EN ISO 17117-1:2025
(Main)Health informatics - Terminological resources - Part 1: Characteristics (ISO 17117-1:2025)
Health informatics - Terminological resources - Part 1: Characteristics (ISO 17117-1:2025)
This document defines universal and specialized characteristics of health terminological resources that make them fit for the purposes required of various applications. It covers only terminological resources that are primarily designed to be used for clinical concept representation or to those parts of other terminological resources designed to be used for clinical concept representation.
This document helps users to assess whether a terminology has the characteristics or provides the functions that will support their specified requirements. In order to do that, this document focuses on defining characteristics and functions of terminological resources in healthcare that can be used to identify different types of terminological resources for categorization purposes.
NOTE 1 Categorization of healthcare terminological systems according to the name of the system might not be helpful and has caused confusion in the past.
The following aspects are not covered in this document:
— evaluations of terminological resources;
— health service requirements for terminological resources and evaluation criteria based on the characteristics and functions;
— the nature and quality of mappings between different terminologies;
NOTE 2 It is unlikely that a single terminology will meet all the terminology requirements of a healthcare organization: some terminology providers produce mappings to administrative or classification systems such as the International Classification of Diseases (ICD). The presence of such maps would be a consideration in the evaluation of the terminology.
— the nature and quality of mappings between different versions of the same terminology;
NOTE 3 To support data migration and historical retrieval, terminology providers can provide maps between versions of their terminology. The presence of such maps would be a consideration in the evaluation of the terminology.
— terminology server requirements and techniques and tools for terminology developers;
— characteristics for computational biology terminology.
Medizinische Informatik - Terminologische Ressourcen - Teil 1: Merkmale (ISO 17117-1:2025)
Informatique de santé - Ressources terminologiques - Partie 1: Caractéristiques (ISO 17117-1:2025)
Le présent document définit des caractéristiques universelles et propres aux ressources terminologiques en santé qui rendent ces dernières adaptées aux usages prescrits dans le cadre de différentes applications. Il couvre uniquement les ressources terminologiques principalement conçues pour être utilisées à des fins de représentation de concepts cliniques, ou les parties d’autres ressources terminologiques conçues dans ce même but.
Le présent document aide les utilisateurs à déterminer si une terminologie possède les caractéristiques ou propose les fonctions permettant de répondre à leurs exigences particulières. Pour ce faire, le présent document porte principalement sur la définition des caractéristiques et fonctions liées aux ressources terminologiques dans le domaine des soins de santé et pouvant être utilisées pour identifier les différents types de ressources terminologiques à des fins de catégorisation.
NOTE 1 La catégorisation des systèmes terminologiques en soins de santé selon leur intitulé peut n’être d’aucune utilité et a été source de confusion par le passé.
Les aspects suivants ne sont pas couverts dans le présent document:
— les évaluations des ressources terminologiques;
— les exigences des services de santé concernant les ressources terminologiques et les critères d’évaluation basés sur les caractéristiques et fonctions de ces ressources;
— la nature et la qualité des mises en correspondance des différentes terminologies;
NOTE 2 Il semble peu probable qu’une terminologie unique réponde à toutes les exigences terminologiques d’un organisme de soins de santé: certains fournisseurs de terminologie effectuent des mises en correspondances avec des systèmes administratifs ou des systèmes de classification, tels que la Classification internationale des maladies (CIM). De telles correspondances sont à prendre en considération dans l’évaluation de la terminologie.
— la nature et la qualité des mises en correspondance des différentes versions d’une même terminologie;
NOTE 3 Pour aider à la migration des données et à la récupération de l’historique, les fournisseurs de terminologie peuvent mettre à disposition les correspondances entre les différentes versions de leur terminologie. De telles correspondances sont à prendre en considération dans l’évaluation de la terminologie.
— les exigences relatives aux serveurs terminologiques ainsi que les techniques et outils disponibles pour les personnes chargées de l’élaboration de terminologies;
— les caractéristiques de la terminologie de la biologie computationnelle.
Zdravstvena informatika - Terminološki viri - 1. del: Značilnosti (ISO/FDIS 17117-1:2025)
General Information
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Standards Content (Sample)
SLOVENSKI STANDARD
oSIST prEN ISO 17117-1:2024
01-oktober-2024
Zdravstvena informatika - Terminološki viri - 1. del: Značilnosti (ISO/DIS 17117-
1:2024)
Health informatics - Terminological resources - Part 1: Characteristics (ISO/DIS 17117-
1:2024)
Medizinische Informatik - Terminologische Ressourcen - Teil 1: Merkmale (ISO/DIS
17117-1:2024)
Informatique de santé - Ressources terminologiques - Partie 1: Caractéristiques
(ISO/DIS 17117-1:2024)
Ta slovenski standard je istoveten z: prEN ISO 17117-1
ICS:
01.020 Terminologija (načela in Terminology (principles and
koordinacija) coordination)
35.240.80 Uporabniške rešitve IT v IT applications in health care
zdravstveni tehniki technology
oSIST prEN ISO 17117-1:2024 en,fr,de
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.
oSIST prEN ISO 17117-1:2024
oSIST prEN ISO 17117-1:2024
DRAFT
International
Standard
ISO/DIS 17117-1
ISO/TC 215
Health informatics —
Secretariat: ANSI
Terminological resources —
Voting begins on:
Part 1: 2024-07-22
Characteristics
Voting terminates on:
2024-10-14
Informatique de santé — Ressources terminologiques —
Partie 1: Caractéristiques
ICS: 35.240.80; 01.020
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oSIST prEN ISO 17117-1:2024
DRAFT
ISO/DIS 17117-1:2024(en)
International
Standard
ISO/DIS 17117-1
ISO/TC 215
Health informatics —
Secretariat: ANSI
Terminological resources —
Voting begins on:
Part 1:
Characteristics
Voting terminates on:
Informatique de santé — Ressources terminologiques —
Partie 1: Caractéristiques
ICS: 35.240.80; 01.020
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Published in Switzerland Reference number
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ii
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ISO/DIS 17117-1:2024(en)
Contents Page
Foreword .v
Introduction .vi
1 Scope . 1
2 Normative references . 2
3 Terms and definitions . 2
3.1 General terms .2
3.2 Relations between concepts .4
3.3 Formal concept representation .5
3.4 Terminological resources (in health domain).7
4 Characteristics of terminological resources in the health domain . 8
4.1 Basics .8
4.2 Pre-coordinated characteristics aiming at identification of a specific concept/term .9
4.2.1 Term identifier .9
4.2.2 Concept identifier .9
4.2.3 Concept orientation .9
4.3 Characteristics related to extensibility for concept representations .10
4.3.1 Characteristics to specify more detailed concepts .10
4.3.2 Characteristics to broaden coverage of concepts .11
4.4 Characteristics related to data aggregation or classification .11
4.4.1 General .11
4.4.2 Mutual exclusiveness .11
4.4.3 Exhaustiveness . 12
4.5 Characteristics related to formal concept representation and semantic interoperability . 12
4.5.1 Compositionality . 12
4.5.2 Hierarchical relation . 12
4.5.3 Associative relation . 13
4.5.4 Categorial structure . 13
4.5.5 Semantic consistency .14
4.6 Characteristics related to maintenance of terminological resources .14
4.6.1 Context-free identifiers .14
4.6.2 Persistence of identifiers .14
4.6.3 Version identifier . . 15
4.6.4 Editorial information . 15
4.6.5 Obsolete marking . 15
4.6.6 Responsiveness . . 15
5 Functions invoked by a certain set of characteristics .15
5.1 Basics . 15
5.2 Data capture . 15
5.2.1 General . 15
5.2.2 Extensibility for concept representation .16
5.2.3 Providing semantically consistent formal concept representation . .16
5.3 Display/presentation/identification .17
5.3.1 General .17
5.3.2 Accessing concepts using terminology structure .17
5.4 Data aggregation for statistical analysis .18
5.5 Reasoning .18
5.5.1 Reasoning of internal consistency .18
5.6 Maintenance-related functions.19
5.6.1 Concept permanence .19
5.6.2 Version control .19
Annex A (informative) Relations between characteristics, functions, requirements and
evaluation criteria of terminological resources .21
iii
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Annex B (informative) Relations among terminological resources .22
Bibliography .23
iv
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Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out through
ISO technical committees. Each member body interested in a subject for which a technical committee
has been established has the right to be represented on that committee. International organizations,
governmental and non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely
with the International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization.
The procedures used to develop this document and those intended for its further maintenance are described
in the ISO/IEC Directives, Part 1. In particular the different approval criteria needed for the different types
of ISO documents should be noted. This document was drafted in accordance with the editorial rules of the
ISO/IEC Directives, Part 2 (see www.iso.org/directives).
Attention is drawn to the possibility that some of the elements of this document may be the subject of patent
rights. ISO shall not be held responsible for identifying any or all such patent rights. Details of any patent
rights identified during the development of the document will be in the Introduction and/or on the ISO list of
patent declarations received (see www.iso.org/patents).
Any trade name used in this document is information given for the convenience of users and does not
constitute an endorsement.
For an explanation on the voluntary nature of standards, the meaning of ISO specific terms and
expressions related to conformity assessment, as well as information about ISO's adherence to the World
Trade Organization (WTO) principles in the Technical Barriers to Trade (TBT) see the following URL:
www.iso.org/iso/foreword.html.
This document was prepared by ISO/TC 215, Health informatics.
This first edition of ISO 17117-1 cancels and replaces ISO/TS 17117:2002, which has been technically revised.
A list of all the parts of ISO 17117 is available on the ISO website.
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Introduction
Health terminology is complex and multifaceted. It has been estimated that up to 45 million different terms
are needed to adequately describe health-related concepts like conditions of patients and populations,
actions in healthcare and related concepts, such as medicines, biomedical molecules, genes, organisms,
[3]
technical methods and social concepts. Many formal and less formal terminological resources exist to
represent this complexity. These may be called terminological systems, coding systems, formal concept
representation systems, classification systems, and others. Specific features of different terminological
resources make them more or less useful for particular purposes and technological environments.
The need for formal terminological resources to support health information management has been widely
[6][7][8]
recognized. Such resources are required for precise data collection, accurate interpretation of data and
[7]
interoperability among information systems that exchange such data. National governments, healthcare
organizations and others are currently concerned with the question of which of the available terminological
resources will meet their requirements, i.e. they wish to ‘assign value’ to specific terminological resources
to decide which are suitable for their purposes and healthcare contexts.
A set of criteria to support such evaluations was originally published by ISO in 2002 (ISO/TS 17117). The
main purpose was to enable users to assess whether a terminological resource has the characteristics that
will support their specified requirements, since the characteristics of a terminological resource influence
its utility and appropriateness in applications. There has been much progress in the study and use of
[9][10]
terminological resources since that time and some experience of formal evaluations. This revision
updates the original Technical Specification with a revised scope and purpose commensurate with present
and future healthcare and technology contexts, incorporating new definitional standards where relevant.
As the first part of the entire revision work, this document (ISO 17117-1) identifies the characteristics of
terminological resources in healthcare (Clause 4) and functions or roles invoked by those characteristics
(Clause 5). This document also provides a framework to identify different types of terminological resources
using a combination of those characteristics and functions, which is essential for the development of criteria
for the categorization of terminological resources in healthcare. Requirements for, and evaluation criteria
of, terminological resources in healthcare, which will be addressed in the future parts of ISO 17117, are
tightly related to the characteristics of terminological resources and functions that they can provide.
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DRAFT International Standard ISO/DIS 17117-1:2024(en)
Health informatics — Terminological resources —
Part 1:
Characteristics
1 Scope
This document defines universal and specialized characteristics of health terminological resources that
make them fit for the purposes required of various applications. It refers only to terminological resources
that are primarily designed to be used for clinical concept representation or to those parts of other
terminological resources designed to be used for clinical concept representation.
This document helps users to assess whether a terminology has the characteristics or provides the functions
that will support their specified requirements. The focus of this document is to define characteristics and
functions of terminological resources in healthcare that can be used to identify different types of them
for categorization purposes. Clauses 4 and 5 support categorization according to the characteristics and
functions of the terminological resources rather than the name.
NOTE Categorization of healthcare terminological systems according to the name of the system might not be
helpful and has caused confusion in the past.
The target groups for this document are:
a) organizations wishing to select terminological systems for use in healthcare information systems;
b) developers of terminological systems;
c) developers of terminology standards;
d) those undertaking independent evaluations/academic reviews of terminological resources;
e) terminology Registration Authorities.
This document contains general characteristics and criteria with which systems can be evaluated.
The following considerations are outside the scope of this document.
— Evaluations of terminological resources.
— Health service requirements for terminological resources and evaluation criteria based on the
characteristics and functions.
— The nature and quality of mappings between different terminologies. It is unlikely that a single
terminology will meet all the terminology requirements of a healthcare organization: some terminology
providers produce mappings to administrative or statistical classifications such as the International
Classification of Diseases (ICD). The presence of such maps would be a consideration in the evaluation of
the terminology.
— The nature and quality of mappings between different versions of the same terminology. To support data
migration and historical retrieval, terminology providers can provide maps between versions of their
terminology. The presence of such maps would be a consideration in the evaluation of the terminology.
— Terminology server requirements and techniques and tools for terminology developers.
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— Characteristics for computational biology terminology. Progress in medical science and in terminology
science will necessitate updating of this document in due course.
2 Normative references
There are no normative references in this document.
3 Terms and definitions
For the purposes of this document, the following terms and definitions apply.
ISO and IEC maintain terminological databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at https:// www .electropedia .org/
3.1 General terms
3.1.1
concept
unit of knowledge created by a unique combination of characteristics (3.1.3)
Note 1 to entry: Informally, the term ‘concept’ is often used when what is meant is ‘concept representation’. However,
this leads to confusion when precise meanings are required. Concepts arise out of human individual and social
conceptualizations of the world around them. Concept representations are artefacts constructed of symbols.
Note 2 to entry: Concept representations are not necessarily bound to particular languages. However, they are
influenced by the social or cultural context of use often leading to different categorizations.
[SOURCE: ISO 1087:2019, 3.2.7, modified — changed the notes.]
3.1.2
term
linguistic representation of a concept in a specific subject field (3.1.15)
3.1.3
characteristic
abstraction of a property
EXAMPLE ‘Being a disease of the nervous system’ as a characteristic of the concept ‘Functional parkinsonism’.
Note 1 to entry: Characteristics are used for describing concepts (3.1.1).
[SOURCE: ISO 1087:2019, 3.2.1, modified — changed the example.]
3.1.4
term identifier
sequence of letters, numbers or symbols, capable of uniquely identifying a term within the terminological
resource
Note 1 to entry: Term identifier shall be unique within the terminological resource.
3.1.5
concept identifier
canonical expression (3.3.5), or sequence of letters, numbers or symbols, capable of uniquely identifying a
concept within the terminological resource
Note 1 to entry: Concept identifier shall be unique within the terminological resource, so terms shall not be used for
the purpose here in case polysemy exists.
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3.1.6
code
identifier expressed by a series of letters, numbers, or symbols
Note 1 to entry: A code is a concept identifier (3.1.5) when used in a coding system (3.4.4).
3.1.7
terminological resource identifier
unique permanent identifier of a terminological resource (3.4.1) for use in information interchange
Note 1 to entry: This is equivalent to Health Coding Scheme Designator in EN 1068:2005 for registration of coding
systems.
Note 2 to entry: Globally unique schemes such as OIDs, UUIDs, and URIs may be used for this purpose.
3.1.8
terminological resource version identifier
version identifier
identifier assigned to a version under which a terminological resource (3.4.1) is published or updated
3.1.9
coding scheme
collection of rules that maps the elements in one set, the “coded set”, onto the elements in a second set, “the
code set”
Note 1 to entry: The two sets are not part of the coding scheme.
3.1.10
composite characteristic
representation of a characteristic (3.1.3)
EXAMPLE has Cause Bacteria; Location = LeftUpperLobeOfLung.
Note 1 to entry: Typically expressed by a semantic link (3.2.5) and a characterizing concept (3.1.11).
3.1.11
characterizing concept
concept that is referenced by a semantic link (3.2.5) in a composite characteristic (3.1.10)
EXAMPLE “Bacterium” in the construct “Disease that has Cause Bacterium”; “Yellow” in the construct “Skin
Lesion that has Colour Yellow”.
3.1.12
characterizing generic concept
characterizing category
value domain
formal category whose specialization by a domain constraint (3.1.14) is allowed to be used as characterizing
concept (3.1.11) in a particular context
EXAMPLE 1 = {bacterium, virus, parasite}, in the context of “infection that has Cause
INFECTIOUS_ORGANISM”.
EXAMPLE 2 has Cause Bacteria; Location = LeftUpperLobeOfLung.
Note 1 to entry: The context includes a superordinate concept and a semantic link.
3.1.13
sanctioned characteristic
formal representation of a type of characteristics (3.1.3)
EXAMPLE 1 performed Using ; hasLocation .
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EXAMPLE 2 “Cause Of Inflammation can Be set {bacteria, virus, parasite, autoimmune, chemical, physical}”, where
“can Be” is the semantic link, and “set {bacteria, virus, parasite, autoimmune, chemical, physical}” is the characterizing
generic concept.
Note 1 to entry: A sanctioned characteristic is typically made up of a combination of a semantic link (3.2.5) and a
characterizing generic concept (3.1.12), and can be used in domain constraints (3.1.14).
3.1.14
domain constraint
sanction rule prescribing the set of sanctioned characteristics (3.1.13) that are valid to specialize a concept
(3.1.1) in a particular subject field (3.1.15)
EXAMPLE “Infection possibly has Location Skeletal Structure” describes that an infection in a certain context can
be located in a structure that is a kind of skeletal structure.
Note 1 to entry: The rule describes the set of potential characteristics by combining the semantic link (3.2.5) and the
characterizing generic concept (3.1.12) it links to, possibly by enumeration of the concepts in the characterizing generic
concept.
Note 2 to entry: Different levels of sanctioning are possible (e.g. conceivable, sensible, normal, usually In The Context
Of, necessary).
[SOURCE: ISO 17115:2020]
3.1.15
subject field
domain
field of special knowledge
Note 1 to entry: The borderlines of a subject field are defined from a purpose-related point of view.
[SOURCE: ISO 17115:2020]
3.2 Relations between concepts
3.2.1
generic relation
generalization-specialization relation
genus-species relation
relation between two concepts where the intension of one of the concepts includes that of the other concept
and at least one additional delimiting characteristic
Note 1 to entry: A generic relation exists between the concepts ‘word’ and ‘pronoun’, ‘vehicle’ and ‘car’, ‘person’ and
‘child’.
Note 2 to entry: This relation is equivalent to ‘parent-child’ or ‘is-a’ relation. The child concept has the same intension
as the parent concept and at least one additional delimiting characteristic. Also the same in X ‘is-a’ Y.
Note 3 to entry: The use of the term ‘relation’ from an English perspective means that this is describing the concept
(i.e. this concept is a generic relation of another concept) not the relationship. However, the ‘generic relation’ here
means the relationship itself, not a concept.
[SOURCE: ISO 17115:2020, 3.2.1]
3.2.2
partitive relation
whole-part relation
relation between two concepts where one of the concepts constitutes the whole and the other concept a part
of that whole
Note 1 to entry: A partitive relation exists between the concepts ‘week’ and ‘day’, ‘molecule’ and ‘atom’.
Note 2 to entry: This relation is different from generic relation (3.2.1). For example, a day is part of a week, but is not a
specialization of a week, i.e. it is not a type of week.
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[SOURCE: ISO 17115:2020, 3.2.2]
3.2.3
hierarchical relation
relation between two concepts which may be either a generic relation (3.2.1) or a partitive relation (3.2.2)
EXAMPLE Relations such as ‘stomach’ ↔ ‘organ’ and ‘stomach’ ↔ ‘body’ are hierarchical relations, but the former
is a generic relation and the latter is a partitive relation.
Note 1 to entry: Partitive relations (3.2.2) have several sub-types, such as “constitutional part of”, “regional part of”,
“grouped by”, and so on, which are also hierarchical types of relations.
Note 2 to entry: A characteristic which is explicitly identified in the terminological resource may be used to determine
a hierarchy, and includes declaration of directionality. There may be more than one such characteristic in which case
the terminological resource can be said to have “poly-hierarchy”. The characteristic must have a value in the two
concepts at either end of the relation which can be compared to determine the hierarchy.
[SOURCE: ISO 1087:2019, 3.2.12, modified — added the example and notes.]
3.2.4
associative relation
associative concept relation
pragmatic relation
non-hierarchical concept relation
EXAMPLE The relation between disease “X” and virus “Y” is not a hierarchical but an associative relation. The
relation exists under a certain theme of interest (e.g. “a disease and its causative agent”) and explicitly recognized by
virtue of experience.
[SOURCE: ISO 1087:2019, 3.2.23, modified—added the example]
3.2.5
semantic link
formal representation of a directed associative relation (3.2.4) or partitive relation (3.2.2) between two
concepts
EXAMPLE hasCause (with inverse isCauseOf).
Note 1 to entry: This includes all relations except the generic relation (3.2.1)
Note 2 to entry: A semantic link always has an inverse, i.e. another semantic link with the opposite direction.
[SOURCE: ISO 17115:2020, 3.2.5]
3.3 Formal concept representation
3.3.1
axiomatic concept representation
atomic concept representation
concept representation that is not composed of other simpler concept representations within a formal
(concept representation) system (3.4.7)
EXAMPLE ‘Liver’, ‘Incision act’, ‘Pain’
Note 1 to entry: In many cases, axiomatic concept representations will correspond to what philosophers call “natural
kinds”. Such an entity cannot be meaningfully decomposed. These should form the basis of all concept representations.
Note 2 to entry: A coding system may include axiomatic concept representations as well as compositional concept
representations required for different use cases.
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3.3.2
compositional concept representation
composite concept representation
intensional definition of a concept using as delimiting characteristics one or more composite characteristics
(3.1.10)
Note 1 to entry: Each characterizing concept (3.1.11) in a composite characteristic (3.1.10) may be axiomatic concept
representation (3.3.1) or another compositional concept representation.
Note 2 to entry: This allows inference of subsumption within a formal (concept representation) system (3.4.7). It is often
expressed in a formalism, such as description logic.
Note 3 to entry: Compositional concept representation can be further divided into pre-coordinated concept
representation (3.3.3) and post-coordinated concept representation (3.3.4).
3.3.3
pre-coordinated concept representation
compositional concept representation (3.3.2) predefined within a formal (concept representation) system
(3.4.7), with an equivalent single unique concept identifier
EXAMPLE In SNOMED CT, “cancer of colon” is predefined and has a single unique identifier, which means to the
SNOMED CT that it represents a “single” concept. However, “colon” is a synonym for “colon structure” and “cancer” is a
synonym for “malignant neoplastic disease” in SNOMED CT. Therefore, “colon cancer” is non-atomic as it can be broken
down into compositional concept representation (e.g. “cancer of colon” = “malignant neoplastic disease” < Finding_
Site: “colon structure”>.).
3.3.4
post-coordinated concept representation
compositional concept representation (3.3.2), which is not pre-coordinated and therefore shall be represented
using more than one concept from one or many compositional systems (3.4.5), combined using mechanisms
within or outside the compositional systems
EXAMPLE 1 Problem.Main = Fracture, Problem.Location = Femur (within a template for a problem description).
EXAMPLE 2 Some common terminological resources, such as IETF BCP-47 for language tags, explicitly construct
post-coordinated concept representations from disparate coding systems for language, script, region, and so on.
Note 1 to entry: Combining concepts from disparate terminologies can cause problems with overlapping and/or
conflicting concepts, because there might be various ways to form compositional concept representations for the same
concept. Typically, the mechanisms for making compositional concept representations across disparate terminological
resources are specified in an information model (e.g. as templates for a certain type of concept).
3.3.5
canonical expression
concept name
term (3.1.2) which uniquely designates a concept within a terminological system (3.4.2)
EXAMPLE 1 Machine readable: >(with compositional
characteristics sorted alphabetically after semantic link) instead of
EXAMPLE 2 General language: Inflammation that has cause bacteria and has location lung (with compositional
characteristics sorted alphabetically after semantic link) instead of pulmonary infection that has cause bacteria.
Note 1 to entry: It is unique within the system and unambiguous.
3.3.6
categorial structure
minimal set of domain constraints (3.1.14) for representing terminological systems (3.4.2) in a subject field
(3.1.15)
[SOURCE: ISO 17115:2020, 3.1.1]
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3.4 Terminological resources (in health domain)
3.4.1
terminological resource
controlled set of terms (3.1.2) in health domain
Note 1 to entry: Usually designed and controlled for use with computers for a specific purpose in the health domain,
such as data entry, aggregation, retrieval and analysis. Accordingly, it has usability characteristics in health domain as
described in Clause 4.
Note 2 to entry: It has a generic relation to the following types (3.4.2 to 3.4.7).
3.4.2
terminological system
terminology
concept representation system
structured human and machine-readable representation of health concepts and relationships
Note 1 to entry: Every terminological system shall be organized by hierarchical relations (3.2.3) and/or associative
relations (3.2.4). Typically, most terminological systems are organized by hierarchical relations.
Note 2 to entry: Every terminological system shall have term representations of health concepts for human-readability.
Note 3 to entry: It is used directly or indirectly to describe health concepts such as health conditions and healthcare
activities, and allow their subsequent retrieval for analysis.
3.4.3
classification system
statistical classification
classification
terminological resource which has characteristics of mutual exclusiveness and exhaustiveness to aggregate
data to a pre-prescribed level of specialization for a specific purpose
Note 1 to entry: Both of the two additional characteristics are indispensable to provide data aggregation function
(5.4), and accordingly, to suit the use case for statistical analysis and data aggregation.
Note 2 to entry: It usually includes hierarchical relations (3.2.3) as well as definitions and rules for use but might not,
as in the example simple classification of gender: Male, Female.
Note 3 to entry: It does not necessarily consist of a pre-defined exhaustive set of mutually exclusive categories. Some
classification systems may have explicit rules to enable mutual exclusiveness.
3.4.4
coding system
combination of a set of concepts (coded concepts) (3.1.1), a set of code (3.1.6) values, and at least one coding
scheme (3.1.9) mapping code values to coded concepts
Note 1 to entry: Coded concepts are typically represented by terms, but can have other representation. Code values
are typically numeric or alphanumeric.
Note 2 to entry: Coding systems without organization by hierarchical relations and/or associative relations, such as
ISO 3166-1 for country codes, are not terminological systems.
3.4.5
compositional system
compositional terminology
terminological system (3.4.2) that supports the creation of compositional concept representation (3.3.2)
Note 1 to entry: The definition is equivalent to “a terminological system that has an ability of post-coordination.” It
does not preclude that a compositional system also includes axiomatic and pre-coordinated concepts.
Note 2 to entry: Pre-defined concepts in a compositional system are not necessarily represented as compositional
concept representation (3.3.2), since pre-defined concepts may include axiomatic concepts.
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3.4.6
nomenclature
compositional system (3.4.5) structured systematically according to pre-established naming rules
EXAMPLE 1 Naming rules for a family of molecules such as ‘—ane’, ‘—ene’, ‘halo—‘, ‘hydroxyl—‘ in prefix or suffix
is an example of pre-established naming rules in the compositional concept creation.
EXAMPLE 2 In SNOMED CT, “fully specified names” use a number of pre-established naming rules.
3.4.7
formal (concept representation) system
compositional system (3.4.5) with a set of machine processable definitions in a subject field
Note 1 to entry: Each definition of a pre-defined concept shall be an axiomatic concept representation (3.3.1), a
compositional concept representation (3.3.2) or a formal extensional definition.
4 Characteristics of terminological resources in the health domain
4.1 Basics
The characteristics of a terminological resource influence its utility and appropriateness in clinical
applications. Terminological resources should be evaluated within the context of their stated scope and
purpose and are intended to complement and utilize those notions already identified by other national and
international standards bodies.
This document explicitly refers only to terminological resources that are primarily designed to be used for
health concept representation or to the aspect of a terminological resource designed to be used for health
concept representation. This document will also provide terminological resource developers and users with
the basic characteristics and functions invoked by those characteristics that should be taken into account
on the occasion of assessing whether a terminological resource meets their requirements. These tenets do
not attempt to specify all the richness that can be incorporated into a healthcare terminological resource.
However, this document does specify the minimal characteristics, which will ensure that the terminological
resource can provide the functions that are indispensable for the requirements on it. Figure 1 illustrates
how those components are related to each other.
Figure 1 — Relations among the components in ISO 17117
This document will also provide terminology developers with a sturdy starting point for the development of
healthcare terminological resources. This foundation serves as the basis from which terminology developers
will build robust, large-scale, reliable and maintainable terminological resources.
Some classes of terminological resources defined in Clause 3 may have overlaps. For example, classification
systems (3.4.3) are typically coding systems (3.4.4). Each class of terminological resource defined in Clause 3
may have several characteristics defined in this clause. To assess whether a terminological resource meets
the applicable requirements, it is necessary for users and developers to pay considerable attention to the
characteristics the terminological resource has and functions invoked by those characteristics, rather than
its class name.
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Annex A gives relations between characteristics, functions, requirements and evaluation criteria of
terminological resources. Relations among terminological resources are given in Annex B.
4.2 Pre-coordinated characteristics aiming at identification of a specific concept/term
4.2.1 Term identifier
Every term in a terminological resource should have a term identifier (3.1.4).
EXAMPLE 1 In UMLS, the term ‘headache’ has the lexical unique identifier (LUI) ‘L0018681’, which is an example of
a term identifier at the ‘lexical’ level according to the definition in UMLS. Each LUI is also related to one or more lexical
variants, such as upper-lower case or punctuation difference, each of which is assigned a string unique identifier
called SUI. For example, ‘Headache’ has SUI ‘S0046854’ and ‘headaches’ has ‘S1459113’, which are also examples of
term identifiers at the ‘string’ level. Since UMLS is a meta-thesaurus which provides a mapping structure among
vocabularies, every occurrence of a string in each source vocabulary is assigned a unique identifier called atom unique
identifier (AUI). In this example, the term ‘Headache’ coming from SNOMED CT is given the UMLS AUI ‘A2882187’, and
‘Headache’ coming from MeSH is given the UMLS AUI ‘A0066000’, both of which are related to the same SUI ‘S0046854’.
The AUIs are also term identifiers at the ‘source vocabulary’ level of granularity.
NOTE Some terminological resources have no term identifiers. For example, MeSH has no identifiers for entry terms.
Term identifier shall be different from concept identifier, because different terms may point to the same
concept.
4.2.2 Concept identifier
Every concept in a terminological resource shall have a concept identifier (3.1.5).
EXAMPLE 1 In UMLS, the concept ‘Headache’ has the concept unique identifier (CUI) ‘C0018681’.
EXAMPLE 2 In UMLS, there are three terms related to the same concept ‘Headache’ (C0018681) with a different
term identifier (3.1.4): ‘headache’ (L0018681), ‘cranial pain’ (L1406212) and ‘cephalgia head pain’ (L0290366). This
is an example of different
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