Health informatics -- Categorial structure for representation of 3D human body position system

This document describes the high-level concepts required for representation of 3D data in health information systems from a terminological perspective. It is intended to be used in analysing, developing and managing terminologies in HBPS. The use cases include clinical findings, disorders, problem lists and procedures. Topics considered in the scope of this document: —   description of terminological concepts for representation of 3D data for human body; —   establishing of the relationships needed for 3D data in terminological systems; —   use cases. Topics considered outside the scope of this document: —   3D data structure, implementation and software functionality.

Informatique de santé -- Structure catégorielle pour la représentation du système de positionnement du corps humain en 3D

General Information

Status
Published
Publication Date
27-May-2021
Current Stage
5060 - Close of voting Proof returned by Secretariat
Start Date
21-Apr-2021
Completion Date
21-Apr-2021
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TECHNICAL ISO/TS
SPECIFICATION 23541-1
First edition
2021-05
Health informatics — Categorial
structure for representation of 3D
human body position system —
Part 1:
Bones
Informatique de santé — Structure catégorielle pour la
représentation du système de positionnement du corps humain en
3D —
Partie 1: Os
Reference number
ISO/TS 23541-1:2021(E)
ISO 2021
---------------------- Page: 1 ----------------------
ISO/TS 23541-1:2021(E)
COPYRIGHT PROTECTED DOCUMENT
© ISO 2021

All rights reserved. Unless otherwise specified, or required in the context of its implementation, 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
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
Phone: +41 22 749 01 11
Email: copyright@iso.org
Website: www.iso.org
Published in Switzerland
ii © ISO 2021 – All rights reserved
---------------------- Page: 2 ----------------------
ISO/TS 23541-1:2021(E)
Contents Page

Foreword ........................................................................................................................................................................................................................................iv

Introduction ..................................................................................................................................................................................................................................v

1 Scope ................................................................................................................................................................................................................................. 1

2 Normative references ...................................................................................................................................................................................... 1

3 Terms and definitions ..................................................................................................................................................................................... 1

3.1 General ........................................................................................................................................................................................................... 1

3.2 Characterizing categories .............................................................................................................................................................. 3

4 Categorial structure of 3D human body position system ........................................................................................... 5

4.1 Overview ...................................................................................................................................................................................................... 5

4.2 Representational relations ........................................................................................................................................................... 6

4.2.1 shareElement ...................................................................................................................................................................... 6

4.2.2 isBodyPart ............................................................................................................................................................................. 6

4.2.3 hasFinding ............................................................................................................................................................................. 7

4.2.4 hasIntervention .................. .................................................... ........................................................................................... 7

4.2.5 hasObservation ................................................................................................................................................................. 7

4.2.6 hasObject ................................................................................................................................................................................ 8

4.2.7 hasModel ...................................................................... ........................................................................................................... 8

Bibliography .............................................................................................................................................................................................................................10

© ISO 2021 – All rights reserved iii
---------------------- Page: 3 ----------------------
ISO/TS 23541-1:2021(E)
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 of 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 www .iso .org/

iso/ foreword .html.

This document was prepared by Technical Committee ISO/TC 215, Health informatics.

Any feedback or questions on this document should be directed to the user’s national standards body. A

complete listing of these bodies can be found at www .iso .org/ members .html.
iv © ISO 2021 – All rights reserved
---------------------- Page: 4 ----------------------
ISO/TS 23541-1:2021(E)
Introduction

Anatomical descriptions can be very abstract, requiring long narrative descriptions. These descriptions

can lead to ambiguity and coding inconsistency. Text-based expressions lack expressiveness and

accuracy, medical information is not captured and re-used sufficiently and there are also issues in

interoperability. There is currently no unified way of expressing anatomical concepts.

However, recent advancements in imaging technology are dramatically revolutionizing the field. For

instance, the spatial resolution in a CT scan is less than 1 mm. Regarding accuracy and expressiveness,

it is believed that the gap between medical imaging and clinical terminology is increasing over time.

Patients are also having problems understanding their disease because visualization is not given by

standard terminology.

Healthcare workers are seeking to achieve additional expressiveness by adopting 3D data in the

medical field. Radiation therapies are designed by 3D systems to generate optimal intensities while

protecting adjacent tissue. In operating theatres, operations are often guided by 3D navigation

systems. For example, arthroplasties are designed and simulated before surgery using 3D technology.

Researchers are also studying ways to simulate operation tactics using 3D data by 3D printing, such

as AR (augmented reality) and VR (virtual reality). Since 3D systems can deliver accurate spatial

information in the human body, it is evident that a standard terminology infrastructure will provide

additional expressiveness, accuracy and comparability when 3D data is adopted in medical informatics.

Since anatomy is a key piece of information in many clinical descriptions, 3D data can increase the

accuracy and expressiveness of clinical terminology. 3D data are numbers that can be processed by

mathematical functions providing more computability in research, software production and artificial

intelligence.

3D systems provide a consistent way of expressing anatomical concepts in a precise manner. Accurate

data can improve data exchange between electronic health records, epidemiological analysis and

quality. Increased accuracy also means better clinical decision support systems for patient safety,

reducing medical errors and improving efficiency. It also provides visual information for patients and

caregivers when conventional standard terminology system does not. HBPS (Human body position

system) is intended to be used in electronic health records, personal health record and various medical

research purposes.

HBPS is a way of expressing clinical concepts by combining 3D data and text-based terminology.

Although the main purpose of 3D is graphical expression, it can play a terminological role in many

ways as it has accurate anatomical concept. It can have attributes that are similar to codes in semantic

terminological system. It can be pre- or post-coordinated, just as conventional terminological concepts.

Since the data inside a 3D system is purely numeric, it can be captured and retrieved better than

semantic medical information.
© ISO 2021 – All rights reserved v
---------------------- Page: 5 ----------------------
TECHNICAL SPECIFICATION ISO/TS 23541-1:2021(E)
Health informatics — Categorial structure for
representation of 3D human body position system —
Part 1:
Bones
1 Scope

This document describes the high-level concepts required for representation of 3D data in health

information systems from a terminological perspective. It is intended to be used in analysing,

developing and managing terminologies in HBPS. The use cases include clinical findings, disorders,

problem lists and procedures.
Topics considered in the scope of this document:

— description of terminological concepts for representation of 3D data for human body;

— establishing of the relationships needed for 3D data in terminological systems;

— use cases.
Topics considered outside the scope of this document:
— 3D data structure, implementation and software functionality.
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 http:// www .electropedia .org/
3.1 General
3.1.1
3 dimensional
computer graphics that define an object by its width, length and depth
Note 1 to entry: See Figure 1.
© ISO 2021 – All rights reserved 1
---------------------- Page: 6 ----------------------
ISO/TS 23541-1:2021(E)
Figure 1 — Three-dimensional space and coordinate of a point
3.1.2
3D data element

unit of 3D data for which the definition, identification, representation, and permissible values are

specified by means of a set of attributes

Note 1 to entry: A 3D data element include vertex (a single point that has three-dimensi

...

TECHNICAL ISO/TS
SPECIFICATION 23541-1
First edition
Health Informatics — Categorial
structure for representation of 3D
human body position system —
Part 1:
Bones
PROOF/ÉPREUVE
Reference number
ISO/TS 23541-1:2021(E)
ISO 2021
---------------------- Page: 1 ----------------------
ISO/TS 23541-1:2021(E)
COPYRIGHT PROTECTED DOCUMENT
© ISO 2021

All rights reserved. Unless otherwise specified, or required in the context of its implementation, 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
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
Phone: +41 22 749 01 11
Email: copyright@iso.org
Website: www.iso.org
Published in Switzerland
ii PROOF/ÉPREUVE © ISO 2021 – All rights reserved
---------------------- Page: 2 ----------------------
ISO/TS 23541-1:2021(E)
Contents Page

Foreword ........................................................................................................................................................................................................................................iv

Introduction ..................................................................................................................................................................................................................................v

1 Scope ................................................................................................................................................................................................................................. 1

2 Normative references ...................................................................................................................................................................................... 1

3 Terms and definitions ..................................................................................................................................................................................... 1

3.1 General ........................................................................................................................................................................................................... 1

3.2 Characterizing categories .............................................................................................................................................................. 3

4 Categorial structure of 3D human body position system ........................................................................................... 5

4.1 Overview ...................................................................................................................................................................................................... 5

4.2 Representational relations ........................................................................................................................................................... 6

4.2.1 shareElement ...................................................................................................................................................................... 6

4.2.2 isBodyPart ............................................................................................................................................................................. 6

4.2.3 hasFinding ............................................................................................................................................................................. 7

4.2.4 hasIntervention .................. .................................................... ........................................................................................... 7

4.2.5 hasObservation ................................................................................................................................................................. 7

4.2.6 hasObject ................................................................................................................................................................................ 8

4.2.7 hasModel ...................................................................... ........................................................................................................... 8

Bibliography .............................................................................................................................................................................................................................10

© ISO 2021 – All rights reserved PROOF/ÉPREUVE iii
---------------------- Page: 3 ----------------------
ISO/TS 23541-1:2021(E)
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 of 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 www .iso .org/

iso/ foreword .html.

This document was prepared by Technical Committee ISO/TC 215, Health informatics.

Any feedback or questions on this document should be directed to the user’s national standards body. A

complete listing of these bodies can be found at www .iso .org/ members .html.
iv PROOF/ÉPREUVE © ISO 2021 – All rights reserved
---------------------- Page: 4 ----------------------
ISO/TS 23541-1:2021(E)
Introduction

Anatomical descriptions can be very abstract, requiring long narrative descriptions. These descriptions

can lead to ambiguity and coding inconsistency. Text-based expressions lack expressiveness and

accuracy, medical information is not captured and re-used sufficiently and there are also issues in

interoperability. There is currently no unified way of expressing anatomical concepts.

However, recent advancements in imaging technology are dramatically revolutionizing the field. For

instance, the spatial resolution in a CT scan is less than 1 mm. Regarding accuracy and expressiveness,

it is believed that the gap between medical imaging and clinical terminology is increasing over time.

Patients are also having problems understanding their disease because visualization is not given by

standard terminology.

Healthcare workers are seeking to achieve additional expressiveness by adopting 3D data in the

medical field. Radiation therapies are designed by 3D systems to generate optimal intensities while

protecting adjacent tissue. In operating theatres, operations are often guided by 3D navigation

systems. For example, arthroplasties are designed and simulated before surgery using 3D technology.

Researchers are also studying ways to simulate operation tactics using 3D data by 3D printing, such

as AR (augmented reality) and VR (virtual reality). Since 3D systems can deliver accurate spatial

information in the human body, it is evident that a standard terminology infrastructure will provide

additional expressiveness, accuracy and comparability when 3D data is adopted in medical informatics.

Since anatomy is a key piece of information in many clinical descriptions, 3D data can increase the

accuracy and expressiveness of clinical terminology. 3D data are numbers that can be processed by

mathematical functions providing more computability in research, software production and artificial

intelligence.

3D systems provide a consistent way of expressing anatomical concepts in a precise manner. Accurate

data can improve data exchange between electronic health records, epidemiological analysis and

quality. Increased accuracy also means better clinical decision support systems for patient safety,

reducing medical errors and improving efficiency. It also provides visual information for patients and

caregivers when conventional standard terminology system does not. HBPS (Human body position

system) is intended to be used in electronic health records, personal health record and various medical

research purposes.

HBPS is a way of expressing clinical concepts by combining 3D data and text-based terminology.

Although the main purpose of 3D is graphical expression, it can play a terminological role in many

ways as it has accurate anatomical concept. It can have attributes that are similar to codes in semantic

terminological system. It can be pre- or post-coordinated, just as conventional terminological concepts.

Since the data inside a 3D system is purely numeric, it can be captured and retrieved better than

semantic medical information.
© ISO 2021 – All rights reserved PROOF/ÉPREUVE v
---------------------- Page: 5 ----------------------
TECHNICAL SPECIFICATION ISO/TS 23541-1:2021(E)
Health Informatics — Categorial structure for
representation of 3D human body position system —
Part 1:
Bones
1 Scope

This document describes the high-level concepts required for representation of 3D data in health

information systems from a terminological perspective. It is intended to be used in analyzing,

developing and managing terminologies in HBPS. The use cases include clinical findings, disorders,

problem lists and procedures.
Topics considered in the scope of this document:

— description of terminological concepts for representation of 3D data for human body;

— establishing of the relationships needed for 3D data in terminological systems;

— use cases.
Topics considered outside the scope of this document:
— 3D data structure, implementation and software functionality.
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 http:// www .electropedia .org/
3.1 General
3.1.1
3 dimensional
computer graphics that define an object by its width, length and depth
Note 1 to entry: See Figure 1.
© ISO 2021 – All rights reserved PROOF/ÉPREUVE 1
---------------------- Page: 6 ----------------------
ISO/TS 23541-1:2021(E)
Figure 1 — Three-dimensional space and coordinate of a point
3.1.2
3D data element

unit of 3D data for which the definition, identification, representation, and permissible values are

specified by means of a set of attributes

Note 1 to entry: A 3D data element include vertex (a single point that has three-dimensional position and corner

of a 3D model), edge (where two faces meet), face (surface
...

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