Vague Terms Research Articles

Assessing multiple-choice questions based on language precision and best practices to promote equity in the Dental Physiology course

Student assessment in professional schools is conducted mainly through examinations based on multiple-choice questions (MCQs). Although grading this type of assessments saves time, questions that are not well-written may impact students’ performance. Technical flaws in MCQs include those that provide irrelevant difficulty and those that provide an advantage to test-wise examinees. In addition, MCQs with these flaws may disproportionately affect students with weaker undergraduate science backgrounds and those from underrepresented groups including English Language Learners and first-generation college students. Inclusive teaching practices aim to create a level field by removing barriers and providing equal access to students regardless of their background.It is hypothesized that technical flaws in MCQs increase their difficulty. The objectives of this study are: 1) to rate the quality of the MCQs used in a Dental Physiology course at Boston University and 2) to examine the effect of questions with technical flaws on item performance. To measure the performance of specific items, two analyses will be conducted: item difficulty, defined as the percentage of students who choose an item correctly, and item discrimination which refers to the correlation of how well a test taker does on a particular item and their performance on the whole test.An evaluation instrument based on the one developed and validated by Breakall et al. (2019) was employed to identify item writing flaws that add irrelevant difficulty. Examples of item flaws that provide irrelevant difficulty based on the National Board of Medical Examiners (NBME) guidelines are: (a) items with complicated stems and lead-ins that include negative forms, (b) item options that are not written succinctly or include vague terms, (c) numerical data not presented consistently, (d) items that include nonparallel options, or (e) that include “none of the above.” This instrument was used to assess MCQs from a Dental School Physiology exam.The frequency of item flaws indicated that of all items analyzed, 56% items contained at least one flaw. The most common item flaws identified were those where the answer choices were not of approximately the same length (32%), did not have parallel grammatical form and structure (24%) or those that included negative phrasing (16%). In conclusion, this assessment indicates that the MCQs used in this Dental Physiology course have room for improvement. To better understand if the identified flaws affect item performance, exam data provided by Exam Soft Analytics will be analyzed. Based on those results, decisions could be made about modifying MCQs to better serve the needs of our diverse student population.

Optimization of fuzzy K-objective fractional assignment problem using fuzzy programming model

The assignment problem is one of the core combinatorial optimization problems in the optimization branch, and the theory and applications of fractional programming have made great strides in recent years. Usually, the possible coefficient values of linear fractional programming and real-world problems are frequently only known to the decision in vague or uncertain terms. Hence, it would be more acceptable to interpret the coefficients for as fuzzy numerical information. In this paper, a fuzzy bi-objective fractional assignment (FBOFAP) has been formulated. A problem has been defined. Here, triangular shapes are used to indicate the parameters. The fuzzy problem is turned into a typical crisp problem through α-cut using a fuzzy number and then the compromise solution is generated by fuzzy programming.

Vagueness and the Evolution of Consciousness

<i>Vagueness and the Evolution of Consciousness</i>

Conceptualization of Biomimicry in Engineering Context among Undergraduate and High School Students: An International Interdisciplinary Exploration.

Biomimicry is an interdisciplinary design approach that provides solutions to engineering problems by taking inspiration from nature. Given the established importance of biomimicry for building a sustainable world, there is a need to develop effective curricula on this topic. In this study, a workshop was conducted twice in Singapore: once with 14 students from a local high school in Singapore, and once with 11 undergraduate students in engineering from the United States. The workshop aimed to better understand how students conceptualize biomimicry following the bottom-up and top-down biomimetic methods. The workshop contained a lecture and laboratory session, and data were collected via questionnaires, field observation, and participant presentations at the end of the laboratory session. A qualitative analysis revealed that the top-down biomimetic approach was initially understood using vague and generic terms. In contrast, the students described the bottom-up approach using precise and technical vocabulary. By naming the themes highlighting the students' conceptualizations, it was concluded that strengthening the principle that makes the natural object unique and increasing interdisciplinary knowledge are needed to help them perform the top-down approach. The results from this work should be confirmed with a more significant number of participants, and they could help develop a curriculum to teach the two approaches effectively by providing tools to help the students generalize their ideas and abstract meaning from systems.

Who is ‘the person of unsound mind’? The problem of terminological incompatibility in law and medical sciences in the context of the proper legal protection of people with mental disorders subjected to penal coercive measures

IntroductionPenal coercive measures (e.g., detention) seriously interfere with the individual’s fundamental rights (especially the right to liberty). It is necessary to have proper guarantee mechanisms to protect an individual against the arbitrariness of decisions made in this regard. It is especially significant in the case of people with mental disorders (MD). This group of entities may not be able to take intended legal actions to protect their rights and, thus, requires enhanced legal protection. The effectiveness of legal solutions depends on the appropriate terminology. Vague, ambiguous, or archaic terms pose a risk of over-interpretation and create an area for abuse. An example of such solution is art. 5(1)(e) of the European Convention on Human Rights (ECHR) allows deprivation of liberty for “the person of unsound mind.”ObjectivesThe study aims to analyze the concept of “person of unsound mind” appearing in the ECHR and to define its semantic scope in relation to mental disorders. This procedure aims to determine whether the status of a person of unsound mind is the same as the status of a person with MD - both in legal and medical contexts.MethodsThe study consists of two stages. The first stage included the narrative review of the literature by searching the PubMed and Google Scholar databases with the keywords “unsound mind” and “person of unsound mind”. The second stage included the analysis of the European Court of Human Rights judgments relating to art. 5(1)(e) of ECHR, collected in the HUDOC database. Forty-four articles and 128 judgments met inclusion criteria and were included for further analysis.ResultsThe study shows that the concept of a “person of unsound mind” is primarily indefinite. The term does not correspond to the current standards of medical terminology. It relates to mental disorders but has a narrower scope. The term “unsound mind” refers only to “true mental disorder”, which is of that kind or degree that warrants compulsory confinement. To be considered a “true” mental disorder has to be of a certain severity. This term should be interpreted narrowly, but there are no grounds to limit its scope to psychotic disorders only. However, including some non-psychotic disorders in its scope may be questionable (e.g., antisocial personality disorder).ConclusionsThe structure of art. 5(1)(e) ECHR does not comply with the current medical terminology standards. This inconsistency in terminology and primary indefinite character of the “unsound mind” may implicate a lot of difficulties in precisely defining its meaning and scope of use in individual cases. It is dangerous from the perspective of the personal liberty of people with MD. This term should be replaced with the term “mental disorders,” the meaning of which is well-established in medicine.Disclosure of InterestNone Declared

The good, the bad, and the ugly: Analysis of three arguments in the ongoing debate concerning the polarity of Mesozoic arcs along the western margin of North America

The debate concerning eastward versus westward subduction along the western margin of Mesozoic North America involves three main arguments: The tomography argument (westward) claims subducted slabs are observed by tomographic processing of seismic waves; the geologic evidence argument (eastward) claims subduction polarity is recorded by tripartite accretionary complex−forearc basin−magmatic arc assemblages; and the crucial geologic test argument (eastward) claims endemic terranes are characterized by detrital zircons of appropriate age and abundance, particularly Precambrian zircons. Reconstruction of the arguments in standard logic form as categorical syllogisms indicates that all three arguments are valid. However, evaluation of the truth-falsehood of the propositions supporting the arguments suggests: (1) propositions for the tomography argument seem more truthful than false; (2) propositions for the geologic test argument seem more false than truthful; and (3) propositions for the crucial geologic test argument also seem more false than truthful. Thus, the tomography argument appears to be a “good” argument (i.e., valid and sound); the geologic evidence argument appears to be a “bad” argument (i.e., valid and unsound); and the crucial geologic test argument appears to be an “ugly” argument—in the spirit that some mathematical proofs are ugly (i.e., valid and unsound, in addition to being convoluted and couched in vague terms such as “appropriate”). Proposed tests for falsification of the arguments include application of an alternate tomographic processing method to obtain non-wall-like structures in the mantle, demonstration that tripartite successions are not consanguineous, and procurement of additional evidence showing that endemic terranes do not contain Precambrian detrital zircons of appropriate age and abundance.

Semantic Adaptation to the Interpretation of Gradable Adjectives via Active Linguistic Interaction.

When communicating, people adapt their linguistic representations to those of their interlocutors. Previous studies have shown that this also occurs at the semantic level for vague and context-dependent terms such as quantifiers and uncertainty expressions. However, work to date has mostly focused on passive exposure to a given speaker's interpretation, without considering the possible role of active linguistic interaction. In this study, we focus on gradable adjectives big and small and develop a novel experimental paradigm that allows participants to ask clarification questions to figureout their interlocutor's interpretation. We find that, when in doubt, speakers do resort to this strategy, despite its inherent cognitive cost, and that doing so results in higher semantic alignment measured in terms of communicative success. While not all question-answer pairs are equally informative, we show that speakers become better questioners as the interaction progresses. Yet, the higher semantic alignment observed when speakers are able to ask questions does not increase over time. This suggests that conversational interaction's key advantage may be to boost coordination without committing to long-term semantic updates. Our findings shed new light on the mechanisms used by speakers to achieve semantic alignment and on how language is shaped bycommunication.

Rubber gloves in orthopaedic surgery (part II): Cooke and Goodyear; Halsted and Caroline's gloves of love; from cotton to rubber after Perthes' experiments; double glove technique with Urist.

This study determines the timeline for surgeons adopting rubber gloves and the double glove technique in the operating room for orthopaedic surgery. Using the vague historical terms of discovery, acceptance, commonplace, and consistency, we analyzed the influence of the different actors in each period. Cotton or silk was used for early gloves; they were permeable, sometimes coated with paraffin. Uses of rubber date to the 1600s when the Mesoamericans used rubber to make shoes. After the discovery of rubber in 1735 by the French scientist Charles de la Condamine in Peru, the rubber glove was imagined in 1834 and done for the first time by R. F. Cooke. The acceptance of rubber gloves arrived when the Goodyear-Rubber Society began to manufacture rubber gloves. Halsted, at Johns Hopkins Hospital, negotiated in 1889 with the Goodyear Rubber Company to produce thin rubber gloves to protect his nurse's hands from the dermatologic effects of the carbolic acid used to sterilize instruments. Commonplace to protect patients from bacteria of hand surgeons necessitated several decades. Dr. Joseph Bloodgood (Halsted's senior resident) remarked that gloving the surgeon with rubber gloves reduced the infection rate. Still, surgeons were reluctant to wear gloves that impaired the sense of touch. Laboratory experiments performed by G. Perthes on cotton and rubber gloves were necessary to generalize rubber gloves for practice in orthopaedic surgery. Consistency of the double-glove technique arrived during World War II when M. Urist proposed the double protection against bites from bone or bullet fragments while exploring war wounds. Only in 1965, when The Ansell Rubber Company utilized gamma irradiation as a low-cost method of sterilizing the gloves they produced, did disposable gloves become sterile. This article helps to understand the detailed discussions before surgical gloves' modern operating equipment.

Palm Oil Diaspora: Afro-Brazilian Landscapes and Economies on Bahia's Dendê Coast

Palm Oil Diaspora: Afro-Brazilian Landscapes and Economies on Bahia's Dendê Coast

A GRASP-VND algorithm to solve the multi-objective fuzzy and sustainable Tourist Trip Design Problem for groups

The design and planning of group tourist itineraries is a current trend. Group planning should be done according to the maximum capacity of the site under current COVID-19 conditions, the transport flow, and the benefits associated with individual preferences. Tourists commonly express the benefits and limitations of travel in vague and imprecise linguistic terms. In this paper, a hybrid algorithm is presented that combines Greedy Randomized Adaptive Search Procedure, Variable Neighborhood Descendent, and Pareto optimality to solve the multi-objective problem of planning sustainable group tourists itineraries under uncertainty. A set of experiments is performed with real-world tourism data from Sucre, Colombia and benchmark instances from the literature to validate the algorithm’s performance. The results are compared with optimal solutions obtained by CPLEX and other algorithms from previous works. Our approach demonstrates superior performance to different multi-target algorithms and builds more realistic routes.

Development of an Advance Care Planning Portal-Based Tool for Community-Dwelling Persons Living With Cognitive Impairment: The ACPVoice Tool.

Background: Patient portals can be an innovative and efficient way to engage patients in advance care planning (ACP). However, comprehension and judgment in older adults with cognitive impairment presents several barriers and challenges to engaging in new technology. Our objective was to develop an ACP portal-based tool (ACPVoice) for community-dwelling persons living with cognitive impairment (PLCI) by engaging end-users in the design process. Methods: Two rounds of cognitive interviews were conducted to identify and resolve cognitive issues related to comprehension, judgment, response, and to assess content validity. Purposive sampling was used with the goal of enrolling 15 different participants (five with mild cognitive impairment and five dyads (those with mild dementia and their care partner) in each round to assess respondents' understanding of questions related to advance care planning to be administered via the patient portal. Results: Twenty PLCI (mean age 78.4, 10 females [50%]) and ten care partners (mean age 60.9, 9 females [90%]) completed cognitive interviews between May 2021 and October 2021. The mean Mini-Mental State Examination score for PLCI was 25.6 (SD 2.6). Unclear wording and undefined vague and/or unfamiliar terms were the major issues identified. Revisions to item wording, response options, and instructions were made to improve question comprehension and response as well as navigational ease. Conclusion: Minor changes to the wording, format, and response options substantially improved respondents' ability to interpret the item content of the ACPVoice tool. Dissemination and implementation of the ACPVoice tool could help to engage community-dwelling PLCI in ACP discussions.

Building back better through feminist entrepreneurship policy

PurposeMost feminists policies are aspirational. Deficiencies include vague terms of what constitutes ‘feminist’ within policy, ambiguous investment criteria, lack of consultation and the use of the binary definition of gender negating gender-diverse people (Tiessen, 2019). The purpose of this study is to identify parameters that characterize feminist entrepreneurship policies and to advance recommendations to operationalize these policies.Design/methodology/approachThe COVID-19 pandemic has unveiled fragilities in the socio-economic gains that women entrepreneurs have achieved. Gender-regression is, in part, the product of entrepreneurship policies that fail to recognize the nature and needs of women entrepreneurs. To inform recovery measures, this article considers two research questions: what are the parameters of feminist entrepreneurship policies? and how can parameters of feminist entrepreneurship policy be operationalized in pandemic recovery measures? To inform the questions, the study draws on the academic literature and thematic analysis of three collective feminist action plans to operationalize ten parameters that characterize feminist entrepreneurship policy.FindingsSupplanting ‘feminist’ for women in the construction of entrepreneurship policies, without specifications of how parameters differ dilutes government's efforts to achieve gender quality and women's economic empowerment. To inform policy, recommendations of three feminist recovery policies clustered under seven themes: importance of addressing root causes of inequality; need to invest in social and economic outcomes; economic security; enhancing access to economic resources; investment in infrastructure; inclusive decision-making; and need for gender disaggregated data to inform policy. Differences in policy priorities between collective feminist recovery plans and the academic literature are reported.Research limitations/implicationsThe parameters of feminist entrepreneurial policy require further interpretation and adaptation in different policy, cultural and geo-political contexts. Scholarly attention might focus on advisory processes that inform feminist policies, such as measures to address gender-regressive impacts of the COVID-19 pandemic. Research is also needed to understand the impacts of feminist policies on the lived experiences of diverse women entrepreneurs. Limitations: The study design did not incorporate viewpoints of policymakers or capture bureaucratic boundary patrolling practices that stymie feminist policies. Thematic analysis was limited to three feminist recovery plans from two countries.Practical implicationsRecommendations to operationalize feminist entrepreneurship policies in the context of pandemic recovery are described.Originality/valueTen parameters of feminist entrepreneurship policy are explored. The conceptual study also advances a framework of feminist entrepreneurship policy and considers boundary conditions for when and how the parameters are applicable.

Theoretical and Empirical Investigations of Divination and Magic: Manipulating the Divine ed. by Jesper Sørensen and Anders Klostergaard Petersen

Reviewed by: Theoretical and Empirical Investigations of Divination and Magic: Manipulating the Divine ed. by Jesper Sørensen and Anders Klostergaard Petersen Vanessa Da Silva Baptista jesper sørensen and anders klostergaard petersen, eds. Theoretical and Empirical Investigations of Divination and Magic: Manipulating the Divine. Leiden and Boston: Brill, 2021. Pp. viii + 288. Terminology is a perennial issue in the social sciences. Scholars must decide whether to use vast and vague catch-all terms to capture a variety of distinct practices that share some similarities or to use only culturally and temporally specific categories. Jesper Sørensen's and Anders Klostergaard Petersen's edited volume focuses on two especially complicated terms: magic and divination. [End Page 337] Sørensen and Petersen problematize the categories of magic and divination, particularly in the context of colonialism and the emergent Western esoterism that influenced early anthropology. However, through theoretical reflections which take their cues from twenty-first century cognitive science, they ultimately provide a defence of the communicative, as opposed to analytic, value of these terms. Across ten chapters, which are unified in their attention to the methodologies and frameworks of cognitive science, the collection evaluates the effective use of magic and divination as categories in various specific contexts from ancient Greece to the contemporary world. Corby Kelly and Jörg Rüpke analyze how divination and magic, respectively, were conceived in distinct times and places. They demonstrate how the acceptability of these activities was partially determined by their associations with other factors. Kelly examines the fourth century Pseudo-Platonic Epinomis, placing it within wider contemporary trends of Greek philosophical writing. Kelly convincingly argues that the Epinomis outlines a structure of the universe which actively marginalized divination by relating it to wage earning and the unseeable, and thereby unknowable, elements of the universe. Rüpke's article complements Kelly's in examining how magic was understood by a single intelligent Roman individual, Propertius. In his close reading, Rüpke shows that Propertius's allusions to magic establish that it was one of several legitimate recourses open to ancient Roman people but that, due to its connection with potions and therefore resemblance to the illegal activity of poisoning, it was predominantly understood as a last resort. Other contributions seek to examine the relationship between magic or divinatory practices and religion. Dimitris Xygalatas's article argues largely for continuity in the importance and popularity of divinatory practices throughout Greek history, from antiquity to the present day. Xygalatas shows how the Orthodox Church has frequently chosen to be pragmatic in their response to extra-liturgical practices, choosing to turn a blind eye or, on occasion, even engaging in or condoning these practices at a local level. Gideon Bohak's contribution provides an edition and translation of a medieval Jewish recipe for opening doors and contextualizes this within medieval Jewish culture. Bohak demonstrates that while it may have had its detractors, the Torah's prohibition of magic meant that the Jewish people who used this recipe would not have considered it to be magic. However, Bohak defends the practice of calling this recipe magic as this allows for the investigation of similar recipes, in a medieval Jewish context and cross-culturally, that were variously understood as magical or licit. Jørgen Podemann Sørensen's and Jesper Sørensen's contributions are highly theoretical, aiming to build morphologies and models that allow for the [End Page 338] comparative study of divinatory practices. Podemann Sørensen makes a persuasive case for the continued use of divination as a category of academic interrogation by comparing a sample of five temporally and geographically distinct divinatory practices under a simple model wherein an act randomly selects a text which is interpreted to provide meaning. While generally convincing, it felt at times that the example of the oracle at Delphi was an outlier that did not comfortably fit into this framework. Sørensen's contribution argues that by examining the various cognitive mechanisms at play in divinatory practices scholars can unpack their logic and function, thereby allowing a diverse set of practices to be synthesized into complementary models. While the examples are interesting, the attempts to systematize various practices without recalling the...

What was Killing Babies in Hermoupolis, Greece? An Investigation of Infant Mortality Using Individual Level Causes of Death, 1861–1930

This paper employs individual level cause of death data from the port city of Hermoupolis on the Greek island of Syros, in order to test the newly-constructed ICD10h coding system. By constructing cause specific death rates for infants from the late 19th century to early 20th century, the paper contributes to a comparative approach, which aims to show how causes of death differ across several locations within Europe and how they develop over time. Given the scarcity of cause of death data both at the individual and aggregate level in Greece roughly prior to the 1920s, the availability of such data in the draft death registers (for sporadic runs of years in the second half of the 19th and early 20th century) and the civil registration (from 1916 onwards) in Hermoupolis provides a deeper understanding of the history of cause-of-death reporting in the country. Infant mortality in Hermoupolis was relatively high throughout the study period, with water-food borne diseases accounting for the highest number of infant deaths, especially during the hot and dry summer months. While the prominent winter peak of neonatal mortality but also congenital-birth disorders could be partially associated with birth seasonality and/or low temperatures over the winter months. Finally, certain vague terms such as 'atrophy' and 'athrepsy', but especially 'drakos' require further investigation until they are firmly understood.

144 Clinical epidemiology of Masson tumor

Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson tumor–a rare, benign vascular lesion typically presenting in the skin as a subcutaneous nodule – may be clinically mistaken for other neoplasms such as hemangiomas and lipomas. IPEH is classically categorized into three types:1) pure type arising in dilated endovascular spaces; 2) mixed type developing from preexisting vascular abnormalities; 3) extravascular type. While the prognosis of IPEH is excellent, it must be differentiated from malignant tumors such as angiosarcomas, which may require intensive treatments. Because the literature on IPEH is limited, we sought to characterize clinical and pathological features of IPEH. Subjects were identified using the Mass General Brigham (MGB) Research Patient Data Registry and included individuals with pathologically proven diagnosis of IPEH from 1/1980 to 8/2021 at Massachusetts General Hospital, Brigham and Women’s Hospital (BWH), and the BWH Faulkner Hospital. Demographic information, clinical documentation, and pathology reports were reviewed for data extraction. 261 individuals were diagnosed with IPEH, with the majority being women (60%) and white (74%). The average age at diagnosis was 53 years old [4-98 years old]. The most frequently involved anatomic sites were the upper (29%) and lower (24%) extremities. Common initial clinical diagnoses of lesions were cysts, hemangiomas, and lipomas. The pure subtype of IPEH was the most common (50%), followed by the mixed (46%) and extravascular subtypes (4%). Extravascular IPEH occurred more frequently in women (5%) compared to men (1%). We found that most clinicians’ initial impressions prior to biopsy did not include the final diagnosis of IPEH -- often using vague terms such as “soft tissue mass” -- indicating a potential need for greater awareness of this condition. Given the differential diagnosis of IPEH often includes conditions such as melanoma or angiosarcoma, clinicopathologic correlation is of utmost importance for this uncommon vascular lesion.

How might we co‐design energy transition policy in old industrial regions?

AbstractThere has been growing interest in collaborative approaches such as co‐creation and co‐design for strategic energy planning and energy policy design. However, existing analyses have conceptualized collaboration in rather vague terms, have focused primarily on the involvement of industrial actors and have been set in Western Europe. In this paper, we assess an inclusive energy transition policy co‐design experiment in Ida‐Virumaa, a region in Estonia historically dominated by the oil shale industry and with scarce experience of cross‐sector collaboration to date. The experiment had a twofold purpose: (1) to establish a network of people interested in renewable energy and energy efficiency in the region, (2) to develop and validate proposals for policies that could accelerate the energy transition. We found that expectation alignment, social learning, resource mobilization and developmental evaluation can be used to create synergy among participants and can lead to innovative policy proposals. However, collaboration increases the time needed for policy development, the existence of alternative venues can undermine the collaborative process, fluid roles can create confusion around implementation and there might not be many resources to build on in old industrial regions. We conclude that it is still relatively easy to co‐design energy policy or a strategic energy plan even in a setting that does not enjoy a well‐developed collaborative culture but it is much more challenging to co‐create a strong network of committed actors with clear roles in the implementation of policies and plans.

Italy’s Sea: Empire and Nation in the Mediterranean, 1895–1945

Italy’s Sea: Empire and Nation in the Mediterranean, 1895–1945

“‘For Your Freedom and Ours’: Polonia and the Struggle for Polish Independence,” special issue, Rocznik Przemyski 55, no. 3 (23)

“‘For Your Freedom and Ours’: Polonia and the Struggle for Polish Independence,” special issue, <i>Rocznik Przemyski</i> 55, no. 3 (23)

RAMSIFICATION AND SEMANTIC INDETERMINACY

AbstractIs it possible to maintain classical logic, stay close to classical semantics, and yet accept that language might be semantically indeterminate? The article gives an affirmative answer byRamsifying classical semantics, which yields a new semantic theory that remains much closer to classical semantics than supervaluationism but which at the same time avoids the problematic classical presupposition of semantic determinacy. The resultingRamsey semanticsis developed in detail, it is shown to supply a classical concept of truth and to fully support the rules and metarules of classical logic, and it is applied to vague terms as well as to theoretical or open-ended terms from mathematics and science. The theory also demonstrates how diachronic or synchronic interpretational continuity across languages is compatible with semantic indeterminacy.

Magnitude of terminological bias in international health services research: a disambiguation analysis in mental health.

Health services research (HSR) is affected by a widespread problem related to service terminology including non-commensurability (using different units of analysis for comparisons) and terminological unclarity due to ambiguity and vagueness of terms. The aim of this study was to identify the magnitude of the terminological bias in health and social services research and health economics by applying an international classification system. This study, that was part of the PECUNIA project, followed an ontoterminology approach (disambiguation of technical and scientific terms using a taxonomy and a glossary of terms). A listing of 56 types of health and social services relevant for mental health was compiled from a systematic review of the literature and feedback provided by 29 experts in six European countries. The disambiguation of terms was performed using an ontology-based classification of services (Description and Evaluation of Services and DirectoriEs - DESDE), and its glossary of terms. The analysis focused on the commensurability and the clarity of definitions according to the reference classification system. Interrater reliability was analysed using κ. The disambiguation revealed that only 13 terms (23%) of the 56 services selected were accurate. Six terms (11%) were confusing as they did not correspond to services as defined in the reference classification system (non-commensurability bias), 27 (48%) did not include a clear definition of the target population for which the service was intended, and the definition of types of services was unclear in 59% of the terms: 15 were ambiguous and 11 vague. The κ analyses were significant for agreements in unit of analysis and assignment of DESDE codes and very high in definition of target population. Service terminology is a source of systematic bias in health service research, and certainly in mental healthcare. The magnitude of the problem is substantial. This finding has major implications for the international comparability of resource use in health economics, quality and equality research. The approach presented in this paper contributes to minimise differentiation between services by taking into account key features such as target population, care setting, main activities and type and number of professionals among others. This approach also contributes to support financial incentives for effective health promotion and disease prevention. A detailed analysis of services in terms of cost measurement for economic evaluations reveals the necessity and usefulness of defining services using a coding system and taxonomical criteria rather than by 'text-based descriptions'.