Abstract
BackgroundA great challenge in sharing data across information systems in general practice is the lack of interoperability between different terminologies or coding schema used in the information systems. Mapping of medical vocabularies to a standardised terminology is needed to solve data interoperability problems.MethodsWe present a system to automatically map an interface terminology ICPC-2 PLUS to SNOMED CT. Three steps of mapping are proposed in this system. The UMLS metathesaurus mapping utilises explicit relationships between ICPC-2 PLUS and SNOMED CT terms in the UMLS library to perform the first stage of the mapping. Computational linguistic mapping uses natural language processing techniques and lexical similarities for the second stage of mapping between terminologies. Finally, the post-coordination mapping allows one ICPC-2 PLUS term to be mapped into an aggregation of two or more SNOMED CT terms.ResultsA total 5,971 of all 7,410 ICPC-2 terms (80.58%) were mapped to SNOMED CT using the three stages but with different levels of accuracy. UMLS mapping achieved the mapping of 53.0% ICPC2 PLUS terms to SNOMED CT with the precision rate of 96.46% and overall recall rate of 44.89%. Lexical mapping increased the result to 60.31% and post-coordination mapping gave an increase of 20.27% in mapped terms. A manual review of a part of the mapping shows that the precision of lexical mappings is around 90%. The accuracy of post-coordination has not been evaluated yet. Unmapped terms and mismatched terms are due to the differences in the structures between ICPC-2 PLUS and SNOMED CT. Terms contained in ICPC-2 PLUS but not in SNOMED CT caused a large proportion of the failures in the mappings.ConclusionMapping terminologies to a standard vocabulary is a way to facilitate consistent medical data exchange and achieve system interoperability and data standardisation. Broad scale mapping cannot be achieved by any single method and methods based on computational linguistics can be very useful for the task. Automating as much as is possible of this process turns the searching and mapping task into a validation task, which can effectively reduce the cost and increase the efficiency and accuracy of this task over manual methods.
Highlights
A great challenge in sharing data across information systems in general practice is the lack of interoperability between different terminologies or coding schema used in the information systems
Effective information retrieval across information systems in health care is limited by the lack of semantic interoperability between terminologies used by sectors in the health system
Duplicates, and language variations, 6,502 terms currently have active status, which is 87.75% of the International Classification of Primary Care Version 2 (ICPC-2) PLUS vocabulary. These terms are mapped to 6,141 unique Concept Unique Identifiers (CUI) in Unified Medical Language System (UMLS)
Summary
A great challenge in sharing data across information systems in general practice is the lack of interoperability between different terminologies or coding schema used in the information systems. To achieve interoperability and enable exchanging and sharing of data across organisations, the need for improved matching between non-standard terms and a standard medical terminology becomes more important [1,2]. The use of SNOMED CT to create standardised detailed clinical information will enable more accurate documentation of patient data and improve health quality. The Australian government is proposing to adopt SNOMED CT for describing certain aspects of clinical encounters, coding clinical records, and as a standard terminology in Australian health organisations. This decision creates the need to map existing interface terminologies to the SNOMED CT reference terminology [4]. To complete this task in a reasonable amount of time and improve accuracy, some computational methods of matching concepts between terminologies are needed to assist humans to complete the task
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