1. Veterinary Medical Informatics VMRCVM Conduits Between Anatomical Hierarchies in SNOMED Dr. Jeff R. Wilcke Dr. Penny Livesay Dr. Larry Freeman

2. Veterinary Medical Informatics VMRCVM Digital Anatomist “motivated by the belief that anatomy is the basis of all the biomedical sciences” “goal is to represent anatomy in a comprehensive and consistent way, which should meet the needs of all biomedical applications that require anatomical knowledge.” Completely anthropocentric http://sig.biostr.washington.edu/projects/da/

7. Veterinary Medical Informatics VMRCVM SNOMED History College of American Pathologists 1963 SNOP Systematized Nomenclature of Pathology 1974 SNOMED Systematized Nomenclature of Medicine 1993 “SNOVET” amalgamation Tools inadequate to the task 1999 SNOMED-RT Tools are adequate, now someone must repair the content.

8. Veterinary Medical Informatics VMRCVM SNOMED – SNOVET SNOVET included two kinds of codes/concepts 1) Concepts and codes that were the same as SNOMED 2) Concepts and codes that were added for special veterinary needs

9. Veterinary Medical Informatics VMRCVM SNOMED – SNOVET Reconciliation outcomes Concepts and codes that were the same, retained concept name and code Concepts that were truly unique to veterinary medicine had their own codes and given a “V” flag so that they could easily be removed from human systems. Concepts that were “analogues” were added as synonyms but not given their own unique codes and the synonym got a “V” flag.

10. Veterinary Medical Informatics VMRCVM SNOMED III Hand = T-D8700 Forefoot = T-D8700V Forepaw = T-D8700V Forepaw and forefoot were not concepts in their own right, but stored as synonyms with a “V” designator in a “type of synonym” field.

11. Veterinary Medical Informatics VMRCVM SNOMED-RT Hand = T-D8700 ForeFoot = T-D9702 ForePaw is a synonym for Forefoot IMPLICATION of this is that the forefoot of a horse = the forepaw of a rat and these are both “kinds of” hand.

12. Veterinary Medical Informatics VMRCVM Veterinary Disease “Laminitis of the right front foot of a horse” Equine Laminitis (D0-54200) Associated topography : forefoot (T-D9702) Has laterality : Right (G-A100)

13. Veterinary Medical Informatics VMRCVM Laminitis definition (SRT) Equine laminitis (disorder) Is a Disease of foot

14. Veterinary Medical Informatics VMRCVM Laminitis definition (SRT) Equine laminitis (disorder) Is a Disease of foot Associated topography right “hand”

15. Veterinary Medical Informatics VMRCVM So where are we? It’s Christmas eve. We’re peering into a box. We’re sure there’s a bicycle in there, but have not reached the part of the instructions that indicate we’ve found it.

16. Veterinary Medical Informatics VMRCVM Comparative Anatomy of the Stomach Stomach (body structure) Parent(s): Abdominal viscus (body structure) Digestive organ (body structure) Hollow viscus (body structure) Child(ren): Avian stomach (body structure) Glandular stomach (body structure) Non-glandular stomach (body structure) Ruminant stomach (body structure)

17. Veterinary Medical Informatics VMRCVM Comparative Anatomy “Conduit” Mechanism: A set of concepts and relationships connecting species-specific anatomical hierarchies. Goal: To accurately compute the anatomical analogies and differences among species.

18. Veterinary Medical Informatics VMRCVM Comparative Anatomy “Conduits” Identify structures with common comparative “heritage”. Determine subtypes of common parent(s) necessary for species- based anatomical comparisons. Map individual species “parts” to the template.

19. Veterinary Medical Informatics VMRCVM The “Scheme” Each concept should have a definition that is context- independent. Create logical and true relationships between concepts

20. Veterinary Medical Informatics VMRCVM The “Scheme” Allow the rapid and easy addition of anatomical variations as they are called into use by comparative anatomy. as they are discovered, defined

21. Veterinary Medical Informatics VMRCVM The “Scheme” Express comparable anatomical sites across a wide range of species, including man analogous structures should be grouped under a parent that defines their similarities.

22. Veterinary Medical Informatics VMRCVM The “Scheme” Enable data processing that excludes the comparative anatomy axis where no such depth or complexity is desired the searcher wants to see only human (or equine, bovine, canine) topographical sites.

23. Veterinary Medical Informatics VMRCVM The “Scheme” Disruption and redefinition of the existing "human-based" nomenclature should be strictly minimized.

24. Veterinary Medical Informatics VMRCVM Kinds of Stomach  Non-compartmented  Simple  Human being, dog, cat, guinea pig, rabbit  Compound  Rat, mouse, horse, pig  Compartmented  Camelid  Camels, llamas  Ruminant  Cattle, sheep, goats * Naming convention is subject to debate

25. Veterinary Medical Informatics VMRCVM Gaster (parent of all stomachs) Gaster Non-compartmented stomach Compartmented Stomach Camelid Ruminant Glandular Glandular/ Squamous

26. Part of Is a Gaster Structure Gaster Part Whole Gaster Glandular Portion Of Gaster Non-Compartmented Stomach Structure Non-compartmented Compound Stomach Structure Non-compartmented Simple Stomach Structure Stomach T-57000* (Human) Dog Stomach* Mouse Stomach*Horse Stomach* Squamous Epithelial Portion Glandular Portion Analogue Whole Complex Non-compartmented Stomach Complex Non-Compartmented Stomach Part Non-compartmented Stomach Part Whole Non-compartmented Stomach Whole Non-compartmented Simple Stomach Non-compartmented Simple Stomach Part *members of species-specific hierarchy

27. Part of Is a Glandular Portion Of Gaster Gaster Structure Gaster Part Whole Gaster ReticulumAbomasumRumenOmasum Distal C3C1C2Proximal C3 Ruminant Stomach Structure Camelid Stomach Structure Compartmented Stomach Structure Analogue Whole Ruminant Stomach Ruminant Stomach Part Whole Camelid Stomach Camelid Stomach Part Compartmented Stomach Part Whole Compartmented Stomach Fermenting Portion Of Compartmented Stomach

28. Veterinary Medical Informatics VMRCVM Stomach Structure (Human Stomach) Upper Gastrointestinal Tract Structure Gaster Structure Non-compartmented Stomach Structure Peaceful Co-existance

29. Veterinary Medical Informatics VMRCVM Peaceful Co-existance Man Mouse Cattle Dog Rat Conduit

30. Veterinary Medical Informatics VMRCVM Goals Convince our friends in “two-legged” medicine that they can’t live without an accurate comparative anatomy. Convince these same friends that we should be paid to provide it. Enlist interested veterinary anatomists in the effort.