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，广泛接受的术语，牙科的发现和诊断是一个重大障碍，系统地测量和改善口腔健康。1999年，美国牙科协会发布了牙科系统命名法（SNODENT）;然而，该术语尚未在临床牙科中进行评估，也未使用。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率知之甚少。本申请的目的是测量几个医疗术语（包括SNODENT）在一般牙科实践中常用的诊断和发现的覆盖范围，并使用结果将SNODENT开发为该领域的有效临床参考术语。我们的第一个目标是收集临床概念的诊断工作和治疗计划的20例患者的情况下，由10个普通牙医，并通过观察120个初始患者的检查进行40个普通牙医。使用NLM MetaMap Transfer工具，训练集（收集的概念的80%）将使用五项量表与SNODENT、SNOMED、MeSH和ICD-10进行匹配：“完全匹配（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）”。“我们认为，不超过60%的概念将有一个“良好的匹配”，即得分优于1，在任何目标术语。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、牙医和牙科技师组成的专家组将建议对SNODENT进行修改，这些修改将由项目工作人员实施。我们将使用Apelon开发环境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中进行的评估。我们的工作假设是，“新的SNODENT”将有超过80%的“良好匹配”在这个试点评估。在这两个具体目标，我们将使用现有的牙科调查结果和诊断词汇表，以提供我们的结果外部验证。我们建议开发的参考术语将具有多方面的好处。首先，它可以作为发展派生的专门术语的来源，例如治疗理由分类。第二，从长远来看，我们期望它能促进在个人、群体和人群层面测量和改善口腔健康状况方面取得重大进展;实现循证牙科学;加速将研究转化为实践;并在NHII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.