Health informatics - A syntax to represent the content of medical classification systems - ClaML

1.1   Main purposes
The main purpose of this European Standard is to support the safe transfer of the majority of hierarchical healthcare classification systems between organisations and dissimilar software products. It is intended to serve as the core representation, from which all publication forms can be derived. The Standard shall therefore be in depth enough to uniquely identify and describe the structure and the relevant elements in those systems. This Standard does not intend to prescribe the meaning of structuring elements in classification systems. This Standard is not meant to be a direct format for printing or viewing the contents of a classification system. Views and prints shall be derived from this representation by post processing.
1.2   Target groups of this European Standard
This European Standard is applicable to:
a)   developers of first and second generation [2] classification systems and terminologies, to assist in the construction, maintenance and publication (both in paper and electronic formats) of a particular system;
b)   developers of information systems to assist in the inclusion of mechanisms for unambiguous loading of classification systems in their applications;
c)   organisations responsible for updating classification systems;
d)   institutions receiving updated classification systems.
1.3   Topics considered outside the scope of this European Standard
This European Standard is not intended to:
a)   provide a normative syntax on how a classification system shall be constructed;
b)   define link types between elements in a classification system; this is left to the developers of classification systems;
c)   provide a representation for direct viewing or printing.

Medizinische Informatik - Syntax zur Darstellung des Inhalts medizinischer Klassifikationssysteme (ClaML)

Informatique de la santé - Syntaxe permettant de représenter le contenu des systèmes de classification médicaux - ClaML

1.1   Objectifs principaux
La présente Norme européenne a pour objectif principal d’aider à transférer en toute sécurité la plupart des systèmes de classification hiérarchiques de santé entre les organismes et les produits logiciels dissemblables. Elle vise à jouer le rôle de représentation centrale, à partir de laquelle toutes formes de publication peuvent être dérivées. La norme doit donc être suffisamment riche pour identifier et décrire sans équivoque la structure et les éléments correspondants de ces systèmes. La présente Norme ne vise pas à prescrire la signification des éléments structurants des systèmes de classification. Elle n’est pas sensée constituer un format direct d’impression ou de visualisation du contenu d’un système de classification. Les visualisations et les impressions doivent être dérivées de cette représentation par un traitement ultérieur.
1.2   Groupes cibles de la présente Norme européenne.
La présente Norme européenne est applicable par :
a)   les concepteurs de systèmes de classification et de terminologies de la première et de la seconde générations [2], pour les aider à concevoir, diffuser et assurer la maintenance d’un système particulier (que ce dernier soit en format papier ou électronique) ;
b)   les concepteurs de systèmes informatiques, pour les aider à intégrer des mécanismes permettant de charger sans ambiguïté les systèmes de classification dans leurs applications ;
c)   les organismes responsables de la mise à jour des systèmes de classification ;
d)   les institutions recevant les systèmes de classification mis à jour.
1.3   Sujets estimés en dehors du domaine d’application de la présente Norme européenne
La présente Norme européenne n’est pas destinée à :
a)   fournir une syntaxe normative sur la façon dont il faut construire un système de classification ;
b)   définir les types de liens entre les éléments d’un système de classification, aspect qui est à la charge des concepteurs de systèmes de classification ;

Zdravstvena informatika - Sintaksa predstavitve vsebine klasifikacijskih sistemov v medicini - ClaML

General Information

Status
Withdrawn
Publication Date
13-Nov-2007
Withdrawal Date
02-Apr-2013
Current Stage
9960 - Withdrawal effective - Withdrawal
Due Date
03-Apr-2013
Completion Date
03-Apr-2013

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2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.Health informatics - A syntax to represent the content of medical classification systems - ClaMLZdravstvena informatika - Sintaksa predstavitve vsebine klasifikacijskih sistemov v medicini - ClaMLInformatique de santé - Syntaxe permettant de représenter le contenu des systèmes de classification médicaux - ClaMLMedizinische Informatik - Syntax zur Darstellung des Inhalts medizinischer Klassifikationssysteme (ClaML)Ta slovenski standard je istoveten z:EN 14463:2007SIST EN 14463:2008en35.240.80Uporabniške rešitve IT v zdravstveni tehnikiIT applications in health care technologyICS:SIST-TS CEN/TS 14463:20061DGRPHãþDSLOVENSKI

STANDARDSIST EN 14463:200801-februar-2008

EUROPEAN STANDARDNORME EUROPÉENNEEUROPÄISCHE NORMEN 14463November 2007ICS 35.240.80Supersedes CEN/TS 14463:2003

English VersionHealth informatics - A syntax to represent the content of medicalclassification systems - ClaMLInformatique de la santé - Syntaxe permettant dereprésenter le contenu des systèmes de classificationmédicaux - ClaMLMedizinische Informatik - Syntax zur Darstellung desInhalts medizinischer Klassifikationssysteme (ClaML)This European Standard was approved by CEN on 7 October 2007.CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this EuropeanStandard the status of a national standard without any alteration. Up-to-date lists and bibliographical references concerning such nationalstandards may be obtained on application to the CEN Management Centre or to any CEN member.This European Standard exists in three official versions (English, French, German). A version in any other language made by translationunder the responsibility of a CEN member into its own language and notified to the CEN Management Centre has the same status as theofficial versions.CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland,France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal,Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and United Kingdom.EUROPEAN COMMITTEE FOR STANDARDIZATIONCOMITÉ EUROPÉEN DE NORMALISATIONEUROPÄISCHES KOMITEE FÜR NORMUNGManagement Centre: rue de Stassart, 36

B-1050 Brussels© 2007 CENAll rights of exploitation in any form and by any means reservedworldwide for CEN national Members.Ref. No. EN 14463:2007: E

EN 14463:2007 (E) 2 Contents Page Foreword..............................................................................................................................................................4 Introduction.........................................................................................................................................................5 1 Scope......................................................................................................................................................6 1.1 Main purposes........................................................................................................................................6 1.2 Target groups of this European Standard..........................................................................................6 1.3 Topics considered outside the scope of this European Standard...................................................6 2 Conformance..........................................................................................................................................6 3 Normative references............................................................................................................................7 4 Terms and definitions...........................................................................................................................7 5 Symbols and abbreviations..................................................................................................................8 6 Classification mark-up language.........................................................................................................8 6.1 Basis of the syntax................................................................................................................................8 6.2 Document Type Definition....................................................................................................................8 6.3 Semantic description of the Classification Markup Language (DTD)............................................16 6.3.1 ClaML....................................................................................................................................................16 6.3.2 Variants.................................................................................................................................................17 6.3.3 Variant...................................................................................................................................................17 6.3.4 Meta.......................................................................................................................................................18 6.3.5 Identifier................................................................................................................................................18 6.3.6 Title........................................................................................................................................................18 6.3.7 Authors.................................................................................................................................................19 6.3.8 Author...................................................................................................................................................19 6.3.9 ClassKinds...........................................................................................................................................20 6.3.10 UsageKinds..........................................................................................................................................20 6.3.11 RubricKinds..........................................................................................................................................20 6.3.12 UsageKind............................................................................................................................................20 6.3.13 ClassKind.............................................................................................................................................21 6.3.14 RubricKind............................................................................................................................................21 6.3.15 Display..................................................................................................................................................21 6.3.16 Modifier.................................................................................................................................................22 6.3.17 ModifierClass.......................................................................................................................................23 6.3.18 Class.....................................................................................................................................................24 6.3.19 ModifiedBy............................................................................................................................................25 6.3.20 ExcludeModifier...................................................................................................................................26 6.3.21 ValidModifierClass...............................................................................................................................26 6.3.22 Rubric....................................................................................................................................................27 6.3.23 Label......................................................................................................................................................27 6.3.24 History...................................................................................................................................................28 6.3.25 SuperClass...........................................................................................................................................29 6.3.26 SubClass...............................................................................................................................................29 6.3.27 Reference..............................................................................................................................................29 6.3.28 Para.......................................................................................................................................................30 6.3.29 Fragment...............................................................................................................................................30 6.3.30 Include..................................................................................................................................................32 6.3.31 IncludeDescendants............................................................................................................................33 6.3.32 List.........................................................................................................................................................33 6.3.33 ListItem.................................................................................................................................................34

EN 14463:2007 (E) 3 6.3.34 Table.....................................................................................................................................................35 6.3.35 Caption.................................................................................................................................................35 6.3.36 THead....................................................................................................................................................35 6.3.37 TBody....................................................................................................................................................36 6.3.38 TFoot.....................................................................................................................................................36 6.3.39 Row.......................................................................................................................................................36 6.3.40 Cell........................................................................................................................................................36 6.3.41 Term......................................................................................................................................................40 Annex A (informative)

Examples of usage of this standard.........................................................................42 A.1 Representing the Dagger and Asterisk System of ICD...................................................................42 A.2 References to different languages....................................................................................................44 A.3 Text containing repetition and layout...............................................................................................45 Annex B (informative)

Suggested Usage of ClaML-attributes......................................................................48 B.1 Class kind attributes...........................................................................................................................48 B.2 Usage Kind Attributes.........................................................................................................................48 B.3 Rubric kind attributes.........................................................................................................................49 Bibliography......................................................................................................................................................50

EN 14463:2007 (E) 4 Foreword This document (EN 14463:2007) has been prepared by Technical Committee CEN/TC 251 “Health informatics”, the secretariat of which is held by NEN. This European Standard shall be given the status of a national standard, either by publication of an identical text or by endorsement, at the latest by May 2008, and conflicting national standards shall be withdrawn at the latest by May 2008. This document supersedes CEN/TS 14463:2003. According to the CEN/CENELEC Internal Regulations, the national standards organizations of the following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and United Kingdom.

EN 14463:2007 (E) 5 Introduction Many classification systems are still distributed in a form suitable for direct text processing like MS Word etc. This is a very dangerous forma because unwanted and unspotted mistakes are easily made. For example, the accidental deletion of a tab makes a sibling rubric into a parent.

Industry is faced with a variety of formats in which classification systems are delivered. Many different parsers have to be maintained and yet, due to the informal nature of texts, it is hard to give a 100 % guarantee for correct parsing into more formal structures.

For work on classification systems, revision work and especially when terminological tools are used for work on classification systems there is a need to store and transfer classification systems while maintaining the structure of codes, rubrics, comments, inclusion/exclusion criteria etc. A neutral format like plain ASCII files with comma separated value fields is widely used, but has insufficient structuring capabilities. XML is the chosen format for this Standard as a) XML provides the necessary structuring elements, and b) there are many readily available XML parsers in existence. This standard builds on CEN/TS 14463:2002 in that CEN/TS 14463:2002 primary focus was to support Electronic Data Processing. Assessment of CEN/TS 14463:2002 as well as growing insights from other areas has revealed the need for a tighter version management. The scope of the standard therefore has been explicitly extended.

EN 14463:2007 (E) 6

1 Scope 1.1 Main purposes The main purpose of this European Standard is to support the safe transfer of the majority of hierarchical healthcare classification systems between organisations and dissimilar software products. It is intended to serve as the core representation, from which all publication forms can be derived. The Standard shall therefore be in depth enough to uniquely identify and describe the structure and the relevant elements in those systems. This Standard does not intend to prescribe the meaning of structuring elements in classification systems. This Standard is not meant to be a direct format for printing or viewing the contents of a classification system. Views and prints shall be derived from this representation by post processing. 1.2 Target groups of this European Standard This European Standard is applicable to: a) developers of first and second generation [2] classification systems and terminologies, to assist in the construction, maintenance and publication (both in paper and electronic formats) of a particular system; b) developers of information systems to assist in the inclusion of mechanisms for unambiguous loading of classification systems in their applications; c) organisations responsible for updating classification systems; d) institutions receiving updated classification systems. 1.3 Topics considered outside the scope of this European Standard This European Standard is not intended to: a) provide a normative syntax on how a classification system shall be constructed; b) define link types between elements in a classification system; this is left to the developers of classification systems; c) provide a representation for direct viewing or printing. 2 Conformance The normative part of this standard is written in the form of a DTD. Many commercially available XML tools provide facilities to test the conformance of an XML document with a DTD. Users of this standard are encouraged to perform such a test before distributing their classifications in the format of this standard.

EN 14463:2007 (E) 7 3 Normative references The following referenced documents are indispensable for the application of this document. For dated references, only the edition cited applies. For undated references, the latest edition of the referenced document (including any amendments) applies. EN ISO 3166-1, Codes for the representation of names of countries and their subdivisions – Part 1: Country codes (ISO 3166-1:2006) ISO 639-2, Codes for the representation of names of languages – Part 2: Alpha-3 code

4 Terms and definitions For the purposes of this document, the following terms and definitions apply. 4.1 preferred term term rated according to the scale of the term acceptability rating as the primary term for a given code [ISO 1087-1:2000] 4.2 reference pointer within a rubric to an other class NOTE The reference may be either within or between classifications. A reference does not specify the nature of the pointer. It is not necessarily a mapping. 4.3 rubric descriptive phrase for a given concept NOTE Preferred term is an example of a rubric kind. Other examples are inclusions, exclusions and editorial notes. 4.4 variant one instance of a collection of related documents EXAMPLE The ICD10-CM is a variant of the WHO ICD10 classification. 4.5 version exclusive identifier of a variant NOTE It is suggested to use the major.minor.patch scheme for version numbering.

EN 14463:2007 (E) 8 5 Symbols and abbreviations ClaML Classification Markup Language XML

Extensible Markup Language 1.0 DTD

Document Type Definition 6 Classification mark-up language 6.1 Basis of the syntax The basis of the syntax is to represent the content of medical classification systems. The syntax defined in this Standard is called Classification Mark-up Language. It is defined here in the form of a Document Type Definition (DTD). The reference to this syntax will be headed to ClaML in the remainder of this document. 6.2 Document Type Definition IncludeDescendants| Fragment | List | Table"> Meta*,
Identifier*,
Title,
Authors?,
Variants?,
ClassKinds, UsageKinds?,
RubricKinds,
Modifier*,
ModifierClass*,
Class*) > version CDATA #REQUIRED >

EN 14463:2007 (E) 9 name ID #REQUIRED > name CDATA #REQUIRED
value CDATA #REQUIRED
variants IDREFS #IMPLIED > authority NMTOKEN #IMPLIED
uid CDATA #REQUIRED > name NMTOKEN #REQUIRED
version CDATA #IMPLIED

date CDATA #IMPLIED >

name ID #REQUIRED >

EN 14463:2007 (E) 10
name ID #REQUIRED > name ID #REQUIRED
inherited (true|false) "false" > name ID #REQUIRED
mark CDATA #REQUIRED > xml:lang NMTOKEN #REQUIRED
variants IDREF #IMPLIED > Meta*,
SubClass*,
Rubric*, History*) > code NMTOKEN #REQUIRED
EN 14463:2007 (E) 11
variants IDREFS #IMPLIED > Meta*,
SuperClass,
SubClass*,
Rubric*, History*) > modifier NMTOKEN #REQUIRED
code NMTOKEN #REQUIRED
usage IDREF #IMPLIED
variants IDREFS #IMPLIED > Meta*,
SuperClass*,
SubClass*,
ModifiedBy*,
ExcludeModifier*,
Rubric*, History*) > code NMTOKEN #REQUIRED
kind IDREF #REQUIRED
usage IDREF #IMPLIED
variants IDREFS #IMPLIED
EN 14463:2007 (E) 12 > Meta*, ValidModifierClass*) > code NMTOKEN #REQUIRED
all (true|false) "true"
position CDATA #IMPLIED

variants IDREFS #IMPLIED > code NMTOKEN #REQUIRED

variants IDREFS #IMPLIED > code NMTOKEN #REQUIRED

variants IDREFS #IMPLIED > id ID #IMPLIED
kind IDREF #REQUIRED
usage IDREF #IMPLIED
EN 14463:2007 (E) 13 > xml:lang NMTOKEN #REQUIRED xml:space (default|preserve) "default"
variants IDREFS #IMPLIED > author IDREF #REQUIRED
date NMTOKEN #REQUIRED > code NMTOKEN #REQUIRED
variants IDREFS #IMPLIED > code NMTOKEN #REQUIRED
variants IDREFS #IMPLIED > class CDATA #IMPLIED
authority NMTOKEN #IMPLIED
uid NMTOKEN #IMPLIED
code NMTOKEN #IMPLIED
usage IDREF #IMPLIED
EN 14463:2007 (E) 14
variants IDREFS #IMPLIED > class CDATA #IMPLIED > class CDATA #IMPLIED
usage IDREF #IMPLIED
type (item | list) "item" > class CDATA #IMPLIED

rubric IDREF #REQUIRED > code NMTOKEN #REQUIRED
kind IDREF #REQUIRED > class CDATA #IMPLIED > EN 14463:2007 (E) 15 | Include | List | Table)* >

class CDATA #IMPLIED > class CDATA #IMPLIED > class CDATA #IMPLIED > class CDATA #IMPLIED > class CDATA #IMPLIED >
EN 14463:2007 (E) 16 class CDATA #IMPLIED >

class CDATA #IMPLIED > class CDATA #IMPLIED
rowspan CDATA #IMPLIED
colspan CDATA #IMPLIED > class CDATA #IMPLIED >

6.3 Semantic description of the Classification Markup Language (DTD) 6.3.1 ClaML 6.3.1.1 General The element ClaML identifies a Classification Markup Language file.

EN 14463:2007 (E) 17 6.3.1.2 Contents The element ClaML shall contain: - optional number of Meta elements; - optional number of Identifier elements; - one Title element; - one optional Authors element; - one optional Variants element; - one ClassKinds element; - one optional UsageKinds element; - one RubricKinds element; - optional number of Modifier elements; - optional number of ModifierClass elements;

- optional number of Class elements. 6.3.1.3 Required attribute The attribute version shall specify the version of ClaML used in the remaining document. The value to indicate the current version must be “2.0.0”. 6.3.2 Variants Optionally, this standard supports multiple variants of a classification in the same ClaML file. The element Variants defines the variants that are contained within the ClaML file. 6.3.3 Variant 6.3.3.1 General The element Variant uniquely identifies a variant within the ClaML file. 6.3.3.2 Required attribute The attribute name uniquely identifies the variant in the remainder of the ClaML file. EXAMPLE

Clinical Modification
Australian Modification

EN 14463:2007 (E) 18 6.3.4 Meta 6.3.4.1 General The element Meta shall be used to define meta information about a class or the classification. 6.3.4.2 Contents The element Meta has no contents. 6.3.4.3 Required attributes The attribute name defines the name for the meta information. The attribute value defines the contents of the meta information. The attribute variants defines the variants in which this Meta element is valid. When the attribute is absent the Meta element is valid in all variants. EXAMPLE 6.3.5 Identifier 6.3.5.1 General The optional element Identifier may occur multiple times. It defines an issuing authority and the unique identifier for the coding scheme defined by that authority. 6.3.5.2 Contents The element Identifier has no contents. 6.3.5.3 Required attribute The attribute uid is required and defines the unique identifier for the coding scheme. 6.3.5.4 Optional attribute The optional attribute authority identifies the authority that issued the uid. EXAMPLE

6.3.6 Title 6.3.6.1 General The element Title defines the title for the coding scheme. 6.3.6.2 Contents The contents of the element Title is limited to plain text.

EN 14463:2007 (E) 19 6.3.6.3 Required attribute The attribute name defines a short name for the classification. 6.3.6.4 Optional attributes The attribute version defines the version of the classification. It is recommended to use the well-known major.minor.patch version numbering scheme. The attribute date defines the date of publication. It is recommended to use the date format as defined by ISO 8601. EXAMPLE International Classification of Diseases, version 10 6.3.7 Authors 6.3.7.1 General The element Authors defines the authors of the ClaML file. 6.3.7.2 Contents The element Authors contains an optional number of the element Author. 6.3.8 Author 6.3.8.1 General The element Author represents the name of an author of the classification. 6.3.8.2 Contents The contents of the element Author is limited to plain text. 6.3.8.3 Required attribute The attribute name uniquely identifies the author. The first character of the attribute id must be a letter, underscore or colon. This attribute is referenced in the element History. EXAMPLE

World Health Organisation
Dutch WHO-FIC

EN 14463:2007 (E) 20 6.3.9 ClassKinds 6.3.9.1 General The element ClassKinds lists the kinds of classes, which are present in the coding scheme. 6.3.9.2 Contents The element ClassKinds contains one or more elements ClassKind. 6.3.10 UsageKinds 6.3.10.1 General The optional element UsageKinds lists the kinds of usage of classes, which are present in the coding scheme. 6.3.10.2 Contents The element UsageKinds contains one or more elements UsageKind. 6.3.11 RubricKinds 6.3.11.1 General The element RubricKinds lists the kinds of rubrics, which are present in the coding scheme. 6.3.11.2 Contents The element RubricKinds contains one or more elements RubricKind. 6.3.12 UsageKind 6.3.12.1 General The element UsageKind defines the name of a UsageKind. 6.3.12.2 Contents The element UsageKind is empty. 6.3.12.3 Required attribute The attribute name defines the name for a UsageKind. The first character of the attribute name must be a letter, underscore or colon. The attribute mark specifies how the code of a Class with a specific UsageKind shall be marked. EXAMPLE



EN 14463:2007 (E) 21 6.3.13 ClassKind 6.3.13.1 General The element Kind defines the name of a Class. 6.3.13.2 Contents The element ClassKind contains an optional number of the element Display. 6.3.13.3 Required attribute The attribute name defines the name for the class kind. The first character of the attribute name must be a letter, underscore or colon. 6.3.14 RubricKind 6.3.14.1 General The element Kind defines the name of a RubricKind. 6.3.14.2 Contents The element RubricKind contains an optional number of the element Display. 6.3.14.3 Required attribute The attribute name defines the name for the rubric kind. The first character of the attribute name must be a letter, underscore or colon. The attribute inherited specifies if rubrics with this rubric kind are inherited by subclasses. The default value for this attribute is false. 6.3.15 Display 6.3.15.1 General The element Display defines how a ClassKind or RubricKind is to be displayed in a specific language. 6.3.15.2 Display The contents of the element Display is limited to plain text. 6.3.15.3 Required attribute The attribute xml:lang defines the language of the content of the element. The attribute values of xml:lang shall follow ISO 639-2 if they are three-letter codes, and EN ISO 3166-1 if they contain two-letter sub codes. Language identifiers registered with the IANA shall contain the prefix "I-" or "i-". Any privately used codes shall contain the prefix "X-" or "x-".

EN 14463:2007 (E) 22 6.3.15.4 Optional attributes The attribute variants define the variants in which this

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