Coupling ontology driven semantic representation with multilingual natural language generation for tuning international terminologies.

OBJECTIVES: The importance of clinical communication between providers, consumers and others, as well as the requisite for computer interoperability, strengthens the need for sharing common accepted terminologies. Under the directives of the World Health Organization (WHO), an approach is currently being conducted in Australia to adopt a standardized terminology for medical procedures that is intended to become an international reference. METHOD: In order to achieve such a standard, a collaborative approach is adopted, in line with the successful experiment conducted for the development of the new French coding system CCAM. Different coding centres are involved in setting up a semantic representation of each term using a formal ontological structure expressed through a logic-based representation language. From this language-independent representation, multilingual natural language generation (NLG) is performed to produce noun phrases in various languages that are further compared for consistency with the original terms. RESULTS: Outcomes are presented for the assessment of the International Classification of Health Interventions (ICHI) and its translation into Portuguese. The initial results clearly emphasize the feasibility and cost-effectiveness of the proposed method for handling both a different classification and an additional language. CONCLUSION: NLG tools, based on ontology driven semantic representation, facilitate the discovery of ambiguous and inconsistent terms, and, as such, should be promoted for establishing coherent international terminologies.

Reconciliation of ontology and terminology to cope with linguistics.

OBJECTIVES: To discuss the relationships between ontologies, terminologies and language in the context of Natural Language Processing (NLP) applications in order to show the negative consequences of confusing them. METHODS: The viewpoints of the terminologist and (computational) linguist are developed separately, and then compared, leading to the presentation of reconciliation among these points of view, with consideration of the role of the ontologist. RESULTS: In order to encourage appropriate usage of terminologies, guidelines are presented advocating the simultaneous publication of pragmatic vocabularies supported by terminological material based on adequate ontological analysis. CONCLUSIONS: Ontologies, terminologies and natural languages each have their own purpose. Ontologies support machine understanding, natural languages support human communication, and terminologies should form the bridge between them. Therefore, future terminology standards should be based on sound ontology and do justice to the diversities in natural languages. Moreover, they should support local vocabularies, in order to be easily adaptable to local needs and practices.

XML as standard for communicating in a document-based electronic patient record: a 3 years experiment.

During the past few years, the eXtensible Markup Language (XML) has progressively become a gold standard for accessing, representing and exchanging information, especially in the health care environment. This paper presents an implementation of the use of XML for the electronic patient record (EPR) and discusses more specifically its growing use in two areas of the EPR: first, as a format for the exchange of structured messages, and second, as a comprehensible way of representing patient documents. These statements rely on a 3 years experiment conducted at the Geneva University Hospital as part of its document-centered EPR.

Clinical documents: attribute-values entity representation,context, page layout and communication.

This paper presents how acquisition, storage and communication of clinical documents is implemented at the University Hospitals of Geneva. Careful attention has been given to user-interfaces, in order to support complex layouts, spell checking, and templates management with automatic prefilling. A dual architecture has been developed for storage using an entity-attribute-value unified database and a consolidated, patient-centered, layout-respectful file-based storage, providing both representation power and speed of access. This architecture allows a great flexibility for storing a continuum of data types, ranging from simple typed values to complex clinical reports. Finally, communication is entirely based on HTTP-XML internally, and a HL-7 CDA interface V2 is currently studied for external communication. Some of the problems encountered, mostly related to the typology of documents and the ontology of clinical attributes are evoked.

XML as standard for communicating in a document-based electronic patient record: a three years experiment.

During the past few years, the eXtensible Markup Language (XML) has experienced a growing use for accessing, representing and exchanging information, especially in the health care environment. This paper discusses the potentials of the use of XML for the electronic patient record (EPR) in two ways: first, as a format for the exchange of structured messages, and second, as a comprehensible way of representing patient documents. These statements rely on a three years experiment conducted at the Geneva University Hospital as part of its document-centred EPR.