What's in a class? Lessons learnt from the ICD - SNOMED CT harmonisation

Area of Science:

• Medical Informatics
• Ontology Engineering
• Clinical Terminology

Background:

• The International Classification of Diseases, 11th Revision (ICD-11) is set to harmonize with SNOMED CT.
• This harmonization aims to integrate clinical terminology and diagnostic classification systems.
• A common ontological layer (CO) is proposed as the mechanism for this integration.

Purpose of the Study:

• To investigate the feasibility of harmonizing ICD-11 and SNOMED CT through simple ontology alignment.
• To test the hypothesis that differing ontological commitments between ICD-11 and SNOMED CT preclude direct alignment.
• To propose an alternative method for binding ICD-11 codes to a common ontological layer.

Main Methods:

• Analysis of the ontological commitments of ICD-11 linearization codes and SNOMED CT.
• Evaluation of the suitability of simple ontology alignment for harmonization.
• Development and assessment of a query-based approach for linking ICD-11 codes to ontological classes.

Main Results:

• Evidence suggests that simple ontology alignment is insufficient due to diverging ontological commitments.
• ICD-11 linearization codes function primarily as diagnostic statements.
• SNOMED CT's common ontology is structured around clinical situations.
• A query-based approach is identified as a more appropriate method for binding ICD-11 codes to the common ontology.

Conclusions:

• Direct ontology alignment between ICD-11 and SNOMED CT is problematic.
• The differing nature of ICD-11 codes (diagnostic statements) and the common ontology (clinical situations) requires a nuanced approach.
• A query-based binding strategy is recommended for effectively integrating ICD-11 with SNOMED CT via a common ontological layer.