Concept-oriented Standardization and Statistics-oriented Classification: Continuing the Classification versus Nomenclature Controversy

Abstract

Nowadays, most activities on controlled medical vocabularies focus on the provision of a sufficient atomic-level granularity for representing clinical data. Amongst others, clinical vocabularies should be concept oriented, compositional and should also reject “Not Elsewhere Classified” [1]. We strongly share the opinion that there is a need to deal with serious deficits of existing manually created vocabularies and with new demands for computer-based advanced processing and exchange of medical language data. However, we do not share the opinion that methodological requirements like observational and structural comparability needed for sound statistics should not be included in desiderata of controlled medical vocabularies. Statistical-oriented classifications are not developed for representing detailed clinical data but for providing purposedependent classes where cases of interest are assigned uniquely. Either statistical classifications are not included into the set of controlled medical vocabularies in the sense of Cimino, or his desiderata are misleading. We argue that statistical classifications should be linked to (formal) concept systems, but again this linkage does not change their different natures. With this article we continue the “classification versus nomenclature” controversy referring to Cote [2].

Ontological and Non-Ontological Resources for Associating Medical Dictionary for Regulatory Activities Terms to SNOMED Clinical Terms With Semantic Properties

“…Such model brings several advantages such as improving the maintenance of large terminologies (Cimino et al, 1994), and formal definitions were implemented in several terminologies such as the NCI-Thesaurus (Hartel et al, 2005). Our approach is more in line with what is recommended by Ingenerf and Giere (1998), that is to say, to keep terminologies with disjoint classes required for statistics (in a clinical terminology, the same term may be present in several separate categories because of multiple inheritance and be counted more than once) and instead implement a mapping of terms of first-generation system to a formal system. This allows keeping the MedDRA terminology in its current format, counting ADRs according to predefined categories that are standardized and replicable at the international level with MedDRA and building new categories on demand by using knowledge engineering methods.…”

Coding Diagnoses from the Electronic Death Certificate with the 11th Revision of the International Statistical Classification of Diseases and Related Health Problems: An Exploratory Study from Germany

“…Around two thirds of the diagnosis texts were coded with only one code. It should be mentioned here that the coding approach attempted not only at an assignment of a diagnosis text to a single class but also at a representation of the diagnosis text [ 15 ]. The frequent use of more than one code could therefore be expected.…”