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Evaluation of a "Lexically Assign, Logically Refine" Strategy for Semi-automated Integration of Overlapping Terminologies

Affiliations of the authors: Kaiser Permanente, Southern California, La Palma, California (RHD); Intermountain Health Care, Salt Lake City, Utah (SMH); Departamento de Cirurgia, Universidade Federal do Paranà, Paranà, Brazil (RAR); Department of Pathology, Oregon Health Sciences University, Portland, Oregon (KAS); and the Section on Medical Informatics, Stanford University School of Medicine, Stanford, California (KEC).

Correspondence and reprint requests to: Robert H. Dolin, MD, Kaiser Permanente, 5 Centerpointe Dr, La Palma, CA 90623. E-mail: <Robert.H.Dolin{at}kp.org>.

Abstract Objective: To evaluate a "lexically assign, logically refine" (LALR) strategy for merging overlapping healthcare terminologies. This strategy combines description logic classification with lexical techniques that propose initial term definitions. The lexically suggested initial definitions are manually refined by domain experts to yield description logic definitions for each term in the overlapping terminologies of interest. Logic-based techniques are then used to merge defined terms.

Methods: A LALR strategy was applied to 7,763 LOINC and 2,050 SNOMED procedure terms using a common set of defining relationships taken from the LOINC data model. Candidate value restrictions were derived by lexically comparing the procedure's name with other terms contained in the reference SNOMED topography, living organism, function, and chemical axes. These candidate restrictions were reviewed by a domain expert, transformed into terminologic definitions for each of the terms, and then algorithmically classified.

Results: The authors successfully defined 5,724 (73%) LOINC and 1,151 (56%) SNOMED procedure terms using a LALR strategy. Algorithmic classification of the defined concepts resulted in an organization mirroring that of the reference hierarchies. The classification techniques appropriately placed more detailed LOINC terms underneath the corresponding SNOMED terms, thus forming a complementary relationship between the LOINC and SNOMED terms.

Discussion: LALR is a successful strategy for merging overlapping terminologies in a test case where both terminologies can be defined using the same defining relationships, and where value restrictions can be drawn from a single reference hierarchy. Those concepts not having lexically suggested value restrictions frequently indicate gaps in the reference hierarchy.

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