Mar 7, 2008 - ... theories about the basis of natural order, not dull catalogues compiled only to avoid chaos." Stephen Jay Gould. (1990, Wonderful Life p.98) ...
Beyond classifications – entities of knowledge exchange
Bedirhan Üstün & Nenad Kostanjsek Classifications, Terminology and Standards, WHO Geneva
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Emporio celestial de conocimientos benévelos
Los Animales se dividen en:
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pertenecientes al emperador embalsamados amaestrados lechones sirenas fabulosos perros sueltos incluidos en esta clasificación que se agitan como locos innumerables dibujados con un pincel finísimo de pelo de camello etcetera que acaban de romper el jarrón que de lejos parecen moscas
Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Jorge Luis BORGES "Otras Inquisiciones" (1952)
The Passage from an Imaginary Chinese Encyclopedia Animals are divided into following classes
those belonging to emperor those that are embalmed those that are domesticated the suckling pigs the sirens fabulous ones the roaming dogs those included in the present classification those that drive themselves crazy innumerable ones those painted with a very fine brush of camel hair et cetera those who have just broken the jug those who resemble flies from afar Jorge Luis BORGES
"Otras Inquisiciones" (1952)
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
The Science of Classification Taxonomy is often undervalued as a glorified form of filing—with each species in its prescribed place in an album
Classification is a fundamental and dynamic science, dedicated to exploring the causes of relationships and similarities among entities.
Classifications are theories about the basis of natural order, not dull catalogues compiled only to avoid chaos." Stephen Jay Gould (1990, Wonderful Life p.98)
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
From taxonomies to knowledge representationKey questions
Why do we need it? What are the promises and constrains? How can we do it?
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Selection of bodily systems classified in ICF
digestive respiratory skeletal musculatory circulatory | Conference on 7| Beyond classification: entities of knowledge exchange Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
immune
Underneath the bodily systems classified in ICF Tissue
Muscle tissue Nerve tissue Connective tissue Epithelial tissue Blood
Cell
Mitochondria Nucleus Endoplasmic reticulum Cell membrane
Organelle Protein DNA
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Synthesis of various “Health Information levels”
Public Health Patient Groups Patient Organ – Systems Molecules - Genes
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Public Health Informatics Health Care Informatics Medical Imaging Bioinformatics
Real Time Public Health Rule-based Aggregation @ Individual, Facility, Population levels Public Health, Epi & Surveillance
Reimbursement Resource Management
Clinical Information
Findings
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Events
Interventions
Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Synthesis of Health Information accross different service actors and settings Health services actors Health insurances, payers Self carer
Laboratories
Pharmacies
Specialists, dentists, etc.
Informal carers
General practitioners Community centres, hospitals, etc. Public health organisations
Primary care
Secondary care
Tertiary care
Community nurses, physiotherapists, etc.
Citizens
Health Promotion
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Diagnosis
Therapy
Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Rehabilitation
Long-term care
"Nothing about us without us" Consumer ownership of health information
1. Health services meet my needs 2. I share my health record with my providers 3. I have rights & responsibilities on my health and my community's health 12 |
Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Promises: Sharing the power of information – Connecting information sources for health • Talking to each other:
meaningful exchange
– IT for those most in need - compass for equity – Creating digital tools to overcome: • The information paradox : least information on big problems • Information asymmetry : between providers and consumers • Digital divide : between have's and have-nots – Home for international public goods
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Constraints in the real world Human variability – People can’t always interoperate • Machines will never interoperate better than the people that use them
Too many requirements … so priorities unclear – Intimately intertwined with EHRs, Public health, Decision support, Clinical care…
Poor match of problem space & solution space – Poor definition of purpose • “What’s it for?”
20 years of intensive work in IT has not yet provided a solution Temptation to do more than is possible
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
What is the concept behind the term Apple =
or
Mars =
or
or
Seeing = Watching ? Grooming = Caring for skin, teeth, hair & washing body parts ?
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
What is Ontology?
Ontology (philosophy) –
the explicit – operational description of the conceptualization of a domain: • Concepts: entity and quality (properties and attributes)
An ontology defines: –
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☺ !!!
Ontology (computer science) –
the Organization of Reality
Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
a common vocabulary a shared understanding/exchange: • among people • among software agents • between people and software – to reuse data - information – to introduce standards to allow interoperability
Approaching complexity
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Mastering the complexity © Erik Sundvall et al., Linköpings Universitet
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Coding cycling accident in ICD-10 V12.24 Pedal cyclist injured in collision with two- or threewheeled motor vehicle, unspecified pedal cyclist, non-traffic accident, while resting, sleeping, eating or engaging in other vital activities
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
The history of cycling codes 1972 ICD-9 (E826): 8 codes READ-2 (T30..): 81 codes READ-3: 87: 82 codes 1999 ICD-10: 587 codes
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Defusing the exploding bicycle:
500 codes in pieces 10 things to hit… – Pedestrian / cycle / motorbike / car / HGV / train / unpowered vehicle / a tree / other
5 roles for the injured… – Driving / passenger / cyclist / getting in / other
5 activities when injured… – resting / at work / sporting / at leisure / other
2 contexts… – In traffic / not in traffic V12.24 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
Conceptual Lego… it could be...
Goodbye to picking lists… Structured Data Entry File
Edit
Help
Cycling Accident
What you hit
Your Role
Activity
Location
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
What is the answer? ... what is the question?
Computers are useless. They can only give you answers. Pablo Picasso (1881-1973)
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Beyond classification: entities of knowledge exchange | Conference on Bridging Knowledge in LTC, Barcelona, 5-7 March 2008
