Conceptual schemata for terminology: a continuum from headings to values in patient records and messages

We developed a technique of reverse engineering to extract a conceptual schema--also called "categorial structure" in the European standard CEN ENV 12264 (MoSe)--from a set of terminological phrases. The technique was originally applied to coding systems, ie. to large value sets. We applied this technique to subsets of two new terminological resources for message standards: headings of patient record from Clinical LOINC and names of "Context Groups" for structured reporting from SNOMED DICOM Microglossary (SDM). Both sources provide context-independent names for message fields and domains of admitted values. Therefore conceptual schemata on the potential content for a field are compatible with the ones on names of the fields themselves. Both kinds of schemata can be compared and integrated with conceptual schemata for the information system that manages the patient record. This continuity in the schemata allows the coupling of applications with different organization of data, and will facilitate mapping from an application to standard messages and viceversa. Moreover, the simplified representation produced according the MoSe approach is easy to understand by healthcare operators, allowing their progressive involvement in cooperative efforts of design, discussion and validation of the schemata.