The clinical utility of META: an analysis for hypertension

To evaluate the clinical completeness of the National Library of Medicine Metathesaurus(META), we coded the conceptual information found in 2000 problem oriented (SOAP) notes for hypertension from one COSTAR site. To minimize the effects of practice idiosyncracy, we analyzed an additional 500 notes from a second, geographically remote site. Concepts occurring at either site numbered 1337. We classified concepts occurring at both sites as core concepts and these numbered 121. We attempted to find a matching concept of the proper semantic type in META for each of the items. All matching was done by program with a manual review by a physician. The overall success rate for matching was: [table: see text] We observed the greatest frequency of unmatched concepts in physical examination, medications, symptoms, personal behavior, non-medical therapies and counselling. We conclude that the current release of META is not sufficiently rich to describe the process of care in the ambulatory management of hypertension. However, the construction and breadth of the current scheme holds promise for medical knowledge representation and translation.