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Consensus Development of a Modern Ontology of Emergency Department Presenting Problems-The Hierarchical Presenting Problem Ontology (HaPPy).
Horng, Steven; Greenbaum, Nathaniel R; Nathanson, Larry A; McClay, James C; Goss, Foster R; Nielson, Jeffrey A.
Afiliación
  • Horng S; Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.
  • Greenbaum NR; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.
  • Nathanson LA; Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.
  • McClay JC; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.
  • Goss FR; Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.
  • Nielson JA; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.
Appl Clin Inform ; 10(3): 409-420, 2019 05.
Article en En | MEDLINE | ID: mdl-31189204
OBJECTIVE: Numerous attempts have been made to create a standardized "presenting problem" or "chief complaint" list to characterize the nature of an emergency department visit. Previous attempts have failed to gain widespread adoption as they were not freely shareable or did not contain the right level of specificity, structure, and clinical relevance to gain acceptance by the larger emergency medicine community. Using real-world data, we constructed a presenting problem list that addresses these challenges. MATERIALS AND METHODS: We prospectively captured the presenting problems for 180,424 consecutive emergency department patient visits at an urban, academic, Level I trauma center in the Boston metro area. No patients were excluded. We used a consensus process to iteratively derive our system using real-world data. We used the first 70% of consecutive visits to derive our ontology, followed by a 6-month washout period, and the remaining 30% for validation. All concepts were mapped to Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT). RESULTS: Our system consists of a polyhierarchical ontology containing 692 unique concepts, 2,118 synonyms, and 30,613 nonvisible descriptions to correct misspellings and nonstandard terminology. Our ontology successfully captured structured data for 95.9% of visits in our validation data set. DISCUSSION AND CONCLUSION: We present the HierArchical Presenting Problem ontologY (HaPPy). This ontology was empirically derived and then iteratively validated by an expert consensus panel. HaPPy contains 692 presenting problem concepts, each concept being mapped to SNOMED CT. This freely sharable ontology can help to facilitate presenting problem-based quality metrics, research, and patient care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Consenso / Servicio de Urgencia en Hospital / Ontologías Biológicas / Atención Ambulatoria Tipo de estudio: Guideline / Qualitative_research Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Appl Clin Inform Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Consenso / Servicio de Urgencia en Hospital / Ontologías Biológicas / Atención Ambulatoria Tipo de estudio: Guideline / Qualitative_research Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Appl Clin Inform Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania