Ontology Resources - SNOMED
2011-07-30 09:13阅读：
What does it cover?
- The Systematized Nomenclature of Medicine Clinical Terms
(SNOMED CT) Ontology includes “a Core terminology of over 364,000
health care concepts with unique meanings and formal logic—based
definitions organized into hierarchies. As of January 2005, the
fully populated table with unique descriptions for each concept
contains more than 984,000 descriptions. Approximately 1.45 million
semantic relationships exist to enable reliability and consistency
of data retrieval. It is available in English, Spanish and German
language editions.”
- The primary goal is to advance “patient care through the
delivery of a dynamic and sustainable, scientifically validated
terminology and infrastructure that enables clinicians, researchers
and patients to share health care knowledge worldwide, across
clinical specialties and sites of care.”
- National government agreements with NLM (UMLS Metathesaurus)
and NPfIT (UK)
- Pri
mary concept hierarchies include clinical findings, procedures,
body structure, etc. These are linked by IS-A and attribute (such
as associated morphology, body structure—part of…)
relationships.
Curating authority/Who maintains it?
- SNOMED International: College of American Pathologists (CAP);
clinical content experts; medical informatics experts; United
Kingdom's National Health Service representatives; liaisons from
clinical specialties and government agencies; professional medical
translators, editors and validators; physicians and nurses; a
Scientific Director; and external stakeholders.http://www.snomed.org/about/organization.html
- Working groups also exist for various components (e.g., Mapping
or Nursing).
- UMLS links contains the active core content of SNOMED CT
Primary citation:
SNOMED International [
http://www.snomed.org/]
What is its structure?
- Core content includes the concepts table, descriptions table,
relationships table, history table, an ICD-9-CM mapping, and the
Technical Reference Guide. Can map to other medical terminologies
and classification systems already in use.
- Over 366,170 concepts with unique meanings and formal
logic-based definitions organized into 18 hierarchies (see end of
sheet for entire table). http://www.snomed.org/snomedct/documents/July05_CT_FactSheet.pdf
- Contains more than 993,420 English language descriptions or
synonyms for flexibility in expressing clinical concepts.
For example:Concept Fully Specified Name=Pain in
throat (finding) à Associated Descriptions= Sore throat, Throat
pain, Pain in pharynx, Throat discomfort, Pharyngeal pain, Throat
soreness
- Approximately 1.46 million semantic relationships:
- IS-A (within single hierarchy)
- Attribute relationships (connects concepts in different
hierarchies; see end for full table): e.g., Disorder & Finding;
Body Structure; Context; Measurement Procedures; Procedure'
Specimen; Additional attributes
- It is meant to be complementary to LOINC (Logical Observations
Identifiers, Names, Codes), another clinical terminology important
for laboratory test orders and results.
What process is used to construct and maintain it?
'As an American National Standards Institute (ANSI) approved
standards developer, the College of American Pathologists has
committed to a review process that incorporates ANSI's minimum due
process requirements. Recognition of the SNOMED CT structure as an
approved ANSI standard was received on September 30, 2003.'
The SNOMED CT development process incorporates the efforts of a
team of internal and external modelers. A documented scientific
process is followed that
focuses on understandability,
reproducibility and usefulness. Content is defined and
reviewed by multiple clinician editors, with additional experts
being consulted as necessary to review the scientific integrity of
the content.
The quality control process is continuously supplemented by
feedback from users. Parallel to domain specialist review, U.S. and
U.K. editors continue to review the content and are actively making
adjustments and refinements as needed.
Expert Input: The College of American
Pathologists (CAP); clinical content experts; medical informatics
experts from the U.S. and the United Kingdom 's National Health
Service; professional medical translators, editors and validators;
physicians; and nurses. These individuals bring expertise in
national and international standards, medical informatics, software
development and implementation, database licensing, biotechnology,
clinical and academic medicine, managed care, laboratory medicine,
pharmacy, nursing, education and database services.
Working Groups: An open terminology development
process supports working groups providing input about the direction
of the terminology to a detailed review of specific nomenclature
domains.
How is it currently used?
Essentially used in human healthcare fields:
- “Electronic medical records, ICU monitoring, clinical decision
support, medical research studies, clinical trials, computerized
physician order entry, disease surveillance, image indexing and
consumer health information services. Beyond electronic medical
records, the terminology is used for physician ordering of drugs
and lab tests, genomic databases, telemedicine, public health
reporting, and clinical research. Sharing of data will increase the
accuracy of clinical documentation, facilitate clinical decision
support, and improve patient safety and enhance clinical
outcomes.”
- “SNOMED CT will help structure and computerize the medical
record, reducing the variability in the way data is captured,
encoded and used for clinical care of patients and medical
research. For patients, that means that doctors and other
care providers are more likely to have information about a
patient's medical history, illnesses, treatments, and laboratory
results at their fingertips, whenever it is needed. A care provider
can more easily send to and receive electronic information from
another health care practitioner to deliver the best patient care
possible.”
An example in Radiology/Imaging:
“imaging-related content provides broad representation of
the procedures, drugs (such as contrast materials), anatomical
structures, and findings specific to clinical imaging.… Through
SNOMED's collaboration with DICOM (Digital Imaging and
Communication in Medicine), and to an increasing degree with RSNA
(Radiologic Society of North America), we are working toward a
single, convergent, widely accepted terminology representing the
imaging domain. SNOMED hosts the quarterly Structured Reporting
Working Group meetings of DICOM. As terminology content is added to
the DICOM standard, it also added to SNOMED.”
- Single contrast barium enema (procedure)
Defining characteristics
- Imaging (action)
- Large intestinal structure (body structure)
- Barium sulfate (substance)
- Filling defect (finding)
- Malignant tumor of colon (disorder)
Defining characteristics
- Malignant tumor (disorder)
- Malignant neoplasm of primary, secondary, or uncertain origin
(morphology)
- Colon structure (body structure)
How can BIRN benefit?
A. Within a Test Bed:
Potentially provides 1) an anatomical term set for the human body,
esp. the brain (Body Structure concept hierarchy); 2) clinical
assessment terms for human psychiatric conditions (Staging and
Scales concept hierarchy); and potential source of disorders
terminology with links to anatomical terms (Disorder and
Finding/Associated Morphology).
B. Across Test-Beds:
Items in A will be relevant to both morph and function BIRN, and
can be set up similarly (with first reviews to incorporate
schizophrenia and Alzheimer's disease related terms). The
anatomical terms and disorders may be relevant to matching with
mouse BIRN.
18 hierarchies of concepts
Clinical Finding:
• Finding (Swelling of arm)
• Disease (Pneumonia)
|
Linkage concept
• Link assertion (Has etiology)
• Attributes (Finding site) |
| Procedure/intervention
(Biopsy of lung) |
Physical object (Suture
needle) |
| Observable entity (Tumor
stage) |
Physical force
(Friction) |
| Body structure (Structure
of thyroid) |
Events (Flash
flood) |
| Organism (DNA
virus) |
Environments/geographical locations
(Intensive care unit) |
| Substance (Gastric
acid) |
Social context (Organ
donor) |
| Pharmaceutical/biologic product
(Tamoxifen) |
Context-dependent categories
(No nausea) |
| Specimen (Urine
specimen) |
Staging and scales
(Nottingham ten-point ADL index) |
| Qualifier value
(Bilateral) |
Special concept (Inactive
concept) |
All Attributes
| Disorder and Finding (Clinical
Finding) |
Body Structure |
Procedure |
Specimen |
| Finding Site |
Laterality |
Procedure Site |
Specimen Procedure |
| Associated With/• After/• Causative
Agent/• Due To |
Part of |
Procedure Device |
Specimen Source Topography |
| Associated Morphology |
Context |
Procedure Morphology • Direct /•
Indirect |
Specimen Source Morphology |
| Severity |
Associated Finding |
Method |
Specimen Substance |
| Onset |
Associated Procedure |
Direct Substance |
Specimen Source Identity |
| Course |
Finding Context |
Using |
Additional Attributes |
| Episodicity |
Procedure Context |
Access |
Has Active Ingredient |
| Interprets |
Subject Relationship Context |
Approach |
Associated Finding |
| Has Interpretation |
Temporal Context |
Priority |
|
| Pathological Process |
Measurement Procedure |
Has Focus |
|
| Has Definitional Manifestation |
Has Measurement Component |
Has Intent |
|
| Occurrence |
Measurement Method |
Recipient Category |
|
| Stage |
Has Specimen |
Access Instrument |
|
| Subject of Information |
Time Aspect |
Revision Status |
|
|
Property |
Has Specimen |
|
|
Scale Type |
Component |
