ISO/TS 16843-1:2016
(Main)Health informatics — Categorial structures for representation of acupuncture — Part 1: Acupuncture points
Health informatics — Categorial structures for representation of acupuncture — Part 1: Acupuncture points
ISO/TS 16843-1:2016 specifies the categorial structure within the subject field of acupuncture by defining a set of domain constraints of sanctioned characteristics each composed of a semantic link and an applicable characterizing category in order to represent the concept of acupuncture point. ISO/TS 16843-1:2016 describes sanctioned characteristics with semantic links and characterizing categories for representation of acupuncture points. Concepts of acupuncture points are used in clinical practices for applying stimulation such as insertion, pricking, scratching, scrubbing, massaging or pressing with various kinds of needles, moxibustion, acupressure and cupping in various medical domains. The potential uses for this conceptual framework are the following: - provide a conceptual framework for the generation of compositional concept representation of acupuncture point; - provide a core model to describe the structure of acupuncture point, and facilitate improved semantic correspondence with information models; - facilitate the mapping and semantic correspondence between different terminological resources by proposing with a core specification of acupuncture point; - support developers of new terminological systems concerning acupuncture point; - support developers of new detailed content areas of existing terminological resources concerning acupuncture point to ensure conformance; - facilitate the representation of acupuncture point in a manner suitable for computer processing; - provide the monitoring system for adverse events and adverse reactions; - provide the characterization of clinical research related to acupuncture point. The target groups for this document are the following: - developers of terminology systems acupuncture point; - developers of information systems that require a structured framework of concepts to facilitate implementation and communication; - informaticians, analysts and epidemiologists who require common models of knowledge to facilitate analysis of current and legacy data from one or more information systems; - clinicians and coders to provide greater consistency in structure and organization when entering and retrieving data using one or more terminological resources; - managers and administrative personnel in providing a benchmark by which to judge terminology and information system solutions: as to whether the potential options will deliver compatibility with legacy data and future proofing to emerging terminology products. Topics considered outside the scope of this document include an exhaustive list of all possible characterizing concepts that could be used to describe acupuncture points.
Informatique de santé — Structures catégoriques pour la représentation de l'acupuncture — Partie 1: Points d'acupuncture
General Information
Relations
Standards Content (Sample)
TECHNICAL ISO/TS
SPECIFICATION 16843-1
First edition
2016-11-15
Health informatics — Categorial
structures for representation of
acupuncture —
Part 1:
Acupuncture points
Informatique de santé — Structures catégoriques pour la
représentation de l’acupuncture —
Partie 1: Points d'acupuncture
Reference number
©
ISO 2016
© ISO 2016, Published in Switzerland
All rights reserved. Unless otherwise specified, no part of this publication may be reproduced or utilized otherwise in any form
or by any means, electronic or mechanical, including photocopying, or posting on the internet or an intranet, without prior
written permission. Permission can be requested from either ISO at the address below or ISO’s member body in the country of
the requester.
ISO copyright office
Ch. de Blandonnet 8 • CP 401
CH-1214 Vernier, Geneva, Switzerland
Tel. +41 22 749 01 11
Fax +41 22 749 09 47
copyright@iso.org
www.iso.org
ii © ISO 2016 – All rights reserved
Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 2
3 Terms and definitions . 2
4 Categorial structure . 8
4.1 Outline . 8
4.2 Characterizing categories . 9
4.2.1 Point location . 9
4.2.2 Clinical findings.10
4.2.3 Efficacy .10
4.3 Semantic links .10
4.3.1 identifies .10
4.3.2 locates .11
4.3.3 is_located_at .11
4.3.4 is_used_for_clinical_outcome_of .11
4.4 Additional links.11
5 Conformance .11
5.1 Conformance principles .11
5.2 Conformity to this document .12
5.3 Supplemental recommendation .12
Annex A (normative) Selected terms and definitions from ISO 17115:2007 .13
Annex B (normative) Selected terms and definitions from ISO 1087‑1:2000 .19
Annex C (normative) Selected terms and definitions from ISO 16278:2016 .26
Annex D (informative) Sample diagrams of life force flow channel and acupuncture points .30
Bibliography .32
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 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.
The committee responsible for this document is Technical Committee ISO/TC 215, Health informatics.
A list of all parts in the ISO 16843 series can be found on the ISO website.
iv © ISO 2016 – All rights reserved
Introduction
Acupuncture therapy originated from scrubbing or pressing sensitive areas on the body surface. Wood
stick or stone was primarily used as a stimulation tool, then, in the course of improvement, needling
was gradually developed. Today, those points or zones are used not only in acupuncture practices but
also in other kinds of intervention such as acupressure, moxibustion, cupping, or classic massage. New
acupuncture points, such as auricular points and oral acupuncture points, have also been discovered in
diverse practice of acupuncture.
The practice of traditional medicine is still the subject of scientific criticism. However, it is well known
that there is a certain amount of contemporary scientific papers or reports on the interventions using
acupuncture points showing considerable therapeutic effects.
[10][11]
Thus in the last two decades, many clinical trials have been conducted to prove efficacy, and
a large number of research projects on the mechanism of acupuncture have been undertaken using
modern scientific methodology. Among various medical domains and countries/regions, there can be
[3][4][5]
found a lot of synonyms and polysemes impeding meta-analysis, accurate information exchange,
data processing and knowledge acquisition related to the principles and practice of acupuncture.
[2][3][4][5]
In order to solve these problems, it is essential to prepare definite concept system for the
[2]
representation of acupuncture points, with concept harmonization. The resultant categorial
structure will support the development of reliable terminological systems, information models and/or
mapping among terminological resources.
It is notable that even in the countries with high GDP, only a small portion of the population can receive
modern medicine service at will. Also, the WHO Western Pacific Regional Office reports that a high
[23]
percentage of the population uses traditional medicine in the nations within the region. These are
the reasons why the WHO is trying to explore ways of collecting statistical data not only depending on
modern medicine concepts but also the concepts of traditional medicines.
As expected, the accuracy of statistics is dependent upon consistent and agreed terms and definitions
[1][2][3][4][5]
harmonized with the backbone of a concept system.
For these two reasons, there is a strong need for common conceptual model regarding acupuncture points.
There are many different medical domains such as modern medicine, traditional Chinese medicine,
Ayurveda and Thai medicine, and their concept systems also vary. If the concepts of each medical
domain are represented in different conceptual models, it will be difficult to find the common elements
among them. It means mapping or semantic correspondence among terminological resources will be
costly and potentially error prone. In turn, such situation causes obstruction of knowledge management
and acquisition.
[5]
It has been estimated that between 0,5 and 45 million concepts are needed to be adequately described
in acupuncture. There is no intention to specify conceptual models for each as international standards.
[1][2][3][4][5]
Instead, the concepts with similarities have been harmonized at a high level in this document.
With a categorial structure, the minimum elements for common descriptiveness, exchangeability,
accountability, reproducibility, and verification necessary for representation of acupuncture points of
various medical domains are defined.
Any specific characteristics needed in a specific medical domain should be specified in the projects
of other technical committees and domestic or international organizations, along with their specific
values or code systems.
TECHNICAL SPECIFICATION ISO/TS 16843-1:2016(E)
Health informatics — Categorial structures for
representation of acupuncture —
Part 1:
Acupuncture points
1 Scope
This document specifies the categorial structure within the subject field of acupuncture by defining
a set of domain constraints of sanctioned characteristics each composed of a semantic link and an
applicable characterizing category in order to represent the concept of acupuncture point.
This document describes sanctioned characteristics with semantic links and characterizing
categories for representation of acupuncture points. Concepts of acupuncture points are used in
clinical practices for applying stimulation such as insertion, pricking, scratching, scrubbing, massaging
or pressing with various kinds of needles, moxibustion, acupressure and cupping in various medical
domains.
The potential uses for this conceptual framework are the following:
— provide a conceptual framework for the generation of compositional concept representation of
acupuncture point;
— provide a core model to describe the structure of acupuncture point, and facilitate improved
semantic correspondence with information models;
— facilitate the mapping and semantic correspondence between different terminological resources
by proposing with a core specification of acupuncture point;
— support developers of new terminological systems concerning acupuncture point;
— support developers of new detailed content areas of existing terminological resources concerning
acupuncture point to ensure conformance;
— facilitate the representation of acupuncture point in a manner suitable for computer processing;
— provide the monitoring system for adverse events and adverse reactions;
— provide the characterization of clinical research related to acupuncture point.
The target groups for this document are the following:
— developers of terminology systems acupuncture point;
— developers of information systems that require a structured framework of concepts to facilitate
implementation and communication;
— informaticians, analysts and epidemiologists who require common models of knowledge to facilitate
analysis of current and legacy data from one or more information systems;
— clinicians and coders to provide greater consistency in structure and organization when entering
and retrieving data using one or more terminological resources;
— managers and administrative personnel in providing a benchmark by which to judge terminology
and information system solutions: as to whether the potential options will deliver compatibility
with legacy data and future proofing to emerging terminology products.
Topics considered outside the scope of this document include an exhaustive list of all possible
characterizing concepts that could be used to describe acupuncture points.
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:
— IEC Electropedia: available at http://www.electropedia.org/
— ISO Online browsing platform: available at http://www.iso.org/obp
NOTE Additional background terms and definitions from ISO 17115, ISO 1087-1 and ISO 16278 are provided
in Annex A, Annex B and Annex C, respectively.
3.1
stimulus
stimuli
something that can elicit or evoke a physiological and/or psychological response(s) in a living thing
EXAMPLE 1 Mechanical, thermal and optical stimuli such as stroke, scrub, press, prick, pinch, strike; warm,
heat, cool, ice, flushing.
EXAMPLE 2 Smell, taste, sound, light, vestibular sense, and somatic sense (touch, pressure, pain, and
temperature).
Note 1 to entry: Included under the threshold to be recognized.
Note 2 to entry: Can be “noxious” or “invasive”.
3.2
stimulation
application of a stimulus/stimuli (3.1) to a targeted acupuncture point (3.7) with the intention of medical
diagnosis or care
3.3
stimulating tool
medical device or part(s) of the human body of a practitioner used to apply stimulus (3.1)
Note 1 to entry: Usually determines modality of sensation.
Note 2 to entry: Some values (3.30) for a stimulating tool are described, but not limited to, References [21] to [23].
3.4
acupuncture
acupuncture therapy
remedial procedure of somatic stimulation to acupuncture point (3.7)
EXAMPLE 1 A round-pointed needle is used for massaging;a spoon needle is used for pressing.
EXAMPLE 2 Pricking, scratching, scrubbing/massaging, or pressing on a particular area of the body surface
with a needle is also called acupuncture.
2 © ISO 2016 – All rights reserved
3.5
acupuncture needle
needle used for acupuncture (3.4); as stimulating tool (3.3)
EXAMPLE The nine types of classical needles (filiform needle, shear needle, round-pointed needle, spoon
needle, lance needle, round-sharp needle, stiletto needle, long needle and big needle), stone needle, round-
pointed wood stick.
3.6
anatomical zone
anatomical entity characterized by specific features and/or uses
EXAMPLE 1 Location of the Hégǔ (合谷) is the anatomical zone “on the dorsum of the hand, between the first
and second metacarpal bones, in the middle of the second metacarpal bone on the radial side” and is palpated
with a detecting technique (3.12) with the findings such as concavity, tenderness and so on.
EXAMPLE 2 In Nogier’s Auricular acupuncture treatment, location of the ovary and testicular points is
[15]
“slightly above the supratragic notch, on the inside of the ascending helix.”
EXAMPLE 3 Location of the Y-point of the large intestine is the anatomical zone “in the angle formed by the
[15]
temple hairline and the upper edge of the zygomatic arch.”
EXAMPLE 4 When an anatomical zone of tenderness is found on the back through palpitating with detecting
technique (3.12), if it is not a named point (3.8), it is an anonymous point (3.9).
Note 1 to entry: Not only sensory organ but also other material physical anatomical entity can be an
anatomical zone.
Note 2 to entry: This term is only applied to traditional medicine.
3.7
acupuncture point
anatomical zone (3.6) to which stimulus (3.1) is applied with the intention to induce reaction(s) for
diagnosis or therapy
EXAMPLE When the location of Hégǔ (合谷) is palpated with the finding of concavity, heat stimuli is applied
to the surface of the point as acupuncture point.
Note 1 to entry: The acupuncture point is often restricted to be applied only with appropriate stimulation (3.2)
because of its characteristics.
[SOURCE: ISO 16278:2016]
3.8
named point
named acupuncture point
acupuncture point (3.7) that has a designation or designation to point (3.19)
3.9
anonymous point
anonymous acupuncture point
acupuncture point (3.7) that has no designation for it
3.10
anatomical landmark
anatomical landmark for acupuncture
reference location on the body surface used to identify an acupuncture point (3.7)
EXAMPLE 1 In auricular acupuncture treatment, anthelix, tragus are often used as anatomical landmark.
EXAMPLE 2 In oral acupuncture treatment, each tooth is used as anatomical landmark.
3.11
measuring system
measuring system for acupuncture
traditional measuring method for somatometry in acupuncture (3.4)
EXAMPLE 1 In traditional “Chinese medicine”, proportional bone (skeletal) cun, finger cun, and finger breadth.
EXAMPLE 2 In Ayurveda, anguli, or anguli parimana.
3.12
detecting technique
anatomical zone detecting technique
the technique to find an anatomical zone (3.6) point which is appropriate for applying stimulation (3.2)
EXAMPLE Inspection, palpation, and electric conductivity test.
3.13
related anatomy
anatomical structure near an acupuncture point (3.7)
Note 1 to entry: Related anatomy includes both regional anatomy (3.14) and layered anatomy (3.15).
3.14
regional anatomy
three-dimensional shape of an anatomical structure near an acupuncture point (3.7)
3.15
layered anatomy
anatomical structure from a certain body surface to stimulation site, with the value (3.30) of spatial
dimension set to “0”
3.16
stereotactic restriction
specification of a body position and/or posture in order to permit an appropriate approach (3.17) for
keeping away non-targeted material physical anatomical entities
3.17
approach
approach to acupuncture site
appropriate track of stimulation (3.2) to reach a stimulation site with stereotactic restriction (3.16)
Note 1 to entry: Approach is determined by stereotactic restriction (3.16), as well as by the direction and the lean
of the stimulating tool (3.3) and by the depth of stimulation (3.2) for reaching a stimulation site.
3.18
medical domain
specific concept of a generic concept of various medical systems
Note 1 to entry: Modern medicine or biomedicine is also a type of medical domain.
EXAMPLE Modern medicine, Ayurveda, traditional African medicine, traditional Australian (Aboriginal),
traditional Canadian, Chinese or traditional Chinese (TCM), traditional Japanese (Kampo), traditional Korean,
Mongolian, New Zealand (Maori), Thailand, Tibetan, or Vietnamese, and so on.
3.19
designation of point
term and/or code that denote(s) acupuncture point concept
EXAMPLE 1 The deepest point in the concave of a foot sole is designated by both the term Yǒngquán (湧泉) and
[6]
the code “KI 1” in a terminological resource (3.33) of the World Health Organization (WHO). On the other hand,
[22]
in marma therapy of Ayurveda, the same point/area is designated by the term Talahridaya (of foot).
4 © ISO 2016 – All rights reserved
EXAMPLE 2 In Yamamoto New Scalp Acupuncture, the point ventral to the mastoid apex immediately behind
[15][24]
the earlobe is designated by the code “G1”.
[22]
EXAMPLE 3 In Ayurveda, the centre of the palm of the hands is designated by the term Talahridaya (of hand).
EXAMPLE 4 In Nogier’s Auricular acupuncture treatment system, some of the points are named after
[15]
corresponding organ such as ACTH.
EXAMPLE 5 The point of Shuǐgōu (水溝) has an alternative location; different locations are used in Japan
and China.
Note 1 to entry: Some points only have either term or code.
Note 2 to entry: In clinical practices, anonymous areas are often used for acupuncture therapy called Ashi
point (阿是穴).
Note 3 to entry: In order to avoid confusion arising from polysemy, the class of designation of point include
medical domain (3.18) as attribute.
3.20
applicable therapy
applicable therapies for acupuncture points
therapies or types of intervention suitable for application to an acupuncture point (3.7)
EXAMPLE 1 Needling, moxibustion, acupressure, oil massage, aromatherapy; asana, meditation.
EXAMPLE 2 Tàiyuān (太淵) is applied with its applicable therapy of needling, moxibustion, and acupressure.
Wàihuáijiān (外踝尖) is usually inhibited from insertion of needle.
Note 1 to entry: Applicable therapy or intervention varies according to medical domains (3.18) because of their
different theories.
3.21
biomedical specifics
observed biomedical findings and/or driven response by a given stimulation (3.2) to a certain
acupuncture point (3.7)
EXAMPLE Change in blood pressure, brain wave.
3.22
life force specifics
characteristics and features of a life force (3.23) at a certain point location
EXAMPLE Life force specifics are described as life force flow, its channel (3.24), connection to life force flow
(3.25), connection via life force flow (3.26), feature in force flow (3.27) and viscus and bowel (3.28).
3.23
life force
basic element that constitutes the universe and produces everything and sustains life activities
Note 1 to entry: One of the fundamental beliefs of traditional philosophies, life force is the basic element and life-
sustaining force. The movements or changes or transformations of life force produces everything including the
human body, and sustains life activity.
Note 2 to entry: Life force tends to refer to multiple aspects, the element itself, nutritive substances and its
functional activities, organs and their functions and activities. In addition, life force can refer to one of its
subcategories. In other words, the term that represents life force tends to have polysemes.
EXAMPLE 1 In ancient Chinese medicine, Qi: Qi, Blood , Fluid .
EXAMPLE 2 In Ayurveda, Prana; Vata, Pitta, Kapha.
EXAMPLE 3 In traditional Thai medicine, Lhom, or Lhom Pran.
EXAMPLE 4 In traditional Tibetan medicine, rLung.
Note 3 to entry: In ancient Chinese medicine, Qi: Qi, Blood , Fluid . In this context (3.29), both of them
are not blood or water in modern medicine/science meaning, rather, they are produced or transformed from Qi
and have each ideological function. The same can be said in other traditional medicines, in greater or lesser.
3.24
life force flow channel
channel
ideological channels within/around the human body in which the life force (3.23) travels
Note 1 to entry: One of the fundamental beliefs of traditional philosophies is that these ideological channels in
which a life force (3.23) travels within/around the human body forming networks together and can also connect
viscera and bowels (3.28) in the context (3.29) of traditional medicines based on holism.
EXAMPLE 1 In ancient Chinese medicine, Meridians , Collaterals , Vessels , Divergences .
Cutaneous Regions and Sinews are occasionally associated with each other, but it is regarded that
Sinews are not connected to Viscera and Bowels .
EXAMPLE 2 In Ayurveda, Nadi, Srotas.
EXAMPLE 3 In traditional Tibetan medicine, Tsa.
EXAMPLE 4 In traditional Thai medicine, Sen, or Sen sib (Sen sip).
Note 2 to entry: The terms listed in EXAMPLE 1 designate superordinate concept according to channel, so, there
are terms for subordinate concepts, e.g. Lung Meridian (Shǒu Tàiyīn Fèijīng; 手 太陰 肺経), Conception Vessel
(Rènmài; 任脈) and so on.
Note 3 to entry: Life force flow can be regarded to have normal flow direction along a channel.
3.25
connection to life force flow
ideological connection between an acupuncture point (3.7) and the corresponding life force flow
channels (3.24)
Note 1 to entry: One of the fundamental beliefs of traditional philosophies in the context (3.29) of traditional
medicines based on holism.
EXAMPLE 1 In ancient Chinese medicine, Tàiyuān (太淵) connects to Lung Meridian , then also to
Lung and Middle Energizer . See also 3.26 and D.1.
EXAMPLE 2 In Ayurveda, Guda connects to Alambusha Nadi. See D.2.
3.26
correspondent to life force flow
ideological correspondence between an acupuncture point (3.7) and viscera and bowels (3.28) by life
force flow
Note 1 to entry: One of the fundamental beliefs of traditional philosophies in the context (3.29) of traditional
medicines based on holism.
EXAMPLE 1 In ancient Chinese medicine, the Lung Meridian has 11 acupuncture points: The first point is
the Zhōngfǔ (中府), the second one is the Yúnmén (雲門), the seventh is Lièquē (列缺), the ninth is Tàiyuān (太淵),
and the eleventh is Shǎoshāng (少商). All these connect via the Meridian to the Lung and the Middle
Energizer . Lung Meridian terminates at Shǎoshāng (少商) but Qi flows to the next channel (3.24), the
Large Intestine Meridian . See D.1.
EXAMPLE 2 At Lièquē (列缺), the Lung Median connects to the Conception Vessel . The life force of
the Vessel converges to the Tàiyuān (太淵), which is one of eight influential points.
EXAMPLE 3 In Ayurveda, Yashasvati Nadi originates from the Muladhara (Root Chakra) and goes up to the
Manipura (Naval Chakra) where it diverges to the right hand and foot. The Nadi then radiates from the centre of
the right hand and right foot to the five fingers and toes, ending in the right thumb and big toe. See D.2.
EXAMPLE 4 Talahridaya, Muladhara, Manipura also connect to Kshipra. See D.2.
6 © ISO 2016 – All rights reserved
Note 2 to entry: The correspondent to life force flow is not identified in some acupuncture points, e.g. extra
points .
3.27
feature in life force flow
ideological feature(s) or function(s) of an acupuncture point in the relation with the life force flow(s)
Note 1 to entry: One of the fundamental beliefs of traditional philosophies in the context (3.29) of traditional
medicines based on holism.
EXAMPLE 1 In ancient Chinese medicine, the Zhōngfǔ (中府) is one of the alarm points (募穴); the Lièquē
(列缺) is one of the connecting points (絡穴), and at the same time, one of the confluence points of the eight
vessels (八脈交会穴); the Tàiyuān (太淵) is one of the source points (原穴), transport points
(兪穴), and eight meeting points (八会穴); the Shǎoshāng (少商) is one of the well points (井穴).
EXAMPLE 2 The Tàiyuān (太淵) belongs to the Lung Meridian of the hand; therefore, the acupuncture to
this point is effective to the problems of the respiratory system . This therapeutic action is called 疏風 解
表, which means dispersing the external Wind Pathogen for relieving the exterior pattern/syndrome .
Therefore, this point, combined with the Lièquē (列缺), is used to treat coughing and wheezing.
EXAMPLE 3 The Tàiyuān (太淵) is the influential point on the pulse and the Vessels ; therefore, the
acupuncture to this point is effective in addressing problems of the circulatory system . This therapeutic
action is called replenishing Heart and freeing Yáng (益心 通陽), and defusing Vessels stasis and
relieving Vessels (怯瘀 通脈).
EXAMPLE 4 In Ayurveda, Nabhi marma is located in the same position with Manipura (Naval Chakra) and
belong to Vishvodhara nadi which controls the digestive system . Therefore, acupressure to this
acupuncture point targets digestive problems .
EXAMPLE 5 Vitapa marma is influential point on the Shukravaha Srotas which controls the reproductive
system ; therefore, acupuncture to this point addresses infertility or menstrual problems in
females and sperm deficiency in males.
Note 2 to entry: Feature in life flow characterizes the therapeutic action of the acupuncture point, mainly due to
connection to life force flow (3.25) and/or correspondent to life force flow (3.26).
Note 3 to entry: Many acupuncture points have more than one therapeutic action by itself.
Note 4 to entry: Combination of several acupuncture points accentuate a particular therapeutic action.
Note 5 to entry: Acupuncture points can have harmful action when inappropriate intervention is applied or when
intervention is based on inappropriate diagnosis.
3.28
viscus and bowel
viscera and bowels
the ideological and functional internal organ(s)
Note 1 to entry: One of the fundamental beliefs of traditional philosophies in the context (3.29) of traditional
medicines based on holism.
Note 2 to entry: Viscera and bowels have two aspects: one is abstract of the physiological functions which consist
of some functions of different organs or body systems in modern medicine and the other is materialistic and
anatomical substance.
EXAMPLE In ancient Chinese medicine, viscus means the internal organ where Qi and Qi derivatives
are formed and stored. On the other hand, generally speaking, bowel means a part of the digestive organs ,
but three bowels , i.e. Triple Energizers (Sānjiāo; 三焦), do not correspond to any anatomical organ.
3.29
context
related conditions and situations that provide a useful understanding and meaning of a subject
Note 1 to entry: Context illustrates a concept or the use of a designation.
Note 2 to entry: See also ISO 1087-1:2000, 3.6.10.
[SOURCE: ISO/TR 17119:2005, 2.4]
3.30
value
designation of characterizing concept or individual concept within a characterizing generic concept, i.e.
characterizing category
3.31
source
source of terminological data
reference
terminological resource (3.32) which contains terminological data or some of it in the subject field
[SOURCE: ISO 10241:1992, 5.1.4 and ISO 1087-1:2000, 3.8.10 (for the French term)]
3.32
terminological resource
controlled set of terms
Note 1 to entry: Usually designed and controlled for use with computers for specific healthcare purpose, such as
data entry, aggregation, retrieval and analysis.
Note 2 to entry: It is an inclusive term for terminological system (3.33).
[SOURCE: AWI WD 17117–1, 2013, 3.4.1, modified.]
3.33
terminological system
terminology
concept
representation system
structured human and machine-readable representation of healthcare concepts and
relationships
Note 1 to entry: Can have associated rules and definitions.
Note 2 to entry: Used directly or indirectly to describe health conditions and healthcare activities, and allow
their subsequent retrieval for analysis.
Note 3 to entry: Every terminological system should have term representations of healthcare concepts for
human-readability.
[SOURCE: AWI WD 17117–1, 2013, 3.4.2, modified.]
4 Categorial structure
4.1 Outline
Categorial structure is a minimal set of domain constraints, which is a set of sanctioned
characteristics composed of a semantic link and the applicable characterizing category to which
[3][4][5]
the semantic link refers.
In the formal concept representation system for the subject field, acupuncture points has semantic
links to the following characterizing categories: point location (4.2.1), clinical findings (4.2.2) and
efficacy (4.2.3). Characterizing categories are specified in 4.2 and semantic links are specified in 4.3.
These and the concept system around them are illustrated in a concept diagram in Figure 1.
8 © ISO 2016 – All rights reserved
Figure 1 — Concept system around acupuncture point
In this diagram, essential characteristics are “point location”, “clinical findings” and “efficacy”,
while additional characterizing concepts are “stereocratic restriction” and “approach”. “Applicable
therapy”, “adverse event” and “contraindication”are aspects in therapeutics, while “reference”, “related
anatomy”, life force specific” and “modern medicine specific” represent the rationale for the causal
relation between point location with clinical findings and efficacy. Designation and reference are
also shown in order for the support to terminology work.
4.2 Characterizing categories
4.2.1 Point location
Point location refers to the acupuncture point or the anatomical zone on the body surface which leads
to the acupuncture point.
NOTE 1 Point location that is valid for representation of acupuncture point includes {anatomical landmark},
{direction} and {distance} with {measuring system}.
NOTE 2 Values for point location of named points are described in References [12] to [22], but not limited
to them.
EXAMPLE 1 Zhōngfǔ is_located_at {the same level as the first intercostal space}, {lateral to the infraclavicular
fossa}, {6 B-cun lateral to the anterior median line}, {body cun}.
EXAMPLE 2 Tàiyuān is_located_at {between the radical styloid process and the scaphoid bone, in the concave
ulnar to the abductor pollicis longus tendon}.
EXAMPLE 3 Lohitaksha leg arma is_located_at {femoral triangle}, {where the femoral artery passes}, {2 anguli
lateral to the symphysis pubis}, {anguli}.
NOTE 3 Point location is_identified_by [reverse of identifies (4.3.1)] clinical findings. Point location is_
related_to related anatomy. Point location specifies stereotactic restriction.
4.2.2 Clinical findings
Clinical findings refers to unusual findings that appear or are detected at or around the point location
before acupuncture.
NOTE 1 Clinical findings during or after acupuncture is called “elicited response.” Adverse effects are called
adverse event.
NOTE 2 Clinical findings that are valid for representation of acupuncture point can include {detecting
technique}.
NOTE 3 Values for clinical findings are described in References [10], [11], [12], [13], [15], [17], [18], [20] and
[21], but not limited to them.
EXAMPLE 1 Referred pain, tenderness, pressure pain, swelling, piriform concaved area, trigger point, electric
conductivity.
EXAMPLE 2 Lower electric conductivity area compared around there.
NOTE 4 Clinical findings identifies point location in the context of searching appropriate stimulation site of
named points. Clinical findings locates point location in the context of searching appropriate stimulation site of
anonymous points. See also 4.3.1 and 4.3.2.
NOTE 5 Clinical findings is not a delimiting characteristic but an essential characteristic.
4.2.3 Efficacy
Efficacy refers to the potential effect(s) of acupuncture at a certain point locations.
NOTE 1 Efficacy that is valid for representation of acupuncture point includes {medical domain}.
NOTE 2 Values for efficacy are described in References [12] to [22], but not limited to them.
EXAMPLE 1 Tàiyuān is_used_for_clinical_outcome_of (4.3.4) easing cough and wheeze.
EXAMPLE 2 Lohitaksha leg marma is_used_for_clinical_outcome_of treating thyroid hypertrophy.
4.3 Semantic links
4.3.1 identifies
identifies is the semantic link that identifies clinical findings in a point location
NOTE 1 identifies is used in the context of searching appropriate stimulation site of named points. Point
location varies from designation because of individual differences.
NOTE 2 Every acupuncture point terminological phrase complying with this document uses either identifies
or locates (4.3.2).
10 © ISO 2016 – All rights reserved
4.3.2 locates
locates is a semantic link that locates clinical findings in a point location
NOTE 1 locates is used in the context of searching appropriate stimulation site of anonymous points. When
locating anonymous points only by clinical findings, it will specify a point location because an anonymous point
does not have an identifier.
NOTE 2 Every acupuncture point terminological phrase complying with this document has either identifies
or locates. See also 4.3.3.
4.3.3 is_located_at
is_located_at is a semantic link between acupuncture point and point location where acupuncture
point is located
Every acupuncture point terminological phrase complying with this document shall have this
semantic link.
EXAMPLE See 4.2.1.
4.3.4 is_used_for_clinical_outcome_of
is_used_for_clinical_outcome_of is a semantic link between acupuncture point and efficacy for which
clinical outcome for acupuncture is used
Every acupuncture point terminological phrase complying with this document shall have this
semantic link.
NOTE 1 All the acupuncture points subject to acupuncture intervention are expected to have some
therapeutic effect.
EXAMPLE See 4.2.3.
4.4 Additional links
4.4.1 is_characterized_by — semantic link between life force specifics and point location of
acupuncture point whose function is characterized by
NOTE 1 Characteristics of life force specifics and applying of applicable therapy causes the efficacy of
acupuncture therapy in the context of traditional medicines.
NOTE 2 Characteristics of life force specifics is recognized in the context of traditional medicines that the
imbalance or disorder of viscus and bowel reflects on the clinical findings of point location.
4.4.2 is_verified_by — semantic link between biomedical specifics and the stimulation to point
location of acupuncture point eliciting physiological response is verified by
NOTE Biomedical specifics can verify the efficacy of acupuncture therapy in the context of modern
medicines.
5 Conformance
5.1 Conformance principles
To be conformant with EN 12264:2005 and ISO 17115, any categorial structures for representation of
acupuncture points in a system shall be provided the following:
— categories that organize healthcare objects for representation of acupuncture point and subdividing
their representation in the domain;
— a list of semantic links authorized by domain constraints;
— the goal for which the categorial structure is set;
— a list of minimal domain constraints required by the goal of the categorial structure.
5.2 Conformity to this document
The categorial structure representing acupuncture point claiming conformance to this document shall
provide the information described in 5.1 and 5.2 and shall be conformant to the following minimum rules:
— sanctioned characteristics for acupuncture point shall consist of a point location (4.2.1) and
efficacy (4.2.3) accompanied with is_located_at (4.3.3) and is_used_for_clinical_outcome_of
(4.3.4);
— sanctioned characteristics for acupuncture point shall consist of clinical findings (4.2.2) with
locates (4.3.2) in addition to the above, in the context of detection and usage of anonymous point.
5.3 Supplemental recommendation
If acupuncture point is specific in a certain medical domain, it should be identified with a subject label,
especially in clinical terminology. In addition, country identifier and language identifier should be
included, if needed.
12 © ISO 2016 – All rights reserved
Annex A
(normative)
Selected terms and definitions from ISO 17115:2007
The following terms and definitions are selected from ISO 17115:2007, Clause 2. They are included
here as background information to key terms and definitions in Clause 3. The numbering in this annex
follows the numbering in ISO 17115:2007, Clause 2 for consistency.
2.1 Specialization
2.1.4
generic concept
category
concept in a generic relation having the narrower intension [and the wider extension]
2.2 Formal representation of characteristics
2.2.1
composite characteristic
qualifier
representation of a characteristic
EXAMPLE hasCause Bacteria; Location = LeftUpperLobeOfLung.
Note 1 to entry: Typically expressed by a semantic link and a characterizing concept.
Note 2 to entry: Can be compared to an attribute-value pair in a compositional system.
Note 3 to entry: A qualifier often denotes characteristics with a small simple characterizing generic
concept, such as laterality (left or right), or severity (low, moderate, high).
2.2.2
characterizing concept
concept that is referenced by a semantic link in a composite characteristic
EXAMPLES “Bacterium” in the construct “Disease that hasCause Bacterium”; “Yellow” in the construct
“SkinLesion that hasColor Yellow”.
2.2.3
semantic link
formal representation of a directed associative relation or partitive relation between two concepts
EXAMPLES hasLocation (with inverse isLocationOf); isCauseOf (with inverse hasCause)
Note 1 to entry: This includes all relations except the generic relation .
Note 2 to entry: A semantic link always has an inverse, i.e. another semantic link with the opposite direction.
Note 3 to entry: A semantic link can be part of a composite characteristic where it describes the role of the charac-
terizing concept. Similarly, it defines the role of a characterizing generic concept in a sanctioned characteristic.
2.3 Sanctioned specialization
2.3.1
sanctioned characteristic
formal representation of a type of characteristic
EXAMPLE 1 performedUsing ; hasLocation .
EXAMPLE 2 “CauseOfInflammation canBe set{bacteria, virus, parasite, autoimmune, chemical, physical}”, where
“canBe” is the semantic link, and “set {bacteria, virus, parasite, autoimmune, chemical, physical}” is the characteriz-
ing generic concept.
Note 1 to entry: A sanctioned c
...
Questions, Comments and Discussion
Ask us and Technical Secretary will try to provide an answer. You can facilitate discussion about the standard in here.