SV: Terminology bindings ... again

Mikael Nyström mikael.nystrom at
Mon Mar 12 02:57:58 EDT 2018


Yes, it is correct that expressions include single code binding. Those kinds of bindings are just the simplest variants of expressions. :-)

I think that in a few years’ time nearly all implementations of SNOMED CT not only implement the international version, but also one are a few international, national or local extensions, so this use case is probably the normal use case and not the exceptional use case.

                             (Among other things SNOMED CT Implementation Advisor)

Från: openEHR-clinical [mailto:openehr-clinical-bounces at] För Pablo Pazos
Skickat: den 12 mars 2018 01:39
Till: For openEHR clinical discussions <openehr-clinical at>
Kopia: Openehr-Technical <openehr-technical at>
Ämne: Re: Terminology bindings ... again

Now that I have more experience with SNOMED expressions, I like the idea of doing the binding with an expression, also I think an expression includes the single code binding, if that is correct there is no need of defining a different notation for single code binding, just use a simple expression formed by one specific concept code. Also the expression being something processable and very versatile, we can express complex concepts with a few codes, which will help on adding knowledge to the archetype and serve to a better and simpler CDS.
About the metadata, there should be expressed against which SNOMED release this expression was created. We can't be sure only with min version. I should be responsibility of the user to check if the expression works on a different version/release of SNOMED. Another metadata is if the version is a local extension, some countries have their own extensions.
I don't know if we need to support other terminologies (technically) and if doing that is useful (strategically). Terminology services can do SNOMED to ICD, and ICD is not clinical relevant. LOINC is useful, but there is a SNOMED-LOINC collaboration, so we might expect an official mapping in the future ( IMO we should focus on SNOMED.

On Mon, Jul 17, 2017 at 11:19 AM, Thomas Beale <thomas.beale at<mailto:thomas.beale at>> wrote:
Recently we discussed terminology bindings. We probably still have not got them right, but we don't have a model of what we think they should be. I posted a quick idea of a possible more structured version:

    term_bindings = <

        ["snomed_ct"] = <

            ["/data[id3]/events[id4]/data[id2]/items[id26]"] = (SIMPLE_BINDING) <

             target = <> -- Apgar score at 1 minute

             notes = <"some notes">

             min_version = <"2017-02-01">

             etc = <"etc">


            ["id26"] = (CONSTRAINT_BINDING) <

               target = <"71388002 |Procedure| : 405815000 |Procedure device|  =  122456005 |Laser device| , 260686004 |Method|  =  129304002 |Excision - action| ,405813007 |Procedure site - direct|  =  1549700l6 |Ovarian structure|">

                  min_version = <"2017-04-01">

               notes = <"some notes">

               etc = <"etc">




I noted that the right hand side of a binding can be a few different things, each of which would be accompanied by various meta-data, including:

  *   a single concept code
  *   a single code or other id referring to an external value set in an external terminology (in SNOMED it is a SNOMED code; for e.g. ICD10, there is no standard that I know of)
  *   a composition expression that refers to a more refined concept
  *   possible a constraint expression that locally determines a value set intensionally, to be resolved by application to the Terminology service.
I'd rather avoid the last, because of the brittleness of intensional ref-set query syntax expressions. In any case, we need a better idea of what meta-data are needed. E.g.:

  *   something to do with (min) version of terminology required for the reference to be valid
  *   something to do with purpose?
  *   other notes - a tagged list of basic types?
I would like to get a better idea of the requirements.

- thomas

Thomas Beale
Principal, Ars Semantica<>
Consultant, ABD Team, Intermountain Healthcare<>
Management Board, Specifications Program Lead, openEHR Foundation<>
Chartered IT Professional Fellow, BCS, British Computer Society<>
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