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A Rossi Mori

Publications and source records attributed to A Rossi Mori.

10 recordsLinked to original sources

Structures of clinical information in patient records.

In order to support the preparation of the European Prestandard on "Communication of Electronic Health Care Record--Part 2: Domain Termlist" we carried out an analytical study about names of clinical documents, titles of generic sections, names of data elements, according to our terminological methods. We defined three layers of structures for clinical information: i) documents and sections, ii) clinical statements, iii) systematic details within statements. We prepared in correspondence many lists suitable to develop a principled coarse-grained markup for transmission and homogeneous browsing of disparate patient records across many institutions, without any preventive agreement on existing coding systems, data elements, record organization. This achievement is the basis for federated records, in particular for the virtual life-long patient record.

Europe↗

Structuring clinical information in healthcare records.

We carried out an analytical study about names of clinical documents, titles of generic sections, names of data elements, to prepare the European Prestandard CEN ENV13606-2 on "Health Informatics--Communication of Electronic Health Care Record--Part 2: Domain Termlist". The goal of the standard is to facilitate transmission and/or homogeneous browsing of clinical information from disparate patient records, without any preliminary agreement on coding systems, data elements, record organization. With the assistance of the members of CEN/TC251/PT27 and under the control of CEN/TC251/WG I and WG II, we defined three layers to structure clinical information (structuring records into complexes, complexes into statements, statements into details) and we prepared many lists suitable to represent coarse-grained information about the different constructs used in the above layers.

Data Collection↗

Exploiting the terminological approach from CEN/TC251 and GALEN to support semantic interoperability of healthcare record systems.

We apply the principles included in two CEN standards (ENV 12265, ENV 12264) to the analysis of the semantic structure of health record systems, to support their semantic interoperability. This result was made possible by dramatic methodological progress in the field of terminological systems--due to a worldwide evolution towards a new generation--and by the experience we acquired in the GALEN-IN-USE (formerly GALEN) project. The meaning behind names, content and context of record items and record item complexes can be considered as a 'semantic continuum'. This continuum is made explicit, by building a suitable paraphrase in a controlled language. We can then apply the principles we previously elaborated for the second generation of terminological system. Methodology and tools for generating a controlled language and a second-generation terminological system were developed and successfully used in the GALEN-IN-USE project and promising experiments were performed on elements of record structure listed in LOINC and SDM. In this way, the semantic structures of different record systems can be expressed by the resulting common formalism and thus, information units can be faithfully exchanged among different structures.

Italy↗

Building cross-thesauri with the support of UMLS.

The absence of a robust system of descriptors (cross-thesaurus) hampers the development of combinatorial terminological systems. We developed a tool (I-BROWSE) to produce a cross-thesaurus by analyzing terminological corpora. To facilitate the work of experts and to produce re-usable results, our application interacts via the Internet with the UMLS Knowledge Sources Server. We applied our tool on 2999 dissections on surgical procedures produced in the project GALEN-IN-USE, as a part of the internal Quality Assurance program. Support from UMLS seems mostly promising about descriptors on , , and . Additional assistance can be given to domain experts on less frequent descriptors on pervasive modifiers. We plan to apply our tool also to production of terminological standards in CEN, as a part of a worldwide process of gradual convergence and transformation of coding systems into second-generation systems and terminological services.

Artificial Intelligence↗

Standards to support development of terminological systems for healthcare telematics.

The Technical Committee on "Medical Informatics" of the European Committee for Standardization (CEN/TC251) is supporting developers of terminological systems in healthcare by a series of standards. The dream of "universal" coding system was abandoned in favor of a coherent family of terminologies, diversified according to tasks; two ideas were introduced: (1) the "categorical structure", i.e. a model of semantic categories and their relations within a subject field and (2) the "cross-thesaurus", i.e. a system of descriptors to build a systematic representation (called here "dissection") for each terminological phrase, coherent across diverse terminologies on a given subject field. The goal is to assure coexistence and interoperability (and reciprocal support for development and maintenance) to three generations of systems: (1) traditional paper-based systems (first generation); (2) compositional systems built according to a categorical structure and a cross-thesaurus (second generation) and (3) formal models (third generation). Various scenarios are presented, on the exploitation of computer-based terminological systems. The idea of "operational meaning" of terminological phrases within administrative and organizational contexts and the idea of "task-oriented details" are also introduced, to justify and exploit design constraints on terminological systems.

Europe↗

An ontological perspective on surgical procedures.

We studied terminological phrases on surgical procedures-from coding systems, controlled vocabularies, textbooks, and medical records-by an ontological point of view. A surgical procedure can be accurately described only by a set of sentences, in textbooks or surgical reports; a terminological phrase is just a short synthesis of that description. We outline three points of view actually used to construct a phrase, based on i) relevant phases and variants; ii) focus on structures, functions and pathologies; iii) evolution of information and decisions during the process of care. For each of them we discuss potential principles and mechanisms, with the aim of deriving guidelines to generate homogeneous systematic names, to organize regularities in classifications and nomenclatures, to normalize expressions in formal languages.

Medical Informatics Computing↗

Coding systems and controlled vocabularies for hospital information systems.

Modern healthcare information systems are requested to support an increasing interaction among professionals (inside and across the borders of the hospital) and a growing integration of specialised tasks (provision of care, reimbursement, document retrieval, optimisation of resource use, clinical audit, etc.). Coding systems were conceived and optimised independently for various specific purposes. They are now facing each other and thus conflicting into this new environment; the solution will be in a more application-independent representation of concepts. Developments are going towards three complementary directions: (i) to separate different functions about the management of terms and concepts, and thus to produce more specialised software components; (ii) to develop a new class of software which is able to manage terminological diversity without imposing uniformity; and (iii) to enhance reusability of concepts, and facilitate a spontaneous convergence among controlled vocabularies.

Artificial Intelligence↗

A model for the structured description of healthcare activities and related data.

Rehabilitation involves long-term, interdisciplinary processes. A model was developed, for the structured description of typical healthcare activities. Telematic services based on this model can support accurate data acquisition and communication among healthcare teams. Presentation of data within their context and according to the specific user's view is envisaged, based on deviations from the typical behaviours. Benefits are also expected in better understanding of the care processes themselves, easier comparison of different approaches, and diffusion of consensus-based knowledge.

Data Collection↗

KAVAS-2: Knowledge Acquisition, Visualization and Assessment System.

The objective of KAVAS-2 is the development of a tool, named KAVIAR, with which domain experts can make their knowledge explicit. It contains components for (computer assisted) knowledge elicitation and for machine learning. A key issue in KAVAS is the assessment of the quality of the classification and domain models built. Various quality measures are available and implemented in KAVIAR to assess the quality of models, specifically those developed from data bases by machine learning techniques.

Computer Simulation↗

Semantic standards for the representation of medical records.

Physicians developed their sublanguage (a system to represent medical concepts and their relations) to store and transmit general medical knowledge and patient-related information. Adequate formalisms are needed to obtain a standard representation of semantics of medical expressions for computer use. Comparison of the semantic contents of two expressions is possible only if a unique canonical form is defined; the transmission of medical facts or patient-related information is really meaningful only by defining a set of primitives (semantic categories and links) and the domains of values (concepts). These primitives must be harmonized to yield a "common core subset" of semantic categories and links. This subset provides a common basis; a procedure to register extension sets of primitives must also be defined, to comply with specific representation needs of specialties and classes of application software.

Artificial Intelligence↗