ISO/TS 22789:2010
(Main)Health informatics — Conceptual framework for patient findings and problems in terminologies
Health informatics — Conceptual framework for patient findings and problems in terminologies
The purpose of ISO/TS 22789:2010 is to specify a categorial structure, within the subject field of patient findings and problems, by defining a set of common domain constraints for use within terminological systems including a classification, coding scheme, coding system, reference terminology and clinical terminology. Clinical findings are concepts that are recorded in clinical records and can describe any state observed directly or indirectly concerning a patient and their relationship with the environment. ISO/TS 22789:2010 is focused on a sub-population of these findings concerning in vivo descriptions of state (structure and function) directly related to the patient. ISO/TS 22789:2010 describes a concept system detailing a domain constraint of sanctioned characteristics each composed of a semantic link and an applicable characterizing category.
Informatique de santé — Cadre conceptuel pour les constats des patients et les problèmes de terminologies
General Information
Standards Content (Sample)
TECHNICAL ISO/TS
SPECIFICATION 22789
First edition
2010-06-15
Health informatics — Conceptual
framework for patient findings and
problems in terminologies
Informatique de santé — Cadre conceptuel pour les constats des
patients et les problèmes de terminologies
Reference number
©
ISO 2010
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ii © ISO 2010 – All rights reserved
Contents Page
Foreword .iv
Introduction.v
1 Scope.1
1.1 Main purpose.1
1.2 Target groups .2
1.3 Topics considered outside the scope.2
2 Terms and definitions .2
3 Conceptual framework for patient findings and problems .5
3.1 Overview.5
3.2 Sanctioned characteristics.5
4 Conformity to the Technical Specification .9
Bibliography.11
Foreword
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(ISO member bodies). The work of preparing International Standards is normally carried out through ISO
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In other circumstances, particularly when there is an urgent market requirement for such documents, a
technical committee may decide to publish other types of document:
⎯ an ISO Publicly Available Specification (ISO/PAS) represents an agreement between technical experts in
an ISO working group and is accepted for publication if it is approved by more than 50 % of the members
of the parent committee casting a vote;
⎯ an ISO Technical Specification (ISO/TS) represents an agreement between the members of a technical
committee and is accepted for publication if it is approved by 2/3 of the members of the committee casting
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rights. ISO shall not be held responsible for identifying any or all such patent rights.
ISO/TS 22789 was prepared by Technical Committee ISO/TC 215, Health informatics.
iv © ISO 2010 – All rights reserved
Introduction
Enormous investment has occurred over the last two decades in creating health care terminological systems.
Further expansion or additions are likely. Many developments overtly or covertly share features of a common
model of clinical findings.
The objective of this Technical Specification is to express a core categorial structure of clinical findings
based upon existing schemes including the World Health Organization ICD-10, NHS Clinical Terms Version 3,
International Health Terminology Standards Development Organisation's SNOMED Clinical Terms and the
WONCA 2001 International Classification of Primary Care. The development of a Technical Specification will
help existing users to develop a mapping or cross-walks between one scheme and another and provide a
robust logical framework for construction of new areas or consistency for updated versions of existing
terminological systems. The model describes the underlying principles of clinical findings and important
semantic links referencing a set or sets of characterizing concepts such as anatomy and causative
organisms. It utilizes ISO 17115, which has been designed to describe such patterns for concept
representation in a particular domain.
Within this Technical Specification, the following notation is used:
A bold notation has been used where references are made to terms defined in Clause 2.
An item enclosed by single angle brackets < > refers to a category that can be specialized to various
concepts, as required.
An item enclosed within the text by single accolades { } identifies a semantic link.
TECHNICAL SPECIFICATION ISO/TS 22789:2010(E)
Health informatics — Conceptual framework for patient findings
and problems in terminologies
1 Scope
1.1 Main purpose
The purpose of this Technical Specification is to specify a categorial structure, within the subject field of
patient findings and problems, by defining a set of common domain constraints for use within terminological
systems including a classification, coding scheme, coding system, reference terminology and clinical
terminology.
Clinical findings are concepts that are recorded in clinical records and can describe any state observed
directly or indirectly concerning a patient and their relationship with the environment. This Technical
Specification is focused on a sub-population of these findings concerning in vivo descriptions of state
(structure and function) directly related to the patient. This class of concepts includes:
⎯ diseases, which may be defined as a state caused by a known or assumed pathological process
impairing the normal physiological function and/or anatomical structure affecting all or part of a patient,
where a specific pathological change is caused by a defined mechanism;
⎯ findings of state or function (including normal findings) observed directly relating to a patient.
This Technical Specification describes a concept system detailing a domain constraint of sanctioned
characteristics each composed of a semantic link and an applicable characterizing category.
The potential uses for this conceptual framework are to:
⎯ support developers of new terminology systems concerning patient findings and problems;
⎯ support developers of new detailed content areas of existing terminology systems concerning patient
findings and problems to ensure conformance;
⎯ facilitate the representation of patient findings and problems using a standard core model in a manner
suitable for computer processing;
⎯ provide a conceptual framework for the generation of compositional concept representation of patient
findings and problems;
⎯ facilitate the mapping and improved semantic correspondence between different terminologies by
proposing a core specification for patient findings and problems;
⎯ provide a core model to describe the structure of patient findings and problems, and facilitate improved
semantic correspondence with information models.
1.2 Target groups
The target groups for this Technical Specification are:
⎯ developers of terminology systems concerning patient findings and problems;
⎯ developers of information systems that require a structured framework of concepts to facilitate
implementation;
⎯ IT specialists, 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 terminology systems;
⎯ managers and administrative personnel in providing a benchmark by which to judge terminology
solutions: as to whether the potential options will deliver compatibility with legacy data and future proofing
to emerging terminology products.
1.3 Topics considered outside the scope
Topics considered outside the scope of this Technical Specification include:
⎯ a comprehensive categorial structure for clinical findings;
⎯ laboratory findings (including biochemical and histological results);
⎯ signal findings (including the output from imaging and electrophysiological tests);
⎯ social findings;
⎯ the absence of findings, e.g. absent bowel sounds, the absence of a knee reflex, are not included within
this Technical Specification as it might prejudice subsequent attempts at standardizing the modelling of
such instances;
⎯ an exhaustive list of all possible characterizing concepts that could be used to describe clinical findings.
2 Terms and definitions
For the purposes of this document, the following terms and definitions apply.
2.1
associative relation
relation between two concepts (2.9) having a non-hierarchical thematic connection by virtue of experience
[ISO 1087-1:2000, definition 3.2.23]
EXAMPLE An associative relation (2.1) exists between the concepts (2.9) “education” and “teaching”, “baking”
and “oven”.
NOTE Other relations between concepts (2.9) are: hierarchical, generic, partitive, sequential, temporal and causal.
2.2
categorial structure
minimal set of domain constraints (2.11) for representing concept systems (2.10) in a subject field
[ISO 17115:2007, definition 2.4.5]
2 © ISO 2010 – All rights reserved
2.3
category
formal category
concept (2.9) represented by a formal definition (2.12)
NOTE Adapted from ISO 17115:2007, definition 2.5.3.
2.4
characterizing category
formal category (2.3) whose specialization by a domain constraint (2.11) is allowed to be used as
characterizing concept (2.5) in a particular context
[ISO 17115:2007, definition 2.3.3]
EXAMPLE ={bacterium, virus, parasite}, in the context of “Infection that hasCause
INFECTIOUS_ORGANISM”.
2.5
characterizing concept
concept (2.9) that is referenced by a semantic link (2.17) in a composite characteristic (2.7)
[ISO 17115:2007, definition 2.2.2]
EXAMPLE “Bacterium” in the construct “Disease that hasCause Bacterium” and “Yellow” in the construct
“SkinLesion that hasColor Yellow”.
2.6
characteristic
abstraction of a property of an object or of a set of objects
[ISO 1087-1:2000, definition 3.2.4]
NOTE Characteristics are used for describing concepts (2.9).
2.7
composite characteristic
qualifier
formal representation of a characteristic (2.6)
EXAMPLE hasCause Bacteria; Location = LeftUpperLobeOfLung.
NOTE 1 Adapted from ISO 17115:2007, definition 2.2.1.
NOTE 2 Can be compared to an attribute-value pair.
2.8
compositional concept representation
intensional definition of a concept (2.9) using as delimiting characteristics one or more composite
characteristics (2.7)
[ISO 17115:2007, definition 2.4.1]
NOTE Allows inference and subsumption within a compositional system. Usually expressed in a formalism, such as
description logic.
2.9
concept
unit of knowledge created by a unique combination of characteristics
[ISO 1087-1:2000, definition 3.2.1]
2.10
concept system
system of concepts
set of concepts (2.9) structured according to the relations among them
[ISO 1087-1:2000, definition 3.2.11]
2.11
domain constraint
sanction
rule prescribing the set of sanctioned characte
...
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