ABSTRACT
BACKGROUND: The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS). METHODS: The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or "Basic Stable Input of Care" (BSIC), coded by its principal function or "Main Type of Care" (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal). RESULTS: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making. CONCLUSION: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.
Subject(s)
Clinical Coding/standards , Long-Term Care/organization & administration , Databases, Factual , Delivery of Health Care, Integrated , Europe , Humans , Long-Term Care/classification , Long-Term Care/standardsABSTRACT
OBJECTIVES: Ontologies are a resource that allow the concept of meaning to be represented informatically, thus avoiding the limitations imposed by standardized terms. The objective of this study was to establish the extent to which terminologies could be used for the design of ontologies, which could be serve as an aid to resolve problems such as semantic interoperability and knowledge reusability in healthcare information systems. METHODS: To determine the extent to which terminologies could be used as ontologies, six of the most important terminologies in clinical, epidemiologic, documentation and administrative-economic contexts were analyzed. The following characteristics were verified: conceptual coverage, hierarchical structure, conceptual granularity of the categories, conceptual relations, and the language used for conceptual representation. RESULTS: MeSH, DeCS and UMLS ontologies were considered lightweight. The main differences among these ontologies concern conceptual specification, the types of relation and the restrictions among the associated concepts. SNOMED and GALEN ontologies have declaratory formalism, based on logical descriptions. These ontologies include explicit qualities and show greater restrictions among associated concepts and rule combinations and were consequently considered as heavyweight. CONCLUSIONS: Analysis of the declared representation of the terminologies shows the extent to which they could be reused as ontologies. Their degree of usability depends on whether the aim is for healthcare information systems to solve problems of semantic interoperability (lightweight ontologies) or to reuse the systems' knowledge as an aid to decision making (heavyweight ontologies) and for non-structured information retrieval, extraction, and classification.
Subject(s)
Information Services , Integrated Advanced Information Management Systems , Medical Informatics Applications , Terminology as Topic , Humans , Medical Subject Headings , Semantics , Vocabulary, ControlledABSTRACT
Objetivos: Las ontologías son un recurso que permite trabajarinformáticamente con la conceptualización del significadoy evitar la limitación impuesta por los términos normalizados.El objetivo de este estudio es establecer el grado deusabilidad de las terminologías para el diseño de ontologías,que contribuyan a resolver los problemas de interoperabilidadsemántica, y de reutilización de conocimiento en los sistemasde información clínicos.Métodos: Se han analizado 6 de las terminologías más relevantespara el ámbito clínico, epidemiológico, documentaly administrativo-económico. Se valoraron las siguientes cualidades:cobertura conceptual, estructura jerárquica, granularidadconceptual, relaciones conceptuales y grado de formalismoutilizado en la representación conceptual, paraestablecer el grado de usabilidad.Resultados: Se consideran como ontologías ligeras los MeSH,los DeCS y el UMLS, aunque con diferencias entre ellas, alexplicitar los conceptos, el tipo de relación y las restriccionesentre los conceptos asociados. SNOMED y GALEN, con suformalismo declarativo basado en descripciones lógicas, incluyenla explicitación de las cualidades, una mayor restricciónpara relacionar conceptos y las reglas de combinaciónentre ellos, por lo que se consideran como ontologías pesadas.Conclusiones: El análisis de la representación declarada delas terminologías muestra las posibilidades de su reutilizacióncomo ontologías. Su grado de usabilidad dependerá de si sepretende que los sistemas de información clínicos resuelvanlos problemas de interoperabilidad semántica (ontologías ligeras)o además reutilizar su conocimiento para sistemas deayuda a la toma de decisiones (ontologías pesadas) y paratareas de recuperación, extracción y clasificación de informaciónno estructurada(AU)
Objectives: Ontologies are a resource that allow the conceptof meaning to be represented informatically, thus avoiding thelimitations imposed by standardized terms. The objective of thisstudy was to establish the extent to which terminologies couldbe used for the design of ontologies, which could be serve asan aid to resolve problems such as semantic interoperability andknowledge reusability in healthcare information systems.Methods: To determine the extent to which terminologies couldbe used as ontologies, six of the most important terminologiesin clinical, epidemiologic, documentation and administrative-economiccontexts were analyzed. The following characteristics wereverified: conceptual coverage, hierarchical structure, conceptualgranularity of the categories, conceptual relations, and thelanguage used for conceptual representation.Results: MeSH, DeCS and UMLS ontologies were consideredlightweight. The main differences among these ontologies concernconceptual specification, the types of relation and the restrictionsamong the associated concepts. SNOMED andGALEN ontologies have declaratory formalism, based on logicaldescriptions. These ontologies include explicit qualitiesand show greater restrictions among associated concepts andrule combinations and were consequently considered as heavyweight.Conclusions: Analysis of the declared representation of theterminologies shows the extent to which they could be reusedas ontologies. Their degree of usability depends on whetherthe aim is for healthcare information systems to solve problemsof semantic interoperability (lightweight ontologies) orto reuse the systems knowledge as an aid to decision making(heavyweight ontologies) and for non-structured informationretrieval, extraction, and classification(AU)
