Ontology of Pain
Barry SmithNational Center for Ontological Research
University at Buffalo
BFO
A simple top-level ontology to support information integration in scientific research
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Basic Formal Ontology
Continuant Occurrent(Process, Event)
IndependentContinuant
(thing, substance)
DependentContinuant
http://ifomis.uni-saarland.de/bfo/3
Continuant
IndependentContinuant
DependentContinuant
..... .....
Non-realizableDependentContinuant(quality)
Realizable DependentContinuant(function, role, disposition)
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Specifically dependent continuants
Examples:
the height (quality) of this patient
the disposition of this patient to experience diarrhea
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Continuant
IndependentContinuant
DependentContinuant
..... .....
Non-realizableDependentContinuant
(quality)
Realizable DependentContinuant(function, disposition)
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depends_on
Continuant Occurrent
process
IndependentContinuant
thing
DependentContinuant
quality
.... ..... .......temperature dependson bearer
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universals, types, kinds
Continuant Occurrent
process, eventIndependentContinuant
DependentContinuant
.... ..... .......9particulars, instances
the particular case of redness (of this particular fly’s left eye)
the universal red
instantiates
this instance of eye (in this particular fly)
the universal eye
instantiates
depends_on
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this particular case of redness
red
instantiates
this eye (in this particular fly)
eye
instantiates
depends on
color anatomical structure
is_a is_a
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this particular eye (in this particular fly)
the universal eye
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instantiates at t1
this particular eye (in this particular fly)
the universal eye
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instantiates at t1
instantiates at t2
instantiates at t3
portion of water
this portion of H20
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portion of ice
portion of liquid water
portion of gas
instantiates at t1
instantiates at t2
instantiates at t3
Phase transitions
human
John
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embryo fetus adultneonate infant child
instantiates at t1
instantiates at t2
instantiates at t3
instantiates at t4
instantiates at t5
instantiates at t6
in nature, no sharp boundaries here
temperature
John’s temperature
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37ºC 37.1ºC 37.5ºC37.2ºC 37.3ºC 37.4ºC
instantiates at t1
instantiates at t2
instantiates at t3
instantiates at t4
instantiates at t5
instantiates at t6
in nature, no sharp boundaries here
in nature, no sharp boundaries here
Dependent Continuants
DependentContinuant
Quality, Pattern
Realizable Dependent Continuant
if the bearer ceases to exist, then its quality, function, role ceases to exist
the color of my skin
the function of my heart to pump blood
my weight18
Realizable dependent continuants
Disposition: fragility, virulence, susceptibility, genetic disposition to disease X
Function: to pump (of the heart), to unlock (of the key)
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OGMS
Ontology for General Medical Science,
http://code.google.com/p/ogms/
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Big Picture
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Disorder
an independent continuant
fiat object part of
the whole organism
(boundaries hard to specify)
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Where does Mount Everest begin and end?Cf. Barry Smith and David M. Mark, “Do Mountains Exist?”, Environment and Planning B, 30, 2003.
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Disorder
A fiat object part of an organism which serves as the bearer of a disposition of a certain sort
This fiat object may have no determinate boundaries
(compare: Downtown Santa Barbara)
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A disease is a disposition having as its bearer a physical disorder in the organism and realized in pathological processes.
etiological process
produces
disorder
bears
disposition
realized_in
pathological process
produces
abnormal bodily features
recognized_as
signs & symptomsinterpretive process
produces
diagnosis
used_in27
Influenza - infectious Etiological process - infection of
airway epithelial cells with influenza virus produces
Disorder - viable cells with influenza virus bears
Disposition (disease) - flu realized_in
Pathological process - acute inflammation produces
Abnormal bodily features recognized_as
Symptoms - weakness, dizziness Signs - fever
Symptoms & Signs used_in
Interpretive process produces
Hypothesis - rule out influenza suggests
Laboratory tests produces
Test results - elevated serum antibody titers used_in
Interpretive process produces
Result - diagnosis that patient X has a disorder that bears the disease flu
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independentcontinuant
dependentcontinuant
disposition
diseasedisorder
John’s disordered
heart
John’s coronary heart
disease
occurrent
process
course of disease
course of John’s disease
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coronary heart disease
John’s coronary heart disease
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coronary disease at the
stage of asymptomatic
(‘silent’) infarction
coronary disease at the stage of early lesions and
small fibrous plaques
coronary disease at the
stage of stable angina
coronary disease the
stage of surface
disruption of plaque
coronary disease at the stage
of unstable angina
instantiates at t1
instantiates at t2
instantiates at t3
instantiates at t4
instantiates at t5
time
OGMS:pathological processdef. – A process in an organism that is clinically
abnormal.*
i) is not part of the life plan for an organism of the relevant type (unlike aging, pregnancy or menopause),
ii) is causally linked to an elevated risk either of pain or other feelings of illness, or of death or dysfunction, and
iii) is such that the elevated risk exceeds a certain threshold level.
* ≠ statistically abnormal
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OGMS:disease
def. – A disposition (i) to undergo pathological processes that (ii) exists in an organism because of one or more disorders in that organism.
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Big Picture
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Ontology for Mental Health
Werner CeustersUniversity at Buffalo
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Ontology for Mental Health V0.0001Legend
representation
process
continuant
disjunction
MHO BFO/OGMS
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some obvious links left out to aid readability
Ontology for Mental Health V0.0001Legend
representation
process
continuant
disjunction
MHO BFO/OGMS
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MENTAL PROCESS (L1,U)=def. BODILY PROCESS which brings into being, sustains or modifies a COGNITIVE REPRESENTATION or a BEHAVIOR INDUCING STATE
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MENTAL FUNCTIONING RELATED ANATOMICAL STRUCTURE (L1,U)
• =def. ANATOMICAL STRUCTURE in which there inheres the DISPOSITION to be the agent of a MENTAL PROCESS
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Mental Functioning Related Anatomical Structure
an independent continuant
fiat object part of
brain + central and
peripheral nervous
system
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• MENTAL DISORDER =def. DISORDER in one or more MENTAL FUNCTIONING RELATED ANATOMICAL STRUCTURES
• PATHOLOGICAL MENTAL PROCESS =def. PATHOLOGICAL PROCESS which is the manifestation of a MENTAL DISORDER
• MENTAL DISEASE =def. a DISEASE which is a DISPOSITION to undergo PATHOLOGICAL MENTAL PROCESSES
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Big Picture
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Big Picture
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Clinical Evaluation Terms
Sign =def. – A bodily feature of a patient that is observed in a physical examination and is deemed by the clinician to be of clinical significance. (Objectively observable features)
Symptom =def. – An experienced bodily feature of a patient that is observed by and observable only by the patient and is of the type that can be hypothesized by a patient to be a realization of a disease. (A restricted family of phenomena including: nausea, anger, drowsiness, itchiness, anguish, and pain, which are of their nature experienced in the first person)
Symptoms are subjective. But this does not mean that there is no objective fact of the matter whether a given symptom exists
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Symptoms Signs Physical Basis Examples
Canonical PainPCT: Pain with concordant tissue damage
Pain Manifestation of tissue damageSignals sent to nociceptive system
Activation of emotion- generating brain centers, which can produce increased heart rate, blood pressure, galvanic skin response.
Peripheral tissue damage Intact nociceptive system
Primary sunburnPain from strained musclePain from fracturePulpitis
Variant PainPNT: pain without concordant tissue damage
Pain Manifestation of some disorder in the patientSignals sent to nociceptive system Patient reports of pain are either exaggerated or muted relative to disorderActivation of emotion generating brain centers
Physical disorder of amplitude control mechanisms associated with the nociceptive systemIntact nociceptive system
Myofascial pain disorderTension-type headacheChronic back pain
NN: neuro-pathic nociception
Pain Neurological test confirming nerve damage
Disorder in the nociceptive system
Trigeminal neuralgiaPost-herpetic neuralgiaDiabetic neuropathyCentral pain
PRP: Pain-Related Phenomena Without PainPBWP: pain behavior without pain
? Report of painSick role behaviors accompanied by normal clinical examinationGrossly exaggerated pain behaviors Identified external incentives
Mental states such as anxiety, rather than peripheral tissue locus Disordered emotional or cognitive systems misinterpreting sensory signals
Factitious painMalingeringAnxiety-induced pain report
TWP: tissue-damage without pain
No pain Manifestation of tissue damage normally of the sort to cause pain
Suppression of pain system by one or other mechanism
Stress associated with sudden emergenciesPhysiological damping of the pain process caused by endorphins Placebo-induced opioid analgesiaGenetic insensitivity to pain
Pain Ontology (PN)
Closing remarks about borderline cases
• The methodology of canonical ontology
Where does Mount Everest begin and end?Cf. Barry Smith and David M. Mark, “Do Mountains Exist?”, Environment and Planning B, 30, 2003.
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