VA National Drug File Reference Terminology: a cross-institutional content coverage study

Area of Science:

• Medical Informatics
• Clinical Terminology
• Health Data Standards

Background:

• Content coverage studies assess terminology utility for users.
• The VA National Drug File Reference Terminology (NDF-RT) is a description logic-based resource for clinical operations.
• This study evaluates NDF-RT's representation of dictated medication list phrases from the Mayo Clinic.

Purpose of the Study:

• To evaluate the content coverage and representational accuracy of NDF-RT for dictated medication list phrases.
• To assess the general utility of NDF-RT in a real-world clinical setting outside its primary design parameters.

Main Methods:

• Extracted 847 medication concepts from 509 dictated patient notes.
• Utilized the SmartAccess Vocabulary Server (SAVS) for algorithmic mapping to NDF-RT.
• Two non-VA physicians reviewed algorithmic mappings for accuracy and NDF-RT content coverage.

Main Results:

• NDF-RT covered 97.8% of medication concepts.
• The SAVS engine achieved 95.4% precision and 99.9% recall in mapping.
• Gaps in coverage included OTCs, food supplements, and missing synonyms.

Conclusions:

• NDF-RT demonstrates significant general utility for representing clinical medication lists.
• The findings support NDF-RT's applicability in diverse healthcare settings.
• NDF-RT's performance exceeds initial design expectations.