Abstract
BackgroundWHO-ART and MedDRA are medical terminologies used for the coding of adverse drug reactions in pharmacovigilance databases. MedDRA proposes 13 Special Search Categories (SSC) grouping terms associated to specific medical conditions. For instance, the SSC "Haemorrhage" includes 346 MedDRA terms among which 55 are also WHO-ART terms. WHO-ART itself does not provide such groupings. Our main contention is the possibility of classifying WHO-ART terms in semantic categories by using knowledge extracted from SNOMED CT. A previous paper presents the way WHO-ART term definitions have been automatically generated in a description logics formalism by using their corresponding SNOMED CT synonyms. Based on synonymy and relative position of WHO-ART terms in SNOMED CT, specialization or generalization relationships could be inferred. This strategy is successful for grouping the WHO-ART terms present in most MedDRA SSCs. However the strategy failed when SSC were organized on other basis than taxonomy.MethodsWe propose a new method that improves the previous WHO-ART structure by integrating the associative relationships included in SNOMED CT.ResultsThe new method improves the groupings. For example, none of the 55 WHO-ART terms in the Haemorrhage SSC were matched using the previous method. With the new method, we improve the groupings and obtain 87% coverage of the Haemorrhage SSC.ConclusionSNOMED CT's terminological structure can be used to perform automated groupings in WHO-ART. This work proves that groupings already present in the MedDRA SSCs (e.g. the haemorrhage SSC) may be retrieved using classification in SNOMED CT.
Highlights
WHO-ART and MedDRA are medical terminologies used for the coding of adverse drug reactions in pharmacovigilance databases
We propose a Description Logic model corresponding to the following requirements: 1. The model should be populated with automatically extracted knowledge
Using the technique presented in the previous sections, 85.9% (1,597) of WHO-ART terms were successfully mapped through Unified Medical Language System (UMLS) to one or more SNOMED CT synonyms
Summary
WHO-ART and MedDRA are medical terminologies used for the coding of adverse drug reactions in pharmacovigilance databases. Based on synonymy and relative position of WHO-ART terms in SNOMED CT, specialization or generalization relationships could be inferred. This strategy is successful for grouping the WHO-ART terms present in most MedDRA SSCs. the strategy failed when SSC were organized on other basis than taxonomy. WHO-ART (World Health Organization – Adverse Reaction Terminology) and MedDRA (Medical Dictionary for Drug Regulatory Activities) are the terminologies used in pharmacovigilance for case report coding and statistical data analysis. The generation of new knowledge on adverse drug reactions ( called signal detection) depends on the structure of the terminology. Precise coding requires a large number of (precise) terms, and statistical analysis requires a highly interconnected structure linking these terms. If the concepts are numerous but not sufficiently connected, statistical analysis will be done on sparse data and drug safety signals based on groupings will be more difficult to detect
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