Controlled vocabularies for health & medicine

Jane FrazierData Librarian

Australian National Data Servicejane.frazier@ands.org.au

@mignon1915

This work is licenced under http://creativecommons.org/licenses/by/2.0/au

Road map

● What a controlled vocabulary is and isn’t

● Bridging communication gaps & making connections

LCSH

Scull, Andrew. Madness in Civilization : a Cultural History of Insanity, from the Bible to Freud, from the Madhouse to Modern Medicine. Princeton: Princeton University Press, 2015. Print.

What isn’t a controlled vocabulary?Natural language & controlled language and everything in between

Part 1: What a controlled vocabulary is and isn’t

Part 1: What a controlled vocabulary is and isn’t

Part 1: What a controlled vocabulary is and isn’t

Part 1: What a controlled vocabulary is and isn’t

Part 1: What a controlled vocabulary is and isn’t

https://en.wikipedia.org/wiki/Cancer#/media/File:Tumor_Mesothelioma2_legend.jpghttps://en.wikipedia.org/wiki/Cancer_(constellation)#/media/File:Sidney_Hall_-_Urania%27s_Mirror_-_Cancer.jpg

https://en.wikipedia.org/wiki/History_of_astrology#/media/File:Venice_ast_sm.jpghttps://en.wikipedia.org/wiki/Cancer_(genus)#/media/File:Cancer_bellianus_Johnston_1861_stuffed_museum_La_Rochelle.jpg

“Ay, it must be that; the ghost of some old sin, the cancer of some concealed disgrace…” Robert Louis Stevenson, Dr. Jekyll and Mr. Hyde

Part 1: What a controlled vocabulary is and isn’t

MedlinePlus Medical Dictionary: http://www.merriam-webster.com/medlineplus/cancer

Natural language in health & medicine

The Dictionary of Cell and Molecular Biology: http://www.sciencedirect.com/science/book/9780123849311

Part 1: What a controlled vocabulary is and isn’t

Heart Attack

heart attack

Heart -- Infarction

MI (Myocardial Infarction)

Myocardial infarction

MYOCARDIAL INFARCT

Myocardium--Infarction

M.I.

Part 1: What a controlled vocabulary is and isn’t

Heart Attack

heart attack

Heart -- Infarction

MI (Myocardial Infarction)

Myocardial infarction

MYOCARDIAL INFARCT

Myocardium--Infarction

M.I.

Arabic: نوبة قلبي

Czech: mrtvice, infarkt, záchvat: srdeční záchvat

German: herzanfall, herzinfarkt, herzschlag

Greek: έμφραγμα

Spanish: infarto, ataque del corazón

Estonian: südameatakk

Persian(Farsi): سكتھ

French: crise cardiaque

Hungarian: szívinfarktus, szívroham

Italian: cardiaco

Latvian: sirdslēkme

Maori: mate manawa

Polish: atak serca

Portuguese: ataque de coração, infarto, ataque cardíaco

Russian: инфаркт (мед.), сердечный приступ

Serbian: srčana kap, srčani napad

Slovak: infarkt

Swedish: hjärtattack, hjärtinfarkt

Turkish: kâlp krizi

Part 1: What a controlled vocabulary is and isn’t

https://getreferralmd.com/2013/11/top-healthcare-twitter-hashtags-use-tweeting/ https://twitter.com/search?src=typd&q=%23icd10

Part 1: What a controlled vocabulary is and isn’t

What is a controlled vocabulary?

Part 1: What a controlled vocabulary is and isn’t

Part 1: What a controlled vocabulary is and isn’t

“Ay, it must be that; the ghost of some old sin, the cancer of some concealed disgrace…”

Robert Louis Stevenson, Dr. Jekyll and Mr. Hyde

...Not natural language ...Not social tagging

Part 1: What a controlled vocabulary is and isn’t

Health vocabularies

Cumulative Index of Nursing and Allied Health Literature

(CINAHL)RxNorm

Australian Doctor Command Language (DOCLE)

Part 1: What a controlled vocabulary is and isn’t

Preferred label

Definition

Date of creation

Unique ID

The anatomy of a concept

Alternate labels

Hierarchical locators

Related concepts

Part 1: What a controlled vocabulary is and isn’t

Relationships

Central Nervous System

Brain Meninges Spinal Cord

Hierarchical EquivalenceAssociative

Nursing Nursing Education

is related to

Parkinson Disease

Paralysis Agitans

is the same as

Part 1: What a controlled vocabulary is and isn’t

Relationships

Acute Coronary Syndrome

Myocardial Ischemia

Angina Pectoris

Coronary Disease

Myocardial Infarction

Myocardial Stunning

Shock, Cardiogenic

Hierarchical

Associative

Equivalence

Part 1: What a controlled vocabulary is and isn’t

Myocardial Infarction

Myocardial Infarctionis the same as

Equivalence

Part 1: What a controlled vocabulary is and isn’t

Bridging communication gaps & making connections

Part 2

In the real world

A. Improved search & retrieval of digital health resourcesB. Improved description of digital health resourcesC. Automatic concept recognitionD. Diving deeperE. Missed opportunities in the wild

Part 2: Bridging gaps & making connections

Discovery services that make use of health vocabularies

Part 2: Bridging gaps & making connections

A. Improved search & retrieval

...a few examples using

Part 2A: Improved search & retrieval

Increasing precision in searching

Part 2A: Improved search & retrieval

Neoplasms

unique ID: D009369

Making use of alternate labels/equivalence relationships

Part 2A: Improved search & retrieval

Part 2A: Improved search & retrieval

B. Improved description

Part 2: Bridging gaps & making connections

Health vocabulary browsers

browsers that include health CVs along with non-health CVs

browsers that include only health CVs

browsers that include a single health CV

MeSH BrowserBrowser

Part 2B: Improved description

results for tibia in all MeSH concepts

results for tibia in all concepts in

all vocabularies included in BioPortal

Part 2B: Improved description

C. Automatic concept recognition

Part 2: Bridging gaps & making connections

Part 2C: Automatic concept recognition

D. Diving deeper

Part 2: Bridging gaps & making connections

Part 2D: Diving deeper

Electronic health record keeping

EHR System

Part 2D: Diving deeper

Harland et.al. "Empowering Industrial Research with Shared Biomedical Vocabularies." Drug Discovery Today 16.21/22 (2011): 940-947.

Asking complex research questionsPart 2D: Diving deeper

Improved interaction with health dataPart 2D: Diving deeper

Patient-healthcare provider communication

broken = fracturedbleeding = hemorrhaging

heart attack = myocardial infarctionstitches = sutures

diarrhea ≠ loose stoolcast ≠ splint

Hadlow et.al. “The understanding of common health terms by doctors, nurses and patients.” Social Science & medicine 32.2 (1991): 193-196.

Lerner et.al. “Medical communication: Do our patients understand?” American Journal of Emergency Medicine 18.7 (2000): 764-766.

Part 2D: Diving deeper

Patient-healthcare provider communication

Cumulative Index of Nursing and Allied Health Literature (CINAHL)

consumer health topic vocabulary

Part 2D: Diving deeper

Patient-healthcare provider communication

Unified Medical Language System (UMLS) Metathesaurus

Unified Medical Language System (UMLS) Metathesaurus

Part 2D: Diving deeper

PharmacovigilancePart 2D: Diving deeper

Pharmacovigilance

http://pi.lilly.com/us/zyprexa_relprevv.pdf

“In the tables and tabulations that follow for ZYPREXA RELPREVV, the MedDRA terminology has been used to classify reported adverse reactions. Data obtained from oral olanzapine studies was reported using the COSTART dictionary.”

Part 2D: Diving deeper

E. Missed opportunities ‘in the wild’

Part 2: Bridging gaps & making connections

Part 2E: Missed opportunities

https://researchdata.ands.org.au/394858

Part 2E: Missed opportunities

ANZSRC-FOR concept: Public Health and Health Services

ANZSRC-FOR concept: Public Health and Health Services not elsewhere classified

Uncontrolled tag: Australian women

Uncontrolled tag: Longitudinal Studies

Uncontrolled tag: women’s health

Uncontrolled tag: cohort studies

“women’s health”Women’s

Health≠“women’s health” ≠ “womens health”

Part 2E: Missed opportunities

Wrapping it all up

Natural language & controlled language and everything in between

takeaways:

Natural language is great for direct person to person communication

Controlled language is great when that communication is facilitated by a digital system

There are hundreds of CVs for health and medicine

Wrapping it all up

Bridging communication gaps and making connectionstakeaways:

Lots of tools make use of health CVs to help search for health information

Health CVs help bridge gaps in health communication

Health CVs allow us to ask more specific or complex research questions

Health CVs allow us to more richly describe health resources

Health CVs improve researcher interaction with health data

Australian National Data Service is funded by the Commonwealth under the NCRIS Program

Thank you.

Any questions?