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SNOMED CT - ein künftiger terminologischer Standard für Life Science ? Stefan Schulz Institut für Medizinische Biometrie und Medizinische Informatik Universitätsklinikum.

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Präsentation zum Thema: "SNOMED CT - ein künftiger terminologischer Standard für Life Science ? Stefan Schulz Institut für Medizinische Biometrie und Medizinische Informatik Universitätsklinikum."—  Präsentation transkript:

1 SNOMED CT - ein künftiger terminologischer Standard für Life Science ? Stefan Schulz Institut für Medizinische Biometrie und Medizinische Informatik Universitätsklinikum Freiburg

2 SNOMED CT Standardized Nomenclature of Medicine – Clinical Terms: Terminologiesystem für die Kodierung von Inhalten in der elektronischen Patientenakte Konzipiert als weltweiter terminologischer Standard mit dem Schwerpunkt klinische Dokumentation (nicht biomedizinische Grundlagenwissenschaften!) Verbreitet von der 2007 gegründeten IHTSDO (International Health Terminology Standards Development Organisation): Mitgliedsstaaten: US, UK, AU, NZ, CA, DK, SE, NL, LV, (ES,…) (bisher nicht Deutschland) SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

3 SNOMED CT: Facetten SNOMED CT als kontrolliertes Vokabular SNOMED CT als formales System SNOMED CT als Ontologie SNOMED CT: Trends SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

4 SNOMED CT als kontrolliertes Vokabular SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

5 SNOMED CT als kontrolliertes Vokabular Zuordnung von medizinischen Fachtermini (einschließlich Synonymen und Übersetzungen) zu sprachunabhängigen Konzepten z.Zt Konzepte z.Zt engl. Terme SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

6 SNOMED CT als formales System SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

7 SNOMED CT als formales System Hierarchien: Strikte Spezialisierung (is-a) SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

8 SNOMED CT als formales System Restriktionen: auf einfacher Beschreibungslogik beruhend: C1 – Rel – C2 zu interpretieren als: x: instanceOf(x, C1) y: instanceOf(C2) Rel(x,y) Relationen (Attribute): z.B. Associated morphology Finding site (50 Relationstypen) SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

9 SNOMED CT als formales System definierte vs. primitive Konzepte SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

10 Defizit von nicht-formalen Ansätzen (frühere SNOMED-Versionen) D Acute appendicitis, NOS D Appendicitis, NOS G-A231Acute M-41000Acute inflammation, NOS G-C006In T-59200Appendix, NOS G-A231Acute M-40000Inflammation G-C006In T-59200Appendix, NOS SNOMED INTERNATIONAL Unterschiedliche Beschreibungen desselben Sachverhalts sind nicht aufeinander abbildbar Aneinanderreihung von Konzepten und Relationen nicht eindeutig interpretierbar SNOMED CT Terminologie Logik Ontologie Trends Fazit

11 Vorteil von formalen Beschreibungen Unterschiedliche Beschreibungen desselben Sachverhalts können durch maschinelle Reasoner auf eine kanonische Beschreibung abgebildet werden Bedeutung der (definierten) Klassen ist durch logische Sprache eindeutig erkennbar …aber… SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

12 Immenser Pflegeaufwand (Gesamtsystem muss immer konsistent gehalten werden) Vollständige Klassifikation überfordert gegenwärtige Reasoner bzw. erzwingt schmerzhafte Abstriche in der Mächtigkeit der Beschreibungssprache Gefahr inadäquater Schlüsse Amputation of toe is_a amputation of foot Proximal hemiphalangectomy of toe is_a Amputation of toe. Absence of liver or gallbladder NOS is_a Congenital absence of liver and gallbladder Risiko formalen Beschreibungen SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

13 SNOMED CT als Ontologie SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

14 SNOMED CT als Ontologie Ordnung der Domäne nach ihren generischen, invarianten Eigenschaften Toplevel-Ontologie: idealerweise nichtüberlappende Kategorien mit strikt definierten Kriterien (z.B. process, object, substance, quality) Relationen-Ontologie: idealerweise präzise definierte Kernrelationen (z.B. part-of, has-location, …) Ontological commitment: Festlegung, was eine Ontologie beschreibt: Dinge der Welt (z.B. mein Thoraxschmerz) Dokumentationsobjekte(z.B. der EPR-Eintrag zu meinem Thoraxschmerz Wissen (z.B. was mein Arzt gegenwärtig über meinen Thoraxschmerz weiß) SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

15 Social context (10) Community Family Group (…) Special concept Namespace concept Navigational concept Non-current concept Specimen (45) Biopsy sample Body substance sample Cardiovascular sample (…) Staging and scales (6) Assessment scales Endometriosis classification of American Fertility Society (…) Substance (11) Allergen class Biological substance Body substance (…) Body structure (10) Acquired body structure Anatomical organizational pattern (…) Clinical finding (22) Administrative statuses Adverse incident outcome categories (…) Environment or geographical location Environment Geogr. and/or political region of the world Event (19) Abuse Accidental event Bioterrorism related event (…) Linkage concept Attribute Link assertion Observable entity Age AND/OR growth period Body product observable (…) Clin. history / examination observable (21) Device observable Drug therapy observable Feature of Entity (…) Organism (11) Animal Chromista Infectious agent (…) Pharmaceutical / biologic product (58) Alcohol products Alopecia preparation Alternative medicines (…) Physical force (21) Altitude Electricity (…) Physical object (8) Device Domestic, office and garden artefact Fastening (…) Procedure (23) Administrative procedure Community health procedure (…) Qualifier value (52) Action Additional dosage instructions (…) Record artifact Record organizer Record type Situation with explicit context (17) A/N risk factors Critical incident factors (…) SNOMED CT Toplevel SNOMED CT Terminologie Logik Ontologie Trends Fazit

16 Access (attribute) Associated finding (attribute) Associated morphology (attribute) Associated procedure (attribute) Associated with (attribute) Clinical course (attribute) Component (attribute) Direct substance (attribute) Episodicity (attribute) Finding context (attribute) Finding informer (attribute) Finding method (attribute) Finding site (attribute) Has active ingredient (attribute) Has definitional manifestation (attribute) Has dose form (attribute) Has focus (attribute) Has intent (attribute) Has interpretation (attribute) Has specimen (attribute) Interprets (attribute) Laterality (attribute) Measurement method (attribute) Method (attribute) Occurrence (attribute) Part of (attribute) Pathological process (attribute) Priority (attribute) Procedure context (attribute) Procedure device (attribute) Procedure morphology (attribute) Procedure site (attribute) Property (attribute) Recipient category (attribute) Revision status (attribute) Route of administration (attribute) Scale type (attribute) Severity (attribute) Specimen procedure (attribute) Specimen source identity (attribute) Specimen source morphology (attribute) Specimen source topography (attribute) Specimen substance (attribute) Subject of information (attribute) Subject relationship context (attribute) Surgical approach (attribute) Temporal context (attribute) Time aspect (attribute) Using energy (attribute) Using substance (attribute) SNOMED CT: Relationen SNOMED CT Terminologie Logik Ontologie Trends Fazit

17 SNOMED CT : taxonomische Hierarchien SNOMED CT Terminologie Logik Ontologie Trends Fazit

18 SNOMED CT : taxonomische Hierarchien SNOMED CT Terminologie Logik Ontologie Trends Fazit

19 SNOMED CT : taxonomische Hierarchien Root Concept: Acute appendicitis (disorder) The following 36 "Is a" antecedents are present in the SNOMED hierarchy: Disorder of appendix (disorder) Disorder of digestive system (disorder) Disease (disorder) Appendicitis (disorder) Disorder of digestive organ (disorder) Disorder of lower gastrointestinal tract (disorder) Disorder of digestive tract (disorder) Disorder of intestine (disorder) Finding by site (finding) Finding of large intestine (finding) Disorder of abdomen (disorder) Disorder of gastrointestinal tract (disorder) General finding of abdomen (finding) Disorder of large intestine (disorder) Disorder by body site (disorder) Disorder of trunk (disorder) Inflammatory disorder (disorder) Acute inflammatory disease (disorder) Inflammatory disorder of digestive tract (disorder) SNOMED CT Concept (SNOMED RT+CTV3) Abdominal organ finding (finding) Bowel finding (finding) Finding of appendix (finding) Finding of body region (finding) Inflammation of large intestine (disorder) Finding of trunk structure (finding) Disorder of body system (disorder) Inflammation of specific body organs (disorder) Inflammation of specific body structures or tissue (disorder) Inflammation of specific body systems (disorder) Inflammatory disorder of digestive system (disorder) Digestive system finding (finding) Gastrointestinal tract finding (finding) Disorder of body cavity (disorder) Clinical finding (finding) Viscus structure finding (finding) Root Concept: Acute appendicitis (disorder) The following 36 "Is a" antecedents are present in the SNOMED hierarchy: SNOMED CT Terminologie Logik Ontologie Trends Fazit

20 SNOMED CT: kritische Betrachtung SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

21 SNOMED CT: kritische Betrachtung Fehlen klarer Unterscheidungskriterien zwischen Toplevel-Kategorien Bunte Mischung unterschiedlicher, teils unverträglicher Klassifikationsprinzipien: massiv parallele Is-a Hierarchien Vermischung von ontologischen mit epistemologischen Charakteristika, unklares ontology commitment Fehlende Verlinkung zwischen Konzepten Aufblähung durch Tendenz zu unnötigen Präkoordinationen Ausführliche Analysen und Bewertungen: Josef Ingenerf: Die Referenzterminologie SNOMED CT©, MMI-Verlag Alan Rector (2007): Barriers, approaches and research priorities for integrating biomedical ontologies. Stefan Schulz, Boontawee Suntisrivaraporn, Franz Baader (2007). SNOMED CT's problem list: ontologists' and logicians' therapy suggestions. Stud Health Technol Inform. 2007;129(Pt 1): SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

22 burn head burn burn of ear burn erythema of ear superficial corrosion of ear second degree burn of ear deep partial thickness burn of ear second degree burn of preauricular region of face superficial partial thickness burn of ear third degree burn of ear deep full thickness burn of ear, with loss of body part deep full thickness burn of the ear without loss of body part deep third degree burn of ear burn of eye region burn of eye AND/OR adnexa burn of anterior eyeball segment acid chemical burn of cornea AND/OR conjunctival sac alkaline chemical burn of cornea AND/OR conjunctival sac chemical injury to conjunctiva non-chemical burn of cornea AND/OR conjunctival sac burn with resulting rupture AND/OR destruction of eyeball chemical burn of eyelid AND/OR periocular area full thickness burn of the eye deep full thickness burn of the eye without loss of body part deep full thickness burn of the eye, with loss of body part non-chemical burn of eyelid AND/OR periocular area partial thickness burn of eye deep partial thickness burn of the eye superficial partial thickness burn of the eye superficial burn of the eye burn of eye structure burn confined to eye and adnexa burn of anterior eyeball segment acid chemical burn of cornea AND/OR conjunctival sac alkaline chemical burn of cornea AND/OR conjunctival sac chemical injury to conjunctiva non-chemical burn of cornea AND/OR conjunctival sac burn of conjunctiva acid chemical burn of cornea and conjunctival sac alkaline chemical burn of cornea and conjunctival sac chemical injury to conjunctiva thermal injury to conjunctiva burn of sclera scleral wound burn burn resulting in eyeball rupture and destruction of eyeball burn with resulting rupture AND/OR destruction of eyeball corneal burn alkaline chemical burn of cornea and conjunctival sac burn to cornea - blister burn to cornea - full thickness chemical injury to cornea acid chemical burn of cornea and conjunctival sac chemical keratitis corneal wound burn thermal and radiation injury to the cornea Labrador keratopathy snow blindness welders' keratitis corrosion with resulting rupture and destruction of eyeball full thickness burn of the eye deep full thickness burn of the eye without loss of body part deep full thickness burn of the eye, with loss of body part laser coagulation burn to retina partial thickness burn of eye deep partial thickness burn of the eye superficial partial thickness burn of the eye superficial burn of the eye burn of periorbital region burn erythema of periorbital region second degree burn of periorbital region third degree burn of periorbital region burn of skin of eye region eyelid burn burn to eyelid - blister burn to eyelid - erythema burn to eyelid - full thickness chemical burn of eyelid region lacrimal punctum burn non-chemical burn of eyelid AND/OR periocular area thermal burn of eyelid burn of face AND/OR head burn erythema of face AND/OR head burn of preauricular region of face burn erythema of preauricular region of face second degree burn of preauricular region of face third degree burn of preauricular region of face second degree burn of face AND/OR head third degree burn of nose deep third degree burn of nose deep full thickness burn of nose, with loss of body part burn of mouth burn of cheek burn erythema of cheek superficial corrosion of cheek second degree burn of cheek deep partial thickness burn of cheek superficial partial thickness burn of cheek third degree burn of cheek deep full thickness burn of the cheek without loss of body part deep full thickness burn of the cheek, with loss of body part deep third degree burn of forehead AND/OR cheek with loss of body part third degree burn of forehead AND/OR cheek deep third degree burn of forehead AND/OR cheek deep third degree burn of forehead AND/OR cheek with loss of body part burn of circumoral region burn erythema of circumoral region burn of lip burn erythema of lip burn erythema of labial mucosa superficial burn of lip(s) superficial corrosion of lip burn of labial mucosa burn erythema of labial mucosa second degree burn of labial mucosa third degree burn of labial mucosa full thickness burn of lip(s) deep full thickness burn of the lip(s) without loss of body part deep full thickness burn of the lip(s), with loss of body part third degree burn of labial mucosa partial thickness burn of lip deep partial thickness burn of lip(s) second degree burn of labial mucosa superficial partial thickness burn of lip(s) second degree burn of circumoral region third degree burn of circumoral region full thickness burn of lip(s) deep full thickness burn of the lip(s) without loss of body part deep full thickness burn of the lip(s), with loss of body part third degree burn of labial mucosa burn of mouth and pharynx corrosion of mouth and pharynx burn of oral cavity burn of buccal mucosa burn erythema of buccal mucosa second degree burn of buccal mucosa third degree burn of buccal mucosa burn of floor of mouth burn erythema of floor of mouth second degree burn of floor of mouth third degree burn of floor of mouth burn of gum burn of mandibular attached gingiva burn erythema of mandibular attached gingiva second degree burn of mandibular attached gingiva third degree burn of mandibular attached gingiva burn of maxillary attached gingiva burn erythema of maxillary attached gingiva second degree burn of maxillary attached gingiva third degree burn of maxillary attached gingiva burn of hard palate burn erythema of hard palate second degree burn of hard palate third degree burn of hard palate burn of lip burn erythema of lip burn erythema of labial mucosa superficial burn of lip(s) superficial corrosion of lip burn of labial mucosa burn erythema of labial mucosa second degree burn of labial mucosa third degree burn of labial mucosa full thickness burn of lip(s) deep full thickness burn of the lip(s) without loss of body part deep full thickness burn of the lip(s), with loss of body part third degree burn of labial mucosa partial thickness burn of lip deep partial thickness burn of lip(s) second degree burn of labial mucosa superficial partial thickness burn of lip(s) burn of mandibular vestibule burn erythema of mandibular vestibule second degree burn of mandibular vestibule third degree burn of mandibular vestibule burn of maxillary vestibule burn erythema of maxillary vestibule second degree burn of maxillary vestibule third degree burn of maxillary vestibule burn of soft palate burn erythema of soft palate second degree burn of soft palate third degree burn of soft palate burn of tongue burn erythema of tongue second degree burn of tongue third degree burn of tongue chemical burn of oral mucosa burn of pharynx burn of mouth and pharynx corrosion of mouth and pharynx burn of oropharynx burn erythema of oropharynx burn erythema of tonsillar area burn of tonsillar area burn erythema of tonsillar area second degree burn of tonsillar area third degree burn of tonsillar area second degree burn of oropharynx second degree burn of tonsillar area third degree burn of oropharynx corrosion of pharynx burn of scalp burn erythema of scalp superficial corrosion of scalp second degree burn of scalp deep partial thickness burn of scalp superficial partial thickness burn of scalp third degree burn of scalp deep third degree burn of scalp face burns burn of chin burn of circumoral region burn of forehead AND/OR cheek burn erythema of forehead AND/OR cheek burn erythema of cheek superficial corrosion of cheek burn of cheek burn erythema of cheek superficial corrosion of cheek second degree burn of cheek deep partial thickness burn of cheek superficial partial thickness burn of cheek third degree burn of cheek deep full thickness burn of the cheek without loss of body part deep full thickness burn of the cheek, with loss of body part deep third degree burn of forehead AND/OR cheek with loss of body part third degree burn of forehead AND/OR cheek deep third degree burn of forehead AND/OR cheek deep third degree burn of forehead AND/OR cheek with loss of body part burn of forehead burn erythema of forehead superficial corrosion of forehead second degree burn of forehead deep partial thickness burn of forehead superficial partial thickness burn of forehead third degree burn of forehead deep full thickness burn of the forehead without loss of body part deep full thickness burn of the forehead, with loss of body part deep third degree burn of forehead AND/OR cheek with loss of body part third degree burn of forehead AND/OR cheek deep third degree burn of forehead AND/OR cheek second degree burn of forehead AND/OR cheek burn of nose burn erythema of nose superficial corrosion of nose burn of nasal cavity burn of nasal septum second degree burn of nose deep partial thickness burn of nose superficial partial thickness burn of nose third degree burn of nose deep third degree burn of nose deep full thickness burn of nose, with loss of body part burn of preauricular region of face burn erythema of preauricular region of face second degree burn of preauricular region of face third degree burn of preauricular region of face burn of skin of eye region deep third degree burn of face, head AND/OR neck deep third degree burn of face, head AND/OR neck with loss of body part second degree burn of ear deep partial thickness burn of ear second degree burn of preauricular region of face superficial partial thickness burn of ear first degree burn of head burn erythema of cheek superficial corrosion of cheek burn erythema of chin superficial corrosion of chin burn erythema of circumoral region burn erythema of ear superficial corrosion of ear burn erythema of forehead superficial corrosion of forehead burn erythema of nose superficial corrosion of nose second degree burn of head second degree burn of cheek deep partial thickness burn of cheek superficial partial thickness burn of cheek second degree burn of chin deep partial thickness burn of chin superficial partial thickness burn of chin second degree burn of circumoral region second degree burn of ear deep partial thickness burn of ear second degree burn of preauricular region of face superficial partial thickness burn of ear second degree burn of forehead AND/OR cheek second degree burn of forehead deep partial thickness burn of forehead superficial partial thickness burn of forehead second degree burn of nose deep partial thickness burn of nose superficial partial thickness burn of nose second degree burn of periorbital region second degree burn of scalp deep partial thickness burn of scalp superficial partial thickness burn of scalp third degree burn of head burn to cornea - full thickness burn to eyelid - full thickness deep third degree burn of face AND/OR head deep third degree burn of face AND/OR head with loss of body part deep third degree burn of face, head AND/OR neck with loss of body part deep third degree burn of face, head AND/OR neck deep third degree burn of face, head AND/OR neck with loss of body part full thickness burn of the eye deep full thickness burn of the eye without loss of body part deep full thickness burn of the eye, with loss of body part third degree burn of buccal mucosa third degree burn of cheek deep full thickness burn of the cheek without loss of body part deep full thickness burn of the cheek, with loss of body part deep third degree burn of forehead AND/OR cheek with loss of body part third degree burn of forehead AND/OR cheek deep third degree burn of forehead AND/OR cheek deep third degree burn of forehead AND/OR cheek with loss of body part third degree burn of chin deep third degree burn of chin deep full thickness burn of chin, with loss of body part deep full thickness burn of the chin without loss of body part third degree burn of circumoral region full thickness burn of lip(s) deep full thickness burn of the lip(s) without loss of body part deep full thickness burn of the lip(s), with loss of body part third degree burn of labial mucosa third degree burn of ear deep full thickness burn of ear, with loss of body part deep full thickness burn of the ear without loss of body part deep third degree burn of ear third degree burn of floor of mouth third degree burn of forehead deep full thickness burn of the forehead without loss of body part deep full thickness burn of the forehead, with loss of body part deep third degree burn of forehead AND/OR cheek with loss of body part third degree burn of forehead AND/OR cheek deep third degree burn of forehead AND/OR cheek deep third degree burn of forehead AND/OR cheek with loss of body part third degree burn of hard palate third degree burn of mandibular attached gingiva third degree burn of mandibular vestibule third degree burn of maxillary attached gingiva third degree burn of maxillary vestibule third degree burn of nose deep third degree burn of nose deep full thickness burn of nose, with loss of body part third degree burn of oropharynx third degree burn of periorbital region third degree burn of preauricular region of face third degree burn of scalp deep third degree burn of scalp deep full thickness burn of the scalp without loss of body part deep full thickness burn of the scalp, with loss of body part third degree burn of soft palate third degree burn of tongue

23 SNOMED CT: Trends SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

24 SNOMED CT: Trends Zäsur: Übernahme durch IHTSDO 2007 Einführung von Qualitätsstandards Neubearbeitung teils komplett chaotischer Bereiche (z.B. Substance, Drugs) Überarbeitung von Modellierungsrichtlinien (z.B. Anatomie, unter Beachtung logisch-ontologischer Prinzipien) Erarbeitung von Übersetzungsrichtlinien Eindämmung der weiteren Ausuferung durch striktere Inklusionskriterien SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

25 SNOMED CT: offene Fragen Gelingt eine umfassende Modernisierung des in vieler Hinsicht unbrauchbaren Systems oder wird der Status quo zementiert? Gelingt der Übergang von einer proprietären, teuren und dennoch fehlerträchiger Terminologiepflege hin zu einer offenen, kooperativen Fortentwicklung (Wiki) ? Lässt sich eine klare Grenze zu komplementären Repräsentationssystemen (Wissensbasen, Datenmodellen) ziehen Gibt es außerklinische Use cases? Ist ein Terminologiesystem in dieser Größe überhaupt noch pflegbar? Wenn ja, wird die zur Pflege notwendigen kritische Masse (Nutzerbasis, Lizenzen) erreicht ? SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

26 SNOMED CT – in Deutschland SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

27 SNOMED CT – in Deutschland Bereits für wissenschaftliche Zwecke uneingeschränkt nutzbar. Vorbehalt gegenüber Beitritt zur IHTSDO: kostspielige Übersetzung der Terminologie Status der deutschen Übersetzung Unvollständig Nicht validiert Nicht von der IHTSDO freigegeben SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

28 SNOMED-CT SNOMED CT ist auch sinnvoll ohne Übersetzung nutzbar Für fokussierte Anwendungen wären nur überschaubare Bereiche zu übersetzen Für bestimmte Benutzergruppen sind auch englische Terme zu verwenden Direkte SNOMED – Kodierung durch Ärzte auch bei idealer Übersetzung ein eher unrealistisches und wohl nicht wünschenswertes Szenario SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

29 Pro: Aufschub der SNOMED-CT Übersetzung M.E. schwerwiegendes strukturelles Problem in SNOMED: Keine freitextlichen Definitionen vorgesehen Bedeutung vieler SNOMED-CT Konzepte oft nur (teilweise) aus dem Kontext ableitbar, daher unscharf Diskussion über die Notwendigkeit von freitextlichen Diskussionen innerhalb IHTSDO nicht abgeschlossen Erfahrung derzeitiger Übersetzungsprojekte (Dänisch, Schwedisch) nicht abgeschlossen. SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

30 Pro: Beitritt zur IHTSDO Mitgestaltung eines in der Zukunft bedeutsamen Standards Stärkung der Position nicht-anglophoner Staaten Stärkung der Position der EU bzgl. Standardisierung im Gesundheitswesen Sammeln von Erfahrungen in Deutschland Allmähliches Wachsen einer deutschen Übersetzung relevanter SNOMED CT – Konzepte (SNOMED – WIKI) SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

31 Fazit SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

32 Fazit SNOMED CT: muss trotz teils eklatanter Schwächen ernst genommen werden SNOMED CT sollte auch von den nichtklinischen Bereichen analysiert werden Wissenschaftliche Auseinandersetzung mit SNOMED: Herausforderung für Medizininformatik, Linguistik, Informatik, Logik, analytische Philosophie Deutschland sollte der IHTSDO beitreten Übersetzung von SNOMED CT ins Deutsche vorläufig keine Priorität SNOMED CT Terminologie Logik Ontologie Trends Fazit Stefan Schulz: SNOMED CT - ein künftiger terminologischer Standard für Life Science ?

33 Kontakt: Stefan Schulz Institut für Medizinische Biometrie und Medizinische Informatik, Universitätsklinikum Freiburg Zu SNOMED: SNOMED CT Terminologie Logik Ontologie Trends Fazit

34 Anhang

35 SNOMED: Entwicklung SNOP SNOMED SNOMED II SNOMED 3.0 SNOMED 3.5 SNOMED RT SNOMED CT Nomenklatur / Pathologie mehrachsige Nomenklatur gesamte Medizin Logikbasierte Beschreibungen Fusion mit CTV3 Ontologische Bauprinzipien Context Model IHTSDO SNOMED im UMLS

36 x: instanceOf(x, ChronicAppendicitis) instanceOf(x, Inflammation) y: instanceOf(y, AppendixStructure) hasLocation(x,y) z: instanceOf(z, AcuteCourse) hasCourse(x,z)

37 Jorge Luis Borges "On those remote pages it is written that animals are divided into: a.those that belong to the Emperor b.embalmed ones c.those that are trained d.suckling pigs e.mermaids f.fabulous ones g.stray dogs h.those that are included in this classification i.those that tremble as if they were mad j.innumerable ones k.those drawn with a very fine camel's hair brush l.others m.those that have just broken a flower vase n.those that resemble flies from a distance" The Celestial Emporium of Benevolent Knowledge

38 HOT Topics: SNOMED CT Inhalte Überarbeitung teils komplett chaotischer SNOMED- CT – Bereiche (z.B. Substance) Überarbeitung von Richtlinien (z.B. Anatomie, auf logisch-ontologischer Basis Semantik des Context Model (heuristische vs. formale Ansätze) Übersetzung: Problem unzureichender Konzeptdefinitionen Präkoordinierung – Postkoordinierung: Risiko der Ausuferung durch präkoordinierte Konzepte

39 HOT Topics: IHTSDO Management Einführung von Qualitätsstandards, technische Prozeduren: Dokumentenstandards Erweiterungsanfragen Spannend: Gelingt eine umfassende Modernisierung im laufenden Betrieb oder wird der Status quo zementiert?

40 Persönliche Einschätzung

41 Konzept / Klassenhierarchie Definitionen (Text, Logik) domain or region of DNA [GENIA]: A substructure of DNA molecule which is supposed to have a particular function, such as a gene, e.g., c-jun gene, promoter region, Sp1 site, CA repeat. This class also includes a base sequence that has a particular function. Peptides [MeSH]: Members of the class of compounds composed of AMINO ACIDS joined together by peptide bonds between adjacent amino acids into linear, branched or cyclical structures. OLIGOPEPTIDES are composed of approximately 2-12 amino acids. Polypeptides are composed of approximately 13 or more amino acids. PROTEINS are linear polypeptides that are normally synthesized on RIBOSOMES |chronic ulcer of skin| |is a|= |disease| { |associated morphology|= |chronic ulcer| |finding site|= |skin structure|} Terminologie Benign neoplasm of heart Benign tumor of heart Benign cardiac neoplasm Gutartiger Herzumor Gutartige Neubildung am Herzen Gutartige Neubildung: Herz Gutartige Neoplasie des Herzens Tumeur bénigne cardiaque Tumeur bénigne du cœur Neoplasia cardíaca benigna Neoplasia benigna do coração Neoplasia benigna del corazón Tumor benigno do corazón Informations/Datenmodelle Krankheitsursache: viral bakteriell physikalisch nicht nachgewiesen unbekannt Status des Eingriffs: geplant durchgeführt abgesetzt abgebrochen unbekannt

42 Informationsmodell TerminologieOntologie Ideal Ordnung von Entitäten einer Domäne und Beschreibung ihrer generischen Eigenschaften Modell zur Erfassung und Verwaltung von Information Ordnung und Beschreibung der Fachsprache einer Domäne

43 SNOMED CT ! TerminologieOntologie Informationsmodell


Herunterladen ppt "SNOMED CT - ein künftiger terminologischer Standard für Life Science ? Stefan Schulz Institut für Medizinische Biometrie und Medizinische Informatik Universitätsklinikum."

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