Rector AL, Nowlan WA and Kay S. Conceptual Knowledge: The Core of Medical Information Systems. In Lun KC, Degoulet P, Piemme TE & Rienhoff O, eds. MEDINFO-92. Amsterdam, North Holland, 1992: 1420-1426  Home/Search   Document Not in Database   Summary   Related Articles   Check

.... on the efficient processing and interpreting of medical terminologies and concepts [12, 116, 29, 103] This has led to the proposal of isolating a special subsystem of health care information systems to which are delegated services involving the representation and reasoning about medical concepts [100, 53, 19, 111]. We call such a subsystem Medical Terminology Server, borrowing this name from GALEN, one of the main research projects in the area. A Medical Terminology Server is a knowledge representation system in which knowledge about a given medical domain (ranging from very specific to very general) is ....

....from the knowledge explicitly represented. Several proposals have been made. Such proposals are based on different formalisms, and aim at somewhat different goals, but they all share the notion of Medical Terminology Server. One of the major proposals is the one developed within the GALEN project [98, 101, 99, 100]. GALEN (Generalized Architecture for Language Encyclopedias and Nomenclature in Medicine) is a project funded by the European Community, having the purpose of developing language independent concept representation systems as the foundations for the next generation of multilingual coding systems. ....

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A. Rector, W. Nowlan, and S. Kay. Conceptual knowledge: the core of medical information systems. In Proceedings of MEDINFO-92, pages 1420--1426. NorthHolland: Elsevier Science Publishers, 1992.

....(and all linked semantic elements) and the expressions in ICD represents the pertinent semantic associations that can be made within the classification (Fig. 1) The resulting associations are somewhat similar to the sanctioning process made within semantic networks like the GALEN European project [24]. In GALEN, sanctioning is made between true concepts, as in our implementation, it is made between i) patterns of morphosemantems associations found with words, ii) collocations of words within expressions, iii) groups within aggregates and iv) according to the hierarchy. Fig. 1 : Four sources ....

A.L. Rector, W.A. Nowlan, S. Kay. Conceptual knowledge: The Core Of Medical Information Systems. In Lun KC, Degoulet P, Piemme TE, Rienhof O (Eds). Proceedings of MEDINFO'92, Part 2, Amsterdam: Elsevier Science Publishers, Geneva (1992) 1420-1426.

.... in applications using concept forming languages like KL ONE [ Brachman et al. 1991 ] or Conceptual Graphs [ Sowa, 1984 ] the hierarchy of atomic types, from which more complex descriptions are build, is often a tree, even if defined descriptions constitute an arbitrary hierarchy (cf. GALEN [ Rector et al. 1992 ] In the same way, representational primitives are always considered as mutually exclusive. Considering the historical background, zoological or botanical taxonomies are always trees. 5.2 Reusability of an ontology Claiming that an ontology is reusable entails that it can be used to express ....

A. L. Rector, W. A. Nowlan, and S. Kay. Conceptual knowledge: the core of medical information systems. In K C Lun, P Degoulet, T Piemme, and O Rienhoff, editors, Proceedings of the 7 th World Congress on Medical Informatics, pages 1420--1426, Geneva, Switzerland, 1992. North Holland.

....resource to build a CTL and how the CTL can help the process of acquisition for other kinds of knowledge. We illustrate this method in the context of the Menelas natural language understanding project. INTRODUCTION Taxonomies and hierarchies are widely used in medical knowledge based systems [1, 2]. Some knowledge representation formalisms indeed give a central place to is a hierarchies. In particular, the Conceptual Graph (CG) formalism [3] is organized around a central Concept Type Lattice (CTL) The CTL provides the basic concept vocabulary that all domain descriptions will be built of. ....

. A. L. Rector, W. A. Nowlan, S. Kay. Conceptual knowledge: the core of medical information systems. In Lun et al. [21], pages 1420--1426.

.... of crucial importance and in order to minimise the complexity of classification, the expressiveness of GRAIL s concept and relation forming operators is severely restricted the constructs supported are intended to be just those which are necessary for the modelling of medical terminology [RNK92]. 10 GRAIL may be a useful tool in other application areas but this has yet to be clearly demonstrated. 11 Addition of the restr operator to a simple frame description language changes subsumption from polynomial to co NP hard. 17 2.1.3 Necessary statements terminologically significant ....

A. L. Rector, W. A. Nowlan, and S. Kay. Conceptual knowledge: the core of medical information systems. In K. C. Lun, P. Degoulet, and T. E. Rienhoff, editors, Proceedings of the Seventh World Congress on Medical Informatics (MEDINFO 92), pages 1420--1426. North-Holland Publishers, 1992.

....flexibility must be reflected in any electronic medical note system. The current approach of encoding and classifying each and every possible clinical condition supports standardisation and data interchange but is either combinatorially explosive, or requires additional semantic control mechanisms [14,4]. Medical care is administered by many professionals during one episode of illness, let al..one throughout a patient s lifetime. Hence the medical record has to support a wide range of users with different viewpoints. An accurate reflection of an individual s medical record is that of a story of ....

....Figure 1. The four models of a patient s medical record The CONCEPTS model describes the clinical terminology and information model of the medical record and decision making tasks. This is equivalent to Brachman s T box, but certain assertions are included as the classic T box is too restrictive [4]. The TASKS model represents the process of care implicit and explicit goals, alternative ways of achieving these, activity models, pre defined protocols, plans and criteria for making choices. How repeated measurements are entered into the physical record is part of the task of recording ....

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Rector AL, Nowlan WA and Kay S (1992) "Conceptual Knowledge: The Core of Medical Information Systems" in: Lun KC, Degoulet P, Pierre TE, Rienhoff (eds) MEDINFO 92, Proceedings of the Seventh World Congress on Medical Informatics, Geneva, North-Holland pp.1420-1426

....to facilitate standardisation and data interchange; one of the first coding classification system was devised in 1749. Such systems attempt to encode and classify each and every possible clinical condition and are either combinatorially explosive or require additional semantic control mechanisms [2]. Published in Information Modelling and Knowledge Bases,4th Proceedings of the Euro Japanese seminar on Information Modelling and Knowledge Bases, 1994, IOS Press, Amsterdam 2 Medical care is administered by many professionals during one episode of illness, let al..one throughout a patient s ....

....a unified representation for the other intensional models and the extensional medical record itself. 3. GRAIL: a Model for Medical Concepts GRAIL defines complex entities in terms of composite descriptions made up of a limited set of elementary concepts and assembled according to explicit rules [2,14]. In contrast to some representations certain constructs are excluded (notably existential quantification) and others restricted, in particular universal quantification, disjunction and negation. Certain types of defeasible descriptions and default statements are included but tightly controlled. ....

Rector AL, Nowlan WA and Kay S (1992) "Conceptual Knowledge: The Core of Medical Information Systems" in: Lun KC, Degoulet P, Pierre TE, Rienhoff (eds) MEDINFO 92, Proceedings of the Seventh World Congress on Medical Informatics, Geneva, North-Holland pp.1420-1426

....a generative language for describing a potentially infinite set of (post coordinated) categories. This is the assumption made by those who rely on some sort of compositional language [4, 8] for representing medical information, and in particular by the tenants of knowledge representation languages [9, 10]. Such a complex categorization is generally not reducible to atomic categorizations of structured segments, and must therefore be considered as a distinct class of MLP production. The paradigm we present in this paper naturally caters for the first two types of NLP output: atomic categorization ....

....for coding diagnoses; or different knowledge representations for describing the meaning of a sentence) and provide notations to explicit the nature and extent of each representation; but it does not include means to go from one representation to another. Projects such as the UMLS [42] or GALEN [9] do address this issue. The enriched document paradigm can help, for its part, to anchor these different representations to natural language texts and to one another. 6 Conclusion We have described a general paradigm for managing data produced by medical language processing systems and, more ....

Rector AL, Nowlan WA, and Kay S. Conceptual knowledge: the core of medical information systems. In: Lun KC, Degoulet P, Piemme T, and Rienhoff O, eds, Proc MEDINFO 92, Geneva. North Holland, 1992:1420--6.

....to a subsumptive network with well defined semantics for the is a relationship but with important restrictions to enable computational tractability. Definitions are limited, excluding existential quantifiers and placing restrictions on universal quantifiers, disjunctions and 4 negations (Rector et al. 1992). Indefeasible definitions, defeasible descriptions and default statements are included. The use of inheritance coupled with combinatorial descriptions promises a generative but parsimonious representation. The function of SMK is to validate and express sensible descriptions. A classification ....

Rector AL, Nowlan WA and Kay S : "Conceptual Knowledge: the Core of Medical Information Systems" to appear in Proceedings of MEDINFO '92, Geneva, 1992.

....from medical text to one coding system, or in pairs between coding systems; 3) combining existing coding systems and controlled vocabularies within a common framework to support mapping between these systems for information retrieval. 1. 1 A Descriptive Logic for Medicine Rector and Nowlan [6] suggest that in order to deal with the scale, complexity and variable granularity of the clinical record requires a knowledge representation which is generative but is sure to only generate statements that are medically semantically correct. A descriptive model seems to be more promising than a ....

....to corresponding (or best match) codes in conventional clinical coding schemes. An example application for the TeS is that of supporting the accurate collection of data for the EPR. Doctors cite the time and effort required to enter data as the single biggest barrier to using computers. PEN PAD [6] is a prototype clinical workstation that uses a early version of GRAIL to represent the intensional concept and information mode. PEN PAD uses predictive data entry as a particularly effective way of entering highly structured data quickly and easily. Given a complaint, the system generates a ....

Rector AL, Nowlan WA and Kay S (1992) "Conceptual Knowledge: The Core of Medical Information Systems" in: Lun KC, Degoulet P, Pierre TE, Rienhoff (eds) MEDINFO 92, Proceedings of the Seventh World Congress on Medical Informatics, Geneva, North-Holland pp.1420-1426

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Rector AL, Nowlan WA and Kay S. Conceptual Knowledge: The Core of Medical Information Systems. In Lun KC, Degoulet P, Piemme TE & Rienhoff O, eds. MEDINFO-92. Amsterdam, North Holland, 1992: 1420-1426

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Rector A, Nowlan W, Kay S. Conceptual Knowledge: The Core of Medical Information Systems. In: Lun K, Degoulet P, Pierre T, Rienhoff O, (ed). Seventh World Congress on Medical Informatics, MEDINFO-92. Geneva: North-Holland Publishers, 1991: 1420-1426.

....a modular architecture and uniform applications programming interface which allows client applications to ignore the internal structure and simply use the Server to provide them with terminological, coding, and linguistic functions. 1. Introduction: The Idea of a Terminology Server The authors [1 3]and others [4 7] have argued that if computerised systems are to play a significant role in clinical care, then it is essential to represent clinician s concept systems or ontologies in a form which can be manipulated by the computer. Sophisticated models of concept systems are complex formal ....

Rector A, Nowlan W, Kay S. Conceptual Knowledge: The Core of Medical Information Systems. in: Lun K, Degoulet P, Pierre T, Rienhoff O, (ed). Seventh World Congress on Medical Informatics, MEDINFO-92. Geneva: NorthHolland Publishers, 1991: 1420-1426.

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, p. 503--507. 2. A. L. Rector, W. A. Nowlan, and S. Kay, Conceptual knowledge: the core of medical information systems, in Lun et al. 43

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Rector AL, Nowlan WA, Kay S. Conceptual Knowledge: the core of medical information systems. In Lun KC, Degoulet P, Piemme TE, Rienhoff O (eds.). MEDINFO 92 Proceedings. Amsterdam: North - Holland 1992, 1420-1426.

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