ICD 11 FC and SNOMED CT – finding as Ontologies of Clinical Situations

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Presentation transcript:

ICD 11 FC and SNOMED CT – finding as Ontologies of Clinical Situations Stefan Schulz

Fracture of Radius and Ulna Example 1 Fracture of Ulna Fracture of Radius subClassOf subClassOf Fracture of Radius and Ulna

Example 2

Example 2 Extension of “Pulmonic Valve Stenosis” includes extension of “Tetralogy of Fallot”: FALSE

Example 2 Extension of “Situation with Pulmonic Valve Stenosis” includes extension of “Situation with Tetralogy of Fallot”: TRUE P F P P F P F F P P P

Definition of Clinical Situation A clinical situation with C is a phase of a patient's life in which a condition of the type C is wholly present A clinical situation without X is a phase of a patient's life that does not include any condition of the type X at any time situation without C situation without C C situation C situation

Model according to SemanticHealthNet / BioTopLite 2 includes condition Clinical Diagnosis isAbout Situation Clinical Situation Clinical Condition not includes condition isA isA isA Clinical Disposition Clinical Structure Clinical Process EHR Patient

Situation interpretation in other terminologies (here ICD11 draft) clinical disposition ? clinical process? clinical structure? clinical structure? Situation isA Situation isA Situation isA Situation

Reinterpretation of role groups Clinical Situation Clinical Condition Has condition

Summary Caveat: Situation interpretation may be ambiguous Numerous Is-a links in the SNOMED finding hierarchy only plausible for situations Very difficult to draw a line between conditions and situations, empirical study (AMIA 2012 paper) Findings and disorders best considered as clinical situations Here, “has condition” is the best interpretation of the role group relation Caveat: Bipartition in existing SNOMED situation hierarchy (context model): Situations proper (e.g. Has a red eye) Information entities (e.g. Suspected sarcoma) Caveat: Situation interpretation may be ambiguous HER2-positive carcinoma of breast (disorder) AND Progesterone receptor positive tumor (disorder) One or two tumors

Proper parts or taxonomic parents ? Example from Harold Solbrig VSD PVS RVH OA Red Light Yellow Light Green Light is-a is-a is-a is-a is-a is-a is-a Tetralogy of Fallot Traffic Light