A Poor Precedent
A Poor Precedent
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一个糟糕的先例
DOI：
10.1055/s-0038-1634654
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发表时间：
1996
影响因子：
1.7
通讯作者：
S. J. Nelson
中科院分区：
文献类型：
--
作者：
M. Tuttle;S. J. Nelson
摘要：成功利用基于计算机的患者记录（CPR）的最大障碍是难以创建和维护可比较的患者描述。具体来说，如果CPR存储的患者描述在受控医疗词汇表的连续版本中不具有可比性，那么很难证明广泛部署CPR所需的投资是合理的。因此，有必要解决控制的医疗词汇更新问题的CPR之前，患者描述的可比性可以持续。看起来只是医疗保健企业系统维护者感兴趣的一个狭窄的技术问题，实际上是医疗信息学的一个中心问题。Cimino的“Formal descriptions and adaptive mechanisms for changes in controlled medical vocabularies”描述了1994年版国际疾病分类（ICD-9-CM）中出现的变化的分类。他的论文描述了1993年和1994年ICD-9-CM版本之间发现的差异的转换，以及分类要素转换为医学实体词典（MED）所需的正式变更，这是哥伦比亚长老会医学中心使用的CPR的一部分。由于检测差异的过程始于对ICD-9-CM 1993年和1994年版本的ASCII表示的实证分析，因此计算机程序不可能推断出导致差异的变化的意图;相反，内容专家必须推断出意图，然后相应地更新MED。一个典型的任务是推断命名的变化是否也反映了命名含义的变化。虽然Cimino的方法及其执行在各个方面都是典范，但它们仍然构成了一种“逆向工程”--一种从细节中推断意图的特别尝试。对受控医学词汇进行逆向工程变更是一个糟糕的先例。这些方法应被视为必要的短期经验，所有相关方应努力制定一个渐进的计划，通过该计划，受控医疗词汇表的变更意图可以变得明确和机器可处理。只有这样，患者描述的可比性才能持续下去。
Abstract: The single greatest impediment to the successful leveraging of computer-based patient records (CPRs) is the difficulty of creating and maintaining comparable patient descriptions. Specifically, it will be hard to justify the investment required to deploy CPRs widely if the patient descriptions they store are not comparable across successive releases of controlled health-care vocabularies. Thus, it is necessary to solve the controlled health-care vocabulary update problem for CPRs before the comparability of patient descriptions can be sustained. What may seem to be a narrow technical problem of interest only to maintainers of health-care enterprise systems is, instead, a central problem of medical informatics. Cimino’s “Formal descriptions and adaptive mechanisms for changes in controlled medical vocabularies” describes a classification of the changes appearing in the 1994 Edition of the International Classification of Diseases (ICD-9-CM). His paper describes the conversion of differences detected between the 1993 and 1994 releases of ICD-9-CM and a conversion of the elements of the classification into the required formal changes to the Medical Entities Dictionary (MED), part of the CPR in use at Columbia Presbyterian Medical Center. Because the process of detecting differences begins with an empirical analysis of the ASCII representations of the 1993 and 1994 releases of ICD-9-CM, it is impossible for a computer program to infer the intent of the changes that caused the differences; instead, a content expert must infer the intent and then update the MED accordingly. A typical task is to infer whether a change in naming also reflects a change in the meaning named. While Cimino’s methods and their execution are exemplary in every respect, they nevertheless constitute a kind of “reverse engineering” – an ad hoc attempt to infer intent from details. Reverse engineering of changes to controlled medical vocabularies is a poor precedent. Such methods should be viewed as necessary short-term expedients only, and all parties concerned should work toward an incremental plan by which the intent of changes to controlled health-care vocabularies can be made both explicit and machine processible. Only then can the comparability of patient descriptions be sustained.
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MEME-II 支持术语的协作管理。
DOI：
--
发表时间：
1996
期刊：
Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium
影响因子：
--
作者：
Suarez-Munist,ON;Tuttle,MS;Olson,NE;Erlbaum,MS;Sherertz,DD;Lipow,SS;Cole,WG;Keck,KD;Davis,AN;Hole,WT;Irons,RJ;Ganju,A;Nelson,SJ
通讯作者：
Nelson,SJ
将您的术语和关系添加到 UMLS Metathesaurus。
DOI：
--
发表时间：
1991
期刊：
Proceedings. Symposium on Computer Applications in Medical Care
影响因子：
--
作者：
Tuttle,MS;Sherertz,DD;Erlbaum,MS;Sperzel,WD;Fuller,LF;Olson,NE;Nelson,SJ;Cimino,JJ;Chute,CG
通讯作者：
Chute,CG
合并术语。
DOI：
--
发表时间：
1995
期刊：
Medinfo. MEDINFO
影响因子：
--
作者：
Tuttle,MS;Suarez-Munist,ON;Olson,NE;Sherertz,DD;Sperzel,WD;Erlbaum,MS;Fuller,LF;Hole,WT;Nelson,SJ;Cole,WG
通讯作者：
Cole,WG
致力于在护理点实现可重用的软件组件。
DOI：
--
发表时间：
1996
期刊：
Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium
影响因子：
--
作者：
Tuttle,MS;Sherertz,DD;Olson,NE;Nelson,SJ;Erlbaum,MS;Keck,KD;Davis,AN;Suarez-Munist,ON;Lipow,SS;Cole,WG;Fagan,LM;Acuff,RD;Crangle,CE;Musen,MA;Tu,SW;Wiederhold,GC;Carlson,RW
通讯作者：
Carlson,RW
加拉帕戈斯：基于计算机的医学术语融合发展支持。
DOI：
--
发表时间：
1996
期刊：
Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium
影响因子：
--
作者：
Campbell,KE;Cohn,SP;Chute,CG;Rennels,G;Shortliffe,EH
通讯作者：
Shortliffe,EH