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PubMed2000

Guideline classification to assist modeling, authoring, implementation and retrieval.

The National Guideline Clearinghouse (NGC) and its guideline classification system are significant contributions to the study of clinical practice guidelines (CPGs) and their incorporation into routine clinical care. The NGC classification system is primarily designed to support guideline retrieval. We believe that a guideline classification system should also support identification of features that relate to incorporation of executable CPGs into computer-based applications for sharing and delivering guideline-based advice. We have developed a proposed expansion of the NGC guideline classification for this purpose. The axes of the proposed scheme have implications for designing formal models and structures for representing and authoring CPGs. This scheme also has implications for future research.

Classification↗
PubMed2001

A survey to identify the clinical coding and classification systems currently in use across Europe.

INTRODUCTION: This is a survey to identify what clinical coding systems are currently in use across the European Union, and the states seeking membership to it. We sought to identify what systems are currently used and to what extent they were subject to local adaptation. BACKGROUND: Clinical coding should facilitate identifying key medical events in a computerised medical record, and aggregating information across groups of records. The emerging new driver is as the enabler of the life-long computerised medical record. A prerequisite for this level of functionality is the transfer of information between different computer systems. This transfer can be facilitated either by working on the interoperability problems between disparate systems or by harmonising the underlying data. This paper examines the extent to which the latter has occurred across Europe. METHOD: Literature and Internet search. Requests for information via electronic mail to pan-European mailing lists of health informatics professionals. RESULTS: Coding systems are now a de facto part of health information systems across Europe. There are relatively few coding systems in existence across Europe. ICD9 and ICD 10, ICPC and Read were the most established. However the local adaptation of these classification systems either on a by country or by computer software manufacturer basis; significantly reduces the ability for the meaning coded with patients computer records to be easily transferred from one medical record system to another. CONCLUSIONS: There is no longer any debate as to whether a coding or classification system should be used. Convergence of different classifications systems should be encouraged. Countries and computer manufacturers within the EU should be encouraged to stop making local modifications to coding and classification systems, as this practice risks significantly slowing progress towards easy transfer of records between computer systems.

Classification↗
PubMed2002

[Advances in research on ecological land classification].

Land classification is the base of land evaluation, land planning and land management, and plays an important role in the sustainable development of forestry resource. Ecological land classification (ELC) is the main approuch and direction of land classification. Along with the development of landscape ecology and 3S techniques, developing of ecological classification system (ECS) becomes the keystone of ELC. The definition, history, basic characteristics of ELC, the theory of ECS and its' prospects were systematically reviewed in this paper. The prospects were also described for the development of ECS methodology and the application of ELC. The general direction of ecological land research, which was a multi-factors and multi-levels syntheses based on the multi-objects administration of resource (forest, land and waters), was the combination of quantificational and qualitative research. It is necessary to carry out relevant researches in China.

China↗
PubMed2003

The myelodysplastic syndromes: classification and prognosis.

Myelodysplastic syndrome is a neoplastic clonal stem cell disorder characterized clinically by bone marrow failure and a tendency to progress to acute myelogenous leukemia. Dysplasia is the pathologic hallmark. The French-American-British classification served as the gold standard for more than two decades. Under the auspice of the World Health Organization, more than 100 hematopathologists in a 3-year cumulative effort issued the new World Health Organization classification, which recognizes multilineage dysplasia. Refractory anemia with excess blasts is divided into two groups. Chronic myelomonocytic leukemia is reclassified under a separate category. Refractory anemia with excess blasts in the transformation group was omitted. Finally, 5q-syndrome is a new subgroup. In addition to the pathologic classification, various prognostic predictors were formatted into scoring systems. Bone marrow blast percentage, cytopenias, and cytogenetics are the backbone for those prognostic models. The International Prognostic Scoring System is a product of pooled data from previous scoring systems and a useful tool to predict survival and acute myelogenous leukemia evolution. This paper discusses the classification and prognosis of myelodysplastic syndromes and their evolution.

Classification↗
PubMed2006

ClaML: a standard for the electronic publication of classification coding schemes.

This paper proposes a number of revisions to CEN/TS 14463 (ClaML), which is a pre-standard mark-up language for the electronic publication of classification coding schemes. A CEN Taskforce in close collaboration with the WHO network carefully analysed 70 classifications from the healthcare domain. All were transformed in ClaML using a dedicated classification management tool. The proposal removes all formatting elements and adds a number of layout structuring elements. Several elements have been replaced by attributes to enforce internal consistency. A modest number of extensions are proposed to help users and authors in maintenance and version control. A pilot implementation has shown that ICD10 as one of the most complex traditional classifications can be adequately represented to produce quality printed output.

Forms and Records Control↗
PubMed1986

[Morphology and classification of cleft hands].

It is the intention of this study to present a more profound investigation of the morphology of cleft hands and to provide a new classification based on the results of that investigation. After a short review of the literature, which shows the different opinions regarding heredity, pathogenesis and classification of cleft hand, the authors demonstrate their own patients with 35 cleft hands: The deformities were mostly bilateral and associated with cleft feet. In unilateral cases the right side was more common. Males were in the majority. This paper puts emphasis on the analysis of X-ray morphology. The authors are able to demonstrate that the cleft hand shows several peculiarities which have not been yet sufficiently respected. It was found out, that, apart from aplasia of the bones and soft tissue, synostosis is often the origin of clefting. In 40% of our cases the cleft was caused exclusively by synostosis, in a further 34% it derived partly from synostosis of the phalanges and the metacarpal bones. In the carpus we found osseous deformities surprisingly often, a feature which has hardly been mentioned in former studies. Among the numerous associated malformations emphasis must be placed on the osseous syndactylies and the central polydactylies, because they are closely related to the cleft hand as shown by Ogino. 18 of our own cases belong to this group. Our investigations lead us to the following classification: Cleft hand type 1: Cleft hands with osseous defects (aplasias) Cleft hand type 2: Cleft hands with synostosis Cleft hand type 3: Cleft hands with aplasias and synostosis Hands with central polydactyly and synostosis as preforms of the cleft hand could be classified in type 4. These phenomena form the beginning of the teratological row towards the completely developed cleft hand. In combination with Blauth's distribution of cleft hands, who distinguished the median and medio-lateral form (1976, 1978) this new classification enables each cleft hand to be placed into one of the different types, which are analysed: Type 1 mostly shows a medio-lateral form, is always combined with cleft feet and shows heredity in 50% of the cases. It cannot be classified by the Ogino method. Type 2 mostly shows a median form, is not frequently combined with cleft feet, heredity occurs in one third of the cases. This type can very often be classified by the Ogino method. Type 3 varies from case to case because of the different items of defects.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMedDate not supplied

Current trends in the methodology of classification.

Classification is a fundamental cognitive activity of ordering the objects of the external and the internal (phenomenological) world into sets on the basis of their relationships. The strategies employed vary from the search of "focal essences" identifying natural classes to the purely statistical approach of numerical taxonomy. Medical classifications are eclectic and pragmatic, without clear predominance of any single strategy. In addition to having its share of the general problems of medical taxonomies, classification in psychiatry has to face the dilemma of classifying diseases or people and their problems. The implications of this for the 10th revision of ICD are examined, and criteria for a good classification are tentatively laid down.

Classification↗
PubMed1974

Classification systems used in medical libraries.

The present study identifies the classification systems used in 941 libraries. It explores the reasons behind the choice of the National Library of Medicine Classification by 589 libraries. Reclassification procedures were investigated through a questionnaire sent to twenty-five libraries that have changed to NLM since 1959. Statistics and replies are given on: the classification systems employed prior to reclassification; the use of broad or specific Library of Congress class numbers in the LC schedules outside the scope of the NLM schedules; the number of catalogers in each library doing the reclassification; the use of cut-off dates for retrospective materials; the adoption of MeSH headings; user preference; and cost differences. Chief reasons for the change to NLM proved to be local circumstances, currency, arrangement of subclasses by NLM, its dovetailing with the LC Classification, and reliance upon nationally centralized cataloging services.

Book Classification↗
PubMed1978

Optimal hierarchy as a means of increasing the flexibility of a morbidity classification system.

Established systems of problem or morbidity classification do not always meet special needs for higher levels of specificity in coding. Optional hierarchy is a mechanism that may be employed to achieve the desired specificity for local use while permitting recombination into parent rubrics for external comparisons. Optional hierarchy may be employed to develop subdivision rubrics when justified by the high incidence of specific problems, whether due to geographic or social circumstances or because of the special nature of individual practice(s). It may also be used to meet the sometimes esoteric needs of the researcher, the unique needs of the teacher, or the preferential needs of other individual recorders. While the development of subdivision rubrics is simple, care is required to avoid pitfalls in reversion to the parent rubric. Failure to ensure the accuracy of this reversion can destroy a fundamental purpose of morbidity classification--the intercenter comparison of data. Although this paper discusses the application of optional hierarchy to the International Classification of Health Problems in Primary Care (ICHPPC), it is equally useful in other systems of classification.

Classification↗
PubMed1995

Classification of the drainage patterns of the renal veins.

Variations in the drainage patterns of the renal veins are well described, but existing classifications of the renal veins have deficiencies. This study aimed to formulate a practical classification of their drainage patterns, taking into consideration the number of primary tributaries, additional renal veins and variations. The venous system of 306 kidneys (from 131 males and 22 females) obtained from 100 pairs of resin casts and 53 pairs of plastinated kidneys were analysed. Based on a proposed definition of the renal vein, 3 major types (I, II, III) were identified using the drainage pattern of the primary renal vein tributaries and the renal vein as a basis on both the left and right sides. Type IA occurred most frequently (38.6%) and was commoner on the left. Type IB was the second most frequent (25.2%), with the other types showing lower and similar frequencies (10.1-14.4%). Statistically significant differences were noted between the left and right kidneys with regard to the classification into the different types (P < 0.0001). The proposed classification system is practical and has surgical and uroradiological relevance.

Anatomy, Regional↗
PubMed1994

[The classification of human thermal states during overheating].

A classification of human heat states is based on mechanisms of changes in human temperature status. Quantitative integral criteria (factors F1, F2, F3) elaborated earlier are the main principles of classification, which reflect the mechanisms of temperature changes in various regions of human body exposed to overheating. The classification comprises 4 classes. The first two represent different levels of optimum state, the third one is upper allowable level of overheating, the fourth one--maximal level of overheating. The classification usable for diagnosis of human heat states varying from comfortable one to critical overheating.

Adult↗
PubMedDate not supplied

Consistency of sperm morphology classification methods.

The World Health Organization (WHO) recently suggested new morphometric dimensions for normal sperm heads and new sperm head classification rules. These specifications differ from previous WHO methods and from the Kruger method for strict morphology assessment. We analyzed the WHO and Kruger sperm classification rules to determine their appropriateness as predictive linear models. We reviewed the theoretical requirements for allometric modeling, a more traditional approach for specifying the size relationships between phenotypic characters, and developed valid allometric models based on the statistical properties of over 3,700 measurements of individual sperm head dimensions. We implemented the WHO, Kruger, and Allometric methods on the same set of digitized sperm heads to study the empirical consequences of different metric requirements and classification methods. Results show that the WHO and Kruger methods are internally consistent, but specify nonconstant variance. Hence, they are inappropriate linear models. The allometric models were internally consistent and specified constant variance. Hence, they are appropriate linear models. Significant differences were found in the percentage of normal sperm between the methods. On average, the Kruger method produced the lowest value and the Allometric methods produced significantly higher values than the WHO methods, but no average difference was found between WHO methods or between Allometric methods. Nevertheless, the percentage of normal sperm did change significantly for individual specimens. These results indicate that small differences in metric requirements and classification rules can dramatically change the percentage of normal sperm. Until more rigorous definitions of sperm features can be developed, and valid statistical models can be used to describe the population characteristics of fertile sperm, the prognostic value of sperm morphology is limited.

Classification↗
PubMed1994

[Medical coding and classification systems].

Medical coding and classification systems are expected to become increasingly important in the health care sector. Together with and as an integrated part of the electronic health information systems, the coding and classification systems will be used to improve the quality and effectiveness of the medical services. Activities connected to the different coding and classification systems are a very important component of the attempts at standardization taking place both in Norway and in the rest of Europe within the discipline medical informatics. These activities must be secured a proper professional and economic foundation. It is also of vital importance that national health authorities should participate in these activities and establish formal cooperation with professional bodies. In Norway, the Ministry of Health and Social Affairs has accepted with some miner modifications, our suggestion for a model where the Norwegian Medical Association would be responsible for the medical aspects of the coding and classification systems and for their development, and the Norwegian Centre for Medical Informatic's for organization, distribution, electronic version, integration in information systems and user assistance.

Classification↗
PubMed1976

Methodologic problems of common terminology, measurement, and classification. 11. Modifications and new approaches to taxonomy in long-term care: advantages and limitations of the ICD.

The primary advantage of an internationally accepted classification of diseases is that data from different countries and parts of the world can be compared and even pooled. Two basic conditions have to be fulfilled if the classification is to be used by a heterogeneous group of users and the data are to be compared: there must exist significant agreement on the content of categories, and the categories must be used in the agreed sense. A brief description is given of a WHO project that has attempted to satisfy these two conditions in the field of mental disorders. Additionally, taxonomy in long-term care requires that a classification should 1) be multiaxial and include certain nondisease as well as disease factors that affect treatment and outcome; 2) be a classification of individuals rather than of diseases and reflect the presence of multiple conditions and degrees of severity; 3) allow linkage of episodes of illness and care in the same individual; 4) be suitable for use by nonmedical personnel, who often play a decisive role in long-term care; and 5) be accompanied by glossaries giving operational terms suitable for reliability and validity tests.

Classification↗
PubMed1995

The challenge of an international classification of procedures in medicine.

This paper reviews the international developments with respect to the classification of medical procedures in light of recent work by CEN/TC251 and the situation in the Netherlands. The historical background is outlined, some advantages and disadvantages of ICPM are discussed, and some new initiatives are reported. Recent initiatives all tend towards the same sort of structure for the classification of medical procedures. So far, no international body is taking responsibility for the standardization of the contents of these structures. A questionnaire was sent out in order to investigate the existence or emergence of national coding centers, their wishes with respect to procedure classification, and their willingness to collaborate in the development and use of one international classification. The response to the questionnaire is briefly discussed and some further steps are proposed.

Classification↗
PubMed1998

Standardizing flow cytometry: a classification system of fluorescence standards used for flow cytometry.

The growing number of standards commercially available in the field of flow cytometry makes it difficult to know which standards to use to obtain a desired level of quality assurance. A classification system of fluorescence standards has been developed on the basis of their physical characteristics. In turn, these physical characteristics determine the ability of the specific standards to perform selected functions, such as alignment, target referencing, compensation, and calibration. Knowing the properties and limitations of specific standards will help flow cytometer users to select the appropriate standard for the application that they will be performing, especially in regard to intra- and interlaboratory quality assurance. Common protocols used in conjunction with specific classifications of reference standards can provide unified analysis regions or window of analysis across different instruments and/or laboratories. In addition, specific classifications of calibration standards can help select those standards that will provide independent and direct comparison of instrument performance parameters, especially in studies involving multiple laboratories. Knowledge and understanding of the classification system can guide flow cytometer users in more efficient and accurate instrument setup and quality control when conducting research, as well as clinical applications.

Calibration↗
PubMed2005

Computer classification of nonproliferative diabetic retinopathy.

OBJECTIVE: To propose methods for computer grading of the severity of 3 early lesions, namely, hemorrhages and microaneurysms, hard exudates, and cotton-wool spots, and classification of nonproliferative diabetic retinopathy (NPDR) based on these 3 types of lesions. METHODS: Using a computer diagnostic system developed earlier, the number of each of the 3 early lesions and the size of each lesion in the standard photographs were determined. Computer classification criteria were developed for the levels of individual lesions and for NPDR. Evaluation of the criteria was performed using 430 fundus images with normal retinas or any degree of retinopathy and 361 fundus images with no retinopathy or the 3 early lesions only. The results were compared with those of the graders at the University of Wisconsin Ocular Epidemiology Reading Center and an ophthalmologist. MAIN OUTCOME MEASURES: Agreement rates in the classification of NPDR between the computer system and human experts. RESULTS: In determining the severity levels of individual lesions, the agreement rates between the computer system and the reading center were 82.6%, 82.6%, and 88.3% using the 430 images and 85.3%, 87.5%, and 93.1% using the 361 images, respectively, for hemorrhages and microaneurysms, hard exudates, and cotton-wool spots. When the "questionable" category was excluded, the corresponding agreement rates were 86.5%, 92.3%, and 91.0% using the 430 images and 89.7%, 96.3%, and 97.4% using the 361 images. In classifying NPDR, the agreement rates between the computer system and the ophthalmologist were 81.7% using the 430 images and 83.5% using the 361 images. CONCLUSIONS: The proposed criteria for computer classification produced results that are comparable with those provided by human experts. With additional research, this computer system could become a useful clinical aid to physicians and a tool for screening, diagnosing, and classifying NPDR.

Aneurysm↗
PubMed2002

Attachment classifications among 18-month-old children of adolescent mothers.

OBJECTIVES: To determine (1) patterns of secure vs insecure attachment relationships in infants of adolescent and nonadolescent mothers and (2) if these patterns are mediated by parenting characteristics, including depression, self-esteem, parenting stress, child abuse potential, psychological distress, rating of infant temperament, and the caregiving environment. PARTICIPANTS: Fifty-one adolescent mothers and their 18-month-old infants were compared with 76 nonadolescent mothers and their 18-month-old infants. MAIN OUTCOME MEASURES: Infant attachment classifications were assessed via the Ainsworth Strange Situation. Maternal and infant characteristics were obtained through self-report measures. RESULTS: There were no differences in attachment classification between infants of adolescent mothers and nonadolescent mothers. Secure attachment classification was found in 67% of the infants of adolescent mothers and 62% of the infants of nonadolescent mothers. There were significant differences in the self-reported maternal characteristics. Adolescent mothers reported lower self-esteem (P<.05), more parenting stress (P<.05), more child abuse potential (P<.05), and provided a lower quality of home environment (P<.05) than nonadolescent mothers. Adolescent mothers also rated their infants as having a higher activity level (P<.05) than infants born to nonadolescent mothers. In multivariate analysis, none of these variables or social classes were found to affect attachment classification. CONCLUSIONS: Infants of adolescent and nonadolescent mothers show similar patterns of attachment. Adolescent and nonadolescent mothers show substantial differences in parenting characteristics and in how they rate their infants' temperaments. However, these differences do not seem to impair the infant-mother attachment relationship.

Adolescent↗