ADVANCED TERMINOLOGY SYSTEMS

Nursing Informatics

The Vocabulary Problem

Definition: The failure to achieve a single, integrated terminology with broad coverage of the healthcare domain has been characterized as the vocabulary problem. Several reasons for the vocabulary problem have been posited in health and nursing informatics literature.

 First,

the development of multiple specialized terminologies has resulted in areas of overlapping content exists, and large number of codes and terms. existing terminologies are most often developed to provide sets of terms and definitions of concept for human interpretation, with computer interpretation as only a secondary goal.

Second,

The latter is particularly true for nursing terminologies that have been designed for direct use be nurses in the course of clinical care. Unfortunately, knowledge that is eminently understandable to human is often confusing, ambiguous, or opaque to computer and consequently, current efforts have often resulted in terminologies that are inadequate in meeting the data needs of todays healthcare system.

Concept Orientation
In order to appreciate the significance of conceptoriented approaches, it is important to first to understand the definitions and relationships among things in the world (objects), our thoughts about things in the world (concepts), and the labels we use to represent and communicate our thoughtd about things in the world (terms). These relationship are depicted by a model commonly called semiotic triangle

Definitions of the elements

Concept (thought or reference): Unit of knowledge created by a unique combination of characteristics a characteristic is an abstraction of a property of an object or of a set of objects. Object (referent): Anything perceivable or concievable. Term (symbol): Verbal designationof a general concept in a specific subjects field a general concept corresponds to two or more objects whicg form a group by reason of common properties.

Semiotic Triangle
Thought or Reference

Symbol Sun Soleil

Stands for

Terminology Model
A terminology model is a concept based representation of a collection of domain specific terms that is optimized for the management of terminological definitions. It may be formulated and elucidated in an Ontology Language, Knowledge Representation Specification Syntax, or Web Ontology.

Representation Languages
Ontology languages
Represent

classes (also referred to as concepts, categories, or types) and their properties (also referred to as relations, slots, roles, or attributes). Able to support through explicit semantics, the formal definition, of concepts in terms of their relationship with other concepts.

Computer based Tool

The extent to which a terminology may be suitable for computer processing has been characterized in terms of generations First Generation terminology systems consist of a list of enumerated terms, possibly arranged as a single hierarchy.

Second Generation systems include an abstract terminology model or terminology model schema that describes the organization of the main categories used in particular terminology or set of systems. Third Generation system support sufficient formalisms to enable computer based processing, they include grammar that defines the rules of automated generation and classification of new concepts.

They were also called Formal Concept Representations systems.

Advantages of Advanced Terminology Systems

Advanced terminology systems facilitate two important facet of knowledge representation for computer based systems that support clinical care:
Describing

concepts Manipulating and reasoning about those concepts using computer based tools.

Advantages resulting from the first facet include:

Nonambiguous

representation of concepts Facilitation of data abstraction without loss of original idea Nonambiguous mapping among terminologies Data reuse in different contexts

Advantages resulting from the second facet include:

Automated

classification of new concepts Ability to support multiple inheritance of defining characteristics.

Summary and Implications for Nursing

Provide

for nonambiguous concept definitions Facilitate composition of complex concepts from more primitive concepts Support mapping among terminologies.

Number of benefits have been proposed ( by means of clinical approach):

of evidence based practice Matching of potential research subjects to research protocols for which they are potentially eligible.
Facilitation

 Detection

of and prevention of potential adverse drug

effects Linking online information resources Increased reliability and validity of data for quality evaluation Data mining for purposes such as clinical research, health services research, or knowledge discovery.