The Standards Process

To contribute to the task of developing terminology standards, you will need to know the process. The following information is a proposed approach based on several terminology standards.

Tutorial: How to Construct a Standard Nomenclature

  1. Determine an Area of Focus

Select a field or specialty where a standardized naming system is lacking and focus in on the tests, measurements, observations, and other “objects” that are commonly performed. This will provide a testable base model that can be expanded and adjusted as more objects are incorporated.

Example: Standard nomenclature for devices, observations and measurements used in neurocritical care.

  1. Outline Model Requirements and Use Cases

Determine what this new model needs to accomplish, and what it’s most common uses will be.
Consider answers to the following questions:

  • What information needs to be conveyed?
  • What should be able to be done with this information?
  • How can this model accommodate future research and innovation?
  • What other information sources are needed to construct this model?

Example: For devices, observations, and measurements the standard name should indicate a single method of performance, information about what the sample is and where it came from. The information should be transferable across different device and data storage systems. It must be able to name new types of observations, new devices and new forms of measurement. May require a standardized medical vocabulary with strict definitions for what specific terms mean or refer to.

  1. Construct a Multi-axial System

    Identify Object Attributes (Example: Mean Intracranial Pressure)

Start by thinking about the object in it’s broadest sense.

Example: Mean intracranial pressure is a type of measurement.

And narrow down differentiating characteristics of this object.

Example: It is a measurement of pressure. Looks at pressure inside the skull. It is a calculated value based on continuous measurement over time.


    Determine Axis Labels and Build Descriptor Sets

Using these attributes, axis labels can be made, and the descriptors used can be put into sets.

Example:

Axis Descriptor(s)
Feature of Measurement Pressure, Quantitative, Mean
Temporality Continuous
Location Head, Intracranium
System/Context CNS

  1. Review and Revise the Model

Add in more objects, see if axis descriptor sets need to be expanded, or if descriptors need to be recategorized. Get feedback from clinicians and experts in the field. Expand to other areas of focus and continue revising until the model is shown to be robust and can grow with the medical field.

  1. Develop a Naming Syntax

Syntax will depend on future implementation of the model. In written form, it will require choosing delimiters to distinguish between axes, and to list descriptors when necessary. Limitations may arise when converting standardized names to code and the amount of data that can be stored, managed, and transferred between a variety of systems.

Example: In ISO/IEEE 11073-10101 standard nomenclature, mean intracranial pressure would be written as, “Pressure | Mean | Head, Intracranial | CNS”, where each axis is represented by an index in a 4 member tuple delimited by “ |”, and descriptors can be listed using a secondary delimiter, “ ,”.

Sources

[1] ISO/IEEE 11073-10101
[2] LOINC Website
[3] The Creation of an Ontology of Clinical Document Names
[4] Development of the Logical Observation Identifier Names and Codes (LOINC) Vocabulary