CIMI Semantic Binding Issue It seems to be widely agreed that model binding can align CIMI model properties with the semantics of SNOMED CT concept model attributes, where appropriate. But those attributes are predicated on the root concept of the respective concept models. There is no “is root” attribute in SNOMED. The observable model, for instance, specifies a “precondition” property, but no attribute to define the observable subject of the “has precondition” predicate.

Example In this example, it’s difficult to infer an expression: There is a bound “precondition” attribute. It has a value binding to a conformant value set. But the subject cannot be identified without some very specific assumptions about where to find the observable (e.g., “in observation models, use the value of the code property”). CIMI Model for SBP Observation Element: ? Bound attribute: ? Value: SBP observable Element: body position Bound attribute: Precondition Value: body position value set Expression: ??? : Precondition = sitting Focal concept : attribute = attribute value

Suggestion It has been suggested that the model may contain an “is-a” binding to a concept model root concept. The model would then represent a subset of the instances represented by the concept in the value of that property, and the attributes asserted would be attributes of that subtype. Issue: We don’t model concepts in information models. We model assertions. However, such an approach may work perfectly well for the Topic axis of the proposed CIMI compositional approach. This will require (or enable) leveraging other axes for the assertion.

Example CIMI Model for statement of presence CIMI Model for SBP Observation Element: code Bound code: Is-a Value: Situation Element: code Bound code: Is-a Value: SBP finding Element: ? Bound attribute: finding context Element: method Bound attribute: finding method Value: SBP method value set Value: confirmed present Element: ? Bound code: associated finding Element: code Bound attribute: interprets Value: Observable (SBP Topic) Value: Finding Observable concept model CIMI Model for SBP Topic Finding concept model Key Element: code Bound code: Is-a Value: SBP observable Situation concept model Element: body position Bound attribute: Precondition Value: body position value set CIMI

Questions and issues Is the SNOMED CT Situation with Explicit Context model right? Do we need to enhance it? If so, via IHTSDO, NLM, CIMI, SOLOR? Do we need to replace it? If so, under what semantic regime? Is there some other way we can or should specify these semantics? Does the binding directionality of this model break (or inform) navigability assumptions of the compositional approach to CIMI? Does this affect or depend on assumptions about creation of additional concept model attributes?