Evaluation of alternative standardized terminologies for medical conditions within a network of observational healthcare databases

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• 作者：Christian Reich ; Patrick B. Ryan ; Paul E. Stang ; Mitra Rocca
• 关键词：Terminology standards ; Coding scheme ; Vocabulary ; Taxonomy ; Mapping ; ICD-9-CM
• 刊名：Journal of Biomedical Informatics
• 出版年：2012
• 出版时间：August, 2012
• 年：2012
• 卷：45
• 期：4
• 页码：689-696
• 全文大小：1065 K

文摘

Large electronic databases of health care information, such as administrative claims and electronic health records, are available and are being used in a number of public health settings, including drug safety surveillance. However, because of a lack of standardization, clinical terminologies may differ across databases. With the aid of existing resources and expert coders, we have developed mapping tables to convert ICD-9-CM diagnosis codes used in some existing databases to SNOMED-CT and MedDRA. In addition, previously developed definitions for specific health outcomes of interest were mapped to the same standardized vocabularies. We evaluated how vocabulary mapping affected (1) the retention of clinical data from two test databases, (2) the semantic space of outcome definitions, (3) the prevalence of each outcome in the test databases, and (4) the reliability of analytic methods designed to detect drug-outcome associations in the test databases. Although vocabulary mapping affected the semantic space of some outcome definitions, as well as the prevalence of some outcomes in the test databases, it had only minor effects on the analysis of drug-outcome associations. Furthermore, both SNOMED-CT and MedDRA were viable for use as standardized vocabularies in systems designed to perform active medical product surveillance using disparate sources of observational data.