Representation of ophthalmology concepts by electronic systems: Adequacy of controlled medical terminologies

Michael F. Chiang; Daniel S. Casper; James J. Cimino; Justin Starren

doi:10.1016/j.ophtha.2004.09.032

Representation of ophthalmology concepts by electronic systems: Adequacy of controlled medical terminologies

Michael F. Chiang
, Daniel S. Casper
, James J. Cimino
, Justin Starren

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Objective: To assess the adequacy of 5 controlled medical terminologies (International Classification of Diseases 9, Clinical Modification [ICD9-CM]; Current Procedural Terminology 4 [CPT-4]; Systematized Nomenclature of Medicine, Clinical Terms [SNOMED-CT]; Logical Identifiers, Names, and Codes [LOINC]; Medical Entities Dictionary [MED]) for representing concepts in ophthalmology. Design: Noncomparative case series. Participants: Twenty complete ophthalmology case presentations were sequentially selected from a publicly available ophthalmology journal. Methods: Each of the 20 cases was parsed into discrete concepts, and each concept was classified along 2 axes: (1) diagnosis, finding, or procedure and (2) ophthalmic or medical concept. Electronic or paper browsers were used to assign a code for every concept in each of the 5 terminologies. Adequacy of assignment for each concept was scored on a 3-point scale. Findings from all 20 case presentations were combined and compared based on a coverage score, which was the average score for all concepts in that terminology. Main Outcome Measures: Adequacy of assignment for concepts in each terminology, based on a 3-point Likert scale (0, no match; 1, partial match; 2, complete match). Results: Cases were parsed into 1603 concepts. SNOMED-CT had the highest mean overall coverage score (1.625±0.667), followed by MED (0.974±0.764), LOINC (0.781±0.929), ICD9-CM (0.280±0.619), and CPT-4 (0.082±0.337). SNOMED-CT also had higher coverage scores than any of the other terminologies for concepts in the diagnosis, finding, and procedure categories. Average coverage scores for ophthalmic concepts were lower than those for medical concepts. Conclusions: Controlled terminologies are required for electronic representation of ophthalmology data. SNOMED-CT had significantly higher content coverage than any other terminology in this study.

Original language	English (US)
Pages (from-to)	175-183
Number of pages	9
Journal	Ophthalmology
Volume	112
Issue number	2
DOIs	https://doi.org/10.1016/j.ophtha.2004.09.032
State	Published - Feb 2005
Externally published	Yes

Funding

Supported by the National Eye Institute, Bethesda, Maryland (grant no.: EY13972); National Library of Medicine, Bethesda, Maryland (grant no.: LM07079); and departmental funding provided by Research to Prevent Blindness, New York, New York (MFC).

Funders	Funder number
National Library of Medicine, Bethesda, Maryland	LM07079
National Eye Institute and Casey Eye Institute	K23EY013972
Research to Prevent Blindness

ASJC Scopus subject areas

Ophthalmology

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10.1016/j.ophtha.2004.09.032

Cite this

@article{2ac384fec167445eb30da92db4019307,

title = "Representation of ophthalmology concepts by electronic systems: Adequacy of controlled medical terminologies",

abstract = "Objective: To assess the adequacy of 5 controlled medical terminologies (International Classification of Diseases 9, Clinical Modification [ICD9-CM]; Current Procedural Terminology 4 [CPT-4]; Systematized Nomenclature of Medicine, Clinical Terms [SNOMED-CT]; Logical Identifiers, Names, and Codes [LOINC]; Medical Entities Dictionary [MED]) for representing concepts in ophthalmology. Design: Noncomparative case series. Participants: Twenty complete ophthalmology case presentations were sequentially selected from a publicly available ophthalmology journal. Methods: Each of the 20 cases was parsed into discrete concepts, and each concept was classified along 2 axes: (1) diagnosis, finding, or procedure and (2) ophthalmic or medical concept. Electronic or paper browsers were used to assign a code for every concept in each of the 5 terminologies. Adequacy of assignment for each concept was scored on a 3-point scale. Findings from all 20 case presentations were combined and compared based on a coverage score, which was the average score for all concepts in that terminology. Main Outcome Measures: Adequacy of assignment for concepts in each terminology, based on a 3-point Likert scale (0, no match; 1, partial match; 2, complete match). Results: Cases were parsed into 1603 concepts. SNOMED-CT had the highest mean overall coverage score (1.625±0.667), followed by MED (0.974±0.764), LOINC (0.781±0.929), ICD9-CM (0.280±0.619), and CPT-4 (0.082±0.337). SNOMED-CT also had higher coverage scores than any of the other terminologies for concepts in the diagnosis, finding, and procedure categories. Average coverage scores for ophthalmic concepts were lower than those for medical concepts. Conclusions: Controlled terminologies are required for electronic representation of ophthalmology data. SNOMED-CT had significantly higher content coverage than any other terminology in this study.",

author = "Chiang, \{Michael F.\} and Casper, \{Daniel S.\} and Cimino, \{James J.\} and Justin Starren",

note = "Funding Information: Supported by the National Eye Institute, Bethesda, Maryland (grant no.: EY13972); National Library of Medicine, Bethesda, Maryland (grant no.: LM07079); and departmental funding provided by Research to Prevent Blindness, New York, New York (MFC). ",

year = "2005",

month = feb,

doi = "10.1016/j.ophtha.2004.09.032",

language = "English (US)",

volume = "112",

pages = "175--183",

journal = "Ophthalmology",

issn = "0161-6420",

publisher = "Elsevier Inc.",

number = "2",

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TY - JOUR

T1 - Representation of ophthalmology concepts by electronic systems

T2 - Adequacy of controlled medical terminologies

AU - Chiang, Michael F.

AU - Casper, Daniel S.

AU - Cimino, James J.

AU - Starren, Justin

N1 - Funding Information: Supported by the National Eye Institute, Bethesda, Maryland (grant no.: EY13972); National Library of Medicine, Bethesda, Maryland (grant no.: LM07079); and departmental funding provided by Research to Prevent Blindness, New York, New York (MFC).

PY - 2005/2

Y1 - 2005/2

N2 - Objective: To assess the adequacy of 5 controlled medical terminologies (International Classification of Diseases 9, Clinical Modification [ICD9-CM]; Current Procedural Terminology 4 [CPT-4]; Systematized Nomenclature of Medicine, Clinical Terms [SNOMED-CT]; Logical Identifiers, Names, and Codes [LOINC]; Medical Entities Dictionary [MED]) for representing concepts in ophthalmology. Design: Noncomparative case series. Participants: Twenty complete ophthalmology case presentations were sequentially selected from a publicly available ophthalmology journal. Methods: Each of the 20 cases was parsed into discrete concepts, and each concept was classified along 2 axes: (1) diagnosis, finding, or procedure and (2) ophthalmic or medical concept. Electronic or paper browsers were used to assign a code for every concept in each of the 5 terminologies. Adequacy of assignment for each concept was scored on a 3-point scale. Findings from all 20 case presentations were combined and compared based on a coverage score, which was the average score for all concepts in that terminology. Main Outcome Measures: Adequacy of assignment for concepts in each terminology, based on a 3-point Likert scale (0, no match; 1, partial match; 2, complete match). Results: Cases were parsed into 1603 concepts. SNOMED-CT had the highest mean overall coverage score (1.625±0.667), followed by MED (0.974±0.764), LOINC (0.781±0.929), ICD9-CM (0.280±0.619), and CPT-4 (0.082±0.337). SNOMED-CT also had higher coverage scores than any of the other terminologies for concepts in the diagnosis, finding, and procedure categories. Average coverage scores for ophthalmic concepts were lower than those for medical concepts. Conclusions: Controlled terminologies are required for electronic representation of ophthalmology data. SNOMED-CT had significantly higher content coverage than any other terminology in this study.

AB - Objective: To assess the adequacy of 5 controlled medical terminologies (International Classification of Diseases 9, Clinical Modification [ICD9-CM]; Current Procedural Terminology 4 [CPT-4]; Systematized Nomenclature of Medicine, Clinical Terms [SNOMED-CT]; Logical Identifiers, Names, and Codes [LOINC]; Medical Entities Dictionary [MED]) for representing concepts in ophthalmology. Design: Noncomparative case series. Participants: Twenty complete ophthalmology case presentations were sequentially selected from a publicly available ophthalmology journal. Methods: Each of the 20 cases was parsed into discrete concepts, and each concept was classified along 2 axes: (1) diagnosis, finding, or procedure and (2) ophthalmic or medical concept. Electronic or paper browsers were used to assign a code for every concept in each of the 5 terminologies. Adequacy of assignment for each concept was scored on a 3-point scale. Findings from all 20 case presentations were combined and compared based on a coverage score, which was the average score for all concepts in that terminology. Main Outcome Measures: Adequacy of assignment for concepts in each terminology, based on a 3-point Likert scale (0, no match; 1, partial match; 2, complete match). Results: Cases were parsed into 1603 concepts. SNOMED-CT had the highest mean overall coverage score (1.625±0.667), followed by MED (0.974±0.764), LOINC (0.781±0.929), ICD9-CM (0.280±0.619), and CPT-4 (0.082±0.337). SNOMED-CT also had higher coverage scores than any of the other terminologies for concepts in the diagnosis, finding, and procedure categories. Average coverage scores for ophthalmic concepts were lower than those for medical concepts. Conclusions: Controlled terminologies are required for electronic representation of ophthalmology data. SNOMED-CT had significantly higher content coverage than any other terminology in this study.

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Representation of ophthalmology concepts by electronic systems: Adequacy of controlled medical terminologies

Abstract

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