The Medical Entities Dictionary

Columbia University

Department of Biomedical Informatics

The Medical Entities Dictionary

K#1 = 4.2K#1 = 3.3

K#2 = 3.2

K#1 = 3.0

Retrieving Results Individually

K#1

K#2

K#3 = 2.6

K#3

K#1 = 4.2K#1 = 3.3

K#2 = 3.2

K#1 = 3.0

Retrieving Results by Class

K#1

K#2

K

K#3

K#3 = 2.6

What is in the MED?

• Sunquest lab terms

• Cerner lab terms

• Digimedix drugs

• Cerner Drugs

• Sunquest Radiology

• ICD9-based problem list terms

• Other applications

• Knowledge terms

How Big is the MED?

• Concept-based (77,500)• Multiple hierarchy (115,000)• Synonyms (180,000)• Translations (125,000)• Semantic links (270,000)• Attributes (175,000)

MED Structure

MedicalEntity

PlasmaGlucose

Test

LaboratorySpecimen

PlasmaSpecimen

AnatomicSubstance

Plasma Substance

Sampled

Part of

Has S

pecimen

Substance Measured

LaboratoryProcedure

CHEM-7

LaboratoryTest

Event

DiagnosticProcedure

Substance

BioactiveSubstance

Glucose

Chemical

Carbo-hydrate

Using the MED• Translation

– What is the ICD9 Code for …?– What is the display name for …?– What is the aggregation class for …?

• Translation Tables

• Class-based questions– Is Altace an antihypertensive?– What are all the antibiotics?

• Knowledge queries– What are the pharmaceutic ingredients of…?

Using the MED

MED QueryMEDTranslation

TableInterfaceEngine

WebCIS

DecisionSupport

The MED and Messaging

AncillarySystem

LocalCodes

MEDCodes

ClinicalData

Repository

OtherSubscribers

Interface EngineTranslation

Table

Case Study: Aggregation for C2000

• Labs have multiple codes for the same tests

• C2000 displays tests in spreadsheets (“buttons”)

• One code per column per button

• Unrecognized codes go into “Miscellaneous”

• Labs are always adding new tests and not telling

• How do we keep the C2000 buttons current?

C2000 Buttons in the MED

The “Lytes” Button

Intravascular Sodium Tests

C2000 Buttons in the MED

Querying for Button Parts

Querying for Button Parts

Operationalizing C2000 Aggregation

• Translation from lab code to MED code is done by interface engine

• Aggregation from MED code to C2000 button column (“Intravascular …”) is done by interface engine

• New lab tests that fall into existing columns are automatically aggregated

• New lab tests that don’t fall into existing columns can be identified before ending up in “Miscellaneous”

Translations with the MED

Gentamicin

InjectableGentamicin

Gentamicn Sensitivity

Test

SerumGentamicin

Level

GentamicinToxicity

EtiologyMeasures

Sensitivity

Substance Measured Has ingredient

is-a

IntravascularGentamicin

TestsSummaryReports

DecisionRule

ExpertSystem

DrugInformation

The MED and Eclipsys

• Capturing data from ancillary systems

• Aggregation for summary reporting

• Keeping terminologies up to date (e.g., for order entry)

• Class-based decision rules

• Multiple hierarchies allowed

• Linking to on-line resources