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PubMed2005

Terminological system maintenance: a procedures framework and an exploration of current practice.

The use of electronically stored data requires that the data is recorded in a structured and standardized manner. This has led to the development of terminological systems. The content of these medical terminological systems is subject to continuing changes as a consequence of the developments in the field of medicine.By means of a literature study criteria were obtained for the maintenance of terminological systems. The criteria are used to develop a framework for the management of the maintenance process. The current practice of terminology maintenance was explored in a survey of twenty-seven organizations that currently maintain a terminological system. The results of the survey reveal the diversity and suboptimality of the current maintenance processes. The framework for the management of the maintenance process can be used to eliminate deficiencies in this process. This framework for terminology maintenance is an important step towards standardization of the maintenance of medical terminological systems.

Disease Management↗

PubMed1994

Arthroscopy language.

The authors have devised an "arthroscopy language" to make orthopaedic surgeons' intraoperative communication clear, comprehensive, and concise. This language specifically eliminates surgeons' "freestyle" conversation at the most crucial moments of their procedure, when concentration and the coordinated work of two surgeons are essential. The language uses current arthroscopic terminology and new words that have been adapted by the authors to describe all the basic maneuvers that are used during any arthroscopic procedure. The authors believe the language brings the necessary scientific sophistication into arthroscopic surgeons' speech in the operating theater.

Arthroscopes↗

PubMed1998

Galen-In-Use: using artificial intelligence terminology tools to improve the linguistic coherence of a national coding system for surgical procedures.

GALEN has developed a language independent common reference model based on a medically oriented ontology and practical tools and techniques for managing healthcare terminology including natural language processing. GALEN-IN-USE is the current phase which applied the modelling and the tools to the development or the updating of coding systems for surgical procedures in different national coding centers co-operating within the European Federation of Coding Centre (EFCC) to create a language independent knowledge repository for multicultural Europe. We used an integrated set of artificial intelligence terminology tools named CLAssification Manager workbench to process French professional medical language rubrics into intermediate dissections and to the Grail reference ontology model representation. From this language independent concept model representation we generate controlled French natural language. The French national coding centre is then able to retrieve the initial professional rubrics with different categories of concepts, to compare the professional language proposed by expert clinicians to the French generated controlled vocabulary and to finalize the linguistic labels of the coding system in relation with the meanings of the conceptual system structure.

Artificial Intelligence↗

PubMedDate not supplied

[Subjective non-specific symptoms related with electromagnetic fields: description of 2 cases].

In Italy, as in other countries, an apparently increasing number of subjects is reporting a variety of subjective symptoms that the subjects themselves refer to the exposure to electric, magnetic or electromagnetic fields (EMF) from nearby electric appliances, cellular phones, antennas, etc. Terms like electricity hypersensitivity (EHS), EMF hypersensitivity, or other similar, are frequently adopted to describe such symptoms; nevertheless, up to now, these terms are not entered the medical terminology. No accepted diagnostic criteria or procedures for the diagnosis of EHS are currently available. Furthermore, apart from the subject's self-attribution of the symptoms to EMFs, no direct cause-effect relationship between EHS symptoms and electromagnetic fields has been proved; additionally, evidence of a possible pathogenetic mechanism is lacking. In this paper, two cases developing symptoms of EHS ascribed to overhead power line in the proximity of their house are discussed. Nervous system (asthenia, depression, paraesthesias etc.), cardiovascular system (cardiac palpitations) and the skin (tingling, itching, etc.), are mostly (but not exclusively) involved. Based on available scientific knowledge, the rationale for an approach to subjects claiming for EHS is discussed. The establishment of a National archive for the collection of cases is communicated.

Electromagnetic Fields↗

PubMed1997

Galen-In-Use: an EU Project applied to the development of a new national coding system for surgical procedures: NCAM.

GALEN has developed a language independent common reference model based on a medically oriented ontology and practical tools and techniques for managing healthcare terminology including natural language processing. GALEN-IN-USE is the current phase which applied the modelling and the tools to the development or the updating of coding systems for surgical procedures in different national coding centre co-operating within the European Federation of Coding Centre (EFCC) to create a multilingual knowledge repository for multicultural Europe. NCAM (Nomenclature Commune des Actes Médicaux) is the new French multipurpose coding system for surgical procedures. The labels are processed from the intermediate dissections to the Grail representation and the natural language generation by the electronically related Medical Informatics research centres network of Saint Etienne, Manchester, Geneva and Nijmegen. The national coding centre is able to retrieve the initial labels with different categories of concepts, to compare the professional language proposed by expert clinicians to the French generated controlled vocabulary and to finalize the linguistic labels of the coding system in relation with the meanings of the conceptual system structure.

Electronic Data Processing↗

PubMed1998

Classification of neck dissection: current concepts and future considerations.

In response to the increased number of neck dissection procedures and the lack of uniformity of terminology for describing these, several classification proposals have been made. The consensus report on neck dissection terminology by the American Academy of Otolaryngology-Head and Neck Surgery seems to have gained wide acceptance. This report outlines the Academy's classification system and its definitions for the lymph node groups. Other authors contributions are discussed and recommendations are suggested for future refinements to the classification system.

Head and Neck Neoplasms↗

PubMed2004

Evolving to clinical terminology.

The electronic medical record (EMR) is slowly replacing the paper chart for documenting patient details. As the adoption curve for EMRs rapidly increases, so will the need for clinical terminologies. Currently, administrative classifications such as ICD-9-CM, CPT and HCPCS serve not only billing and reporting purposes, but also are used by healthcare providers for documentation and capturing patient procedures and problem lists. But the use of clinical terminologies, such as SNOMED CT, will assume the interface role in EMRs and thus replace these administrative classifications at the point of care. These billing terminologies will then be relegated back to the coders and payers for use, enabling the clinicians to document using richer and more granular terminologies. During this transition phase to the clinical terminology, training will likely be required as healthcare providers adjust to using terminologies in more robust ways. Clinical informaticists and early adopters will play a role in this training and help to demonstrate the many advantages of richer documentation. The use of clinical standards in EMRs is one of the key evolutions in informatics.

Diffusion of Innovation↗

PubMedDate not supplied

What is a "schedule of reinforcement"?

Several ambiguities in the present terminology of behavior theory obscure some important theoretical assumptions and experimental details in current research. Left unclarified, such ambiguities impede the accurate analysis of laboratory procedures, and prevent reliable communication among researchers. This paper focuses on the term "schedule of reinforcement". It points out that two distinguishable operational rules are implicated in the term: in the case where reinforcement is of the so-called response contingent type, the "schedule" is really a rule to identify the response to be reinforced; in the case of non-contingent reinforcement, the "schedule" is truly a rule for delivery of reinforcement. Other terminological ambiguities that are encountered in a discussion of this term include "reinforcement" and "intermittency." A resolution of these problems will necessarily involve the procedures of non-contingent reinforcement, and the parameter of reinforcement probability.

Conditioning, Classical↗

PubMed1998

A proposed glossary of terminology related to the surgical treatment of vulvar carcinoma.

BACKGROUND: The authors' objective was to provide a glossary of terminology related to the surgical treatment of invasive vulvar carcinoma. There is currently no consensus in the literature regarding the names of the surgical procedures used to treat this disease. METHODS: A surgical glossary should be supported by clear definitions and acceptance of notions related to topographic anatomy that are specific to the surgical practice. A critical review of the classic, chiefly used Italian, French, German, and English textbooks of anatomy revealed some discrepancies and lack of uniformity in descriptions of vulvar and inguinal fascial structures and lymph nodes, which represent the principal landmarks of surgical treatment. In the proposed glossary, the descriptions of these anatomic landmarks integrate classic anatomic knowledge, data from recent gynecologic studies of inguinal anatomy, and the clinical experiences of the authors. RESULTS: The glossary is composed of 16 surgical definitions, which are divided into 3 main sections of terminology describing the surgical treatment of the: 1) vulva, 2) inguinal lymph nodes, and 3) pelvic lymph nodes. The fundamental objective behind the glossary is to describe the area and the depth of the surgical procedure. Three determinants of the area (local, partial, and total) and three determinants of the depth of surgery (superficial, simple, and deep) were used to arrive at the fully articulated definitions in the glossary. CONCLUSIONS: The authors are aware that the proposed glossary should not be considered a definitive one; however, it could serve as a good basis for further debate. The terms employed in the glossary are accompanied by anatomic and descriptive references to help avoid confusion and promote better understanding among gynecologic oncologists who are involved in the treatment of vulvar carcinoma.

Female↗

PubMed1995

Surgical video systems.

Surgical video systems (SVSs), which typically consist of a video camera attached to an optical endoscope, a video processor, a light source, and a video monitor, are now being used to perform a significant number of minimally invasive surgical procedures. SVSs offer several advantages (e.g., multiple viewer visualization of the surgical site, increased clinician comfort) over nonvideo systems and have increased the practicality and convenience of minimally invasive surgery (MIS). Currently, SVSs are used by hospitals in their general, obstetric/gynecologic, orthopedic, thoracic, and urologic procedures, as well as in other specialties for which MIS is feasible. In this study, we evaluated 19 SVSs from 10 manufacturers, focusing on their use in laparoscopic applications in general surgery. We based our ratings on the usefulness of each system's video performance and features in helping clinicians provide safe and efficacious laparoscopic surgery. We rated 18 of the systems Acceptable because of their overall good performance and features. We rated 1 system Conditionally Acceptable because, compared with the other evaluated systems, this SVS presents a greater risk of thermal injury resulting from excessive heating at the distal tip of the laparoscope. Readers should be aware that our test results, conclusions, and ratings apply only to the specific systems and components tested in this Evaluation. In addition, although our discussion focuses on the laparoscopic application of SVSs, much of the information in this study also applies to other MIS applications, and the evaluated devices can be used in a variety of surgical procedures. To help hospitals gain the perspectives necessary to assess the appropriateness of specific SVSs to ensure that the needs of their patients, as well as the expectations of their clinicians, will be satisfied, we have included a Selection and Purchasing Guide that can be used as a supplement to our Evaluation findings. We have also included a Glossary of relevant terminology and the supplementary article, "Fiberoptic Illumination Systems and the Risk of Burns or Fire during Endoscopic Procedures," which addresses a safety concern with the use of these devices. While we made every effort to present the most current information, readers should recognize that this is a rapidly evolving technology, and developments occurring after our study was complete may not be reflected in the text. For additional information on topics related to this study, refer to the following Health Devices articles: (1) our Guidance Article, "Surgical Video Systems Used in Laparoscopy," 24(1), January 1995, which serves as an introduction to SVS terminology and includes a discussion of the significance of many SVS specifications; (2) our Evaluation, "Video Colonoscope Systems," 23(5), May 1994, which includes a detailed overview of video endoscopic applications and technology; and (3) our Evaluations of laparoscopic insufflators (21[5], May 1992, and 24[7], July 1995), which address issues related to the creation of a viewing and working space inside the peritoneal cavity to facilitate visualization in laparoscopic procedures.

Color↗

PubMed2004

[Olfactory dysfunction. Epidemiology, pathophsiological classification, diagnosis and therapy].

The present manuscript is the result of a collaborative effort within the framework of the Working Group of Olfactology and Gustology of the German Society for ENT, Head and Neck Surgery. It provides a comprehensive overview about the current views on the epidemiology, terminology, diagnostics, and therapy of olfactory dysfunction, and aims to offer a framework for the standardized procedures for the diagnosis and therapy of olfactory disorders.

Algorithms↗

PubMed2006

Who let the dogs out? Infection control did: utility of dogs in health care settings and infection control aspects.

Research has substantiated that animals improve human health, both psychologically and physiologically. Therefore, healthcare facilities have begun to implement programs, such as the "Furry Friends Foundation," that bring animals into the facility to improve the quality of life of patients. When implementing these programs, consideration must be given to potential adverse events such as phobias, allergies, and particularly the possibility of zoonotic disease transmission. Santa Clara Valley Medical Centre (SCVMC), a 600-bed county teaching hospital with specialized units (e.g., for burns, rehabilitation, and pediatric care), has implemented programs that incorporate animals into the healthcare setting. This facility allows three categories of dogs to interact with their patients: service dogs, therapy dogs, and pet visitation dogs by the "Furry Friends Foundation." A blurring of the roles of the three categories of dogs occurred when these programs were put into place at SCVMC. The American with Disabilities Act (ADA) states that service animals cannot be prohibited from any area. For example, a "no pet allowed" policy could not apply to these animals. Proof of a person's disability or proof of the service animal's health or training cannot be required. The purpose of this project was to maintain these programs by clarifying the policies regarding animals, specifically dogs, in the healthcare setting. This had to take place to provide a safe and enjoyable environment for the patients and the staff. A comprehensive table was developed to delineate the three categories of dogs and the corresponding policies. Therapy dogs and the visitation animals are more restricted than service dogs. Both therapy dogs and visitation dogs require identification and certification of health and are excluded from certain areas of the facility, including intensive care units and isolation rooms. By complying with the current policies and regulations, the risks from these programs can be minimized. Staff should be educated on the proper terminology and procedures to prevent a blurring of the categories and roles of these animals.

Animals↗

PubMedDate not supplied

[Methodology for the implantation of definitive cardiac pacemakers].

Recent technological improvements in the field of artificial cardiac stimulation have markedly increased the complexities involved in the implantation of cardiac devices. The main purpose of this article is to review the current methodology for implantation of permanent pacemakers. Standardized terminology of the ICHD for the correct identification of permanent pacemakers, indications for their installation and surgical procedures are reviewed. The authors express their personal experiences on the optimal criteria for the selection and use of the pacemakers and comment on the potential problems and complications associated with their use as well as a description of the details of device implantation. Finally, the moral and ethical considerations involved with the prescription and usage of these devices in our country are discussed.

Humans↗

PubMed1966

Electron microscopic observations on antibody-producing lymph node cells.

Lymph node cells of rabbits injected with sheep erythrocytes, identified as antibody-producing by their ability to produce plaques of hemolysis in erythrocyte-containing agar layers, have been examined by electron microscopy, by the use of a procedure devised for subjecting single cells to such examination. The antibody-producing cells thus examined were found to fall into two classes, according to the current terminology: some were in the category of lymphocytes, and others, in the category of plasma cells. Within each class, cells were found to vary in certain characteristics, especially in the degree of development of such organelles as the nucleolus, Golgi apparatus, and the endoplasmic reticulum. In the case of the endoplasmic reticulum especially, it could be seen that a series of these plaque-producing cells, ranked in order of increasing size and development of the endoplasmic reticulum, would extend over a considerable range from those lymphocytes with the least developed organelles to the mature plasma cells with the greatest development of these structures.

Animals↗

PubMed1993

Thoughts on levels of microbial cleanliness and on validating disinfection procedures.

Efforts of the European Committee of Standardization (CEN) and the International Organization for Standardization (ISO) to harmonize production standards for medical devices have brought to the fore the need to standardize definitions and names for different levels of microbial contamination as well as validation procedures for microbial inactivation. Spaulding's categories of medical devices (critical, semi-critical and noncritical items) suggest that different levels of cleanliness can be accepted. Current terminology is imprecise and does not provide the necessary information to the user. A more appropriate one is needed. So are methods to validate microbial inactivation processes to lower levels of cleanliness than sterility. In Sweden, a couple of validation studies have been performed on bacterial inactivation in automatic washing machines which disinfect through a final hot water or steam rinse. However, more studies need to be done, especially on viral inactivation.

Disinfection↗

PubMed1991

[Current status of vaginal ultrasound--a worldwide survey].

In the last five years, vaginosonography has become a routine procedure in Obstetrics and Gynaecology. Many obstetricians, gynaecologists, radiologists and ultrasonographers have recognized the advantages of this method. A number of manufacturers of ultrasound equipment offer several types of vaginal probes. Nevertheless, the rapid development of vaginosonography has led to some disadvantages concerning a standardised terminology and image display. In this study we collected data on the current standards of vaginosonography. To gain data on the current use of vaginosonography, we sent out questionnaires to the 1107 departments of Obstetrics/Gynaecology in the FIGO Registry of 1985. In an accompanying letter we asked the chairmen to pass on the questionnaire to the appropriate specialist. The questionnaire was designed to gather information about the personnel performing vaginosonography and such as technique, transducer frequency, position of the patient and image display used. We received 366 responses. Vaginosonographic investigations are performed in 84% of the Obstetrics/Gynaecological University Departments, of which 90% of vaginosonography was performed by an obstetrician or gynaecologist, 5% by a radiologist and 5% by a technician. Predominantly end firing scanners were preferred. The number of electronic and mechanical scanners were nearly identical (55% vs 45%). The preference for a scanner with a narrow (less than 120 degrees) or wide angle (greater than 120 degrees) was very similar (53% vs 47%). More than half of the replies indicated (54%) used a transducer frequency of 5 MHz, 46% preferred scanners with a frequency between 5.5 and 7.5 MHz. In 55%, the gynaecological examination table was considered superior to a flat table.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross-Cultural Comparison↗

PubMed1992

Current status of vaginosonography: a world-wide inquiry.

In the last 5 years, vaginosonography has become a routine procedure in obstetrics and gynecology. Many obstetricians, gynecologists, radiologists and ultrasonographers have recognized the advantages of this method. Nearly all manufacturers of ultrasound equipment offer several types of vaginal probes. The rapid spread of vaginosonography has also led to some disadvantages concerning the lack of standardized terminology and image display. In this study, we collected data about the current standards of vaginosonography. To obtain data, questionnaires were sent out to the 1107 Departments of Obstetrics and Gynecology in the FIG0 Registry 1985. In the accompanying letter, the chairman was asked to hand over the questionnaire to the appropriate specialist. The questionnaire was designed to gather information about the personnel performing vaginosonography and the techniques, transducer frequency, position of the patient and image display used. A total of 369 responses were received. Vaginosonographic investigations were performed in 84% of the University Departments of Obstetrics and Gynecology. In 90% of these, vaginosonography was performed by the obstetrician or gynecologist, in 4% by the radiologist and in 6% by the technician. Most departments preferred end-firing transducers. The numbers of electronic and mechanical probes were nearly identical (56% vs. 44%). The preferences for a scanner with a narrow (less than 120 degrees ) or wide angle (more than 120 degrees ) were very similar (53% vs. 47%). More than half of the responders (54%) used a transducer frequency of 5 MHz, while 46% preferred scanners with a frequency between 5.5 and 7.5 MHz. In 55%, the gynecological examination table was considered to be superior to a flat table. Of the responders, 52% projected the apex of the vaginal probe to the bottom of the ultrasound monitor. This was particularly the case in Europe (63%). Questioned about a preference for a particular orientation in the future, an additional 7% voted to change to this mode of image display world-wide. When performing a sagittal section, if the probe was projected to the bottom of the screen, dorsally located to the structures were projected twice as often to the left of the screen as to the right.

Journal Article↗

PubMed2004

An ontology on property for physical, chemical, and biological systems.

Current metrological literature, including the International vocabulary of basic and general terms in metrology (VIM 1993), presents a special language slowly evolved without consistent use of the procedures of terminological work; furthermore, nominal properties are excluded by definition. Both deficiencies create problems in fields, such as laboratory medicine, which have to report results of all types of property, preferably in a unified systematic format. The present text aims at forming a domain ontology around "property", with intensional definitions and systematic terms, mainly using the terminological tools--with some additions--provided by the International Standards ISO 704, 1087-1, and 10241. "System" and "component" are defined, "quantity" is discussed, and the generic concept "property" is given as 'inherent state- or process-descriptive feature of a system including any pertinent components'. Previously, the term 'kind-of-quantity' and quasi-synonyms have been used as primitives; the proposed definition of "kind-of-property" is 'common defining aspect of mutually comparable properties'. "Examination procedure", "examination method", "examination principle", and "examination" are defined, avoiding the term 'test'. The need to distinguish between instances of "characteristic", "property", "type of characteristic", "kind-of-property", and "property value" is emphasized; the latter is defined together with "property value scale". These fundamental concepts are presented in a diagram, and the effect of adding essential characteristics to give expanded definitions is exemplified. Substitution usually leads to unwieldy definitions, but reveals circularity as does exhaustive consecutive listing of defining concepts. The top concept may be generically divided according to many terminological dimensions, especially regarding which operators are allowed among the four sets =, not equal to; <, >; +, -; and x, :. The coordinate concepts defined are termed by the modifiers 'nominal', 'ordinal', 'differential', and 'rational' before '...property'. Other possibilities are given, based on the literature, especially the stepwise division into "nominal property" and "quantity"; "ordinal quantity" and "unitary quantity"; "differential unitary quantity" and "rational unitary quantity". As top concepts, , , , , and are i.a. divided homologously to . The term 'observation' and the modifiers 'qualitative', 'semi-quantitative', and 'quantitative' are avoided. "Metrological unit" and "system of metrological units" are defined together with a number of specific concepts. Some problems with characteristics of "SI unit" are discussed and an alternative system shown. The conceptions of "metrological dimension" are outlined, leading to a definition and specific concepts. The generally accepted IUPAC/IFCC syntax for designations of instantiated properties is 'System (specification)--Component(specification); kind-of-property (specification)', and' 'dedicatedkind-of-property" is defined as 'kind-of-property with given sort of system and any pertinent sorts of component'. The related systematic terms may be generated according to ENV 1614 using generative patterns from ENV 12264. The elements of the appellation and examination result of a singular rational property are diagrammed. Finally, the possibilities of representing properties and their results by the formalisms of relation and function from Set Theory and Object-Oriented Analysis are exemplified.

Chemistry, Clinical↗