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Making openEHR Terminology             binding practice                      Jussara Rötzsch           Adapted from Ian Mc...
Terminology binding patterns• Direct node‐binding  – e.g. ‘Urine color’ node     • Node name e.g.. “Urine color”        – ...
Direct‐binding issues• Incomplete terminology / translation coverage   – e.g.. SNOMED  – 50‐70% for histopathology• Effort...
“BP 120/78, sitting, large cuff”Candidate SNOMED CT term bindings: •   Blood pressure finding - ... (finding) – 392570002 ...
Direct‐binding guidance• Concentrate on current requirements  – Archetypes and templates ‘fix’ the semantics     • Initial...
Termset‐binding issues• Very little at Archetype‐level  – Scope of the termset binding is often too broad to     be meanin...
Termset‐binding guidance• Almost all at Template‐level  – Layered constraint approach     • All procedures        – Orthop...
Termset‐binding guidance•      Microsoft / NHS Common User Interface     (CUI)    – Layered constraint with ‘termset filte...
Example: “Family history”
Example: “Family history”                               Term bound to node Name                               ? 371534008 ...
Assessed risk : Family history                           No matches                            found in                   ...
Local terminologies ‐ England
Local terminologies ‐ Scotland
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openEHR terminology binding

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Dra. Jussara Macedo

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openEHR terminology binding

  1. 1. Making openEHR Terminology  binding practice Jussara Rötzsch Adapted from Ian McNicoll
  2. 2. Terminology binding patterns• Direct node‐binding – e.g. ‘Urine color’ node • Node name e.g.. “Urine color” – Automatically has unique internal term ‘at0007’ – Can be ‘run‐time’ coded by external term – Can be ‘run‐time’ mapped to an external term • Node value e.g.. ‘Red, yellow, purple’ – Unique term provided by Internal value set ‘at0009’ – External term mapped to term from Internal value set  – External term used as the value
  3. 3. Direct‐binding issues• Incomplete terminology / translation coverage  – e.g.. SNOMED – 50‐70% for histopathology• Effort – Requires very good terminology skills • Can be challenging to choose correct bindings – Some concepts require post‐coordination to capture  correctly – Is it worth trying to achieve complete node binding?
  4. 4. “BP 120/78, sitting, large cuff”Candidate SNOMED CT term bindings: • Blood pressure finding - ... (finding) – 392570002 • Sitting blood pressure - ... (observable entity) – 163035008 • Blood pressure - ... (observable entity) – 75367002 • Blood pressure taking - ... (procedure) – 46973005 • Diastolic blood pressure - ... (observable entity) – 271650006 • O/E - blood pressure reading - On examination - blood pressure reading (finding) – 163020007 • Blood pressure cuff - ..., device (physical object) – 70665002
  5. 5. Direct‐binding guidance• Concentrate on current requirements – Archetypes and templates ‘fix’ the semantics • Initial efforts guided by actual requirements • More bindings can be added later as requirements  evolve – Node bindings • Use internal value sets. Consider leaving ‘open to allow  for local variation. • Add External terminology bindings where required and  available
  6. 6. Termset‐binding issues• Very little at Archetype‐level – Scope of the termset binding is often too broad to  be meaningful at implementation • E.g. ‘All procedures’ in ACTION.procedure archetype – Very few examples of sensible termset‐bindings in  international archetypes – Much more applicable at national level • esp. National terminologies 
  7. 7. Termset‐binding guidance• Almost all at Template‐level – Layered constraint approach • All procedures – Orthopedic procedures » Knee specialist procedures – But generally have to provide option to override  the constraint for unusual clinical situations • e.g.. Non‐orthopedic procedure carried out in  Orthopedic department.
  8. 8. Termset‐binding guidance• Microsoft / NHS Common User Interface  (CUI) – Layered constraint with ‘termset filters – ‘Get‐out clause’ where constraint is too tight
  9. 9. Example: “Family history”
  10. 10. Example: “Family history” Term bound to node Name ? 371534008 |Summary report (record artifact) ? 422735006 |Summary clinical document (record artifact) Termset-bound to node Value: (Is_a genetic relation) 444148008 | Person in family of subjectTerm bound to node Name:408732007 | Subject Term bound to node internal Value set:relationship context [at0004|Not known] =365873007|Gender unknown (finding)(attribute) [at0004|Not known] =UNK|Gender unknown [at0005|Male] = SNOMEDCT::248153007 | Male (finding) [at0005|Male] = KITH-SEX::M| Male [at0006|Female] = 248152002 | Female(finding) [at0006|Female] = KITH-SEX::F | FemaleTerm bound to node Name:184100006 | Patient sex(observable entity OR Termset-bound to node Value: (??????) 429019009 | Finding related to biological sex
  11. 11. Assessed risk : Family history No matches found in SNOMED CT
  12. 12. Local terminologies ‐ England
  13. 13. Local terminologies ‐ Scotland

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