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Background
                                           Objectives
                     Semantic proximity in archetypes
                     Mapping archetypes to SNOMED




.
    A Study of Semantic Proximity between Archetype
       Terms based on SNOMED CT Relationships
.

      J.L.Allones, D.Penas, M.Taboada, D.Martinez and S.Tellado

                                                                      KEAM Research Group

                                                                       .      .       .       .      .       .

J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                               Objectives
                         Semantic proximity in archetypes
                         Mapping archetypes to SNOMED


. Outline
     .
    1 Background
            OpenEHR archetypes
            SNOMED CT
            Related Work
     .
    2 Objectives
     .
    3 Semantic proximity in archetypes
            Dataset
            Methods
            Results
            Conclusion
     .
    4 Mapping archetypes to SNOMED
            Methods
            Evaluation
            Results
            Discussion
                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                             OpenEHR archetypes
                                               Objectives
                                                             SNOMED CT
                         Semantic proximity in archetypes
                                                             Related Work
                         Mapping archetypes to SNOMED


. Outline
     .
    1 Background
            OpenEHR archetypes
            SNOMED CT
            Related Work
     .
    2 Objectives
     .
    3 Semantic proximity in archetypes
            Dataset
            Methods
            Results
            Conclusion
     .
    4 Mapping archetypes to SNOMED
            Methods
            Evaluation
            Results
            Discussion
                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                            OpenEHR archetypes
                                              Objectives
                                                            SNOMED CT
                        Semantic proximity in archetypes
                                                            Related Work
                        Mapping archetypes to SNOMED


. OpenEHR archetypes

    .
    What is openEHR?
    .
    Open standard speciļ¬cation that describes the management,
    storage and exchange of clinical data in EHR.
    .

    .
    What are the archetypes?
    .
    OpenEHR deļ¬nes clinical data models called archetypes.
    They model the clinical information required to record particular
    clinical statements, such as tobacco use and exposure.
    .


                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                            OpenEHR archetypes
                                              Objectives
                                                            SNOMED CT
                        Semantic proximity in archetypes
                                                            Related Work
                        Mapping archetypes to SNOMED


. OpenEHR archetypes
    Extract of the archetype tobacco:




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                            OpenEHR archetypes
                                              Objectives
                                                            SNOMED CT
                        Semantic proximity in archetypes
                                                            Related Work
                        Mapping archetypes to SNOMED


. OpenEHR archetypes


    .
    Current status of archetypes
    .
    Important institutions have participated in the
    development of archetypes.
    Problem: Archetypes hardly contain mappings
    to standard concepts
    .




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                             OpenEHR archetypes
                                               Objectives
                                                             SNOMED CT
                         Semantic proximity in archetypes
                                                             Related Work
                         Mapping archetypes to SNOMED


. OpenEHR archetypes: Need for clinical terminologies

    .
    Terminologies are required:
            To capture, use and transfer clinical data in a
            standard form.
            To reuse information collected in the course of
            patient care.
    Challenge of health informatics:
    .      To integrate archetypes and terminologies.


                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                            OpenEHR archetypes
                                              Objectives
                                                            SNOMED CT
                        Semantic proximity in archetypes
                                                            Related Work
                        Mapping archetypes to SNOMED


. SNOMED CT



   .
   SNOMED CT is the best positioned terminology
   to semantically annotate archetypes because it is
   an international standard which provides a consistent
   terminology across all health care domains.
   .




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                            OpenEHR archetypes
                                              Objectives
                                                            SNOMED CT
                        Semantic proximity in archetypes
                                                            Related Work
                        Mapping archetypes to SNOMED


. SNOMED CT



   .
   Features:
           Over 300,000 medical concepts.
           Concepts can have several descriptions and semantic
           relationships to other concepts.
   .




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                            OpenEHR archetypes
                                              Objectives
                                                            SNOMED CT
                        Semantic proximity in archetypes
                                                            Related Work
                        Mapping archetypes to SNOMED


. SNOMED CT
   .
   IS A relationships are also known as ā€Supertype -
   Subtype relationshipsā€. IS A relationships are the
   basis of SNOMED CTā€™s hierarchies.
   .




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                            OpenEHR archetypes
                                              Objectives
                                                            SNOMED CT
                        Semantic proximity in archetypes
                                                            Related Work
                        Mapping archetypes to SNOMED


. SNOMED CT

   .
   Attribute relationships associate two concepts speci-
   fying a deļ¬ning characteristic of one of the concepts.
   .




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                         OpenEHR archetypes
                                           Objectives
                                                         SNOMED CT
                     Semantic proximity in archetypes
                                                         Related Work
                     Mapping archetypes to SNOMED




.
Need for automated mapping
.
           SNOMED is a huge terminology
                           ā†“
    Manual annotation of archetypes with SNOMED
          concepts is very time-consuming.
                           ā†“
      Automated mapping methods are needed.
.



                                                                       .      .       .       .      .       .

J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                             OpenEHR archetypes
                                               Objectives
                                                             SNOMED CT
                         Semantic proximity in archetypes
                                                             Related Work
                         Mapping archetypes to SNOMED


. Related Work

    .
    Some studies have used lexical and linguistic
    techniques to compare the strings of archetype
    fragments and SNOMED CT concepts.
    The works have not achieved optimum results:
            They map correctly about 60% of archetype fragments.
            They obtain too many candidate concepts for each
            fragment (many of them are not relevant).
    .


                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                             OpenEHR archetypes
                                               Objectives
                                                             SNOMED CT
                         Semantic proximity in archetypes
                                                             Related Work
                         Mapping archetypes to SNOMED


. Related Work
    .
    Diļ¬ƒculties in automated mapping
    .
       .
      1 Modelling archetypes separately    from SNOMED
            leads to diļ¬€erences between them: disparity in
            documentation granularity or naming diļ¬€erences
    .

    Example of naming diļ¬€erences:




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                             OpenEHR archetypes
                                               Objectives
                                                             SNOMED CT
                         Semantic proximity in archetypes
                                                             Related Work
                         Mapping archetypes to SNOMED


. Related Work
    .
    Diļ¬ƒculties in automated mapping
    .
       .
      2 Some archetype terms have                                       not been explicitly
            modelled in the archetypes.
    .

    Example:




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                                         OpenEHR archetypes
                                           Objectives
                                                         SNOMED CT
                     Semantic proximity in archetypes
                                                         Related Work
                     Mapping archetypes to SNOMED

.
    There are plenty of situations in which archetype clinical
              information is semantically related
      Similarities between the structure of the archetypes and the
                    network of SNOMED relationships
                                    ā†“
.                  This may help in the automated mapping




                                                                       .      .       .       .      .       .

J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                               Objectives
                         Semantic proximity in archetypes
                         Mapping archetypes to SNOMED


. Outline
     .
    1 Background
            OpenEHR archetypes
            SNOMED CT
            Related Work
     .
    2 Objectives
     .
    3 Semantic proximity in archetypes
            Dataset
            Methods
            Results
            Conclusion
     .
    4 Mapping archetypes to SNOMED
            Methods
            Evaluation
            Results
            Discussion
                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background
                                               Objectives
                         Semantic proximity in archetypes
                         Mapping archetypes to SNOMED


. Objectives

    .
        .
        1   To understand better how archetype clinical
            information is semantically related.
        . To evaluate whether a combination of context
        2


          and structure-based techniques with lexical and
          linguistic techniques can improve the automated
          mapping of archetypes.
    .


                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Dataset
                                               Objectives    Methods
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Conclusion


. Outline
     .
    1 Background
            OpenEHR archetypes
            SNOMED CT
            Related Work
     .
    2 Objectives
     .
    3 Semantic proximity in archetypes
            Dataset
            Methods
            Results
            Conclusion
     .
    4 Mapping archetypes to SNOMED
            Methods
            Evaluation
            Results
            Discussion
                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Dataset
                                               Objectives    Methods
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Conclusion


. Studying semantic proximity between archetype terms


    .
    We checked the frequency and type of semantic
    relationships between data fragments of 25
    archetypes.
    SNOMED relationships are the reference.
    .




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Dataset
                                               Objectives    Methods
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Conclusion


. Dataset: 25 Observation archetpes



    .
    25 OBSERVATION archetypes of the NHS repository.

                      information about the condi-
    These archetypes record
    tion of patients, such as the measurement of heart rate
    and tobacco use.
    .




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Dataset
                                               Objectives    Methods
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Conclusion


. Parsing archetypes
    .
    A parser was used to preserve data fragments with clinical meaning.
    Parser gets a dependency tree of data fragments for each
    archetype.
    .




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Dataset
                                               Objectives    Methods
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Conclusion


. Parsing archetypes: Types of data fragments in archetypes




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Dataset
                                              Objectives    Methods
                        Semantic proximity in archetypes    Results
                        Mapping archetypes to SNOMED        Conclusion


. Creating manual mappings
    .
           SNOMED concepts are required to study semantic proximity.
           Problem: Bindings to SNOMED concepts are very scarce.
           We manually created mappings through manual searches.
    .      This process was very tedious and time-consuming.




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Dataset
                                               Objectives    Methods
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Conclusion


. Evaluating the semantic proximity
    .
    We checked if the concepts mapped to these archetype fragments
    are linked through hierarchical and logical relationships of the
    SNOMED terminology.
    .




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Dataset
                                               Objectives    Methods
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Conclusion


. Results
    .
    A high ratio of archetype terms are semantically related:
        30% of Element fragments are subtypes of the Root fragment.
        80% of Value fragments are connected through hierarchical
    .   relationships to any other Value fragment of the archetype




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Dataset
                                               Objectives    Methods
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Conclusion


. Conclusion


    .
              A high ratio of archetype terms are semantically related
                                         ā†“
    The network of SNOMED relationships should
    be exploited during the automated mapping of
                     archetypes.
    .




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                               Objectives    Evaluation
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Discussion


. Outline
     .
    1 Background
            OpenEHR archetypes
            SNOMED CT
            Related Work
     .
    2 Objectives
     .
    3 Semantic proximity in archetypes
            Dataset
            Methods
            Results
            Conclusion
     .
    4 Mapping archetypes to SNOMED
            Methods
            Evaluation
            Results
            Discussion
                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                              Objectives    Evaluation
                        Semantic proximity in archetypes    Results
                        Mapping archetypes to SNOMED        Discussion


. Automated mapping between archetypes and SNOMED

    .
    Several mapping techniques were developed to
    bind archetype fragments to SNOMED concepts:
           Lexical techniques
           Linguistic resource-based techniques
           Terminological context-based techniques
           Structure-based techniques
    .



                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                               Objectives    Evaluation
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Discussion


. Lexical techniques
    .
    Lexical techniques identify SNOMED concepts and
    archetype terms with similar names.
    Both the archetype terms and SNOMED descriptions are nor-
    malized, including plurals, singulars, case-insensitive, etc.
    .

    Example:




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                               Objectives    Evaluation
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Discussion


. Linguistic resource-based techniques
    .
    We used several linguistic                        resources provided by the UMLS.
    These resources use a knowledge-intensive approach based on
    symbolic and natural-language processing, to discover biomed-
    ical concepts referred in a text.
    .

    Example:




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                               Objectives    Evaluation
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Discussion


. Degree of lexical similarity
     .
     Two degrees of            lexical similarity:
            Full or exact match occurs when an archetype terms is exactly
            the same as some SNOMED CT description after normalization.
            Partial match occurs when the archetype term is contained in-
            side some SNOMED CT description.
     .

     Example:




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                              Objectives    Evaluation
                        Semantic proximity in archetypes    Results
                        Mapping archetypes to SNOMED        Discussion


. Mapping algorithm


    .
    The mapping algorithm consists of three steps:
        . Exact Match in entire SNOMED
        1


        . Partial Match in SNOMED contexts
        2


        . Structural similarity
        3
    .




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                                Objectives    Evaluation
                          Semantic proximity in archetypes    Results
                          Mapping archetypes to SNOMED        Discussion


.   First step of Mapping: Exact Match in entire SNOMED
      .
      Lexical and linguistic techniques are used to discover exact or
      almost exact correspondeces between all the SNOMED concepts
      and archetype fragments
      .




                                                                            .      .       .       .      .       .

     J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                                 Objectives    Evaluation
                           Semantic proximity in archetypes    Results
                           Mapping archetypes to SNOMED        Discussion


.   Second step of Mapping: Partial Match in SNOMED contexts
      .
      SNOMED contexts are extracted from the concepts obtained in
      the previous step.
      .




                                                                             .      .       .       .      .       .

      J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                                 Objectives    Evaluation
                           Semantic proximity in archetypes    Results
                           Mapping archetypes to SNOMED        Discussion


.   Second step of Mapping: Partial Match in SNOMED contexts
      .
      Lexical and linguistic techniques are used to discover partial and
      approximate correspondeces in the extracted contexts.
      .




                                                                             .      .       .       .      .       .

      J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                               Objectives    Evaluation
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Discussion


. Third step of Mapping: Structural similarity
    .
    Structure-based techniques identify structural similarities between
    the tree structure of archetypes and the network of SNOMED rela-
    tionships ā†’ Equivalent entities with diļ¬€erent names can be mapped
    .




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                               Objectives    Evaluation
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Discussion


. Evaluation



    .
    Our mapping algorithm was applied to 25 archetypes.

    The evaluation entailed the automated revision of each mapping
    generated by the method against the manual mappings that we
    had created for the study.
    .




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                               Objectives    Evaluation
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Discussion


. Results




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                               Objectives    Evaluation
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Discussion


. Results: Comparison with other approaches




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                               Objectives    Evaluation
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Discussion


. Discussion


    .
    Lessons learned in the work
    .
        Objetive 1: To understand better how archetype clinical infor-
        mation is semantically related.
            We now know the   frequency and type of semantic
            relationships between data fragments of archetypes.
            We found that a high ratio of archetype fragments are seman-
            tically related.
    .



                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                               Objectives    Evaluation
                         Semantic proximity in archetypes    Results
                         Mapping archetypes to SNOMED        Discussion


. Discussion


    .
    Lessons learned in the work
    .
        Objetive 2: To evaluate whether a combination of context and
        structure-based techniques with lexical and linguistic techniques
        can improve the automated mapping.
            Context and structure-based techniques are able to exploit
            SNOMED CT relationships to improve the automated mapping
            of archetypes.
    .




                                                                           .      .       .       .      .       .

    J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                              Objectives    Evaluation
                        Semantic proximity in archetypes    Results
                        Mapping archetypes to SNOMED        Discussion


. Future Work


    .
    We will test the automatic mapping with diļ¬€erent types of
    archetypes.
    We will explore ways to use medical knowledge from SNOMED:
           To facilitate the semi-automatic creation of new archetypes.
           To recommend extensions in existing archetypes.
    .




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                              Objectives    Evaluation
                        Semantic proximity in archetypes    Results
                        Mapping archetypes to SNOMED        Discussion


. Summary


   .
   Clinical models, such as archetypes, need to be inte-
   grated with terminologies to capture, use and transfer
   clinical data in a standard way.

   Manual integration is very time-consuming...
   .




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                              Objectives    Evaluation
                        Semantic proximity in archetypes    Results
                        Mapping archetypes to SNOMED        Discussion


. Summary

   .
   We propose a novel automated method to link data
   fragments of archetypes with concepts of medical ter-
   minologies.
   Besides conventional name-based techniques, the
   method exploits the medical knowledge represented
   in SNOMED to improve the automated mapping and
   thus reduce human participation in the process.
   .

                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o
Background      Methods
                                              Objectives    Evaluation
                        Semantic proximity in archetypes    Results
                        Mapping archetypes to SNOMED        Discussion


. Acknowledgements




                      Thank you for your attention!

    MEC National research project GestiĀ“n de TerminologĀ“ MĀ“dicas
                                       o               ıas e
              para Arquetipos TIN2009-14159-C05-05




                                                                          .      .       .       .      .       .

   J.L. Allones, D. Penas, M. Taboada, D. Martinez et al.   A Study of Semantic Proximity between Archetype Terms based o

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Semantic proximity between archetype terms and SNOMED CT

  • 1. Background Objectives Semantic proximity in archetypes Mapping archetypes to SNOMED . A Study of Semantic Proximity between Archetype Terms based on SNOMED CT Relationships . J.L.Allones, D.Penas, M.Taboada, D.Martinez and S.Tellado KEAM Research Group . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 2. Background Objectives Semantic proximity in archetypes Mapping archetypes to SNOMED . Outline . 1 Background OpenEHR archetypes SNOMED CT Related Work . 2 Objectives . 3 Semantic proximity in archetypes Dataset Methods Results Conclusion . 4 Mapping archetypes to SNOMED Methods Evaluation Results Discussion . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 3. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . Outline . 1 Background OpenEHR archetypes SNOMED CT Related Work . 2 Objectives . 3 Semantic proximity in archetypes Dataset Methods Results Conclusion . 4 Mapping archetypes to SNOMED Methods Evaluation Results Discussion . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 4. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . OpenEHR archetypes . What is openEHR? . Open standard speciļ¬cation that describes the management, storage and exchange of clinical data in EHR. . . What are the archetypes? . OpenEHR deļ¬nes clinical data models called archetypes. They model the clinical information required to record particular clinical statements, such as tobacco use and exposure. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 5. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . OpenEHR archetypes Extract of the archetype tobacco: . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 6. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . OpenEHR archetypes . Current status of archetypes . Important institutions have participated in the development of archetypes. Problem: Archetypes hardly contain mappings to standard concepts . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 7. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . OpenEHR archetypes: Need for clinical terminologies . Terminologies are required: To capture, use and transfer clinical data in a standard form. To reuse information collected in the course of patient care. Challenge of health informatics: . To integrate archetypes and terminologies. . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 8. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . SNOMED CT . SNOMED CT is the best positioned terminology to semantically annotate archetypes because it is an international standard which provides a consistent terminology across all health care domains. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 9. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . SNOMED CT . Features: Over 300,000 medical concepts. Concepts can have several descriptions and semantic relationships to other concepts. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 10. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . SNOMED CT . IS A relationships are also known as ā€Supertype - Subtype relationshipsā€. IS A relationships are the basis of SNOMED CTā€™s hierarchies. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 11. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . SNOMED CT . Attribute relationships associate two concepts speci- fying a deļ¬ning characteristic of one of the concepts. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 12. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . Need for automated mapping . SNOMED is a huge terminology ā†“ Manual annotation of archetypes with SNOMED concepts is very time-consuming. ā†“ Automated mapping methods are needed. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 13. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . Related Work . Some studies have used lexical and linguistic techniques to compare the strings of archetype fragments and SNOMED CT concepts. The works have not achieved optimum results: They map correctly about 60% of archetype fragments. They obtain too many candidate concepts for each fragment (many of them are not relevant). . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 14. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . Related Work . Diļ¬ƒculties in automated mapping . . 1 Modelling archetypes separately from SNOMED leads to diļ¬€erences between them: disparity in documentation granularity or naming diļ¬€erences . Example of naming diļ¬€erences: . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 15. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . Related Work . Diļ¬ƒculties in automated mapping . . 2 Some archetype terms have not been explicitly modelled in the archetypes. . Example: . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 16. Background OpenEHR archetypes Objectives SNOMED CT Semantic proximity in archetypes Related Work Mapping archetypes to SNOMED . There are plenty of situations in which archetype clinical information is semantically related Similarities between the structure of the archetypes and the network of SNOMED relationships ā†“ . This may help in the automated mapping . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 17. Background Objectives Semantic proximity in archetypes Mapping archetypes to SNOMED . Outline . 1 Background OpenEHR archetypes SNOMED CT Related Work . 2 Objectives . 3 Semantic proximity in archetypes Dataset Methods Results Conclusion . 4 Mapping archetypes to SNOMED Methods Evaluation Results Discussion . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 18. Background Objectives Semantic proximity in archetypes Mapping archetypes to SNOMED . Objectives . . 1 To understand better how archetype clinical information is semantically related. . To evaluate whether a combination of context 2 and structure-based techniques with lexical and linguistic techniques can improve the automated mapping of archetypes. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 19. Background Dataset Objectives Methods Semantic proximity in archetypes Results Mapping archetypes to SNOMED Conclusion . Outline . 1 Background OpenEHR archetypes SNOMED CT Related Work . 2 Objectives . 3 Semantic proximity in archetypes Dataset Methods Results Conclusion . 4 Mapping archetypes to SNOMED Methods Evaluation Results Discussion . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 20. Background Dataset Objectives Methods Semantic proximity in archetypes Results Mapping archetypes to SNOMED Conclusion . Studying semantic proximity between archetype terms . We checked the frequency and type of semantic relationships between data fragments of 25 archetypes. SNOMED relationships are the reference. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 21. Background Dataset Objectives Methods Semantic proximity in archetypes Results Mapping archetypes to SNOMED Conclusion . Dataset: 25 Observation archetpes . 25 OBSERVATION archetypes of the NHS repository. information about the condi- These archetypes record tion of patients, such as the measurement of heart rate and tobacco use. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 22. Background Dataset Objectives Methods Semantic proximity in archetypes Results Mapping archetypes to SNOMED Conclusion . Parsing archetypes . A parser was used to preserve data fragments with clinical meaning. Parser gets a dependency tree of data fragments for each archetype. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 23. Background Dataset Objectives Methods Semantic proximity in archetypes Results Mapping archetypes to SNOMED Conclusion . Parsing archetypes: Types of data fragments in archetypes . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 24. Background Dataset Objectives Methods Semantic proximity in archetypes Results Mapping archetypes to SNOMED Conclusion . Creating manual mappings . SNOMED concepts are required to study semantic proximity. Problem: Bindings to SNOMED concepts are very scarce. We manually created mappings through manual searches. . This process was very tedious and time-consuming. . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 25. Background Dataset Objectives Methods Semantic proximity in archetypes Results Mapping archetypes to SNOMED Conclusion . Evaluating the semantic proximity . We checked if the concepts mapped to these archetype fragments are linked through hierarchical and logical relationships of the SNOMED terminology. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 26. Background Dataset Objectives Methods Semantic proximity in archetypes Results Mapping archetypes to SNOMED Conclusion . Results . A high ratio of archetype terms are semantically related: 30% of Element fragments are subtypes of the Root fragment. 80% of Value fragments are connected through hierarchical . relationships to any other Value fragment of the archetype . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 27. Background Dataset Objectives Methods Semantic proximity in archetypes Results Mapping archetypes to SNOMED Conclusion . Conclusion . A high ratio of archetype terms are semantically related ā†“ The network of SNOMED relationships should be exploited during the automated mapping of archetypes. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 28. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Outline . 1 Background OpenEHR archetypes SNOMED CT Related Work . 2 Objectives . 3 Semantic proximity in archetypes Dataset Methods Results Conclusion . 4 Mapping archetypes to SNOMED Methods Evaluation Results Discussion . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 29. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Automated mapping between archetypes and SNOMED . Several mapping techniques were developed to bind archetype fragments to SNOMED concepts: Lexical techniques Linguistic resource-based techniques Terminological context-based techniques Structure-based techniques . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 30. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Lexical techniques . Lexical techniques identify SNOMED concepts and archetype terms with similar names. Both the archetype terms and SNOMED descriptions are nor- malized, including plurals, singulars, case-insensitive, etc. . Example: . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 31. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Linguistic resource-based techniques . We used several linguistic resources provided by the UMLS. These resources use a knowledge-intensive approach based on symbolic and natural-language processing, to discover biomed- ical concepts referred in a text. . Example: . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 32. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Degree of lexical similarity . Two degrees of lexical similarity: Full or exact match occurs when an archetype terms is exactly the same as some SNOMED CT description after normalization. Partial match occurs when the archetype term is contained in- side some SNOMED CT description. . Example: . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 33. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Mapping algorithm . The mapping algorithm consists of three steps: . Exact Match in entire SNOMED 1 . Partial Match in SNOMED contexts 2 . Structural similarity 3 . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 34. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . First step of Mapping: Exact Match in entire SNOMED . Lexical and linguistic techniques are used to discover exact or almost exact correspondeces between all the SNOMED concepts and archetype fragments . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 35. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Second step of Mapping: Partial Match in SNOMED contexts . SNOMED contexts are extracted from the concepts obtained in the previous step. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 36. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Second step of Mapping: Partial Match in SNOMED contexts . Lexical and linguistic techniques are used to discover partial and approximate correspondeces in the extracted contexts. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 37. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Third step of Mapping: Structural similarity . Structure-based techniques identify structural similarities between the tree structure of archetypes and the network of SNOMED rela- tionships ā†’ Equivalent entities with diļ¬€erent names can be mapped . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 38. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Evaluation . Our mapping algorithm was applied to 25 archetypes. The evaluation entailed the automated revision of each mapping generated by the method against the manual mappings that we had created for the study. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 39. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Results . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 40. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Results: Comparison with other approaches . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 41. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Discussion . Lessons learned in the work . Objetive 1: To understand better how archetype clinical infor- mation is semantically related. We now know the frequency and type of semantic relationships between data fragments of archetypes. We found that a high ratio of archetype fragments are seman- tically related. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 42. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Discussion . Lessons learned in the work . Objetive 2: To evaluate whether a combination of context and structure-based techniques with lexical and linguistic techniques can improve the automated mapping. Context and structure-based techniques are able to exploit SNOMED CT relationships to improve the automated mapping of archetypes. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 43. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Future Work . We will test the automatic mapping with diļ¬€erent types of archetypes. We will explore ways to use medical knowledge from SNOMED: To facilitate the semi-automatic creation of new archetypes. To recommend extensions in existing archetypes. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 44. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Summary . Clinical models, such as archetypes, need to be inte- grated with terminologies to capture, use and transfer clinical data in a standard way. Manual integration is very time-consuming... . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 45. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Summary . We propose a novel automated method to link data fragments of archetypes with concepts of medical ter- minologies. Besides conventional name-based techniques, the method exploits the medical knowledge represented in SNOMED to improve the automated mapping and thus reduce human participation in the process. . . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o
  • 46. Background Methods Objectives Evaluation Semantic proximity in archetypes Results Mapping archetypes to SNOMED Discussion . Acknowledgements Thank you for your attention! MEC National research project GestiĀ“n de TerminologĀ“ MĀ“dicas o ıas e para Arquetipos TIN2009-14159-C05-05 . . . . . . J.L. Allones, D. Penas, M. Taboada, D. Martinez et al. A Study of Semantic Proximity between Archetype Terms based o