Multilingual hYpertextual Thesauri for Healthcare
copyright 1999-2001 by CNR-ITBM
Experimental IntraText pages for the presentation of Multilingual Hypertextual Thesauri for Healthcare.
You are authorized to browse and download the following pages for evaluation purpose and are strongly requested to provide a detailed feedback.
WARNING: these pages reuse non-stable knowledge prepared for other tasks, and are not intended to be used in production settings, because they still contain imprecisions and errors.
We will appreciate any comment and suggestion for improvements.
About contents please contact the MYTH Project leader Angelo Rossi Mori at CNR.
About IntraText for terminology please contact Nicola Mastidoro at Eulogos.
Here we present a set of narrow thesauri on the following topics:
Our goal is not to integrate them, but just to provide a uniform presentation tool for different initiatives, in order to
- IntraText Custom: SURGICAL PROCEDURES from GALEN-IN-USE
[Download the whole IntraText Custom]
- IntraText CT: NURSING from the Short Strategic Study for CEN/TC251
- IntraText Custom: NURSING from the Short Strategic Study for CEN/TC251
[Download 990503-Nursing.zip, 82K]
- ARCHETYPES OF SITUATIONS for clinical information, from CEN/TC251/PT27
[Download the whole IntraText Custom]
- facilitate the work of the domain experts in these initiatives,
- support a limited Quality Assurance on the content of each thesaurus,
- diffuse the principles behind the intermediate representation in GALEN and the CEN/TC251/WG II approach
- experiment with the issues of intuitive presentation of the knowledge of the thesaurus, to remove the barriers of the formalisms and the unnecessary complexities for new domain experts
The thesauri are a component of a larger process of systematic representation of healthcare expressions, that we briefly describe below.
The process is being used to produce various standards in CEN/TC251 Health Informatics  and it is a part of the more complete process developed within the GALEN project [15, 23, 30, 31, 32, 33, 36].
It consists on the analysis of terminological systems from different sources, according to a cooperative methodology [21, 22, 37, 42] that is based on a foundation standard .
The goal is to produce a substrate to facilitate maintenance of the individual systems and their gradual convergence.
The principles of the approach are:
- the process is iterative, with a progressive refinement gradually involving more experts, more terminological systems and more entries from each system.
- within each cycle of iteration, analytic views (entry by entry) alternates with global views (by grouping and comparing set of entries with common features)
- each original entry is de-coupled from the original context, by the production of an "interpretation", i.e. an expression that makes the original context explicit
- each interpretation is systematically represented by a "dissection", i.e. a semantic network made of descriptors and semantic links. The dissection is a complete representation of the interpretation (i.e., if two dissections are equal, the respective interpretations are considered as synonyms).
- all descriptors used in the dissections come from a "cross-thesaurus". The cross-thesaurus is agreed among the experts before each cycle, and is gradually refined during each cycle according to the evolution of the dissections. The cross-thesaurus assures the coherence among the dissections produced by different experts, allowing for decentralised developments. Descriptors are grouped into semantic categories (i.e. facets of the cross-thesaurus).
- combinatorial rules among semantic links and semantic categories are described by a categorial structure. Categorial structures in the different subject fields are developed by the experts of the field and become standards in CEN/TC251 Health Informatics.
- categorial structures, cross-thesauri and dissections are the main components of a second generation of terminological systems spontaneously appearing in healthcare [3, 4, 19, 27, 28, 41, 51] .
- a dissection is similar to an intensional definition (superordinate concept + differentiating characteristics), but concepts are taken from the cross-thesaurus and the combination obeys to a categorial structure. Most original entries in healthcare are terminological phrases relevant for a particular goal, made of many words (similarly to classes and attributes in a model).
- the process was used so far to model terminological systems (e.g. on surgical procedures, vital signs, medical devices, nursing diagnoses and interventions, laboratory properties).
Recently we started modelling the structures in the patient record [1, 26, 34, 38, 39, 40, 43, 44, 45, 46, 47, 48] and the models for information systems. In fact, this topic is now crucial for integration of terminologies, health records and data dictionaries [2, 6, 10, 12, 17, 24, 25, 40, 53].
For the modelling of clinical information, we added a step for the normalisation of the interpretations, working out the clinical situation (patient's state, non-healthcare event, or healthcare activity) referred by the entry. We then focussed the process on clinical situations instead on the original entries.
Our goal was in fact to understand and model the nature of clinical information (see the thesaurus on the archetypes of situations, above, taken from ).
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CEN ENV 12265. Medical Informatics — Electronic Healthcare Record Architecture. Brussels: CEN, 1997
CEN ENV 12611. Medical informatics — Categorial structure of systems of concepts — Medical devices. Brussels: CEN, 1996
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CEN prENV 13606-4 Health informatics — Communication of Electronic Health Care Record — Part 4: Messages. Brussels: CEN, 1999
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CEN/TC 251/PT5-021 Vital Signs Information Representation, Final document for Formal Vote (FFV), 1998
Ceusters W., Rogers J, Rossi Mori A et al. Syntactic-semantic tagging as a mediator between linguistic representations and formal modals: an exercise in linking SNOMED to GALEN. Artificial Intelligence in Medicine 1999, 15(1): 5--24.
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Dessena S, Rossi Mori A, Galeazzi E. Development of a cross-thesaurus with Internet-based refinement supported by UMLS. Int J Med Inform 1999; 53:29-41
DICOM. Supplement 23 : Structured Reporting (Frozen Draft for Trial Use) Version 0.97. 1997. Available from http://dumccss.mc.duke.edu/standards/HL7/sigs/image-management/HTML/dicom-home.html
Extensible Markup Language (XML) 1.0 Specification. Available from http://www.w3.org/TR/
Galeazzi E, Rossi Mori A, Consorti F, Errera A. MEDITA: the reference methodology for cooperative production of dissections by terminological analysis. GALEN-IN-USE, report MET01/97, May 1997
Galeazzi E, Rossi Mori A, Consorti F, Errera A. A cooperative methodology to build conceptual models in medicine In: MIE 97, IOS Press 1997
GALEN and GALEN-IN-USE. documentation (1992-98), available from AL Rector, Med. Inform. Group, Dept. Computer Science, Univ. Manchester, Manchester M13 9 PL, UK, http://www.cs.man.ac.uk/mig/galen and http://www.cs.man.ac.uk/mig/giu
Health Level 7 (HL7) Documentation. Available from http://www.mcis.duke.edu/standards/HL7/hl7.htm
HL7 Decision Support SIG. Charter. Available from http://www.mcis.duke.edu/standards/HL7/committees/quality-assurance/missions/sigdecis.htm
HL7 SGML/XML Special Interest Group. The Kona architecture proposal. Available from http://www.mcis.duke.edu/standards/HL7/committees/sgml/kona.htm
LOINC Committee. Logical Observation Identifiers, Names and Codes (LOINC™), 1998. Available from http://dumccss.mc.duke.edu/standards/termcode/loinc.htm
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Rector A, Zanstra P, Solomon D, Rogers J, Baud R, Ceusters W, Claassen W, Kirby J, Rodrigues JM, Rossi Mori A, van der Haring EJ, Wagner J. Reconciling Users' Needs and Formal Requirements: Issues in Developing a Reusable Ontology for Medicine. IEEE Transactions on Information Technology in Biomedicine, 1998; vol.2, 4:229-242
Rector AL, Rossi Mori A, Consorti F, Zanstra P Practical Development of Re-usable Terminologies: GALEN-IN-USE and the GALEN Organization, in: Working Conf. of IMIA WG16, Bermuda, Sept 1997
Rector, A., Rossi Mori A et al. Making sound re-usable terminology practical: The GALEN approach. in Proceedings of "Towards and Electronic Health Care Record, Europe", London 1998, Medical Records Institute, Newton Mass.
Rector, A., Rossi Mori A et al. Practical development of re-usable terminologies: GALEN-IN-USE and the GALEN Organisation. International Journal of Medical Informatics 1998, 48(1-3): 71-84.
Ricci FL, Rossi Mori A, Consorti F. Purposive views in patient records: influence on reuse of clinical information and interoperability, in: Proceedings of the International Working Conference "Electronic Patient Records in Medical Practice", Rotterdam, 8-10 October 1998
Ristrøm L, Rossi Mori A. Development of a standard for the organization of medical device nomenclatures. In: Brender J et al, editors. Medical Informatics Europe '96. Amsterdam: IOS Press; 1996. p., 259-63
Rodrigues JM, Trombert-Paviot B, Baud R, Wagner J, Rusch P and Meusnier F. Galen-In-Use: An EU Project applied to the development of a new National coding system for surgical procedures. In: Pappas C et al, editors. Medical Informatics Europe '97. Amsterdam: IOS Press, 1997. p. 897-901
Rogers JR, Solomon Wd, Rector AL, Pole P, Zanstra P, van der Haring E. Rubrics to dissections to GRAIL to classifications. In: Pappas C et al, editors. Medical Informatics Europe '97. Amsterdam: IOS Press, 1997 p. 241-5
Rossi Mori A, Consorti F Exploiting the terminological approach from CENTC251 to support interoperability of health record systems. International Journal of Medical Informatics 1997 48(1-3): 111-124.
Rossi Mori A, Consorti F Integration of clinical information across patient records: a comparison of mechanisms used to enforce semantic coherence IEEE Transactions on Information Technology in Biomedicine, 1998; vol.2, 4:243-253
Rossi Mori A, Consorti F, editors. . Discussion Documents for the Second Tomelo Workshop (an European Project) . Available from http://www.ehm.kun.nl/tomelo/#Workshops
Rossi Mori A, Consorti F, Galeazzi E and Merialdo P. A second generation of terminological systems is coming. In: Pappas C et al, editors. Medical Informatics Europe '97. Amsterdam: IOS Press, 1997. p.436-40. See also http://win.irmkant.rm.cnr.it/termhome.htm
Rossi Mori A, Consorti F, Galeazzi E Standards to support development of terminological systems for healthcare telematics. Meth Inform Med 1998; 37: 551-563
Rossi Mori A, Consorti F, Galeazzi E. A system of semantic tags to mediate between terminology and structure of patient records in: Proceedings of the International Working Conference "Electronic Patient Records in Medical Practice", Rotterdam, 8-10 October 1998
Rossi Mori A, Consorti F, Galeazzi E. A tagging system for section headings in a CEN standard on patient record, JAMIA symp. suppl., 1998
Rossi Mori A, Consorti F. An European Standard about Structures of Clinical Information in Patient Records. in: Proceedings of the Eurorec Conference, Sevilla, 6-7 May 1999
Rossi Mori A, Consorti F. Meta-analysis of clinical documents for principled markup of Medical Records. in: Proceedings of the Conference "XML Europe '99", Granada, 26-30 April 1999
Rossi Mori A, Consorti F. Structures of Clinical Information in Patient Records accepted for presentation at the AMIA '99 Annual Symposium, Washington, 6-10 Nov 1999
Rossi Mori A, Galeazzi E, Consorti F, Bidgood WD Conceptual schemata for terminology: a continuum from headings to values in patient records and messages JAMIA symp. suppl., 1997:650-4
Rossi Mori A, Gangemi A, Steve G, Consorti F, Galeazzi E. An Ontological Analysis of Surgical Deeds, in Keravnou E et al (eds), Artificial Intelligence In Medicine, Springer Verlag, 1997, 361-372
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- Alschuler L, Brennan S, Rossi Mori A, Sokolowski R, Dudeck J. SGML/XML in Healthcare Information Exchange Standards. in: Proceedings of the Conference "SGML/XML Europe '98", Paris, 17-21 May 1998
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