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. 1999 Jul-Aug;6(4):283-303.
doi: 10.1136/jamia.1999.0060283.

Benefits of an object-oriented database representation for controlled medical terminologies

H Gu  1 , M Halper, J Geller, Y Perl
Affiliations

Benefits of an object-oriented database representation for controlled medical terminologies

H Gu et al. J Am Med Inform Assoc. 1999 Jul-Aug.

Abstract

Objective: Controlled medical terminologies (CMTs) have been recognized as important tools in a variety of medical informatics applications, ranging from patient-record systems to decision-support systems. Controlled medical terminologies are typically organized in semantic network structures consisting of tens to hundreds of thousands of concepts. This overwhelming size and complexity can be a serious barrier to their maintenance and widespread utilization. The authors propose the use of object-oriented databases to address the problems posed by the extensive scope and high complexity of most CMTs for maintenance personnel and general users alike.

Design: The authors present a methodology that allows an existing CMT, modeled as a semantic network, to be represented as an equivalent object-oriented database. Such a representation is called an object-oriented health care terminology repository (OOHTR).

Results: The major benefit of an OOHTR is its schema, which provides an important layer of structural abstraction. Using the high-level view of a CMT afforded by the schema, one can gain insight into the CMT's overarching organization and begin to better comprehend it. The authors' methodology is applied to the Medical Entities Dictionary (MED), a large CMT developed at Columbia-Presbyterian Medical Center. Examples of how the OOHTR schema facilitated updating, correcting, and improving the design of the MED are presented.

Conclusion: The OOHTR schema can serve as an important abstraction mechanism for enhancing comprehension of a large CMT, and thus promotes its usability.

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Figures

Figure 1
Figure 1
Sample content from the Columbia-Presbyterian Medical Entities Dictionary.
Figure 2
Figure 2
Key to symbols used in figures of semantic networks.
Figure 3
Figure 3
Six areas of the Medical Entities Dictionary (see key at ▶).
Figure 4
Figure 4
Area classes corresponding to the areas of the Medical Entities Dictionary shown in ▶.
Figure 5
Figure 5
Key to symbols used in figures of object-oriented database schemas.
Figure 6
Figure 6
Schema derived from the areas of the Medical Entities Dictionary (see key at ▶).
Figure 7
Figure 7
Expanded version of the six areas shown in ▶ (see key at ▶).
Figure 8
Figure 8
Schema for the areas in ▶ (see key at ▶).
Figure 9
Figure 9
Excerpt from the schema for the object-oriented health care terminology repository (see key at ▶).
Figure 10
Figure 10
Partial schema for the object-oriented health care terminology repository, showing the area classes that account for ▶ (see key at ▶).
Figure 11
Figure 11
Improved version of schema shown in ▶ (see key at ▶).
Figure 12
Figure 12
Partial schema for the object-oriented health care terminology repository, detecting the ambiguity of “Black Piedra” (see key at ▶).
Figure 13
Figure 13
Improved version of schema shown in ▶ (see key at ▶).
See this image and copyright information in PMC

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