The need for a concept-based medication vocabulary as an enabling infrastructure in health informatics (original) (raw)
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Evaluation of a proposed method for representing drug terminology
Proceedings. AMIA Symposium, 1999
In the absence of a single, standard, multipurpose terminology for representing medications, the HL7 Vocabulary Technical Committee has sought to develop a model for such terms in a way that will provide a unified method for representing them and supporting interoperability among various terminology systems. We evaluated the preliminary model by obtaining terms, represented in our model, from three leading vendors of pharmacy system knowledge bases. A total of 2303 terms were obtained, and 3982 pair-wise comparisons were possible. We found that the components of the term descriptions matched 68-87% of the time and that the overall descriptions matched 53% of the time. The evaluation has identified a number of areas in the model where more rigorous definitions will be needed in order to improve the matching rate. This paper discusses the implications of these results.
Methods of information in medicine, 2000
No standardized representation of drug indications is currently available that could be used in drug knowledge bases. We describe an object-oriented representation of indications that should make it possible to develop new tools for selecting drugs and checking prescriptions in computerized drug prescription systems. The model was developed using the results of a lexical and semantic analysis of drug indications, collected into a single file and processed using natural language processing software. It distinguishes both the diseases for which the drug may be given and the efficiency of the drug for a given indication. Two aspects of the model were evaluated: the differences if two independent evaluators filled the attributes independently and the loss of information induced by the use of the model. A system based on this model, making it possible for the physician to select all the drugs satisfying various criteria, is also presented.
Semantic Medical Prescriptions – Towards Intelligent and Interoperable Medical Prescriptions
Medication errors are the most common type of medical errors in health-care domain. The use of electronic prescribing systems (e-prescribing) have resulted in significant reductions in such errors. However, dealing with the heterogeneity of available information sources is still one of the main challenges of e-prescription systems. There already exists different sources of information addressing different aspects of pharmaceutical research (e.g. chemical, pharmacological and pharmaceutical drug data, clinical trials, approved prescription drugs, drugs activity against drug targets. etc.). Handling these dynamic pieces of information within current e-prescription systems without bridging the existing pharmaceutical information islands is a cumbersome task. In this paper we present semantic medical prescriptions which are intelligent e-prescription documents enriched by dynamic drug-related meta-data thereby know about their content and the possible interactions. Semantic prescriptions provide an interoperable interface which helps patients, physicians, pharmacists, researchers, pharmaceutical and insurance companies to collaboratively improve the quality of pharmaceutical services by facilitating the process of shared decision making. In order to showcase the applicability of semantic prescriptions we present an application called Pharmer. Pharmer employs datasets such as DBpedia, DrugBank, DailyMed and RxNorm to automatically detect the drugs in the prescriptions and to collect multidimensional data on them. We evaluate the feasibility of the Pharmer by conducting a usability evaluation and report on the quantitative and qualitative results of our survey.
A bottom-up approach to creating an ontology for medication indications
Journal of the American Medical Informatics Association, 2021
Objectives The study sought to learn if it were possible to develop an ontology that would allow the Food and Drug Administration approved indications to be expressed in a manner computable and comparable to what is expressed in an electronic health record. Materials and Methods A random sample of 1177 of the 3000+ extant, distinct medical products (identified by unique new drug application numbers) was selected for investigation. Close manual examination of the indication portion of the labels for these drugs led to the development of a formal model of indications. Results The model represents each narrative indication as a disjunct of conjuncts of assertions about an individual. A desirable attribute is that each assertion about an individual should be testable without reference to other contextual information about the situation. The logical primitives are chosen from 2 categories (context and conditions) and are linked to an enumeration of uses, such as prevention. We found that...
Cross-terminology mapping challenges: A demonstration using medication terminological systems
Journal of Biomedical Informatics, 2012
Standardized terminological systems for biomedical information have provided considerable benefits to biomedical applications and research. However, practical use of this information often requires mapping across terminological systems-a complex and time-consuming process. This paper demonstrates the complexity and challenges of mapping across terminological systems in the context of medication information. It provides a review of medication terminological systems and their linkages, then describes a case study in which we mapped proprietary medication codes from an electronic health record to SNOMED CT and the UMLS Metathesaurus. The goal was to create a polyhierarchical classification system for querying an i2b2 clinical data warehouse. We found that three methods were required to accurately map the majority of actively prescribed medications. Only 62.5% of source medication codes could be mapped automatically. The remaining codes were mapped using a combination of semi-automated string comparison with expert selection, and a completely manual approach. Compound drugs were especially difficult to map: only 7.5% could be mapped using the automatic method. General challenges to mapping across terminological systems include (1) the availability of up-to-date information to assess the suitability of a given terminological system for a particular use case, and to assess the quality and completeness of cross-terminology links; (2) the difficulty of correctly using complex, rapidly evolving, modern terminologies; (3) the time and effort required to complete and evaluate the mapping; (4) the need to address differences in granularity between the source and target terminologies; and (5) the need to continuously update the mapping as terminological systems evolve.
Categorical information in pharmaceutical terminologies
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2006
Drug information sources use category labels to assist in navigating and organizing information. Some category labels describe drugs from multiple perspectives (e.g., both structure and function). The National Drug File - Reference Terminology (NDF RT) is a drug information source that augments a "legacy" categorization system with a formal reference model specifying Chemical Structure, Cellular or Sub-Cellular Mechanism of Action, Organ- or System-Level Physiological Effect, and Therapeutic Intent categories. We examined drug category names from three sources to better understand their information content and evaluate NDF…
Development of an ensemble resource linking MEDications to their Indications (MEDI)
Understanding of medications-disease relationships is critical to distinguish indications from adverse effects, and medication exposures serve as important markers of disease and severity in electronic medical records (EMR). We created a computable medication-indication (MEDI) resource by applying natural language processing and ontology relationships to four public medication resources. Physicians evaluated accuracy of medication-indication relationships. MEDI contained 3,112 medications and 63,343 medication-indication pairs derived from the four resources, whose precisions varied from 56-94%. The MEDI high precision subset (MEDI-HPS) includes indications found within either RxNorm or ≥2 resources and had an estimated precision of 92%. MEDI-HPS contains 13,304 unique indication pairs for 2,136 medications. MEDI is a free, computable resource that links medications with their indications as represented by formal concepts and may assist clinical and research uses of EMR data.
Pharmer–Towards Semantic Medical Prescriptions
The recent proliferation of Linked Open Data that enables the integration of multiple disparate data sources brings into the spotlight a new generation of knowledge management applications. Particularly in the domain of pharmaceutical research and development, many efforts have been done to create a linked open drug data. In this paper we present the Pharmer as an approach to facilitate the creation of semantic prescriptions. Semantic prescriptions are intelligent e-prescription documents enriched by drug-related meta-data thereby know about their content and the possible interactions.
A reference terminology for drugs
Proceedings / AMIA ... Annual Symposium. AMIA Symposium, 1999
GALEN technology for re-usable terminologies using formal classification is being applied to the creation and maintenance of a reference terminology for drugs. GALEN's techniques are being used to address specific deficiencies of existing drug classifications that make it difficult to create and maintain guidelines to support prescribing in the care of patients with chronic diseases. The reference terminology is in two parts; firstly, a re-usable and automatically-classified 'ontology' is built with GALEN technology; this describes generic drugs, their composition in terms of chemicals and chemical classes, their actions, indications and interactions. Secondly, a 'dictionary' of prescribable proprietary products is integrated with this ontology. The result is a drug resource designed to support both the traditional uses of a drug knowledge base (e.g. prescribing and messaging), and the specialized demands of guideline authoring and execution.
Requirements and Strategy for the Development of a Pediatric Drug Ontology
Clinical and epidemiological researchers across all medical special-ties need tools and knowledge representations to support the classi-fication, aggregation, and analysis of medication data. The National Drug File Reference Terminology (NDF-RT), a named standard for classifying medications, is developed by the US Department of Vet-erans Affairs (VA) as an extension to their National Drug File, which is the master list of drugs prescribed to VA patients, which are adults. NDF-RT is organized as a multi-axial hierarchy with addition-al relations between ingredients, medications, chemical structures, mechanism of action, and therapeutic indications. We describe our experience applying NDF-RT to a dataset of encoded medications that were collected from an international cohort of over 8,000 chil-dren. Our data-driven approach allows us to extract selected NDF-RT sub-classes of a researcher-provided concept of "antibiotics". We believe that a subset of concepts and relationship...