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Matching controlled vocabulary words.

This study examines an enabling condition for natural languages access to medical knowledge resources (Medline, CISMeF) indexed with controlled vocabularies (e.g., the MeSH): is the vocabulary of user queries comparable with that of the index terms? The two vocabularies were compared in their original form, then under incrementally normalized forms, using character-based normalizations then linguistic normalizations. Only 16.7% of the user vocabulary, in its original form, is in the MeSH. Progressive normalizations increase this proportion to 65.5%. Besides, if the frequencies of occurrence of words are taken into account, 89.3% of user word occurrences can be matched to MeSH words. This shows the interest of taking into account further matching methods between queries and index terms than those presented here.

France↗

An applied evaluation of SNOMED CT as a clinical vocabulary for the computerized diagnosis and problem list.

The use of a standardized controlled terminology allows diverse systems and applications throughout the enterprise to translate data. In developing a customized enterprise-wide vocabulary for clinical terminology, we implemented SNOMED CT as a base vocabulary, while facilitating the addition of site-specific clinical terms or concepts not represented in SNOMED CT. In this paper, we evaluate the breadth of SNOMED CT terms and concepts for the coding of diagnosis and problem lists by clinicians within a computerized physician order entry (CPOE) system. Clinicians selected diagnosis and problem list terms from a lexicon based on SNOMED CT, submitting requests for clinical terms that were not found in the controlled vocabulary. For each "missing" term, we assigned one of four mapping types, representing the relationship of this new terminology entry to the SNOMED CT reference terminology. Our results show that the majority of diagnosis/problem list terms (88.4%) were found in SNOMED CT. Of the 145 missing terms, only 20 represented significant concepts missing from SNOMED CT, resulting in concept coverage of 98.5%. Our results show that SNOMED CT is a relatively complete standardized terminology on which to base a vocabulary for the clinical problem list.

Abbreviations as Topic↗

A controlled nursing vocabulary for indexing and information retrieval.

The lack of a nursing thesaurus in Finnish has emerged among nursing professionals searching nursing knowledge and librarians when indexing literature to databases. The Finnish Nursing Education Society launched a project focusing on the development of a nursing vocabulary and the compilation of a thesaurus. The content of a vocabulary was created by six experts using Delphi-technique. The validity of the vocabulary was twice tested for indexing nursing research and has afterwards been revised. The vocabulary can be used for indexing and information retrieval purposes. The main challenge is that nurses easily can find national as well as international nursing research from databases and enhance research utilization.

Abstracting and Indexing↗

Diagnostic vocabulary for primary care.

The diagnostic vocabulary of a clinician appears to be specific and measurable for each clinical discipline. The diagnostic vocabulary of 11 primary care physicians over four-years' work has been analyzed. For every 1,000 patients cared for, each physician made, on average, 2,691 diagnoses every year, representing a diagnostic vocabulary of 475 different clinical entities. This vocabulary has been analyzed according to frequency of usage and clinical decision making. The clinical, teaching, and administrative implications of this analysis are discussed.

Diagnosis↗

Utilizing OODB schema modeling for vocabulary management.

Comprehension of complex controlled vocabularies is often difficult. We present a method, facilitated by an object-oriented database, for depicting such a vocabulary (the Medical Entities Dictionary (MED) from the Columbia-Presbyterian Medical Center) in a schematic way which uses a sparse inheritance network of area classes. The resulting Object Oriented Health Vocabulary repository (OOHVR) allows visualization of the 43,000 MED concepts as 90 area classes. This view has provided valuable information to those responsible with maintaining the MED. As a result, the MED organization has been improved and some previously-unrecognized errors and inconsistencies have been removed. We believe that this schematic approach allows improved comprehension of the gestalt of large controlled medical vocabulary.

Classification↗

Vocabulary competence in early childhood: measurement, latent construct, and predictive validity.

We systematically examined relations among 6 measures of child language derived from 3 sources, including observations of the child's speech with mother, experimenter assessments, and maternal reports. A total of 184 20-month-olds and their mothers contributed complete information about child language comprehension and expression. Correlations of child language measures with socioeconomic status and maternal education were accounted for, as were correlations of child language measures with mothers' verbal intelligence, maternal report measures with mothers' tendency to respond in a socially desirable fashion, and experimenter assessments with child social competence. Structural equation modeling supported (1) strong relations among child language measures derived from observations of the child's speech with mother, experimenter assessments, and maternal reports; (2) the loading of multiple measures of child language from different sources on a single latent construct of vocabulary competence; and (3) the predictive validity of the vocabulary competence latent variable at 20 months, as well as receptive vocabulary specifically, for both verbal and performance IQ (verbal better than performance) at 48 months. Neither an index of child monologing (a nonvocabulary language measure) nor symbolic play (a nonlinguistic representational measure) covaried with vocabulary competence. Girls consistently outperformed boys on individual language measures, but no differences emerged in any model in the fit for boys and girls.

Concept Formation↗

A proposal for incorporating health level seven (HL7) vocabulary in the UMLS Metathesaurus.

The HL7 Vocabulary Technical Committee (TC) was organized to select and maintain the vocabulary used in HL7 messages. The goal is to make implementations of the Version 3 HL7 Standard more plug-and-play compatible. In order to make the vocabulary readily accessible to the public, HL7 is collaborating with the U.S. National Library of Medicine (NLM) to include HL7 vocabulary in the Unified Medical Language System (UMLS) Metathesaurus. This article describes a proposal for how HL7 data elements and coded values can be represented accurately in the relational tables of the UMLS Metathesaurus.

Computer Communication Networks↗

An interlingua for electronic interchange of medical information: using frames to map between clinical vocabularies.

The proliferation of medical knowledge has led to the development of extensive dictionaries for electronically accessing information resources. The task of standardizing terminology used for electronic hospital records and for knowledge bases for medical expert systems and indexing the medical literature cannot easily be met by developing a single, monolithic "official" medical vocabulary. Developing a monolithic vocabulary would require a massive effort, and its existence would not guarantee its use by third-party payors, by practicing clinicians, or by developers of electronic medical information systems. Recognizing this, the National Library of Medicine (NLM) has begun to develop the Unified Medical Language System (UMLS) as a means of promoting electronic information exchange among systems with controlled vocabularies. The authors describe a frame-based system developed as an experimental approach to mapping between controlled clinical vocabularies.

Cluster Analysis↗

An innovative method to assess the receptive vocabulary of children with cerebral palsy using event-related brain potentials.

This single-case, multiple-control study illustrates the clinical use of ERPs as part of the linguistic and cognitive assessment of individuals who are unable to provide verbal or motor responses due to their multiple handicaps. The single-word receptive vocabulary of a 17-year-old patient with Cerebral Palsy (CP) and three age-matched controls was measured using an event-related potential (ERP) paradigm. The Peabody Picture Vocabulary Test-Revised (PPVT-R) was adapted for computer presentation, with three levels of difficulty (Preschool, Child, Adult). Individual pictures were presented successively, and correctly (congruent) or incorrectly (incongruent) named auditorially. ERP components were derived for both the congruent and incongruent picture-word pairs. As predicted, the N400 ERP component had a higher peak for the incongruent picture-word pairs at the Preschool and Child levels. At the Adult level, the ERP pattern was reversed (higher peak in congruent condition) for the CP patient and for two of the three controls and, it was substantially attenuated for the third control. These ERP findings indicated that picture-word pairs within the range of acquired receptive vocabulary were identified as correct or incorrect but picture-word pairs above an individual's level could not be differentiated as clearly. The findings demonstrate the clinical application of this paradigm to assessing receptive vocabulary in motor- and communication-impaired patients.

Adolescent↗

eVOC: a controlled vocabulary for unifying gene expression data.

Expression data contribute significantly to the biological value of the sequenced human genome, providing extensive information about gene structure and the pattern of gene expression. ESTs, together with SAGE libraries and microarray experiment information, provide a broad and rich view of the transcriptome. However, it is difficult to perform large-scale expression mining of the data generated by these diverse experimental approaches. Not only is the data stored in disparate locations, but there is frequent ambiguity in the meaning of terms used to describe the source of the material used in the experiment. Untangling semantic differences between the data provided by different resources is therefore largely reliant on the domain knowledge of a human expert. We present here eVOC, a system which associates labelled target cDNAs for microarray experiments, or cDNA libraries and their associated transcripts with controlled terms in a set of hierarchical vocabularies. eVOC consists of four orthogonal controlled vocabularies suitable for describing the domains of human gene expression data including Anatomical System, Cell Type, Pathology and Developmental Stage. We have curated and annotated 7016 cDNA libraries represented in dbEST, as well as 104 SAGE libraries,with expression information,and provide this as an integrated, public resource that allows the linking of transcripts and libraries with expression terms. Both the vocabularies and the vocabulary-annotated libraries can be retrieved from http://www.sanbi.ac.za/evoc/. Several groups are involved in developing this resource with the aim of unifying transcript expression information.

Animals↗

Chronological age, receptive vocabulary, and syntax comprehension in children and adolescents with mental retardation.

This study was designed to examine the association of CA with syntax and vocabulary comprehension in children and adolescents with mental retardation. It was conducted using the PPVT-R and the Test for Reception of Grammar. The cognitive level of participants was estimated by means of three nonverbal intelligence tests. Results indicated that scores on intelligence tests account for 55% and 29% of the variability of syntax and vocabulary scores, respectively. For the vocabulary, the introduction of CA into the regression equation produced a significant increment of the variance explained (17%). However, its contribution to the variance of the syntax test was not significant. This finding suggests that CA-related experience is linked to on the receptive vocabulary of children and adolescents with mental retardation.

Adolescent↗

[Verification of the performance of oralized hearing impaired children in a vocabulary test].

BACKGROUND: Expressive vocabulary of hearing impaired children. AIM: To verify the performance of a group of children with hearing impairment in an expressive vocabulary test. METHOD: The Language Test for Young Children ABFW-Vocabulary was used in 21 children with moderately-severe to profound hearing losses. Children were divided in three groups according to their age: 3 to 4 years and 11 months; 5 to 6 years and 11 months; 7 to 8 years and 11 months. These children used predominately the linguistic oral code in order to communicate. RESULTS: All of the groups presented a higher number of correct answers and substitution processes when compared to the number of non-designations. Overall, children with ages between 7 and 8 years and 11 months presented a better performance than those with ages between 3 and 4 years and 11 moths, and with ages between 5 and 6 years and 11 months. Both of these groups presented similar performances. CONCLUSION: Children presented better performances in the semantic fields of animals, means of transportation and shapes and colors; older children demonstrated to have a greater knowledge of words in most of the tested semantic fields. The ABFW Vocabulary Test identified the semantic fields in which children present a greater or lower domain, as well as the identification of the strategies that hearing impaired children use when trying to name an object. These information allow speech-language pathologists to emphasize the semantic fields that are less known to the children and to explore characteristics and attributes of those objects that are already known by them before their presentation.

Age Distribution↗

Normative implications of the relationship between reading vocabulary and Boston Naming Test performance.

The 60-item Boston Naming Test (BNT) was published in 1983 with norms described as provisional. One recent finding (Thompson & Heaton, 1989) suggests that verbal intelligence, and the Wechsler Adult Intelligence Scale (WA1S)-Revised Vocabulary subtest, in particular, is strongly correlated with BNT performance, and that education is moderately so. High false-positive rates for naming deficit may conceivably result from the application of the published norms with subjects of lower verbal abilities or limited educational backgrounds. To further explore the relationship of naming to other verbal abilities, analyses were undertaken of the correlations between Level 7-9 Gates-MacGinite Reading Vocabulary Test (G-MRVT) and BNT data from 97 schizophrenic, bipolar, and normal subjects. Reading vocabulary is strongly correlated with BNT performance, and the nature of this relationship is essentially the same across the three diagnostic groups. Application of the published norms would have resulted in a high false-positive rate for naming deficit in all groups among subjects with reading vocabularies equivalent to twelfth grade or less. As a word-recognition based reading exercise, the G-MRVT is likely to provide a brain-compromise-resistant index against which the adequacy of naming performances can be assessed. Accordingly, G-MRVT based BNT performance expectation guidelines are presented for use as a complement to the published norms. Other implications are discussed.

Journal Article↗

Coping with changing controlled vocabularies.

For the foreseeable future, controlled medical vocabularies will be in a constant state of development, expansion and refinement. Changes in controlled vocabularies must be reconciled with historical patient information which is coded using those vocabularies and stored in clinical databases. This paper explores the kinds of changes that can occur in controlled vocabularies, including adding terms (simple additions, refinements, redundancy and disambiguation), deleting terms, changing terms (major and minor name changes), and other special situations (obsolescence, discovering redundancy, and precoordination). Examples are drawn from actual changes appearing in the 1993 update to the International Classification of Diseases (ICD9-CM). The methods being used at Columbia-Presbyterian Medical Center to reconcile its Medical Entities Dictionary and its clinical database are discussed.

Medical Records Systems, Computerized↗

A clinical study of the automated assessment of intelligence by the Mill Hill Vocabulary test and the Standard Progressive Matrices test.

As part of the Leicester/DHSS project on microcomputer-aided assessment, 274 patients at five clinical sites were assessed with either a computerized version or the standard version of the Mill Hill Vocabulary (Synonyms) test. Of this group, 178 were retested on the alternative version of the test. Similarly, 184 patients were tested with either a computerized version or the standard version of the Standard Progressive Matrices test, of whom 129 were retested on the alternative test form. High correlations were found between the standard and computerized versions for both tests. For the Mill Hill Vocabulary test, no significant difference was found between test versions for first administration, and the vast majority of retested subjects had very similar scores on each version. On the Standard Progressive Matrices, however, subjects obtained significantly lower scores on the computerized test. It is concluded that whereas the computerized Mill Hill Vocabulary test could be used in place of the standard version of clinical settings, the computerized Standard Progressive Matrices test could not be used.

Adolescent↗

Processing open and closed class-headed nonwords: left hemisphere support for separate vocabularies.

Evidence from studies of sentence production and comprehension points to a distinction between the open and closed class vocabularies. Data from the neurologically impaired suggest the left hemisphere selectively supports this distinction. This study further examines the vocabulary distinction by presenting to the different visual hemifields nonwords embedded with open or closed class portions, and asking normal subjects to make lexical decisions. Results indicate the vocabulary distinction is evident with RVF, but not LVF, presentations. This is discussed in terms of the use to which open and closed class words are put in sentence processing and also bears on the issue of the distinct cognitive styles associated with the different cerebral hemispheres.

Adult↗

Theoretical and methodological implications of language experience and vocabulary skill: priming of strongly and weakly associated words.

The effect of second language experience and vocabulary ability was investigated in a semantic priming experiment with weakly related English word pairs (e.g., city-grass). Participants made lexical decisions to targets preceded by unrelated or weakly related primes or to nonword targets preceded by words. Reliable priming was found for monolingual participants; participants who had acquired a second language showed either marginal or nonreliable effects. A similar pattern of results was found with the analysis of vocabulary ability. Only participants with the greater vocabulary ability showed a priming effect. Although previous research has shown that participants with a broad range of linguistic backgrounds demonstrate the typical semantic priming effect (e.g., green-grass) with strongly associated word pairs, weaker relationships seem to require an extensive contextual history for retrieval.

Adult↗

Qualitative assessment of the International Classification of Functioning, Disability, and Health with respect to the desiderata for controlled medical vocabularies.

BACKGROUND: The International Classification of Functioning, Disability, and Health (ICF), a classification system published in 2001 by the World Health Organization (WHO), provides a common language and framework for describing functional status information (FSI) in health records. METHODS: Informed by ongoing research in coding FSI in patient records, this paper qualitatively assesses the ICF framework with respect to the desiderata for controlled medical vocabularies, an enumerated a list of desirable qualities for controlled medical vocabularies proposed by Cimino [J.J. Cimino, Desiderata for controlled medical vocabularies in the twenty-first century, Meth. Inform. Med. 37 (1998) 394-403]. RESULTS: The ICF satisfies 5 of the 12 desiderata. Five points were not satisfied and two points could not be evaluated. CONCLUSION: The ICF is a rich source of relevant terms, concepts, and relationships, but it was not developed in consideration of requirements for formal terminologies. Therefore, it could serve as a base from which to develop a formal terminology of functioning and disability. This assessment is a key next step in the development of the ICF as a sensitive, universal measure of functional status.

Decision Support Techniques↗