatic knowledge about clinical practice.

Ambulatory Care Information Systems↗

A simplified terminology for abnormalities of the lumbar disk.

The terminology for abnormalities of the lumbar disk has always been a source of confusion. Recent advances in pathological studies have inspired the authors to propose a simple classification of common disk anomalies suitable not only for diagnostic radiologists but also for referring clinicians. Although the diagnosis of a few pathological entities will only be possible with specific imaging techniques, the proposed classification is appropriate for reporting observations from plain films, conventional tomograms, myelograms, diskograms, computed tomography scans and magnetic resonance images. All lumbar disks can thus be classified into one or more of the following categories: normal, aging, scarred, ruptured and herniated. A disk herniation is defined as a localized exit of disk material beyond the limits of the original intervertebral space.

Aging↗

Multiple family member visits to family physicians. Terminology, classification, and implications.

A study was designed to investigate "the family as the unit of care" in family medicine consultations from the patient's end of the physician-patient axis, unlike most previous related studies, which have concentrated on it from the physician's perspective. During 2 separate weeks in November 1987 and February 1988, nine Israeli family physicians collected demographic and family-related data concerning the spontaneous visiting patterns generated by 1156 persons (899 patients and 257 nonpatients) who attended 796 separate consultations at their clinics during this time. More than one patient attended 12% of the consultations, and more than one person, patient or nonpatient, was present at 36%. At 31% of the consultations children alone or children and adults were recorded as patients (child consultations), and at 69% only adult patients were present (adult consultations). Adults were recorded as second or third patients at 19% of the child consultations but at only 5% of the adult consultations. The child consultations alone yielded 86% of all the nonpatients documented. Basic terminology and methodology for investigating such multiple family member visits to family physicians is discussed as well as the composition of the different family units encountered and their possible significance.

Adult↗

Terminology and behavior reduction: the case against "punishment".

Controversy continues to rage over the application of punishment or aversive procedures in treatment and habilitation. A lack of clear definition of terms may be contributing to confusion in the debate. Tracing the history of the term punishment shows that its retention as a description of a behavioral process is due primarily to happenstance. The unfortunate choice of a word long associated with cruel and inhumane treatment has led to considerable confounding of the technical and traditional usages in public debate. The alternative term, aversive, is of more recent origin, yet it also suffers from inconsistent usage and some degree of negative association. Important questions concerning the appropriateness of behavior reduction procedures are made more difficult to answer when those procedures are designated by names laden with surplus meaning. Attempts by professional associations to address the behavior reduction dilemma offer opportunities for implementing more precise, less pejorative terms. Toward that end a conceptual framework is presented that could guide the choice of an alternative terminology for behavior reduction.

Behavior Therapy↗

[Terminology of ultrasound vascular diagnosis].

There is at present no accepted nomenclature regarding diagnostic vascular ultrasound. At two scientific meetings, the Study Group for Vascular Diagnosis of the German Society of Ultrasound in Medicine (DEGUM) developed a terminology for Doppler and duplex sonography of the arteries and veins supplying the brain and of peripheral vessels. The most important of these sonographic terms and their synonyms are presented. Recommendations as to which of the presently employed terms should be avoided, are given.

Blood Flow Velocity↗

[Remarks on the systematization and terminology of smell and taste disorders].

Based on the experience of the Olfactogustometry Laboratories in Halle and in Poznan, a proposal of clinical terminology and systematization of smell and taste disorders has been presented. Individual interpretation of the data from anamnesis in relation to the findings of the olfactogustometric investigations were stressed as indispensable.

Humans↗

[The problem of the terminology of "diffuse neurodermatitis--atopic dermatitis" in the work of the expert physician].

The problem in terminology, regarding diffuse neurodermatitis or atopic dermatitis, is discussed from a viewpoint of an expert physician evaluating the health status of certain patients populations. The author advocates A. A. Kalamkarian and V. A. Samsonov's view point, for it permits expert evaluation of the subjects' health status from a universal clinical and methodological standpoint.

Dermatitis, Atopic↗

A modified terminology for cervical intraepithelial neoplasia.

Recent data are consistent with the concept that human papillomavirus (HPV) is etiologically important in the causation of cervical squamous cell cancer. There appear to be certain important events in the process of HPV infection and neoplasia. It is suggested that the terminology of the HPV-related precursor lesions be modified and that two terms, rather than three, would best satisfy the requirements of both science and clinical care. The "early" lesions should be referred to as "low-grade cervical intraepithelial neoplasia (CIN) with HPV-related changes" and the lesions that have the features of cancer precursors as "high-grade CIN."

Female↗

Causalgia: clarifications in terminology and a case presentation.

By way of literature review, clarifications are made in the terminology employed in discussing the atypical post-traumatic pain syndromes, particularly reflex sympathetic dystrophy (RSD). Causalgia is a form of RSD and is the focus of a case report presented from the files at St. Anne's Hospital-West, Northlake, Illinois.

Adult↗