The Expressive Power of SNOMED-CT Compared with the Discharge Summaries / 대한의료정보학회지

OBJECTIVE: The standard vocabularies need to cover a diverse and enriched field of medical content, thereby facilitating semantic information retrieval, clinical decision support and efficient care delivery. SNOMED-CT(Systematized Nomenclature of Human and Veterinary Medicine-Clinical Term) is a comprehensive and precise clinical reference terminology that provides unsurpassed clinical content and expressivity for clinical documentation and reporting. To investigate whether the SNOMED-CT can serve this function in Seoul National University Hospital(SNUH) environment, we evaluated the coverage of SNOMED-CT as compared with clinical terms in the discharge summary at SNUH. METHODS: We tested for discordance of clinical terms between SNUH discharge summary and those from SNOMED-CT. We extracted 9,554 concepts from 1,000 discharge summaries. From these concepts, we obtained 3,545 unique concepts which are normalized to map with SNOMED-CT. These normalized terms are mapped to concepts of SNOMED-CT with semi-automatic method. RESULTS: We found a degree of concordance between SNOMED-CT and the clinical terms used in the discharge summary. Approximately, 89% of medical terms in the discharge summary are matched and 11% of the concepts are not mapped to those of SNOMED-CT. CONCLUSION: Through this study, we confirmed that SNOMED-CT is appropriate reference terminology in SNUH environment.

Effective Query Expansion using Condensed UMLS Metathesaurus for Medical Information Retrieval / 대한의료정보학회지

Medical vocabularies in medical records are used in several synonyms and various expressions even though they are same concepts. Query expansion using a thesaurus enhances recall of medical information retrieval (IR) system for searching patient records or literatures. This study proposed IR system architecture applied the Metathesaurus of Unified Medical Language System (UMLS). To enhance the retrieval effectiveness at the same time to reduce retrieval time, we reconstructed condensed Metathesaurus (CMT), which is constituted of frequently used terms in medical records. We used 40,000 radiology reports of Brain CT/MRI at Seoul National University Hospital. The retrieval model we used is the Boolean methods. The results showed 15~27% effectiveness for searching relevant documents implementing the UMLS MT into IR system for query expansion. But it took 3.5 times longer for retrieval compared with non-MT implemented IR system. When we applied the CMT into IR system, however, the retrieval time reduced by 50% and the retrieval performance decreased only 8.7% compared with all MT implemented IR system. In this paper, we developed the medical document retrieval system applied UMLS MT for query expansion methods that can improve the relevant document retrieval performance, at the same time it can reduce the retrieval time through consisting condensed Metathesaurus for a specific domain.

A Comparative Study on the 'Sign or Symptom' Concepts of the UMLS(Unified Medical Language System) and Clinical Terms in Korean Medical Records / 대한의료정보학회지

The UMLS is a long-term NLM research and development effort designed to facilitate the retrieval and integration of information from multiple machine-readable biomedical information sources. It is one of the most comprehensive medical terminology systems. The UMLS is to make available to develop systems such as information retrieval, decision-making support system, natural language processing, and voice recognition in medical fields because it can be easily integrated with other systems or databases. It is now support about 15 languages like French, German, Finnish, and Spanish. The goal of this paper is to estimate the availabilities and usefulness that when we will apply the electronic medical records system and then support to Korean medical vocabulary integration. We tested mapping between chief complaint extracted from the discharge records in Seoul National University Hospital and the UMLS sign or symptom concepts term. Among 35% of chief complaint of the SNUH were Conceptually matched with the UMLS Sign or Symptom concepts. Most of 58% these terms were such that diagnosis, operation names, clinical laboratory test not Sign or Symptom terms. The rest terms of 7% were not found in the UMLS or these terms that different application of used concepts. While the UMLS terms are so specific and diverse about patients sign or symptom, we used simplified and usually based on the anatomical region records. Through this study, we exposed underlying of flaws currently in use clinical terms and analyzed the differences of expression patterns in clinical records between the two vocabulary system, we propose the UMLS application of Korean medical vocabulary translation with appropriateness and Interoperability of the UMLS for development the Korean medical technologies.

Design and Evaluation of a Prototype HL7 Message Server for Data Sharing across and within Medical Institutions / 대한의료정보학회지

This study was performed to develop the basic technique for standardization that will be used in the medical environment. The following paper describes the design and implementation of a software framework that could be used to construct an HL7 message server. HL7 message server is combined with existing HIS and generates the corresponding HL7 messages automatically whenever the predefined events occur. We developed HL7 message server modules which can automatically link patient data to the appropriate message component in order to populate ADT and ORU messages. The key modules are UIT monitor, message generator and TCP/IP connection module. UIT is designed to integrate all data items needed to create a message in this HIS database table. The UIT monitor module checks regularly the occurrences of predefined events in HIS. The message generator module links the UIT data to the appropriate message generating functions to create a message. And the TCP/IP connection module works as a socket module for the stable network connection. The prototype of HL7 message server showed the performance of creating 100 messages in a second. This evaluation result confirmed that our HL7 message server presents a promising model for the incorporation of HL7 standard into existing Korean HIS.