V3DT conference call worksheet for Thu, Oct 29, 1998.

1 TECHNICAL INSTANCE IDENTIFIERS

1.1 DATA TYPE "UNRAVELABLE TECHNICAL INSTANCE IDENTIFIER"

Unravelable Technical Instance Identifier
This data type is used to uniquely identifiy some entity that exists within some computer system. Examples are object identifier for RIM class instances, things like medical record number, placer and filler order number, service catalog item number, etc.
component name type/domain optionality description
root ISO
Object Identifier
required This is the required field that guarrantees the uniqueness of the identifier and that permits the origin of the identifier to be determined (un-raveled). This can be the only field in institutions that use OIDs for their internal object identifiers.
extension Charater String optional The extension can be used in case an institution uses non-OID identifiers locally and does not want to map every internal identifier to OIDs. Especially useful if the local identifiers are not purely numeric. This field may never ever be send alone without the connecting root OID.

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1.2 DATA TYPE "DEREFERENCABLE TECHNICAL INSTANCE IDENTIFIER"

Dereferenceable Technical Instance Identifier
This is a dereferencable locator for some instance. For example, a bunch of radiology images that can be retrieved on demand.
component name type/domain optionality description
protocol Code Value
for technical concepts
required This mentions the protocol that can interpret the access string and can do something useful for the user to render the patrticular technical instance refered to. This may be spawning a WWW browser with a particular URL, fetching a DICOM image and show it, or opening a telephone connection to another party.
address Charater String required This is an arbitrary address string that must be meaningful to the protocol.

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2 REAL WORLD CONCEPTS

The data type for Real World Concepts will be defined in as follows.

This is a bottom up approach! We define the small data types before the bigger ones.

2.1 DATA TYPE "CODE VALUE".

Code Value
A code value is exactly one symbol in a code system. The meaning of the symbol is defined exclusively and completely by the code system that the symbol is from.
component name type/domain optionality description
value Character String required this is the plain symbol, like "784.0"
code system a code by itself required, can be
fixed by context
denotes the code system that defined the plain symbol
code system version Character String optional a version descriptor defined specifically for the given code system.
print name Character String optional a sensible name for the code as a curtesy to an interpreter of the message. THE PRINTNAME HAS NO MEANING, it can never be sent alone and it can never modify the meaning of the code value

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2.2 DATA TYPE "CODE TERM"

Code Term
A code term is a list of code values which all together make up a meaning. This can be used for example in SNOMED, where you can combine multiple codes into a new composite meaning. HL7 used to combine codes and modifiers for the OBR specimen source. And HCFA procedure codes also come with modifiers.
ORDERED LIST OF Code Value

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2.3 DATA TYPE "CODE TRANSLATION"

Code Translation
This data type holds one code term as one translation in a set of translations describing a concept. The additional information in this data type points to the source code used in the translation process and describes who or what performed the translation and what the quality of this translation is.
component name type/domain optionality description
code term Code Term required All the meaning of the translation is found here, the rest is descriptive stuff.
origin reference to
CodeTranslation
required This is the code term in the list of translations on which this translation was based. This is a required component which means, whoever adds an additional translation must reference the source code term. No reference here means that the given translation is the original code.
producer Unravelable
Instance
Identifier
optional This identifier tells what system performed the translation. This information can be useful to audit the translation process or to estimate the quality of the term based on prior experience with a the translation of a given producer. This identifier refers to some system not a particular human coding clerk. However, the system identifier can be fine grained enough so that the human operator can be determined in the process of unraveling the identifier.
quality Floating
Point
Number
[0..1]
optional An estimation of the translation quality. This is a value between 0 and 1, where 1 stands for an absolutely accurate translation and 0 stands for random fuzz. We do not require a special method to be used here to estimate the quality. This can just be a subjective estimation of the form we use in eliciting probablilities for a belief network. But we can recommend some example methods of how those values can be computed. We can also map all other quality estimations mentioned in the literature onto the interval [0..1] of real numbers.

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2.4 DATA TYPE "CONCEPT DESCRIPTOR"

Concept Descriptor
A concept descriptor communicates a real world concept (such as a finding or a diagnosis). A given concept may be expressed in multiple terms where each term is a translation of some other term, or is a (re-)encoding of the original human readable text.
component name type/domain optionality description
translations SET OF
Code Translations
required These are the translations or quasi-synonyms of one real world concept. Every translation in the set is supposed to "say the same thing in different words." The translations in the set form one directed graph that is fully connected.
original text Free Text optional This is the original text or phrase entered by a clinician that was the basis for the initial coding. This can also be the text that was displayed to the clinician in a selection menu and thus was the basis for the selection of the particular initial code term in the set of translations.

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