Controlled Vocabulary Design for Clinical Applications

词汇的组成机制提供了几乎完全覆盖健康内容的承诺。基于计算机的患者记录研究所、ANSI-HISB、NCVHS和其他机构都提出声明，在实现护理点受控可比数据编码的承诺之前，必须充分覆盖常规医学文本。我们之前的工作表明，与非组合方法相比，组合方法对医疗问题的即时输入提供了上级的覆盖率（54.0% vs. 27.6%，p<0.0001）。美国病理学家学会将SNOMED-CT定位为美国乃至英语世界的临床数据编码标准。迄今为止，关于拟议范围和目的的术语质量，独立评价提供的数据很少。我们提出以下具体目标：1）评价SNOMED-CT的临床内容覆盖率，并测试SNOMED-CT具有足够的表达能力来表示临床问题列表条目所需的概念的假设，2）确定使用SNOMED-CT创建的组成表达式的可用性，并测试问题列表管理器应用程序可用且不会成为混淆因素的假设，在作为组成性临床术语的SNOMED-CT的临床可用性方面，以及3）使用问题列表管理器应用程序在前瞻性临床试验中评价SNOMED-CT的满意度和性能，以检验SNOMED-CT在临床上可用且适合在床旁输入临床问题列表的假设。我们将编写一组接口来执行自动术语组合和分析，并设计和测试一个高吞吐量机器，以使用大量临床问题（2，000，000个临床问题）来评估SNOMED-CT的内容覆盖率。这项拟议的努力将在临床环境中提供对SNOMED-CT的独立评价。准确和可比的患者数据，在我们的医疗实践的粒度记录，具有深远的研究意义的医疗实践（例如，指南的实施），未来临床医生的教育（例如，信息获取技术）和研究（例如，结果研究）走向循证医学实践。

Compositional mechanisms for vocabulary provide the promise of near complete coverage of health content. The Computer-based Patient Record Institute, ANSI-HISB, the NCVHS and others have all proffered statements that adequate coverage of routine medical text is necessary before the promise of controlled comparable data encoding, at the point-of-care, can be realized. Our previous work demonstrated that a compositional approach to point-of-care entry of medical problems provided superior coverage when compared to a non- compositional approach (54.0% vs. 27.6%, p<0.0001). SNOMED-CT is being positioned by the College of American Pathologists as being a standard for clinical data encoding in the United States and perhaps in the English-speaking world. To date, there is little data available from independent evaluations regarding the quality of the terminology for its proposed scope and purpose. We propose the following Specific Aims: 1) to evaluate the clinical content coverage of SNOMED-CT, and to test the hypothesis that SNOMED-CT has adequate expressivity to represent the concepts required for clinical Problem List entry, 2) to determine the Usability of compositional expressions created using SNOMED-CT, and to test the hypothesis that the Problem List Manager Application is usable and will not be a confounding factor, in terms of the clinical Usability of the SNOMED-CT as a compositional clinical terminology, and 3) to evaluate the satisfaction and performance of SNOMED-CT in a Prospective Clinical Trial using a Problem List Manager Application to test the hypothesis that SNOMED-CT is clinically usable and suitable for clinical problem list entry at the point-of-care. We will write a set of interfaces to perform Automated Term Composition and Dissection and design and test a High Throughput machine to evaluate the content coverage of SNOMED-CT using a large corpus of clinical problems (2,000,000 clinical problems). This proposed effort would provide an independent evaluation of SNOMED-CT in a clinical setting. Accurate and comparable patient data, recorded at the granularity at which we practice medicine, has far reaching research implications for medical practice (e.g., implementation of guidelines), education of future clinicians (e.g., information acquisition techniques) and research (e.g., outcomes research) toward the evidence-based practice of medicine.