International Terminologies Research Articles

NAMASTE portal, data analysis, and understanding of Ayurveda medical records: An initial evaluation

Abstract INTRODUCTION: Traditional medicine is a valuable heritage that has enriched people’s daily lives. Globalization requires a common framework for communicating the details of the medical system in various contexts such as medical research, clinical diagnosis, and medical statistics. The acronym of the NAMASTE portal stands for National Ayush Morbidity and Standardized Terminologies Electronic Portal. On the occasion of the second National Ayurveda Day, which was on October 17, 2017, the Prime Minister of India, Narendra Modiji, launched the NAMASTE portal. It is categorized under initiatives of the Health Information system as it collects data from the related sectors, ensuring health decision awareness programs. The main objective of the NAMASTE portal is to promote the usage of electronic health records across the AYUSH domain. MATERIALS AND METHODS: The portal provides standard terminologies and morbidity codes for Ayurveda, Siddha, and Unani (ASU) to further develop international terminologies and ICD-11. The registered healthcare organizations (HCOs) enter the morbidity data in the statistic dashboard module every month by filling out the Excel sheets of OPDs and IPDs. Based on that, we systematically scrutinized electronic health records. RESULTS: The portal has received the data of 61,92,458 individuals receiving Ayurvedic treatment from the 133 Ayurvedic HCOs registered on the portal. DISCUSSION: Out of the 2888 National Ayurveda Morbidity Codes (NAMC) 2470 were used by HCOs, highlighting the top 10 States using the highest number of morbidity codes. The present paper incorporates statistical data of the Ayurveda medical records from the NAMASTE portal till August 2023, intending to provide statistical data regarding the most prevailing disease in the country.

A Digital Solution for an Advanced Breast Tumor Board: Pilot Application Cocreation and Implementation Study

Cancer treatment is constantly evolving toward a more personalized approach based on clinical features, imaging, and genomic pathology information. To ensure the best care for patients, multidisciplinary teams (MDTs) meet regularly to review cases. Notwithstanding, the conduction of MDT meetings is challenged by medical time restrictions, the unavailability of critical MDT members, and the additional administrative work required. These issues may result in members missing information during MDT meetings and postponed treatment. To explore and facilitate improved approaches for MDT meetings in France, using advanced breast cancers (ABCs) as a model, Centre Léon Bérard (CLB) and ROCHE Diagnostics cocreated an MDT application prototype based on structured data. In this paper, we want to describe how an application prototype was implemented for ABC MDT meetings at CLB to support clinical decisions. Prior to the initiation of cocreation activities, an organizational audit of ABC MDT meetings identified the following four key phases for the MDT: the instigation, preparation, execution, and follow-up phases. For each phase, challenges and opportunities were identified that informed the new cocreation activities. The MDT application prototype became software that integrated structured data from medical files for the visualization of the neoplastic history of a patient. The digital solution was assessed via a before-and-after audit and a survey questionnaire that was administered to health care professionals involved in the MDT. The ABC MDT meeting audit was carried out during 3 MDT meetings, including 70 discussions of clinical cases before and 58 such discussions after the implementation of the MDT application prototype. We identified 33 pain points related to the preparation, execution, and follow-up phases. No issues were identified related to the instigation phase. Difficulties were grouped as follows: process challenges (n=18), technological limitations (n=9), and the lack of available resources (n=6). The preparation of MDT meetings was the phase in which the most issues (n=16) were seen. A repeat audit, which was undertaken after the implementation of the MDT application, demonstrated that (1) the discussion times per case remained comparable (2 min and 22 s vs 2 min and 14 s), (2) the capture of MDT decisions improved (all cases included a therapeutic proposal), (3) there was no postponement of treatment decisions, and (4) the mean confidence of medical oncologists in decision-making increased. The introduction of the MDT application prototype at CLB to support the ABC MDT seemed to improve the quality of and confidence in clinical decisions. The integration of an MDT application with the local electronic medical record and the utilization of structured data conforming to international terminologies could enable a national network of MDTs to support sustained improvements to patient care.

Fast Healthcare Interoperability Resources (FHIR) for Interoperability in Health Research: Systematic Review.

BackgroundThe standard Fast Healthcare Interoperability Resources (FHIR) is widely used in health information technology. However, its use as a standard for health research is still less prevalent. To use existing data sources more efficiently for health research, data interoperability becomes increasingly important. FHIR provides solutions by offering resource domains such as “Public Health & Research” and “Evidence-Based Medicine” while using already established web technologies. Therefore, FHIR could help standardize data across different data sources and improve interoperability in health research.ObjectiveThe aim of our study was to provide a systematic review of existing literature and determine the current state of FHIR implementations in health research and possible future directions.MethodsWe searched the PubMed/MEDLINE, Embase, Web of Science, IEEE Xplore, and Cochrane Library databases for studies published from 2011 to 2022. Studies investigating the use of FHIR in health research were included. Articles published before 2011, abstracts, reviews, editorials, and expert opinions were excluded. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and registered this study with PROSPERO (CRD42021235393). Data synthesis was done in tables and figures.ResultsWe identified a total of 998 studies, of which 49 studies were eligible for inclusion. Of the 49 studies, most (73%, n=36) covered the domain of clinical research, whereas the remaining studies focused on public health or epidemiology (6%, n=3) or did not specify their research domain (20%, n=10). Studies used FHIR for data capture (29%, n=14), standardization of data (41%, n=20), analysis (12%, n=6), recruitment (14%, n=7), and consent management (4%, n=2). Most (55%, 27/49) of the studies had a generic approach, and 55% (12/22) of the studies focusing on specific medical specialties (infectious disease, genomics, oncology, environmental health, imaging, and pulmonary hypertension) reported their solutions to be conferrable to other use cases. Most (63%, 31/49) of the studies reported using additional data models or terminologies: Systematized Nomenclature of Medicine Clinical Terms (29%, n=14), Logical Observation Identifiers Names and Codes (37%, n=18), International Classification of Diseases 10th Revision (18%, n=9), Observational Medical Outcomes Partnership common data model (12%, n=6), and others (43%, n=21). Only 4 (8%) studies used a FHIR resource from the domain “Public Health & Research.” Limitations using FHIR included the possible change in the content of FHIR resources, safety, legal matters, and the need for a FHIR server.ConclusionsOur review found that FHIR can be implemented in health research, and the areas of application are broad and generalizable in most use cases. The implementation of international terminologies was common, and other standards such as the Observational Medical Outcomes Partnership common data model could be used as a complement to FHIR. Limitations such as the change of FHIR content, lack of FHIR implementation, safety, and legal matters need to be addressed in future releases to expand the use of FHIR and, therefore, interoperability in health research.

University Academia’s Perceptions about Using Mother Language or Foreign Language as Medium of Instructions

The language is the utmost necessity for the survival of the races. In broader view, language may not be confined to any territory or nation. The main objectives were to explore the opinions of university faculty members in selection of medium of instructions during lectures, indicators responsible for as key motivators and to investigate the academic confidence among university students when they learn through specific medium of instructions. The perceptions from the universities’ faculty members were collected as the use of national and foreign language is most applicable in teaching learning environment. The simple random sampling technique was used for selection of one hundred university teachers from University of Education and GC University Faisalabad. The Self-developed tool, about mediums of instructions and Faculty Preference Survey (MIFPS) was used. The findings of the study showed that faculty members are more willing to use foreign language during their class lectures. They said foreign language is necessary to explain international terminologies while delivering the lectures. Male students were more optimistic to use foreign language as medium of instruction than that of female students. The learners showed positive attitude when national language is used. The male students’ confidence level was high when teachers use national language as medium of instruction as compared to foreign language. Students revealed to be much creative in using national language for learning purpose. It is suggested that both languages should be used at higher educational level to compete internally and the rest of the world.

Systematic reporting of medical kidney biopsies.

ABSTRACTThe medical kidney biopsy has an important added value in patient care in nephrology. In order to facilitate communication between the pathologist and the nephrologist and optimize patient care, both the content and form of the medical kidney biopsy report matter. With some exceptions, current guidelines in nephropathology focus on content rather than form and, not surprisingly, medical kidney biopsy reports mostly consist of unformatted and often lengthy free text. In contrast, in oncology, a more systematic reporting called synoptic reporting has become the dominant method. Synoptic formats enable complete, concise and clear reports that comply with agreed upon standards. In this review we discuss the possibilities of systematic reporting in nephropathology (including synoptic reporting). Furthermore, we explore applications of electronic formats with structured data and usage of international terminologies or coding systems. The benefits include the timely collection of high-quality data for benchmarking between centres as well as for epidemiologic and other research studies. Based on these developments, a scenario for future medical kidney biopsy reporting is drafted.

Evaluating Suitability of SNOMED CT in Structured Searches for COVID-19 Studies.

Studies investigating the suitability of SNOMED CT in COVID-19 datasets are still scarce. The purpose of this study was to evaluate the suitability of SNOMED CT for structured searches of COVID-19 studies, using the German Corona Consensus Dataset (GECCO) as example. Suitability of the international standard SNOMED CT was measured with the scoring system ISO/TS 21564, and intercoder reliability of two independent mapping specialists was evaluated. The resulting analysis showed that the majority of data items had either a complete or partial equivalent in SNOMED CT (complete equivalent: 141 items; partial equivalent: 63 items; no equivalent: 1 item). Intercoder reliability was moderate, possibly due to non-establishment of mapping rules and high percentage (74%) of different but similar concepts among the 86 non-equal chosen concepts. The study shows that SNOMED CT can be utilized for COVID-19 cohort browsing. However, further studies investigating mapping rules and further international terminologies are necessary.

Coding practice in national and regional kidney biopsy registries

BackgroundKidney biopsy registries all over the world benefit research, teaching and health policy. Comparison, aggregation and exchange of data is however greatly dependent on how registration and coding of kidney biopsy diagnoses are performed. This paper gives an overview over kidney biopsy registries, explores how these registries code kidney disease and identifies needs for improvement of coding practice.MethodsA literature search was undertaken to identify biopsy registries for medical kidney diseases. These data were supplemented with information from personal contacts and from registry websites. A questionnaire was sent to all identified registries, investigating age of registries, scope, method of coding, possible mapping to international terminologies as well as self-reported problems and suggestions for improvement.ResultsSixteen regional or national kidney biopsy registries were identified, of which 11 were older than 10 years. Most registries were located either in Europe (10/16) or in Asia (4/16). Registries most often use a proprietary coding system (12/16). Only a few of these coding systems were mapped to SNOMED CT (1), older SNOMED versions (2) or ERA-EDTA PRD (3). Lack of maintenance and updates of the coding system was the most commonly reported problem.ConclusionsThere were large gaps in the global coverage of kidney biopsy registries. Limited use of international coding systems among existing registries hampers interoperability and exchange of data. The study underlines that the use of a common and uniform coding system is necessary to fully realize the potential of kidney biopsy registries.

Notifiable diseases interoperable framework toward improving Iran public health surveillance system: Lessons learned from COVID-19 pandemic.

BACKGROUND:Direct transmission of notifiable disease information in a real-time and reliable way to public health decision-makers is imperative for early identification of epidemiological trends as well as proper response to potential pandemic like ongoing coronavirus disease 2019 crisis. Thus, this research aimed to develop of semantic-sharing and collaborative-modeling to meet the information exchange requirements of Iran's notifiable diseases surveillance system.MATERIALS AND METHODS:First, the Iran's Notifiable diseases Minimum Data Set (INMDS) was determined according to a literature review coupled with agreements of experts. Then the INMDS was mapped to international terminologies and classification systems, and the Health Level seven-Clinical Document Architecture (HL7-CDA) standard was leveraged to define the exchangeable and machine-readable data formats.RESULTS:A core dataset consisting of 15 classes and 96 data fields was defined. Data elements and response values were mapped to Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) reference terminology. Then HL7-CDA standard for interoperable data exchange were defined.CONCLUSION:The notifiable disease surveillance requires an integrative participation of multidisciplinary team. In this field, data interoperability is more essential due to the heterogeneous nature of health information systems. Developing of INMDS based on HL7-CDA along with SNOMED-CT codes offers an inclusive and interoperable dataset that can help make notifiable diseases data more comparable and reportable across studies and organizations. The proposed data model will be further modifications in the future according probable changes in Iran's notifiable diseases list.

The German Corona Consensus Dataset (GECCO): a standardized dataset for COVID-19 research in university medicine and beyond

BackgroundThe current COVID-19 pandemic has led to a surge of research activity. While this research provides important insights, the multitude of studies results in an increasing fragmentation of information. To ensure comparability across projects and institutions, standard datasets are needed. Here, we introduce the “German Corona Consensus Dataset” (GECCO), a uniform dataset that uses international terminologies and health IT standards to improve interoperability of COVID-19 data, in particular for university medicine.MethodsBased on previous work (e.g., the ISARIC-WHO COVID-19 case report form) and in coordination with experts from university hospitals, professional associations and research initiatives, data elements relevant for COVID-19 research were collected, prioritized and consolidated into a compact core dataset. The dataset was mapped to international terminologies, and the Fast Healthcare Interoperability Resources (FHIR) standard was used to define interoperable, machine-readable data formats.ResultsA core dataset consisting of 81 data elements with 281 response options was defined, including information about, for example, demography, medical history, symptoms, therapy, medications or laboratory values of COVID-19 patients. Data elements and response options were mapped to SNOMED CT, LOINC, UCUM, ICD-10-GM and ATC, and FHIR profiles for interoperable data exchange were defined.ConclusionGECCO provides a compact, interoperable dataset that can help to make COVID-19 research data more comparable across studies and institutions. The dataset will be further refined in the future by adding domain-specific extension modules for more specialized use cases.

Transforming French Electronic Health Records into the Observational Medical Outcome Partnership's Common Data Model: A Feasibility Study.

Common data models (CDMs) enable data to be standardized, and facilitate data exchange, sharing, and storage, particularly when the data have been collected via distinct, heterogeneous systems. Moreover, CDMs provide tools for data quality assessment, integration into models, visualization, and analysis. The observational medical outcome partnership (OMOP) provides a CDM for organizing and standardizing databases. Common data models not only facilitate data integration but also (and especially for the OMOP model) extends the range of available statistical analyses. This study aimed to evaluate the feasibility of implementing French national electronic health records in the OMOP CDM. The OMOP's specifications were used to audit the source data, specify the transformation into the OMOP CDM, implement an extract-transform-load process to feed data from the French health care system into the OMOP CDM, and evaluate the final database. Seventeen vocabularies corresponding to the French context were added to the OMOP CDM's concepts. Three French terminologies were automatically mapped to standardized vocabularies. We loaded nine tables from the OMOP CDM's "standardized clinical data" section, and three tables from the "standardized health system data" section. Outpatient and inpatient data from 38,730 individuals were integrated. The median (interquartile range) number of outpatient and inpatient stays per patient was 160 (19-364). Our results demonstrated that data from the French national health care system can be integrated into the OMOP CDM. One of the main challenges was the use of international OMOP concepts to annotate data recorded in a French context. The use of local terminologies was an obstacle to conceptual mapping; with the exception of an adaptation of the International Classification of Diseases 10th Revision, the French health care system does not use international terminologies. It would be interesting to extend our present findings to the 65 million people registered in the French health care system.

Erratum: Transforming French Electronic Health Records into the Observational Medical Outcome Partnership's Common Data Model: A Feasibility Study.

Background Common data models (CDMs) enable data to be standardized, and facilitate data exchange, sharing, and storage, particularly when the data have been collected via distinct, heterogeneous systems. Moreover, CDMs provide tools for data quality assessment, integration into models, visualization, and analysis. The observational medical outcome partnership (OMOP) provides a CDM for organizing and standardizing databases. Common data models not only facilitate data integration but also (and especially for the OMOP model) extends the range of available statistical analyses. Objective This study aimed to evaluate the feasibility of implementing French national electronic health records in the OMOP CDM. Methods The OMOP's specifications were used to audit the source data, specify the transformation into the OMOP CDM, implement an extract–transform–load process to feed data from the French health care system into the OMOP CDM, and evaluate the final database. Results Seventeen vocabularies corresponding to the French context were added to the OMOP CDM's concepts. Three French terminologies were automatically mapped to standardized vocabularies. We loaded nine tables from the OMOP CDM's “standardized clinical data” section, and three tables from the “standardized health system data” section. Outpatient and inpatient data from 38,730 individuals were integrated. The median (interquartile range) number of outpatient and inpatient stays per patient was 160 (19–364). Conclusion Our results demonstrated that data from the French national health care system can be integrated into the OMOP CDM. One of the main challenges was the use of international OMOP concepts to annotate data recorded in a French context. The use of local terminologies was an obstacle to conceptual mapping; with the exception of an adaptation of the International Classification of Diseases 10th Revision, the French health care system does not use international terminologies. It would be interesting to extend our present findings to the 65 million people registered in the French health care system.

An eHealth Platform for the Support of a Brazilian Regional Network of Mental Health Care (eHealth-Interop): Development of an Interoperability Platform for Mental Care Integration.

BackgroundThe electronic exchange of health-related data can support different professionals and services to act in a more coordinated and transparent manner and make the management of health service networks more efficient. Although mental health care is one of the areas that can benefit from a secure health information exchange (HIE), as it usually involves long-term and multiprofessional care, there are few published studies on this topic, particularly in low- and middle-income countries.ObjectiveThe aim of this study was to design, implement, and evaluate an electronic health (eHealth) platform that allows the technical and informational support of a Brazilian regional network of mental health care. This solution was to enable HIE, improve data quality, and identify and monitor patients over time and in different services.MethodsThe proposed platform is based on client-server architecture to be deployed on the Web following a Web services communication model. The interoperability information model was based on international and Brazilian health standards. To test platform usage, we have utilized the case of the mental health care network of the XIII Regional Health Department of the São Paulo state, Brazil. Data were extracted from 5 different sources, involving 26 municipalities, and included national demographic data, data from primary health care, data from requests for psychiatric hospitalizations performed by community services, and data obtained from 2 psychiatric hospitals about hospitalizations. Data quality metrics such as accuracy and completeness were evaluated to test the proposed solution.ResultsThe eHealth-Interop integration platform was designed, developed, and tested. It contains a built-in terminology server and a record linkage module to support patients’ identification and deduplication. The proposed interoperability environment was able to integrate information in the mental health care network case with the support of 5 international and national terminologies. In total, 27,353 records containing demographic and clinical data were integrated into eHealth-Interop. Of these records, 34.91% (9548/27,353) were identified as patients who were present in more than 1 data source with different levels of accuracy and completeness. The data quality analysis was performed on 26 demographic attributes for each integrable patient record, totaling 248,248 comparisons. In general, it was possible to achieve an improvement of 18.40% (45,678/248,248) in completeness and 1.10% (2731/248,248) in syntactic accuracy over the test dataset after integration and deduplication.ConclusionsThe proposed platform established an eHealth solution to fill the gap in the availability and quality of information within a network of health services to improve the continuity of care and the health services management. It has been successfully applied in the context of mental health care and is flexible to be tested in other areas of care.

Standardizing the Transmission of Genomic-Related Medical Data for the Optimization of Diagnostics and Research in the Field of Oncological Diseases

Introduction: In Germany, there is currently no consistent analytic structure within genomic diagnostics in oncological diseases. Within the framework of the project GENeALYSE, a standardized and interoperable specification for associated uses cases shall be developed. Intended Methods: Through process analysis and interface modeling, problems of the actual processes will be depicted between the involved actors. In the next step, the workflows and relevant findings will be displayed and adapted. In particular, the heterogeneous workflows in genome diagnostics will be represented by semantic annotation in an international terminology. The results of the semantic annotation build the basement for the creation of an implementation guide for standardized genome analytics, referring to HL7 Clinical Document Architecture (HL7 CDA). Discussion: The problems of heterogeneous genomic diagnostics as well as unstructured findings in oncology leave the actors face comparable challenges on a regional and supranational level. Interfaces, ambiguous semantics and manual activities inhibit interoperability, promote errors and lead to risks for patients and their sufficient medical treatment. A major challenge will be consistency between the heterogeneous terms to be found in genome analysis. The problem shall be addressed via using international terminologies as well as appropriate mapping techniques. Conclusions: The aim of the project is to create an implementation guide for standardized digital documentation and communication solutions between diagnostics, medical therapy and research in the field of genome analysis. GENeALYSE is intended to optimize the coordination between the diagnostic genome laboratory and the clinical therapy decision in order to increase the safety and success of medical treatment, as well as to improve the health-related quality of life of the affected patients.

New international standard for dependability

In 2015 International Electrotechnical Commission adopted a new international standard IEC 60050-192 that specifies the main terms in the field of dependability with their definitions. It was developed by IEC/TC 56 “Dependability" under control of TC 1 “Terminology" and forms Part 192 of International electrotechnical vocabulary. This standard substituted the previous similar standard IEC 60050-191 adopted in 1990. This article is dedicated to IEC 60050-192, acquaintance with which is required for all specialists in the field of dependability. The new standard is compared with the previous IEC 60050-191, and with the similar Russian GOST 27.002-89. In comparison with IEC 60050-191 the new standard contains the modified content and scope, with exclusion of the sections containing the terms related to the quality of services of telecommunication and electric power systems. Based on that, IEC 60050-192 is entitled just with one word “Dependability". Therefore, now it totally corresponds to its status of a horizontal (i.e. inter-industrial, basic) standard. Terminology in the field of dependability is given in respect to a technical item, with analysis of the definitions of this notion, probable structure of the item and the number of terms specifying the types of items. IEC 60050-192 gives a new definition for “dependability": the ability of an item to perform as and when required. This definition was discussed actively, among the IEC experts who took part in the standard development, and among Russian specialists as well. The cluster of features of dependability has also changed: availability, reliability, recoverability, maintainability and maintenance support performance, and in some cases durability, safety and security. A new notion here is “recoverability” defined as ability of an item to recover from a failure, without corrective maintenance. This paper describes the standard's sections dedicated to an item's states and time notions, failures and faults, maintenance and repair, dependability indices, testing, design or engineering, analysis and improvement of dependability. It introduces and explains the most important terms, specifies new terms that were added to the standard, and those excluded from it. The article pays attention to the fact that certain terms have no adequate Russian equivalents. Though the Russian and international dependability terminologies have much in common, there are still significant differences between them. It is explained by the fact that the standardization of dependability terminology in our country that started half a century ago developed for a long time in isolation form similar work world-wide. Due to such differences the creation of a new GOST to be harmonized with IEC 60050-192 is currently not possible. But nevertheless it is necessary to seek to a maximum possible convergence of the Russian and international terminologies.

Rare diseases in ICD11: making rare diseases visible in health information systems through appropriate coding.

BackgroundBecause of their individual rarity, genetic diseases and other types of rare diseases are under-represented in healthcare coding systems; this contributes to a lack of ascertainment and recognition of their importance for healthcare planning and resource allocation, and prevents clinical research from being performed.MethodsOrphanet was given the task to develop an inventory of rare diseases and a classification system which could serve as a template to update International terminologies. When the World Health Organization (WHO) launched the revision process of the International Classification of Diseases (ICD), a Topic Advisory Group for rare diseases was established, managed by Orphanet and funded by the European Commission.ResultsSo far 5,400 rare diseases listed in the Orphanet database have an endorsed representation in the foundation layer of ICD-11, and are thus provided with a unique identifier in the Beta version of ICD-11, which is 10 times more than in ICD10. A rare disease linearization is also planned. The current beta version is open for public consultation and comments, and to be used for field testing. The adoption by the World Health Assembly is planned for 2017.ConclusionsThe overall revision process was carried out with very limited means considering its scope, ambition and strategic significance, and experienced significant hurdles and setbacks. The lack of funding impacted the level of professionalism that could be attained. The contrast between the initially declared goals and the currently foreseen final product is disappointing. In the context of uncertainty around the outcome of the field testing and the potential willingness of countries to adopt this new version, the European Commission Expert Group on Rare Diseases adopted in November 2014 a recommendation for health care coding systems to consider using ORPHA codes in addition to ICD10 codes for rare diseases having no specific ICD10 codes. The Orphanet terminology, classifications and mappings with other terminologies are freely available at www.orphadata.org.

How to code rare diseases with international terminologies?

Having codes for each and every rare disease (RD) would help European and national health authorities obtain a better knowledge of healthcare pathways and of their impact on specialised health care services (centres of expertise for instance) and on budget. It would also allow having sound data on the epidemiology and natural history of RD, and provide data for clinical research which is critically needed in this field. Improved codification for rare diseases is cited as a priority in the Council Recommendation on an action in the field of rare diseases (2009). Currently, only a small fraction of rare diseases have codes in international nomenclatures, making it impossible to trace patients with rare diseases in health information systems on a national and international level. Most European countries use ICD 10 or 9 in their health information systems, some (UK, Belgium, Spain) have decided to adopt SNOMED CT. The number of rare diseases which have a specific code in these two nomenclatures is limited: 466 in ICD10 and 2 883 in SNOMED-CT. In order to provide a common nomenclature specific for rare diseases, Orphanet has established, with the support the European Commission, a nomenclature and classification of RD. The nomenclature and classification are based on scientific publications and on expert advice. It is aligned with every medical terminology in use both in the clinical than in research settings, allowing for interoperability between different coding systems. Terms in the Orphanet nomenclature were introduced in the next ICD11 which is expected by 2017, and will be integrated into SNOMED CT thanks to a partnership between Orphanet and IHTSDO. The Orphanet nomenclature is freely available to download from www.orphadata.org in seven languages (Dutch, English, French, German, Italian, Portuguese, Spanish), and is released twice a year as a PDF document downloadable at http://www.orpha.net[2].

Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases in Internal Medicine (Part 8)

Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases in Internal Medicine (Part 8)

Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases in Internal Medicine (Part 7)

Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases in Internal Medicine (Part 7)

Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases in Internal Medicine (Part 6)

Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases in Internal Medicine (Part 6)

Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases in Internal Medicine (Part 5)

Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases in Internal Medicine (Part 5)