SIST-TS CEN/TS 14463:2006
(Main)Health informatics - A syntax to represent the content of medical classification systems (CIaML)
Health informatics - A syntax to represent the content of medical classification systems (CIaML)
The main purpose of this Technical Specification is to support the transfer of the majority of hierarchical healthcare classification systems between organisations and dissimilar software products. The Prestandard should therefore be rich enough to uniquely identify and describe the structure and the relevant elements in those systems. This Prestandard does not intend to prescribe the meaning of structuring elements in classification systems. This Prestandard is not meant to be a direct format for printing or viewing the contents of a classification system. Views and prints can be derived from this representation by post processing.
Medizinische Informatik - Syntax zur Darstellung des Inhalts medizinischer Klassifikationssysteme (ClaML)
Zdravstvena informatika – Sintaksa predstavitve vsebine klasifikacijskih sistemov v medicini (CIaML)
General Information
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Standards Content (Sample)
SLOVENSKI STANDARD
SIST-TS CEN/TS 14463:2006
01-april-2006
Zdravstvena informatika – Sintaksa predstavitve vsebine klasifikacijskih sistemov
v medicini (CIaML)
Health informatics - A syntax to represent the content of medical classification systems
(CIaML)
Medizinische Informatik - Syntax zur Darstellung des Inhalts medizinischer
Klassifikationssysteme (ClaML)
Ta slovenski standard je istoveten z: CEN/TS 14463:2003
ICS:
01.140.20
11.020
35.240.80
SIST-TS CEN/TS 14463:2006 en
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.
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TECHNICAL SPECIFICATION
CEN/TS 14463
SPÉCIFICATION TECHNIQUE
TECHNISCHE SPEZIFIKATION
July 2003
ICS 01.140.20; 11.020; 35.240.80
English version
Health informatics - A syntax to represent the content of medical
classification systems (CIaML)
This Technical Specification (CEN/TS) was approved by CEN on 26 April 2002 for provisional application.
The period of validity of this CEN/TS is limited initially to three years. After two years the members of CEN will be requested to submit their
comments, particularly on the question whether the CEN/TS can be converted into a European Standard.
CEN members are required to announce the existence of this CEN/TS in the same way as for an EN and to make the CEN/TS available. It
is permissible to keep conflicting national standards in force (in parallel to the CEN/TS) until the final decision about the possible
conversion of the CEN/TS into an EN is reached.
CEN members are the national standards bodies of Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Greece,
Hungary, Iceland, Ireland, Italy, Luxembourg, Malta, Netherlands, Norway, Portugal, Slovakia, Spain, Sweden, Switzerland and United
Kingdom.
EUROPEAN COMMITTEE FOR STANDARDIZATION
COMITÉ EUROPÉEN DE NORMALISATION
EUROPÄISCHES KOMITEE FÜR NORMUNG
Management Centre: rue de Stassart, 36 B-1050 Brussels
© 2003 CEN All rights of exploitation in any form and by any means reserved Ref. No. CEN/TS 14463:2003 E
worldwide for CEN national Members.
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CEN/TS 14463:2003 (E)
Contents
Page
Foreword.3
Introduction .4
1 Scope .5
2 Normative References .5
3 Abbreviations .5
4 Classification mark-up language.6
Annex A (informative) Examples of usage of ClaML .9
Annex B (informative) Suggested Usage of ClaML-attributes .20
Bibliography .21
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CEN/TS 14463:2003 (E)
Foreword
This document (CEN/TS 14463:2003) has been prepared by Technical Committee CEN /TC 251, "European
Standardization of Health Informatics", the secretariat of which is held by SIS.
Annexes A and B are informative.
According to the CEN/CENELEC Internal Regulations, the national standards organizations of the following
countries are bound to announce this CEN Technical Specification : Austria, Belgium, Czech Republic, Denmark,
Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Luxembourg, Malta, Netherlands, Norway,
Portugal, Slovakia, Spain, Sweden, Switzerland and the United Kingdom.
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CEN/TS 14463:2003 (E)
Introduction
Many classification systems are still distributed in a form suitable for direct text processing like MSWord etc. This is
a very dangerous format, 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, a 100% guarantee for correct parsing into more
formal structures is hard to give.
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
Prestandard as a) XML provides the necessary structuring elements, and b) there are many readily available XML
parsers in existence.
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CEN/TS 14463:2003 (E)
1 Scope
1.1 Main purposes
The main purpose of this Technical Specification is to support the transfer of the majority of hierarchical healthcare
classification systems between organisations and dissimilar software products. The Prestandard should therefore
be rich enough to uniquely identify and describe the structure and the relevant elements in those systems. This
Prestandard does not intend to prescribe the meaning of structuring elements in classification systems. This
Prestandard is not meant to be a direct format for printing or viewing the contents of a classification system. Views
and prints can be derived from this representation by post processing.
1.2 Target groups of this Technical Specification
This Technical Specification is applicable by
a) developers of classification systems and terminologies, to assist in the dissemination and maintenance of a
particular system, as well for comparisons among different versions;
b) developers of information systems to assist in 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 Technical Specification
This Technical specification is not intended for
a) providing a normative syntax on how a classification system should be constructed;
b) supporting full mark-up information for final printed delivery of classification systems;
c) defining link types between elements in a classification system, this is left to the developers of classification
systems;
d) providing a representation for direct viewing or printing.
2 Normative References
This Technical Specification incorporates by dated or undated reference, provisions from other publications. These
normative references are cited in the appropriate places in the text, and the publications are listed hereafter. For
dated references, subsequent amendments and revisions of any of these publications apply to this Technical
Specification only when incorporated in it by amendment and revision. For undated references, the latest edition of
the publication referred to applies.
Not applicable.
3 Abbreviations
ClaML Classification Markup Language
XML Extensible Markup Language 1.0
DTD Document Type Definition
5
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CEN/TS 14463:2003 (E)
4 Classification mark-up language
4.1 Basis of the syntax
The basis of the syntax is to represent the content of medical classification systems. The syntax defined in this
Prestandard 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
4.2 Document Type Definition
)>
]
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CEN/TS 14463:2003 (E)
NOTE xml:lang - defines the language code in which the content of the element is written in. The attribute values of
xml:lang should follow ISO-639-2 if they are three-letter codes, and ISO-3166 if they contain two-letter sub codes. Language
identifiers registered with the IANA should contain the prefix "I-" or "i-". Any privately used codes should contain the prefix "X-"
or "x-".
4.3 Explanation
A coding scheme consists of:
an optional name, this is a piece of free text
an optional version identification, this can be a number or a piece of text
an optional date, this is a piece of free text
an optional title, this is a piece of free text
an optional list of rubric kinds
zero or more modifiers
zero or more modifier classes
zero or more classes
A list of rubric kinds consists of:
zero or more rubric kinds
A modifier consists of:
a mandatory symbol, this is a piece of free text
zero or more rubrics
A modifier class consists of:
a mandatory symbol, this is a piece of free text
exactly one mandatory super class, which identifies an existing modifier
zero or more rubrics
A class consists of:
a mandatory kind identifier, e.g. chapter, block, category
a mandatory symbol
zero or more super classes, which identify existing classes within the same coding scheme
zero or more ‘modified by’ statements, which identify existing modifiers
zero or more ‘excludemodifier’ statements, which identify existing modifiers
zero or more rubrics
A rubric consists of:
a mandatory language identifier
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CEN/TS 14463:2003 (E)
a mandatory kind identifier, e.g. preferred, includes, excludes
free text, which may include:
references to other codes within the coding scheme
references to other codes in other coding schemes
italic formatted text
bold formatted text
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CEN/TS 14463:2003 (E)
Annex A (informative) Examples of usage of ClaML
A.1 Introduction
A coding scheme is a mapping between a set of code values and a set of code meanings. Central overall aspects
of the coding scheme is described by metadata, using the tags Name, Version, Title, Date
In this standard, each code value is represented as a Symbol element and the related code meaning is
represented by a set of Rubric elements. Each such relation is represented in a Class element along with optional
links to more general classes (pointed to by SuperClass elements), and optional modifiers (pointed to by
ModifiedBy elements). The Class is further specified by a class kind which is specific for the classification in
1
question and typically represents the Class's level in the hierarchy .
A rubric may contain text formatted in italics and bold, it may also contain references to classes within the same
classification or in other, external classifications. It is mandatory to specifiy the kind (e.g. ’includes’, ’excludes’,
’preferred’, etcetera) of rubric, and the language of the rubric.
Classes can in some cases be further specified by one or more modifiers, referred to by a ModifiedBy element, and
described in a Modifier element. Allowable values of such a modifier are described by ModifierClass elements,
each of which has a symbol and a set of Rubric elements describing its meaning.
A.2 References to different languages
The next piece of ClaML demonstrates how the same rubric in different languages would be represented.
ICD
10
2000-12-01
International Codes for Diseases, version 10
A00-B99
Certain infectious and parasitic diseases
Bepaalde infectieziekten en parasitaire aandoeningen
Bestimmte infektiöse und parasitäre Krankheiten
A.3 Representing hierarchy
The hierarchy in a classification system is represented by the SuperClass tag, as is demonstrated in the next piece
of ClaML.
A00-A09
1
For example, Class kinds used in ICD might include Chapter, Section and Block.
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CEN/TS 14463:2003 (E)
A00-B99
Intestinal infectious diseases
A.4 Representing internal references
The next piece of ClaML demonstrates how references to another class in the same classification system would be
represented.
A04
A00-A09
Other bacterial intestinal infections
foodborne intoxications, bacterial (A05)
tuberculous enteritis (A18.3)
A.5 Representing the use of modifiers
Several classification systems contain subclassifications that define codes and rubrics that may be added to
specific categories in the main classification. For example, Chapter XIII of the ICD-10 defines the subclassification
"Site of musculo-skeletal involvement" as follows:
Site of musculoskeletal involvement
The following subclassification to indicate the site of involvement is provided for optional use with appropriate
categories in Chapter XIII. As local extensions or specialty ad
...
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