Pediatric Informatics: Computer Applications in Child Health (Health ...

432 G.R. Kim and S.T. Rosenbloom
Nomenclature:
a system of objects named according to a prescribed set of rules
(e.g., formal anatomic names of organs and spaces within the human body:
Terminologia Anatomica9 )
Taxonomy:
formal classification of concepts according to hierarchical relationships
(e.g., classification of viruses: ICTV10 )
Thesaurus:
collection of terms grouped by concept (e.g., The National Cancer
Institute (NCI) Thesaurus11 )
Ontology:
a data model in which concepts (within a domain) are linked to
each other by relationships and rules (description logic) that are used to reason
and draw conclusions about the concepts within the domain (e.g., The Gene
Ontology12 )
Detailed discussions on biomedical terminologies, 13 standard definitions, 14,15 natural
language processing, 16 the linguistic aspects of terminology 17 are available.
33.3 Current Terminology Challenges for Pediatrics
The American Academy of Pediatrics has articulated the challenges known to
representing pediatric concepts with current terminologies:
[B]arriers that child health care providers encounter in the application of [electronic] systems
relate not to functions of the system but to the inappropriate terminology used to
express concepts (physical examination findings, developmental milestones, diagnoses) in
the…system’s user interface … [suggesting the need for advocacy for] inclusion in these
systems of historical findings, psychosocial risk factors, family structural details, social
history, physical examination findings, developmental problems, behavioral issues, congenital
syndromes, and diagnoses of particular importance to pediatrics 18
Examples of these challenges include:
Inclusion of common pediatric concepts and domains that are not (yet) formalized
in existing biomedical terminologies, such as developmental milestones and
immunizations.
Defining preventive and cognitive services for reimbursement as valued components
of primary health care 19,20
Extending medication library items to meet safe pediatric practices for high-risk
inpatient processes (such as continuous infusions) 21
33.4 Current Work in Creating Pediatric Terminologies
Different approaches have been used to define and encode concepts for inclusion
in pediatric terminologies: