Recording Associated Disorders Using SNOMED CT Ronald Cornet , - - PowerPoint PPT Presentation

Recording Associated Disorders Using SNOMED CT

Ronald Cornet, Nicolette de Keizer

• Dept. of Medical Informatics

Academic Medical Center – University of Amsterdam r.cornet@amc.uva.nl Oral presentation at August 31, 2011 – Oslo

What it has to do with the theme of the conference: User Centered Networked Health Care

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Patient Centered Health Care

u Patient history

§ Chronic condition: Type II diabetes mellitus § Complication: neuropathic arthropathy

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Patient Centered Health Care Physician Centered Health Care

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Physician Centered Health Care

u Patient history

§ Chronic condition: Type II diabetes mellitus § Complication: neuropathic arthropathy

u Diabetologist

§ Type II diabetes mellitus with neuropathic arthropathy

u Neurologist

§ diabetic neuropathic arthropathy

u Rheumatologist

§ arthropathy associated with a neurological disorder

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4 views on one situation

u Not a problem per se u But …

How to deal with this in “User Centered Networked Health Care” ?

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Consistency of Views

u Any combination of these findings can occur

• P. Type II diabetes mellitus + neuropathic arthropathy
• D. Type II diabetes mellitus with neuropathic arthropathy
• N. Diabetic neuropathic arthropathy
• R. Arthropathy associated with a neurological disorder

P1 P2 P3 P4 P5 P D N D R N R

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SNOMED CT enables inference

u Type II diabetes mellitus + neuropathic arthropathy

= Diabetes mellitus type 2 + Arthropathy

u Type II diabetes mellitus with neuropathic arthropathy

= Diabetes mellitus type 2

u Diabetic neuropathic arthropathy

= Arthropathy + Diabetic complication

u Arthropathy associated with a neurological disorder

= Arthropathy

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Inconsistency of inference

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Diabetic neuropathic arthropathy

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u 1 situation; 4 views u 4 inferences u None of these explicitly captures presence

• f “neurological disorder”

§ Only “neuropathic” or “associated with a neurological disorder”

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Problem

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Magnitude of the problem

disorder concepts described by means of ‘associated with’, ‘due to’ and/or ‘after’ 2,804 disorder concepts formally defined with associated with, due to, and/or after relations to disorders. 2,981 Lexical Logical 780 Some 27% overlap

u The patient has diabetes mellitus type II u The patient has arthropathy u The patient has disorder of nervous system

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What should be inferred

associated with associated with associated with

• 1. Leave it to reasoning process

§ E.g., if patient P has Disease D1, and D1 associated with Disease D2, then P has D2

• 2. Store concept references and their interrelations
• 3. Store instance references and their interrelations

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Challenge: finding solutions

Pro Con Reasoner Simple modeling

Complex retrieval and inference

Concepts

Simpler retrieval and inference Need to tackle terminology binding

Instances Simplest retrieval

and inference Need to tackle terminology binding + referent tracking

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Solutions

u Disorders which are associated to other

disorders can not be consistently recorded with different “views”

u This poses a problem for retrieval/inference u It can be solved by explicit recording of

constituting concepts or instances

u This requires terminology binding (and

referent tracking)

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Conclusion