Supporting Jargon of Different Specialisms in Medical Terminology
Supporting Jargon of
Different Specialisms
Feikje Hielkema-Raadsveld
Elze de Groot
Experts Medical Terminology
31 October 2014
Contents
•
Why support jargon?
•
Proposed solution
•
Specification
•
The translation process
•
Result
•
Consequences for implementation
•
Conclusion
Supporting Jargon of Different Specialisms
2
Why support jargon?
•
One concept, multiple descriptions
•
Ablatio retinae
Netvliesloslating
•
Neovascularisatie van cornea
Corneapannus
•
Milia
Gerstekorrel
•
Verruca vulgaris
Virale wrat
•
Ehlers-Danlos syndrome
India rubber skin
Cutis hyperelastica dermatorrhexis
•
Which preferred term?
•
Heuristics not always sufficient, or contradictory
•
Most descriptive or most widely used?
3
Supporting Jargon of Different Specialisms
Why support jargon?
•
One description, multiple concepts
•
Infarct
•
Cardiology = myocardial infarction
•
Neurology = cerebral infarction
•
Syndroom van Silver
•
15069006 |Russel-Silver syndrome (disorder)| (type
of dwarfism)
•
76043009
|H
ereditary sensory-motor neuropathy,
type V
Type 5 (disorder)|
4
Supporting Jargon of Different Specialisms
What do we use descriptions for?
•
Registration
•
Different specialisms search by different
descriptions
•
Supported by SNOMED CT through synonyms
•
Presentation
•
Use different descriptions to present the same
concept to different audiences?
•
Currently unsupported by SNOMED CT
Supporting Jargon of Different Specialisms
5
Risks
•
Miscommunications between specialisms
•
Lengthy disputes over preferred terms
•
Cannot flag descriptions as suitable
‘layman terms’ for communication with
the public
•
Unwilling end users?
Supporting Jargon of Different Specialisms
6
We propose...
•
Each specialism its own preferred term
•
Only for those concepts they expect to use
•
Fewer people have to agree
•
All preferred terms are valid synonyms in all
specialisms
•
Co-creation of content
•
By groups of medical specialists
•
NRC provides tooling, advice, guidelines,
supervision and mediation
Supporting Jargon of Different Specialisms
7
How?
•
How do we achieve this without:
•
Enormous increase of size of SNOMED CT?
•
Loss of compatibility with international
standard?
•
Implementation difficulties for IT-suppliers?
Supporting Jargon of Different Specialisms
8
Option 1: Add column
•
Add a column ‘Specialism’ to denote the
specialism for which the description is
‘preferred term’
•
Advantages:
•
Small increase of size
•
All information in a single language refset
•
Disadvantages:
•
Format of language refset differs from core
Supporting Jargon of Different Specialisms
9
Option 2: Add language refsets
•
Dutch language refset in original format
which contains:
•
The default preferred term
•
All synonyms used in all specialisms
•
(Eventually) Translations of each concept in
SNOMED CT
•
Add specialism-dependent language refsets
which contain:
•
The preferred term for that specialism
•
Only for concepts used in that specialism
Supporting Jargon of Different Specialisms
10
Option 2: Add language refsets
•
Advantages:
•
No deviation of core format
•
One language refset to find all suitable
synonyms
•
Disadvantages:
•
Duplication of information
increase of size
•
May need two language refsets to find suitable
preferred term for presentation
Supporting Jargon of Different Specialisms
11
Chosen solution
•
Prefer size increase over loss of
compatibility
Option 2 it is!
... but what does that entail?
Supporting Jargon of Different Specialisms
12
Specification of Dutch Extension
•
One RF2-file with all Dutch simple refsets
•
One RF2-file with all Dutch language
refsets, containing:
•
One generic Dutch language refset with:
•
One (default) preferred term per concept
•
All Dutch synonyms
•
For each simple refset a language refset with:
•
A preferred term for each concept in the refset
•
No synonyms!
Supporting Jargon of Different Specialisms
13
The translation process
•
Co-creation
•
Authors: groups of specialists
•
Tooling: Nictiz refset editor
•
Creation of simple & language refset
•
First translation
default preferred term
•
Only NRC terminologists can change default
preferred terms
•
NRC supervises translations
•
Also added to corresponding language refset
Supporting Jargon of Different Specialisms
14
The translation process
•
Another editor adopts the same concept:
•
Show the default preferred term and all
synonyms
•
New synonyms are added to generic Dutch
language refset
•
If preferred term is changed
•
Listed in generic Dutch language refset as
synonym
•
Added to specialist refset as preferred term
•
Default preferred term in generic refset does not
change!
Supporting Jargon of Different Specialisms
15
Result
•
Generic Dutch language refset contains all
Dutch descriptions
•
And one default preferred term per concept
•
Dutch module contains a series of
‘specialist’ language refsets:
•
Each corresponds to a Dutch simple refset
•
With one preferred term for each concept in
that simple refset
Supporting Jargon of Different Specialisms
16
Consequences for implementation
•
Search application across all SNOMED CT
concepts:
•
Retrieve all valid Dutch descriptions from the
generic Dutch language reference set
•
Registration application for a single simple
reference set:
•
Retrieve all valid Dutch descriptions from the
generic Dutch language reference set
•
Use the corresponding language refset to
identify the preferred term for this specialism
Supporting Jargon of Different Specialisms
17
Consequences for implementation
•
Present registered concept to other user:
•
Retrieve jargon:
•
Identify specialism of user
•
Optometrist, ophthalmologist, layman?
•
Retrieve specialism’s language refset
•
Retrieve specialism’s preferred term
•
Else retrieve default preferred term
Supporting Jargon of Different Specialisms
18
Conclusion
•
Support the use of jargon when
registering and viewing clinical information
•
Method:
•
Specialism-dependent preferred terms
•
Created by specialists
•
Supervised by NRC
•
Compliant with core format
Supporting Jargon of Different Specialisms
19
20
Supporting Jargon of Different Specialisms
Feikje Hielkema-Raadsveld, Elze de Groot
Experts Medical Terminology
www.nictiz.nl
Good afternoon everyone. I’m here to present the approach to translating SNOMED that we are taking at the Dutch National Release Center.
Our aim is to support effective communication and eliminate misunderstandings as much as possible. Toward this end, we believe it is important to support the use of not just one’s native language, but one’s specialist jargon.
Exploring the challenges and solutions in supporting various medical jargon across different specialisms, discussing the need for standardized terms, potential risks of miscommunication, and proposing a co-creation approach involving medical specialists for better clarity and understanding.
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Presentation Transcript
Supporting Jargon of Different Specialisms Feikje Hielkema-Raadsveld Elze de Groot Experts Medical Terminology 31 October 2014
Contents Why support jargon? Proposed solution Specification The translation process Result Consequences for implementation Conclusion Supporting Jargon of Different Specialisms 2
Why support jargon? One concept, multiple descriptions Ablatio retinae Neovascularisatie van cornea Milia Gerstekorrel Verruca vulgaris Ehlers-Danlos syndrome Cutis hyperelastica dermatorrhexis Which preferred term? Heuristics not always sufficient, or contradictory Most descriptive or most widely used? Netvliesloslating Corneapannus Virale wrat India rubber skin Supporting Jargon of Different Specialisms 3
Why support jargon? One description, multiple concepts Infarct Cardiology = myocardial infarction Neurology = cerebral infarction Syndroom van Silver 15069006 |Russel-Silver syndrome (disorder)| (type of dwarfism) 76043009|Hereditary sensory-motor neuropathy, type V Type 5 (disorder)| Supporting Jargon of Different Specialisms 4
What do we use descriptions for? Registration Different specialisms search by different descriptions Supported by SNOMED CT through synonyms Presentation Use different descriptions to present the same concept to different audiences? Currently unsupported by SNOMED CT Supporting Jargon of Different Specialisms 5
Risks Miscommunications between specialisms Lengthy disputes over preferred terms Cannot flag descriptions as suitable layman terms for communication with the public Unwilling end users? Supporting Jargon of Different Specialisms 6
We propose... Each specialism its own preferred term Only for those concepts they expect to use Fewer people have to agree All preferred terms are valid synonyms in all specialisms Co-creation of content By groups of medical specialists NRC provides tooling, advice, guidelines, supervision and mediation Supporting Jargon of Different Specialisms 7
How? How do we achieve this without: Enormous increase of size of SNOMED CT? Loss of compatibility with international standard? Implementation difficulties for IT-suppliers? Supporting Jargon of Different Specialisms 8
Option 1: Add column Add a column Specialism to denote the specialism for which the description is preferred term Advantages: Small increase of size All information in a single language refset Disadvantages: Format of language refset differs from core Supporting Jargon of Different Specialisms 9
Option 2: Add language refsets Dutch language refset in original format which contains: The default preferred term All synonyms used in all specialisms (Eventually) Translations of each concept in SNOMED CT Add specialism-dependent language refsets which contain: The preferred term for that specialism Only for concepts used in that specialism Supporting Jargon of Different Specialisms 10
Option 2: Add language refsets Advantages: No deviation of core format One language refset to find all suitable synonyms Disadvantages: Duplication of information May need two language refsets to find suitable preferred term for presentation increase of size Supporting Jargon of Different Specialisms 11
Chosen solution Prefer size increase over loss of compatibility Option 2 it is! ... but what does that entail? Supporting Jargon of Different Specialisms 12
Specification of Dutch Extension One RF2-file with all Dutch simple refsets One RF2-file with all Dutch language refsets, containing: One generic Dutch language refset with: One (default) preferred term per concept All Dutch synonyms For each simple refset a language refset with: A preferred term for each concept in the refset No synonyms! Supporting Jargon of Different Specialisms 13
The translation process Co-creation Authors: groups of specialists Tooling: Nictiz refset editor Creation of simple & language refset First translation Only NRC terminologists can change default preferred terms NRC supervises translations Also added to corresponding language refset default preferred term Supporting Jargon of Different Specialisms 14
The translation process Another editor adopts the same concept: Show the default preferred term and all synonyms New synonyms are added to generic Dutch language refset If preferred term is changed Listed in generic Dutch language refset as synonym Added to specialist refset as preferred term Default preferred term in generic refset does not change! Supporting Jargon of Different Specialisms 15
Result Generic Dutch language refset contains all Dutch descriptions And one default preferred term per concept Dutch module contains a series of specialist language refsets: Each corresponds to a Dutch simple refset With one preferred term for each concept in that simple refset Supporting Jargon of Different Specialisms 16
Consequences for implementation Search application across all SNOMED CT concepts: Retrieve all valid Dutch descriptions from the generic Dutch language reference set Registration application for a single simple reference set: Retrieve all valid Dutch descriptions from the generic Dutch language reference set Use the corresponding language refset to identify the preferred term for this specialism Supporting Jargon of Different Specialisms 17
Consequences for implementation Present registered concept to other user: Retrieve jargon: Identify specialism of user Optometrist, ophthalmologist, layman? Retrieve specialism s language refset Retrieve specialism s preferred term Else retrieve default preferred term Supporting Jargon of Different Specialisms 18
Conclusion Support the use of jargon when registering and viewing clinical information Method: Specialism-dependent preferred terms Created by specialists Supervised by NRC Compliant with core format Supporting Jargon of Different Specialisms 19
Feikje Hielkema-Raadsveld, Elze de Groot Experts Medical Terminology www.nictiz.nl Supporting Jargon of Different Specialisms 20
