Semantic Features of an Enterprise Interface Terminology for SNOMED RT

OBJECTIVE To evaluate the utility of SNOMED RT in support of a natural language interface for encoding of clinical assessments. METHOD Using a random sample of clinical terms from the UNMC Lexicon, I mapped the terminology into canonical data entries using SNOMED RT. Working from the source term language, I evaluated lexical mapping to the SNOMED term set, and the function of the SNOMED RT semantic network in support of a language-based clinical coding interface. RESULTS Ambiguity in the source terms was low at 0.3%. Lexical (language-based) mapping could account for only 48.8% of meaning from the source terms. The RT semantic network accounted for 39.5% of meaning, and supplementing the lexical map this led to 80.2% capture of source content. Error rates in the segment of RT which I reviewed were low at 0.6%. 97.6% of source content could be accurately captured in SNOMED RT. CONCLUSION SNOMED RT supported an accurate and reliable representation of clinical assessment data in this sample. The semantic network of RT substantially enhanced the encoding of concepts relative to lexical mapping. However these data suggest that natural language encoding with SNOMED RT in an enterprise environment is unlikely at this time.

[1]  P Carpenter,et al.  Phase II evaluation of clinical coding schemes: completeness, taxonomy, mapping, definitions, and clarity. CPRI Work Group on Codes and Structures. , 1997, Journal of the American Medical Informatics Association : JAMIA.

[2]  James R. Campbell,et al.  Just-in-time coding of the problem list in a clinical environment , 1998, AMIA.

[3]  Stannard Cf Clinical terms project: a coding system for clinicians. , 1994 .

[4]  A Rector,et al.  Practical development of re-usable terminologies: GALEN-IN-USE and the GALEN Organisation. , 1998, International journal of medical informatics.

[5]  D J Rothwell,et al.  Developing a standard data structure for medical language--the SNOMED proposal. , 1993, Proceedings. Symposium on Computer Applications in Medical Care.

[6]  Mark A. Musen,et al.  Research Paper: A Logical Foundation for Representation of Clinical Data , 1994, J. Am. Medical Informatics Assoc..

[7]  A T McCray,et al.  The Nature of Lexical Knowledge , 1998, Methods of Information in Medicine.

[8]  Y. Lussier,et al.  The SNOMED Model: A Knowledge Source for the Controlled Terminology of the Computerized Patient Record , 1998, Methods of Information in Medicine.

[9]  A L Rector,et al.  The GALEN project. , 1994, Computer methods and programs in biomedicine.

[10]  Alexa T. McCray,et al.  Research Paper: Evaluating the Coverage of Controlled Health Data Terminologies: Report on the Results of the NLM/AHCPR Large Scale Vocabulary Test , 1997, J. Am. Medical Informatics Assoc..

[11]  Kent A. Spackman,et al.  SNOMED RT: a reference terminology for health care , 1997, AMIA.

[12]  C Payne,et al.  Read Codes Version 3: A User Led Terminology , 1995, Methods of Information in Medicine.

[13]  C. Stannard Clinical terms project: a coding system for clinicians. , 1994, British journal of hospital medicine.

[14]  Kent A. Spackman,et al.  Compositional concept representation using SNOMED: towards further convergence of clinical terminologies , 1998, AMIA.

[15]  C. Chute,et al.  The content coverage of clinical classifications. For The Computer-Based Patient Record Institute's Work Group on Codes & Structures. , 1996, Journal of the American Medical Informatics Association : JAMIA.

[16]  James R. Campbell,et al.  n Phase II Evaluation of Clinical Coding Schemes : Completeness , Taxonomy , Mapping , Definitions , and Clarity , 2022 .