An evolutionary approach to realism-based adverse event representations.

BACKGROUND: Part of the ReMINE project involved the creation of an ontology enabling computer-assisted decision support for optimal adverse event management. OBJECTIVES: The ontology was required to satisfy the following requirements: 1) to be able to account for the distinct and context-dependent ways in which authoritative sources define the term 'adverse event', 2) to allow the identification of relevant risks against patient safety (RAPS) on the basis of the disease history of a patient as documented in electronic health records, and 3) to be compatible with present and future ontologies developed under the Open Biomedical Ontology (OBO) Foundry framework. METHODS: We used as feeder ontologies the Basic Formal Ontology, the Foundational Model of Anatomy, the Ontology for General Medical Science, the Information Artifact Ontology and the Ontology of Mental Health. We further used relations defined according to the pattern set forth in the OBO Relation Ontology. In light of the intended use of the ontology for the representation of adverse events that have actually occurred and therefore are registered in a database, we also applied the principles of referent tracking. RESULTS: We merged the upper portions of the mentioned feeder ontologies and introduced 22 additional representational units of which 13 are generally applicable in biomedicine and nine in the adverse event context. We provided for each representational unit a textual definition that can be translated into equivalent formal definitions. CONCLUSION: The resulting ontology satisfies all of the requirements set forth. Merging the feeder ontologies, although all designed under the OBO Foundry principles, brought new insight into what the representational units of such ontologies actually denote.

The use of a compliant EHR when providing clinical pathway driven care to a subset of diabetic patients: recommendation from a Working Group.

The Belgian National Health Insurance Institute (NHII) and other Healthcare Authorities intend to improve the quality of care through promoting clinical pathway driven care and by optimising cooperation between the responsible primary care physician and the diabetologist. Patients and healthcare professionals are granted some (financial) benefits when meeting the conditions defined in a mutual agreement.This article describes the conditions and the functional requirements to be met by an EHR to enable and to maximise the benefits of a clinical pathway driven patient care to a specific group of diabetic type 2 patients, based on a mandate issued by the NHII.The generic and specific functional requirements are then translated in test criteria for certification and prioritised in an implementation plan.

Terminology and coding systems of drugs--CDrugs.

The average patient contact that results in a drug prescription depends on the organizational environment. Nevertheless, in any country, more than half of patient contacts results in a prescription. On average in Belgium--a country with a free liberal medicine--more than 80% of the GP-patient contacts results in some kind of medicinal product prescription. Linkage with a drug knowledge base is thus a very important, sometimes even essential, requirement in developing a health information system.

The ANTHEM representation formalism for the alphabetic index of ICD.

This paper describes a formalism in which the knowledge of the Alphabetic Index of ICD is expressed unambiguously in the ANTHEM prototype. The Alphabetic Index may be viewed as a collection of hypotheses on which ICD-codes should be tried first for a given diagnostic expression. The hypotheses generation can be based upon characteristics of the semantic representation of the diagnostic expression. The formalism is described using an "operational" semantics by referring to the processes that have to operate on the expressions in the knowledge base. A close integration between a sound linguistic model of diagnostic expressions and the formalism itself is realized.