The intersection of comics and healthcare, or graphic medicine, includes comics and graphic novels that share personal stories of health, illness, and recovery, and are useful in educating patients as well as providing insight into the patent experience for caregivers and providers. This presentation outlines the methodology and results of a limited pilot study exploring the semantic enrichment of metadata for mental health comics by better connecting their content to healthcare-related Linked Open Data resources. This approach potentially enhances the discoverability of comics content for education and reuse, and is both multilingual and applicable to non-traditionally published works, including self-published and crowd-funded materials. Virtual panel presentation, 2022, October 3-7. International Conference on Dublin Core and Metadata Applications (DCMI 2022): https://www.dublincore.org/conferences/2022/sessions/panel-metadata-for-visual-media-arts/

1. Sean Petiya
Kent State University
spetiya1@kent.edu
https://github.com/comicmeta/LOD-MentalHealth

2. graphic medicine & lod : outline
1) Graphic Medicine
2) Structure of Comics Content
3) Pilot Study* (Methodology & Results)
4) Query Examples
5) Challenges & Future Directions
comicmeta.org / spetiya1@kent.edu
* Originally presented in a virtual poster presentation at The University of San Diego’s Copley
Library's inaugural Comic Studies & Practices Symposium (CSPS) (July, 2022)
https://digital.sandiego.edu/csp-symposium/

3. graphic medicine & lod : background
 Comic books and graphic novels are a visual and engaging medium, a great form of graphic
medicine, defined as “the intersection of comics and healthcare” (Czerwiec et al., 2015)
 Comics about health and illness can help explain complex medical topics, and share personal
healthcare stories between patients, caregivers, and providers (Jaggers et al., 2020)
 Comics can provide insight into the patient experience for healthcare providers (Green & Myers,
2010), and may also help improve empathy and communication (Jaggers et al., 2020)
comicmeta.org / spetiya1@kent.edu
Graphic novels
about bipolar
disorder
https://www.nlm.nih.gov/exhibition/graphicmedicine/index.html

4. graphic medicine & lod : problem
 Metadata describing comics
publications may lack medical
subject headings, or descriptions of
narrative content
 Stories, pages, and panels may
illustrate specific symptoms,
treatments, side-effects, etc.
 Semantic enrichment using LOD
offers an opportunity to enhance
discoverability by linking comics
content to common healthcare
vocabularies and ontologies
comicmeta.org / spetiya1@kent.edu
The Life Sciences Linked
Open Data Cloud from
lod-cloud.net

5. graphic medicine & lod : linked open
data
comicmeta.org / spetiya1@kent.edu
 Data that is made freely available on the Web,
published with an open license (Berners-Lee, 2006)
 Uses common protocols (HTTP)
 Uses common data formats (XML, JSON, etc.)
 Uses common identifiers (URIs) instead of strings for
the names of subjects (#Bob not “Bob”)
 Machine readable and linked to other data
 Intersection of comics and healthcare not only in
content, but also in the metadata.
The Life Sciences Linked Open Data Cloud from lod-cloud.net

6. graphic medicine & lod : structure
comicmeta.org / spetiya1@kent.edu
1 2
3 4 5
1
2
FPG / Hulton Archive / Getty
story/chapter
page
panel
balloon/bubble
 Sequential narrative, and serialized storytelling
 Serialized stories collected in trades/graphic novels
Pages from States of Mind

7. graphic medicine & lod : modeling
comicmeta.org / spetiya1@kent.edu
1 2
3 4 5
Sequence model from the Comic Book Ontology (CBO) Pages from States of Mind

8. graphic medicine & lod : pilot study
 Explore creating LOD for mental health comics,
focusing on States of Mind, a personal memoir of
bipolar disorder
 Common mental health condition; typically
characterized by mood swings: low periods of
depression, emotionally high periods called
hypomania or mania
 Limited insight can affect adherence with treatment
and medication (Látalová, 2012)
 Comics help subvert stereotypical, stigmatizing
representations of mental illness found in other media
(Saji & Venkatesan, 2021)
comicmeta.org / spetiya1@kent.edu
Pages from States of Mind by Patrice and Emilie Guillon
https://health.clevelandclinic.org/4-myths-you-shouldnt-believe-about-
bipolar-disorder/

9. graphic medicine & lod : methodology
 Semantic enrichment is “the process of adding a layer of topical metadata to content so that
machines can make sense of it and build connections to it” (Clarke & Harley, 2014)
 The strategy of semantic enrichment has been successfully implemented by libraries, archives,
and museums (LAMs) to improve discoverability and reuse of their data (Zeng, 2019)
 Adding semantic annotations to digital comics content has been explored using automated tools
like ComSem (Herwegen et al., 2017)
 Community and fan data often includes detailed content indexes (e.g. Grand Comics Database,
The Official Marvel Index, etc.)
 This pilot study builds on these approaches in three phases; (1) a review of existing metadata, (2)
indexing and analyzing content, (3) creating enriched metadata
comicmeta.org / spetiya1@kent.edu

10. graphic medicine & lod : methodology, phase 1 (MARC)
comicmeta.org / spetiya1@kent.edu
https://encore.cuyahoga.lib.oh.us/iii/encore/record/C__Rb11444844__Sstates%20of%20mind__?lang=eng&marcData=Y
520. Summary
650. Subjects (LCSH)
655. Genre/Form (LCGFT)

11. graphic medicine & lod : methodology, phase 1 (RDF)
comicmeta.org / spetiya1@kent.edu
http://experiment.worldcat.org/oclc/1057775520.ttl

12. graphic medicine & lod : methodology, phase 1 (HTML)
comicmeta.org / spetiya1@kent.edu
https://www.comics.org/issue/1963646/
Chapter

13. graphic medicine & lod : methodology, phase 2 (indexing)
comicmeta.org / spetiya1@kent.edu
Comic Book Ontology (CBO) – Sequence Model

14. graphic medicine & lod : methodology, phase 2 (content analysis)
comicmeta.org / spetiya1@kent.edu
schema:name schema:about
https://bioportal.bioontology.org/

15. graphic medicine & lod : methodology, phase
3
comicmeta.org / spetiya1@kent.edu
https://github.com/comicmeta/LOD-MentalHealth

16. graphic medicine & lod : results & limitations
 76 pages or panels illustrating topics related to mental health indexed
 37 total healthcare terms from 11 LOD healthcare ontologies
 Methodology is multilingual and applicable to non-traditionally published work (crowd-funded, etc.)
 Indexing/analysis can be subjective, benefiting from editorial review
 Healthcare term selection accuracy requires review by domain experts
comicmeta.org / spetiya1@kent.edu

17. graphic medicine & lod : graph
comicmeta.org / spetiya1@kent.edu
story
comic
page
panel
about
label
Graph of mental health topics for States of Mind

18. graphic medicine & lod : graph
comicmeta.org / spetiya1@kent.edu
story
comic
about
label
Graph of mental health topics for States of Mind by story/chapter

19. graphic medicine & lod : examples
comicmeta.org / spetiya1@kent.edu
Panic Attack
Onset + Mental Disorder

20. graphic medicine & lod : examples
comicmeta.org / spetiya1@kent.edu
cyamemazine (Tercian)
Loss of Appetite
Blood Lithium Level

21. graphic medicine & lod : challenges & future directions
 Support for multiple perspectives (patient, caregiver, provider)
 Metadata application profile for graphic medicine
 Recommend specific healthcare ontology (e.g. MedDRA, MESH, etc.)
 Create system for sharing indexes of graphic medicine examples
 Enable contributions from non-metadata experts
comicmeta.org / spetiya1@kent.edu

22. graphic medicine & lod : ontologies referenced
comicmeta.org / spetiya1@kent.edu
PREFIX NAME
ICD10CM International Classification of Diseases, Version 10 Clinical Modification
MESH Medical Subject Headings
MEDDRA Medical Dictionary for Regulatory Activities Terminology
OGMS The Ontology for General Medical Science
NDDF National Drug Data File Plus Source Vocabulary
SYMP Symptom Ontology
MEDLINEPLUS MedlinePlus Health Topics
MFOMD MFO Mental Disease Ontology
ICNP International Classification for Nursing Practice
NDFRT National Drug File - Reference Terminology
ICPC2P International Classification of Primary Care - 2 PLUS
See BioPortal (https://bioportal.bioontology.org) for more information

23. graphic medicine & lod : more info
Sean Petiya
spetiya1@kent.edu
Comic Book Ontology (CBO)
https://comicmeta.org/cbo
LOD Mental Health Pilot Study
https://github.com/comicmeta/LOD-MentalHealth
comicmeta.org / spetiya1@kent.edu

24. graphic medicine & lod : references
Berners-Lee, T. (2006). Linked data-design issues. http://www.w3.org/DesignIssues/LinkedData.html
Clarke, M., & Harley, P. (2014). How smart is your content? Using semantic enrichment to improve your user experience and your bottom
line. Science, 37(2), 40-44
Czerwiec, MK., Williams, I., Squier, S. M., Green, M. J., Myers, K. R., & Smith, S. T. (2015). Graphic medicine manifesto. Penn State
Press.
Green, M. J., & Myers, K. R. (2010). Graphic medicine: use of comics in medical education and patient care. Bmj, 340
Herwegen, J. V., Verborgh, R., & Mannens, E. (2017, May). ComSem: Digitization and Semantic Annotation of Comic Books. In European
Semantic Web Conference (pp. 65-70). Springer, Cham
Jaggers, A., Noe, M., & Pomputius, A. (2020). Graphic medicine in your library: Ideas and strategies for collecting comics about health
care. In Ballestro, J. (Ed.), The library's guide to graphic novels (pp. 165-184). ALA Editions, 2020.
Látalová, K. (2012). Insight in bipolar disorder. Psychiatric Quarterly, 83(3), 293-310
Saji, S., & Venkatesan, S. (2021). Metaphors of mental illness in graphic medicine. Taylor & Francis Group.
Zeng, M. L. (2019). Semantic enrichment for enhancing LAM data and supporting digital humanities. Review article. El profesional de la
información, 28(1) https://doi.org/10.3145/epi.2019.ene.03
comicmeta.org / spetiya1@kent.edu