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PubMed1998

A concept model for the automatic maintenance of controlled medical vocabularies.

A controlled medical vocabulary is a fundamental requirement in a range of medical informatics applications. Large vocabularies development and maintenance is labor intensive and costly. Maintainers of medical vocabularies need appropriate tools to do their work correctly. In this paper, we describe our concept model for a controlled medical vocabulary. We present how this model can check vocabulary consistency. We propose a set of tools in a distributed environment, which permits edition, visualization and maintenance of medical terminologies.

Humans↗
PubMed2000

Clinical vocabularies and terminologies: impact on the future of health information management.

As standardized clinical vocabularies and terminologies are being developed, Health Information Management (HIM) practitioners must increase their knowledge of nomenclature and coding systems beyond the traditional ICD-9-CM and CPT. The limited scope of these classifications prevents them from serving as the standard vocabulary for the computer-based patient record. The American Health Information Management Association (AHIMA) Coding Futures Task Force provided insights into the knowledge and skills that HIM professionals will need as clinical vocabularies and terminologies become more integrated into health care systems. Certain characteristics are important in a clinical vocabulary and several clinical vocabularies are in use today.

Abstracting and Indexing↗
PubMed2001

Building a controlled health vocabulary in Japanese.

OBJECTIVES: This study is aimed at developing a controlled clinical vocabulary for use in electronic patient record (EPR) systems. METHODS: In this paper, we propose a model for building the vocabulary. The model is composed of a Canonical Term Dictionary, an Atom Dictionary, a Composite Atom Dictionary, and an Index. Parsing and composing functions are included in this model. Canonical terms were extracted from reference terminologies. Atoms were extracted from the Canonical Term Dictionary and reduced to a set from which the Composite Atom Dictionary can be built. The index was built to link these two dictionaries. For testing the model, we compiled a sample vocabulary and applied the model to a SNOMED translation system (English to Japanese) and a term similarity estimation system. RESULTS: The sample vocabulary consisted of 15,600 atomic terms and 4,450 composite terms. 33,441 SNOMED terms were translated by the SNOMED translation system. The system gave adequate Japanese candidates in 56.3% of cases. The similarity estimation system found an average of 5.4 candidates when the equality ratio was over 50%. CONCLUSIONS: The trial applications produced good results. The model seems promising for building a standard clinical vocabulary system. This system can be applied in certain other Asian countries, such as China and Korea.

Algorithms↗
PubMed2002

A controlled vocabulary for nursing practice and research.

The paper describes the process of evolving a controlled Nursing Vocabulary for indexing and information retrieval purposes. The vocabulary is based on terms of the thesaurus of Medline i.e. MeSH (Medical Subject Headings) by National Library of Medicine and the International Classification for Nursing Practice (ICNP) by the International Council of Nurses. The vocabulary consists of 10 themes central to nursing domain. The vocabulary is added as an independent theme to the Finnish thesaurus FinMeSH. The validity of the vocabulary has been tested for indexing nursing research once and has afterwards been revised. The validity will be tested again during spring 2002.

Finland↗
PubMed1995

Individual differences in vocabulary acquisition in children with Down syndrome.

Children with Down syndrome offer an opportunity for investigators interested in cognition and language problems to study asynchronous development of vocabulary, and syntax in language production relative to comprehension and cognitive status. Our work to date has documented consistent differences in the rate of vocabulary learning in children with DS relative to their mental age matched peers. These deficits increase with advancing age indicating that the learning rate of the DS group is significantly slower than that of the TD group. While the rate of vocabulary acquisition is significantly slower for the children with DS, not all of the children we studied exhibited similar rates of learning. Thirty-five percent of our children had rates of vocabulary growth consistent with mental age expectations. These data suggest that neither the syndrome alone nor the cognitive deficit associated with Down syndrome can explain the differences observed in vocabulary growth. Our next series of studies will evaluate a variety of causal constructs to explain the significant asynchronies in language learning compared with other cognitive abilities.

Down Syndrome↗
PubMed1995

Comparing clinical vocabularies using coding system fidelity.

Much effort has been directed toward the development of an ideal multipurpose controlled medical vocabulary for use in human and veterinary medicine. SNOMED International is one effort that has resulted in a larger and more complex nomenclature system. Although it was able to code more concepts, SNOMED International failed to statistically improve vocabulary fidelity when compared with the 30+ year old SNVDO vocabulary. We found that SNOMED has a lower intercoder consistency than SNVDO and that a greater number of codes were necessary to represent an individual concept. Our study shows a significant Coder-Vocabulary interaction which suggests that more emphasis should be placed on coding guidelines and coder training. Clinician data entry and coding may be necessary for maximum vocabulary fidelity.

Abstracting and Indexing↗
PubMed1995

Taxonomic vocabularies in medicine: the intention of usage determines different established structures.

This paper deals with the reasons for distinguishing taxonomic vocabularies for standardizing terminology according to their different dedicated purposes. Different kinds of vocabularies are defined and then characterized using criteria like purposes, semiotic bases, principles for establishing hierarchical relations, mechanisms for guaranteeing reproducibility, and underlying representation formats. Furthermore, the kinds of taxonomic vocabularies worked out so far are named by preferred terms and assigned to proper places within the whole context of medical routine and research. Finally, it is argued that there must be a careful distinction between a conceptual level on one hand and a purpose-dependent non-conceptual level on the other. Unfortunately, both levels are crucially intertwined in existing vocabularies. Efforts on conceptually linking the vocabularies can help to share and re-use information evolving from different sources due to their common conceptual core. However, one must be aware of the effects resulting from special structural features on a non-conceptual level.

Vocabulary, Controlled↗
PubMed1996

Formal descriptions and adaptive mechanisms for changes in controlled medical vocabularies.

Standard controlled medical vocabularies are typically based on a coding scheme, while medical informatics applications tend to have a more formal conceptual foundation. When such applications attempt to use data coded with standard vocabularies, problems can arise when the standard vocabulary changes over time. A formal taxonomy is presented for describing the semantic changes which can occur in a vocabulary, such as simple addition, refinement, precoordination, disambiguation, redundancy, obsolescence, discovered redundancy, major name changes, minor name changes, code reuse, and changed codes. The taxonomy is described that used to effect change in one concept-based vocabulary (the Medical Entities Dictionary), and the utility of the approach is demonstrated by applying it to the changes appearing in the 1994 release of the International Classification of Diseases, Ninth Edition, with Clinical Modifications (ICD-9-CM).

Classification↗
PubMed1997

Standardized problem list generation, utilizing the Mayo canonical vocabulary embedded within the Unified Medical Language System.

UNLABELLED: VOCABULARY: The Mayo problem list vocabulary is a clinically derived lexicon created from the entries made to the Mayo Clinic's Master Sheet Index and the problem list entries made to the Impression/ Report/Plan section of the Clinical Notes System over the last three years. The vocabulary was reduced by eliminating repetition including lexical variants, spelling errors, and qualifiers (Administrative or Operational terms). Qualifiers are re-coordinated with other terms, at run-time, which greatly increased the number of input strings which our system is capable of recognizing. IMPLEMENTATION: The Problem Manager is implemented using standard windows tools in a Windows NT environment. The interface is designed using Object Pascal. HTTP calls are passed over the World Wide Web to a UNIX based vocabulary server. The server returns a document, which is read into Object Pascal structures, parsed, filtered and displayed. STUDY: This paper reports the results of a recent Usability Trial focused on assessing the viability of this mechanism for standardized problem entry. Eight clinicians engaged in eleven scenarios and responded as to their satisfaction with the systems performance. These responses were observed, videotaped and tabulated. Clinicians in this study were able to find acceptable diagnoses in 91.1% of the scenarios. The response time was acceptable in 92.5% of the scenarios. The presentation of related terms was stated to be useful in at least one scenario by seven of the eight participants. All clinicians wanted to make use of shortcuts which would minimize the amount of typing necessary to encode the concept they were searching for (e.g. Abbreviations, Word Completion). CONCLUSIONS: Clinicians are willing to choose a canonical term from a suggested list (as opposed to their own wording). Clinicians want an "intelligent" system, which would suggest terms within a category (e.g. Types of "Migraine"). They are able to make functional use of our system, in its current state of development. Finally, all clinicians appreciate the value of encoding their problems in a standardized vocabulary, toward improved research, education and practice.

Computer Communication Networks↗
PubMed2006

Assessment of expressive vocabulary outcomes in hearing-impaired children with hearing aids: do bilaterally hearing-impaired children catch up?

OBJECTIVE: To evaluate expressive vocabulary growth in hearing-impaired preschool children wearing hearing aids. DESIGN: Prospective analysis of the outcomes of children included in the 1994 German 'Goettinger Hoer-Sprachregister' (GHR) series, using a repeated-measures paradigm in six- to nine-month intervals (t1-t3). SUBJECTS: Twenty-seven children (aged 2.0-4.4 years) with bilateral sensorineural hearing loss (with averages at frequencies of 0.5, 1, 2 and 4 kHz of > 20 to > 90 dB in the better ear) from the 1994 GHR series. The children were diagnosed at a mean age of 31.4 months (standard deviation (SD) 10.6 months) and fitted with a binaural hearing aid at a mean age of 32.3 months (SD 10.5 months). Nonverbal intelligence was average (five missing data entries). Standardized, age-appropriate picture naming tests (the 'Sprachentwicklungstest für 2-jährige Kinder', the Kaufman Assessment Battery for Children subtest vocabulary, and the 'Aktiver Wortschatztest für drei- bis sechsjährige Kinder') were carried out at three time points and results compared with data from children with normal hearing. The test raw scores were converted to T scores (mean = 50; SD = 10). RESULTS: On average, the children scored far below the normative population at t1 (mean = 28.9; SD = 11.3) and slowly improved as they got older (at t3, mean = 34.1; SD = 16.1; p = 0.010). Children with mild or moderate hearing loss improved most notably (mean difference t1-t3; p = 0.001), except for one child of deaf parents. Two of the five mildly hearing-impaired children and two of the eleven moderately hearing-impaired children caught up with their normal hearing peers with regards to expressive vocabulary. Such expressive vocabulary achievements were not seen in any children with > 70 dB hearing loss or in six of the eleven children (55 per cent) with a 40-70 dB hearing loss, despite receiving adequate personal amplification. CONCLUSION: Testing expressive vocabulary size is a useful clinical tool in assessing linguistic lexical outcome.

Auditory Perception↗
PubMed2003

Vocabulary Assessment of Deaf and Hard-of-Hearing Children From Infancy Through the Preschool Years.

The purpose of this article is to inform researchers and practitioners about potential challenges in the selection, administration, and interpretation of results of measures of vocabulary assessment when working with deaf and hard-of-hearing children. This article reviews methods that can be used to assess vocabulary of children through the age of 5 years, including naturalistic observation, parent report measures, and standardized vocabulary tests. The authors also describe procedures to assess word-learning processes available to children to facilitate vocabulary acquisition. General cautions regarding the use of assessment tools with deaf and hard-of-hearing children are reviewed, as well as cautions for specific assessment measures. Finally, based on available research, suggestions are offered regarding what each assessment test can tell us about deaf and hard-of-hearing children's vocabulary development.

Journal Article↗
PubMed2005

Process dissociation of sight vocabulary and phonetic decoding in reading: a new perspective on surface and phonological dyslexias.

Recent research on developmental dyslexia has suggested a phonological core deficit hypothesis (e.g., Manis, Seidenberg, Doi, McBride-Chang, & Peterson, 1996; Stanovich, Siegel, & Gottardo, 1997) whereby pure cases of developmental phonological dyslexia (dysfunctional phonetic decoding processing but normal sight vocabulary processing) can exist, but pure cases of developmental surface dyslexia (dysfunctional sight vocabulary processing but normal phonetic decoding processing) should not. By applying Jacoby's (1991) and Lindsay and Jacoby's (1994) process dissociation procedure to the reading of regular and exception words, we present a method that serves to estimate readers' reliance on sight vocabulary and phonetic decoding during real word recognition. These reliance estimates are then used in Castles and Coltheart's (1993) regression-based approach to identify normal readers and developmental dyslexics. This new method: (1) allows one to explore normal reading acquisition and both the delay and deviance accounts of developmental dyslexia, (2) provides an alternative to matching dyslexics to both chronological-age and reading-age control groups, and (3) uses only real words. We present evidence that pure cases of developmental surface dyslexia can be obtained with both Castles and Coltheart's measure as well as our own, and that developmental surface dyslexia is not simply a delayed reading deficit. The theoretical importance and utility of estimates of reliance on sight vocabulary and phonetic decoding is discussed.

Child↗
PubMed2003

A vocabulary development and visualization tool based on natural language processing and the mining of textual patient reports.

Medical terminologies are critical for automated healthcare systems. Some terminologies, such as the UMLS and SNOMED are comprehensive, whereas others specialize in limited domains (i.e., BIRADS) or are developed for specific applications. An important feature of a terminology is comprehensive coverage of relevant clinical terms and ease of use by users, which include computerized applications. We have developed a method for facilitating vocabulary development and maintenance that is based on utilization of natural language processing to mine large collections of clinical reports in order to obtain information on terminology as expressed by physicians. Once the reports are processed and the terms structured and collected into an XML representational schema, it is possible to determine information about terms, such as frequency of occurrence, compositionality, relations to other terms (such as modifiers), and correspondence to a controlled vocabulary. This paper describes the method and discusses how it can be used as a tool to help vocabulary builders navigate through the terms physicians use, visualize their relations to other terms via a flexible viewer, and determine their correspondence to a controlled vocabulary.

Algorithms↗
PubMed2005

Relations between vocabulary development and verbal short-term memory: The relative importance of short-term memory for serial order and item information.

Although many studies have shown an association between verbal short-term memory (STM) and vocabulary development, the precise nature of this association is not yet clear. The current study reexamined this relation in 4- to 6-year-olds by designing verbal STM tasks that maximized memory for either item or serial order information. Although empirical data suggest that distinct STM processes determine item and serial order recall, these were generally confounded in previous developmental studies. We observed that item and order memory tasks were independently related to vocabulary development. Furthermore, vocabulary development was more strongly associated with STM for order information in 4- and 6-year-olds and with STM for item information in 5-year-olds. These data highlight the specificity of verbal STM for serial order and item information and suggest a causal association between order STM processes and vocabulary development, at least in 4- and 6-year-olds.

Child↗
PubMed1976

Auditory vocabulary of the right hemisphere following brain bisection or hemidecortication.

Unilateral scores of two commissurotomy and three (one left and two right) hemispherectomy patients were obtained on standardized auditory language comprehension tests which use pointing responses to a pictorial array. Unilateral performance by the commissurotomy patients was achieved by restricting the pictorial array to one visual half field, using a novel contact lens system which permits ocular scanning of the lateralized stimulus and self-monitoring of task performance. Using the Peabody and Ammons Picture Vocabulary Tests, the auditory vocabulary in the disconnected or isolated right hemispheres was found to be equivalent to that of normal subjects of ages 8:1 to 16:3 with a mean of 11:7 (eleven years and 7 months old). At the same time, standardized aphasia tests showed that the picture vocabulary in the right hemispheres is similar to that of a heterogeneous population of aphasics, even though the right hemispheres did not behave quite like any classical aphasic diagnostic group. No significant differences were found between right hemisphere comprehension of object vs. action names. Results indicated that vocabulary as a function of word frequency followed the same pattern in the right and left hemisphere although the right hemisphere was consistently lower. This parallel between the two hemispheres was conjectured to reflect some similar or even shared lexical structures in the two hemispheres. Together with other data on the performance of the right hemisphere on the Token Test (Zaidel, 1976), the results suggest a complex model of the development of language laterality in the brain, in which some, but not all, auditory language functions continue to develop in the right hemisphere past what is generally regarded as the critical period for language acquistion. In general, auditory language comprehension is better characterized as that of an "average aphasic" than that of a child of a specific age.

Aphasia↗
PubMed2005

Short-term memory and vocabulary development in children with Down syndrome and children with specific language impairment.

A longitudinal comparison was made between development of verbal and visuo-spatial short-term memory and vocabulary in children with Down syndrome (DS), children with specific language impairment (SLI), and typically developing children as a control group. Participants were 12 children with DS (6 males, 6 females; mean chronological age 9y 9mo [SD 2.8 mo], range 8y 6mo to 11y 4mo); nine children with SLI (4 males, 5 females; mean chronological age 3y 9mo [SD 4.8mo], range 3y 3mo to 4y 5mo); and 12 typically developing children (5 males, 7 females; mean chronological age 4y 4mo [SD 3.9mo], range 3y 3mo to 4y 3mo). Participants were matched on mental age (mean mental age 4y 3mo). All participants completed verbal short-term memory, visuo-spatial short-term memory, and expressive and receptive vocabulary tasks on three occasions over 1 year. Similarities were seen in the clinical groups for verbal short-term memory. There was some evidence of difficulty in visuo-spatial short-term memory in the children with SLI relative to the other groups, but all three groups showed overlap in visuo-spatial short-term memory performance. At the final time-point vocabulary performance in the clinical groups was similar; the typically developing children showed higher vocabulary abilities than both clinical groups.

Child↗
PubMed1982

Vocabulary deficit and abstraction impairment in hospitalized alcoholics.

The use of a standard intelligence test for detecting cognitive impairment has been re-examined in a cohort of 506 hospitalized alcoholics. The value of Vocabulary scores as indicators of original intelligence was tested by formulating the hypothesis that Vocabulary scores would remain constant despite increasing degrees of alcohol-induced cerebral dysfunction. Subjects were assigned to non-dysfunctional, minimal and severe dysfunctional groups on the basis of psychometric testing and their Wechsler Vocabulary scores categorized as either 'abstract' 'concrete' or 'wrong'. Significant linear deficits in Vocabulary score and loss of abstract ability correlated with increasing dysfunction, irrespective of age but with greater frequency in females.

Adult↗
PubMed1994

Developmental and stylistic variation in the composition of early vocabulary.

Results are reported for stylistic and developmental aspects of vocabulary composition for 1,803 children and families who participated in the tri-city norming of a new parental report instrument, the MacArthur Communicative Development Inventories. We replicate previous studies with small samples showing extensive variation in use of common nouns between age 0; 8 and 1;4 (i.e. 'referential style'), and in the proportion of vocabulary made up of closed-class words between 1;4 and 2;6 (i.e. 'analytic' vs. 'holistic' style). However, both style dimensions are confounded with developmental changes in the composition of the lexicon, including three 'waves' of reorganization: (I) an initial increase in percentage of common nouns from 0 to 100 words, followed by a proportional decrease; (2) a slow linear increase in verbs and other predicates, with the greatest gains taking place between 100 and 400 words; (3) no proportional development at all in the use of closed-class vocabulary between 0 and 400 words, followed by a sharp increase from 400 to 680 words. When developmental changes in noun use are controlled, referential-style measures do not show the association with developmental precocity reported in previous studies, although these scores are related to maternal education. By contrast, when developmental changes in grammatical function word use are controlled, high closed-class scores are associated with a slower rate of development. We suggest that younger children may have less perceptual acuity and/or shorter memory spans than older children with the same vocabulary size. As a result, the younger children may ignore unstressed function words until a later point in development while the older children tend to reproduce perceptual details that they do not yet understand. Longitudinal data show that early use of function words (under 400 words) is not related to grammatical levels after the 400-word point, confirming our 'stylistic' interpretation of early closed-class usage. We close with recommendations for the unconfounding of stylistic and developmental variance in research on individual differences in language development, and provide look-up tables that will permit other investigators to pull these aspects apart.

Child Language↗