A Review of Major Nursing Vocabularies and the Extent to Which They Have the Characteristics Required for Implementation in Computer-based Systems <s> Framework for Analysis <s> This paper deals with the reasons for distinguishing taxonomic vocabularies for standardizing terminology according to their different dedicated purposes. Different kinds of vocabularies are defined and then characterized using criteria like purposes, semiotic bases, principles for establishing hierarchical relations, mechanisms for guaranteeing reproducibility, and underlying representation formats. Furthermore, the kinds of taxonomic vocabularies worked out so far are named by preferred terms and assigned to proper places within the whole context of medical routine and research. Finally, it is argued that there must be a careful distinction between a conceptual level on one hand and a purpose-dependent non-conceptual level on the other. Unfortunately, both levels are crucially intertwined in existing vocabularies. Efforts on conceptually linking the vocabularies can help to share and re-use information evolving from different sources due to their common conceptual core. However, one must be aware of the effects resulting from special structural features on a non-conceptual level. <s> BIB001 </s> A Review of Major Nursing Vocabularies and the Extent to Which They Have the Characteristics Required for Implementation in Computer-based Systems <s> Framework for Analysis <s> I~~~,~~~~~~ ~ Abstract Objective: To construct a large-scale clinical repository that accurately captures a detailed understanding of the data vital to the process of health care and that provides highly efficient access to patient information for the users of a clinical information system. Des&n: Conventional approaches to data modeling encourage the development of a highly specific data schema in order to capture as much information as possible about a given domain. In contrast, current database technology functions most effectively for clinical databases when a generic data schema is used. The technique of "generic data modeling" is presented as a method of reconciling these opposing views of clinical data, using formal operations to transform a detailed schema into a generic one. Results: A complex schema consisting of hundreds of entities and representing a rich set of constraints about the patient care domain is transformed into a generic schema consisting of roughly two dozen tables. The resulting database design is efficient for patient-oriented queries and is highly flexible in adapting to the changing information needs of a health care institution, particularly changes involving the collection of new data elements. Conclusion: Conventional approaches to data modeling can be used to develop rich, complex models of clinical data that are useful for understanding and managing the process of patient care. Generic data modeling techniques can successfully transform a detailed design into an efficient generic design that is flexible enough to meet the needs of an operational clinical information system. <s> BIB002 </s> A Review of Major Nursing Vocabularies and the Extent to Which They Have the Characteristics Required for Implementation in Computer-based Systems <s> Framework for Analysis <s> Abstract The GALEN representation and integration language (GRAIL) has been developed to support effective clinical user interfaces and extensible re-usable models of medical terminology. It has been used successfully to develop the prototype GALEN common reference (CORE) model for medical terminology and for a series of projects in clinical user interfaces within the GALEN and PEN&PAD projects. GRAIL is a description logic or frame language with novel features to support part-whole and other transitive relations and to support the GALEN modelling style aimed at re-use and application independence. GRAIL began as an experimental language. However, it has clarified many requirements for an effective knowledge representation language for clinical concepts. It still has numerous limitations despite its practical successes. The GRAIL experience is expected to form the basis for future languages which meet the same requirements but have greater expressiveness and more soundly based semantics. This paper provides a description and motivation for the GRAIL language and gives examples of the modelling paradigm which it supports. <s> BIB003 </s> A Review of Major Nursing Vocabularies and the Extent to Which They Have the Characteristics Required for Implementation in Computer-based Systems <s> Framework for Analysis <s> Abstract ::: We describe the framework for SNOMED RT (Reference Terminology), designed to complement the broad coverage of medical concepts in SNOMED with a set of enhanced features that significantly increases its value as a reference terminology for representing clinical data. We describe what is meant by a reference terminology, and differentiate SNOMED RT from specialized terminologies that enable user interfaces, electronic messaging, or natural language processing, as well as from other specialized reference terminologies whose primary purpose is for representing data that is not primarily clinical in nature. We then describe how SNOMED RT represents multiple hierarchies and incorporates description logic. We believe that such a comprehensive set of concepts at multiple levels of granularity, with multiple logic-based subsumption hierarchies can meet the requirements of a reference terminology for health care. <s> BIB004
Building on the work of previous authors, 20 -22 the CPRI Work Group on Codes and Structures suggested features of a classification scheme for implementation within a computer-based patient record ( Table 2) .  These features are aimed at enhancing information retrieval, facilitating multiple uses of data, providing unambiguous concept definitions, and managing the size of a vocabulary. Implicit in these features are the characteristics of a formal terminology as defined by Ingenerf in his typology of taxonomic vocabularies (Table 3) , i.e., concepts represented using knowledge formalisms that provide explicit rules for sensible composition of primitive concepts into complex concepts. BIB001 Other authors have also described the significance of the terminology model and the importance of separating this detailed model focused on concept definition and terminology management from the information model used to support the design of clinical applications. BIB002 BIB003 Congruent with these approaches, Spackman et al. BIB004 have labeled associated concepts and relationships organized according to a specific terminology model as the reference terminology-e.g., SNOMED RT -and the terminology used in the actual application interface as the interface terminology.