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These sheets are only for use in connection with the speech. Integration of classifications and terminologies in metadata registries based on ISO/IEC 11179 Sylvie Ngouongo Jrgen Stausberg Ludwig-Maximilian-University of Munich, Germany

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Integration of classifications and terminologies in metadata registries based on ISO/IEC 11179

Sylvie Ngouongo Jürgen Stausberg

Ludwig-Maximilian-University of Munich, Germany Institute of Medical Informatics, Biometry and Epidemiology (IBE)

These sheets are only for use in connection with the speech.

Presented by Sylvie Ngouongo

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MIE 2011, Sylvie Ngouongo 2

Agenda

  • Introduction
  • Objectives
  • Material

– ISO/IEC 11179 V3 – Classifications and Terminologies

  • Methods and Results

– Mapping – Import

  • Discussion
  • Conclusion
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MIE 2011, Sylvie Ngouongo 3

Introduction

  • Empirical medical research

– is based on the collection of observations stored in DBMS; – needs services for the maintenance of item collections and improvement of semantic interoperability:

  • Reuse of item`s definitions
  • Quality improvement through harmonization and standardization,
  • Integration and use of controlled vocabularies as value lists for items.
  • MDR-Project in Germany launched in 2009 by the Federal

Ministry of Education and Research to set up a national Metadata repository for the support of empirical research.

– ISO/IEC 11179 V3

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MIE 2011, Sylvie Ngouongo 4

Objectives

  • Appropriateness of ISO/IEC 11179 V3 “Information technology -

Metadata Registries (MDR)” part 3 “Registry Metamodel and basic attributes” for a national MDR in Germany.

  • Possibilities of including well-established classifications and

terminologies (controlled vocabularies) using the metamodel of ISO/ IEC 11179 V3.

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MIE 2011, Sylvie Ngouongo 5

Material: ISO/IEC 11179 V3 Data Description Package

  • ISO/IEC 11179 describes the method of standardizing and registering
  • f data elements to make data understandable and sharable.

Data_Element_Concept Conceptual_Domain Data_Element Value_Domain Object_Class Characteristic gender karyotype ¡ <men|women> gender ¡<male|female> <male|female> person sex 1 1 1 1 * * * * * 0..1 0..1 representation layer concept layer *

Data Description Package with examples in grey

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MIE 2011, Sylvie Ngouongo 6

Material: ISO/IEC 11179 V3 Concept Metamodel Region

Concept_System Metamodel Region Classification Metamodel Region

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MIE 2011, Sylvie Ngouongo 7

Material: Classifications and Terminologies

  • ICD-10-GM: International Statistical Classification of Diseases and Related

Health Problems 10th Revision German Modifications

  • OPS: German procedure classification
  • The TNM classification of malignant tumors: a well-established standard for

the classification of malignant tumors in oncology. the TNM-system classification provides three axes for post-coordination (T: local tumor, N: regional lymph nodes, M: metastasis).

  • MedDRA: Medical Dictionary for Regulatory Activities, the international

medical terminology used to classify adverse events associated with the use of biopharmaceuticals and other medical products.

  • SNOMED-CT: Systematized Nomenclature of Medicine-Clinical Terms, a

multilingual clinical healthcare terminology, essential for electronic health records.

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Material: Classifications and Terminologies - ClaML

  • Classification Markup Language (ClaML)

is attractive as interface standard for the import of classifications (ICD-10-GM, OPS) into the MDR.

  • ClaML: EN 14463:2007, Standard for

electronic representation of classification coding schemes.

<?xml version="1.0" encoding="utf-8"?> <!DOCTYPE ClaML SYSTEM "claml.dtd"[]> <ClaML version="2.0.0"> <Meta name="TopLevelSort" value="I II III IV V VI VII VIII IX X XI XII XIII XIV XV XVI XVII XVIII XIX XX XXI XXII" /> <Meta name="lang" value="en" /> <Meta name="titleLong" value="International Statistical Classification

  • f Diseases and Related Health Problems 10th Revision"/>

<Identifier authority="WHO" uid="SRFSFto be added later" /> <?xml version="1.0" encoding="utf-8"?> <!DOCTYPE ClaML SYSTEM "claml.dtd"[]> Title <ClaML version 2.0.0"> <Meta name="TopLevelSort ="I II III IV V VI VII VIII IX X XI XII XIII XIV XV XVI XVII XVIII XIX XX XXI XXII < Meta name="lang" value="en" /> <Meta B27.0 name="titleLong" value="International Statistical Classification

  • f Diseases and Related Health Problems 10th Revision"/>

<Identifier authority ="WHO" uid="SRFSFto be added later" =" /> <Title ="2008-05-13 name="ICD-10-2008-EN" version=" 2008" /> < Class code="B27 " kind=" category"> < Small excerpt of ClaML

ClaML and its structure´s elements

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MIE 2011, Sylvie Ngouongo

Methods

  • Mapping

– Approach and results

  • Import

– Approach and results

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MIE 2011, Sylvie Ngouongo 10

Mapping: the approach

  • Mapping of ClaML Elements to elements of ISO/IEC 11179

V3 Metamodel.

  • Mapping of vocabularies structures to elements of the ISO/

IEC 11179 V3 metamodel.

ClAML ICD-10, OPS ISO 11179 V3

1a 2 1b

representation Structure Mapping Structure Mapping

1c

If 1b and 1a, then 1c is possible

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MIE 2011, Sylvie Ngouongo 11

Mapping : the results

Concept_System Metamodel Region Classification Metamodel Region

ClaML.root; ICD-10-GM; OPS; TNM; MedDRA; SNOMED-CT (Vocabularies) ClaML-Classes / Vocabularies-Classes

Hierarchy specialization generalization

ClaML-Classes / Vocabularies-Classes Classification´s semantic Intestinal infectious Diseases (A00-A09) Cholera (A00)

is_a

Example of ICD-10

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MIE 2011, Sylvie Ngouongo 12

Import: approach and results

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MIE 2011, Sylvie Ngouongo 13

Discussion

  • Representation of classifications and terminologies as sources for

value lists of items is quite simple in ISO/IEC 11179 V3, however…

– Terminologies (MedDRA, SNOMED-CT) could be easily represented both in the Concept Metamodel Region and the Data Description Package of ISO/IEC 11179 V3, – Representation of Classifications (ICD-10, OPS, TNM) in the Data Description Package ist not satisfactory yet, – Classifications´rules (inclusions, exclusions…) and exceptions could not be properly mapped in the Concept Package yet.

  • Full coverage of the item semantic is not reached yet,

Implementation on logic level of application needed.

  • Different interpretations and extensions of the ClaML-Standard:

DIMDI (ICD-10-GM 2010) vs. WHO (ICD-10-CM 2008).

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Discussion

  • Example of discrepancies between WHO and DIMDI regarding ClaML

WHO applies <Modifier> (subclassifications´coding) for 4-digit ICD-Classes to their superclasses (3- digit classes) whereas DIMDI applies them to the corresponding 4-digit classes to build the 5-digit

  • subclassifications. M01 (3-digit) à M01.0 (4-digit) à M01.00 (5-digit)

<Class code="M01" kind="category" usage="aster"> <SuperClass code="M00-M03" /> <SubClass code="M01.0" /> <SubClass code="M01.1" < code =" M01" kind="category" usage "> <SuperClass code=" /> <SubClass code="M01.0" /> < SubClass code="M01.1" /> <SubClass code =" M01.2" />

<

ModifiedBy all="

<Class code="M01.0" kind="category" usage="aster"> <SuperClass code="M01"/>

<ModifiedBy all="true" code="S13M00_5"/>

<Rubric kind="preferred"> <Label xml:lang <Class code="M01.0" kind=" category" < usage="aster "> <SuperClass code </ =" Class M01 <Class code="M01" kind="category" usage="aster"> <SuperClass code="M00-M03"/> <SubClass code="M01.0"/> <SubClass code="M01.1"/> <SubClass code="M01.2"/> < <Class code="M01 category" usage="aster"> SuperClass code ="M00-M03"/> <SubClass code <Class code="M01.0" kind="category" usage="aster"> <SuperClass code="M01" /> <Rubric id="D0010244" kind="preferred"> <Label xml:lang="en" xml:space=" <Class code ="M01.0" kind=" category" usage=" aster"> <

WHO DIMDI

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MIE 2011, Sylvie Ngouongo 15

Conclusion

  • ISO/IEC 11179 V3 is powerful and contributes many useful

ideas for the definition of a national MDR.

  • An extension of ISO/IEC 11179 V3 metamodel to meet the

predefined needs of a national MDR might be necessary.

  • A unique interpretation of ClaML by Healthcare
  • rganizations (WHO, DIMDI, …) is essential to continue

work on the ClaML import interface.

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MIE 2011, Sylvie Ngouongo 16

Acknowledgements

The presented work is part of the project MDR - Metadata

Repository funded by the German Federal Ministry of Education and Research (BMBF).

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MIE 2011, Sylvie Ngouongo 17 Take Home Message

  • Support of empirical medical research through Maintenance of item collections:

– Reuse of item´s definitions, – Reviews of item collections through harmonization and standardization, – Integration and use of controlled vocabularies as value lists for items.

  • ISO 11179 is a method of standardizing and registering of data elements to make data understandable

and sharable. It is powerful and contributes many useful ideas for the definition of a national MDR.

  • Representation of classifications and terminologies as sources for value lists of items is quite simple in

ISO 11179 V3. Problems arise when trying to represent classification´s rules (inclusions, exclusions…).

  • An extension of ISO 11179 V3 metamodel to meet the predefined needs of a national MDR might be

necessary.

  • A unique interpretation of the ClaML-Standard by healthcare organizations is required to implement a

common ClaML import interface.

Thanks for your Attention!

ngouongo@ibe.med.uni-muenchen.de