A Controlled Terminology for Diagnoses and Findings in General Dentistry

描述（由申请人提供）：缺乏一个有效的、被广泛接受的牙科发现和诊断术语，是系统测量和改善口腔健康的一个重大障碍。1999年，美国牙科协会发布了《牙科系统命名法》（SNODENT）；然而，这个术语没有被评估过，也没有在临床牙科中使用。牙科概念越来越多地出现在独立/本地化和主流医疗保健术语中，但对这些术语的领域覆盖范围知之甚少。本应用程序的目的是通过几种医疗保健术语（包括SNODENT）来测量一般牙科实践中常用的诊断和发现的覆盖率，并使用结果将SNODENT发展成该领域的有效临床参考术语。我们的第一个目标是通过10名普通牙医对20例患者的诊断检查和治疗计划，以及观察40名普通牙医对120例患者的初步检查，收集临床概念。使用NLM MetaMap Transfer工具，一个训练集（80%收集到的概念）将使用五项量表与SNODENT、SNOMED、MeSH和ICD-10进行匹配：“精确匹配(4)”、“词汇等效匹配(3)”、“语义等效匹配(2)”、“部分匹配(1)”和“不匹配(0)”。我们假设不超过60%的概念在任何目标术语中都有“良好匹配”，即得分高于1。我们的第二个目标是将SNODENT转换为SNOMED-CT的结构，并更新和修改其内容以提高域覆盖率。一个由12名术语专家、牙科信息学家、牙医和牙科保健师组成的专家组将对SNODENT提出修改建议，并由项目工作人员执行。我们将使用Apelon开发环境的术语来指定概念及其属性、限定符、角色和关联。然后，我们将使用测试集（20%的概念）重复在具体目标1中执行的评估。我们的工作假设是“新SNODENT”在本次试点评估中将有超过80%的“良好匹配”。在这两个特定目标中，我们将使用现有的牙科发现和诊断词汇表来为我们的结果提供外部验证。我们建议开发的参考术语将有多种好处。首先，它可以作为开发派生的专门术语的来源，例如处理理由分类。第二，从长期来看，我们期望它能促进在测量和改善个人、群体和人口层面的口腔健康状况方面取得重大进展；支持循证牙科；加快研究成果向实践的转化；以及在国家健康调查的背景下简化口腔健康信息的交流。

DESCRIPTION (provided by applicant): The absence of a validated, broadly accepted terminology for Dental findings and diagnoses is a significant barrier to systematically measuring and improving oral health. In 1999, the American Dental Association released the Systematic Nomenclature of Dentistry (SNODENT); however, this terminology has not been evaluated, nor is it in use, in clinical Dentistry. Dental concepts have increasingly appeared in both standalone/localized and mainstream healthcare terminologies, but little is known about the domain coverage of these terminologies. The objective of this application is to measure the coverage of diagnoses and findings commonly used in general Dental practice by several healthcare terminologies (including SNODENT), and to use the results to develop SNODENT into a validated clinical reference terminology for this domain. Our first Aim is to collect clinical concepts from diagnostic work-ups and treatment planning of 20 patient cases by 10 general Dentists, and by observing 120 initial patient examinations performed by 40 general Dentists. Using the NLM MetaMap Transfer tool, a training set (80% of the collected concepts) will be matched against SNODENT, SNOMED, MeSH and ICD-10 using a five-item scale: "exact match (4),", "lexically equivalent match (3)," "semantically equivalent match (2)," "partial match (1)," and "no match (0). "We posit that no more than 60% of the concepts will have a "good match," i.e. a score better than 1, in any of the target terminologies. Our second Aim is to convert SNODENT to the structure of SNOMED-CT, and to update and modify its content to improve domain coverage. An expert group composed of 12 terminology specialists, Dental informaticians, Dentists and Dental hygienists will recommend changes to SNODENT, which will be implemented by project staff. We will use the Terminology of Apelon Development Environment to specify concepts and their properties, qualifiers, roles and associations. We will then repeat the evaluation performed in Specific Aim 1 using a test set (20% of the concepts). Our working hypothesis is that the "new SNODENT" will have more than 80% "good matches" in this pilot evaluation. In both Specific Aims, we will use existing Dental findings and diagnosis vocabularies to provide external validation of our results. The reference terminology we propose to develop will have multiple benefits. First, it can serve as a source of developing derived, specialized terminologies, such as a reason-for-treatment classification. Second, over the long term, we expect it to facilitate significant advances in measuring and improving oral health status at the individual, group and population level; enabling evidence-based Dentistry; speeding the translation of research into practice; and easing the exchange of oral health information in the context of the NHII.