SNOMED-CT and PTSD Terminologies

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The beginning of health information technologies has improved health care practice and delivery by providing new technologies, which are designed to enhance productivity, patient satisfaction, and the workflow while maintaining the required quality, safety, continuity, and efficiency standards (Trusko et al. 794).

The current applications of health IT are focused on enhancing communication among healthcare providers, communication between the health care providers and their clients, automation of medical information, implementation of evidence-based practices, and reduction of medical errors. Most importantly, health IT seeks to codify the medical information in the electronic medical records into standardized and structured medical terminologies. When the normal clinical information is transformed into a standardized and structured language, the resultant information is called Controlled Medical Terminologies (CMTs).

The importance of CMTs is that they reduce ambiguities besides enhancing consistency in the way medical information is shared between health care providers and their clients. Further, CMTs help clinicians to summarize medical information in such a way that it can be obtained in a timely manner. Some examples of applications of CMTs include the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT), the Unified Medical Language System (UMLS), and the Logical Observation Identifiers Names and Codes (LOINC) (Trusko et al. 795). This paper summarizes, interprets, and evaluates the contents of a research study that seeks to examine the representation of posttraumatic stress disorder (PTSD) terminologies in the SNOMED-CT controlled medical terminologies.

The Purpose of the Research

In the study under review, Trusko and his colleagues examined the extent to which the normal language used to make reference to different aspects of PTSD is represented in the SNOMED-CT controlled medical terminologies. Accordingly, the researchers mapped a list of 153 PTSD terminologies drawn from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and other mental health publications to a collection of over 800,000 SNOMED-CT controlled medical terminologies (Trusko et al. 794).

The Questions Addressed

To achieve the purpose of the current research, Trusko and his colleagues sought to address the question whether there are content shortcomings in the way SNOMED-CT controlled medical terminologies are used to represent various aspects of PTSD including its symptoms, signs, and other terms used in the diagnosis of the disorder.

Further, the researchers wanted to highlight the potential applications of electronic health systems in the retrieval, automation, and codification of the PTSD-specific free text by assessing whether there are any PTSD-related concepts and terms in the existing controlled medical terminologies. Moreover, Trusko and his colleagues sought to answer the question whether there are ways of mapping the PTSD-related concepts and terms to the controlled medical terminologies contained in SNOMED-CT and other applications of the unified medical language system (Trusko et al. 796).

Results

Based on the research questions described in the foregoing discussions, the researchers mapped a total of 153 PTSD-specific concepts and terms to the SNOMED-CT controlled medical terminologies and concept codes. According to the research findings, there were about 104 of the PTSD-related concepts and terms among the pre-coordinated concept codes of SNOMED-CT (Trusko et al. 796). This represents about 68% of the 153 clinical terms generated by the researchers in reference to the symptoms, signs, events, and outcomes of PTSD.

With the inclusion of the post-coordinated concept codes into the pre-coordinated concepts of SNOMED-CT controlled medical terminologies, the researchers found out that more than 91 % of the 153 clinical terms and concepts related to PTSD were represented in the SNOMED-CT unified codes. However, significant variations were noted in the coverage of concepts and terms for different PTSD criteria in the SNOMED-CT concepts.

For example, there were about 53% of PTSD criteria A, 56% of PTSD criteria B, and 80% of PTSD criteria C clinical terms in the pre-coordinated SNOMED-CT concepts. Finally, about 14 (9%) PTSD clinical terms were completely absent in the overall SNOMED-CT concept coverage (Trusko et al. 796).

The Striking Features of the Research

The unique element of the study under review is that it highlights the importance of information technologies, and more specifically, the application of codified language in the area of mental health. Although a lot of studies have documented the applications and effectiveness of health information technologies in different areas of clinical practice, relatively minimal studies have examined the relationship between electronic medical records, health IT, and controlled medical terminologies (Trusko et al. 794).

Moreover, among the studies highlighting the applications of health IT and controlled medical terminologies in the retrieval, automation, and codification of concepts and terms related to different diseases, only a few have documented the use of different applications such as SNOMED-CT in PTSD and other mental health complications. Therefore, the current study is unique in that it seeks to highlight the specific applications of health IT and controlled medical terminologies in the area of mental health disorders.

Further, the most striking feature of the study findings in the current research is that the researchers were able to map out more than 90% of the selected PTSD clinical terms to the SNOMED-CT concepts (Trusko et al. 796). Therefore, these results are promising and very significant to the area of mental health because mental health clinicians can now implement different applications of health IT such as SNOMED-CT in their respective clinical practices with little or no impediments at all.

Implications of the Research

The results of the current research have many implications on the practice and delivery of healthcare services, particularly in the area of mental health. First, the fact that a lot of concepts and clinical terms used in the diagnosis and treatment of PTSD are represented in the SNOMED-CT controlled medical terminologies are very significant to the area of mental health because SNOMED-CT is the largest reference source for the codified information stored in electronic medical records (Trusko et al. 794).

This implies that mental health clinicians will no longer face the challenge of interpreting different kinds of languages, which refer to the same clinical concept. The importance of SNOMED-CT in this regard is that it simplifies the identification of different terms referring to the same clinical concept by designating a numerical identifier to a group of related clinical terms. Hence, the SNOMED-CT system addresses the issue of concept synonymy by grouping related terms and concepts under one numerical identifier. For instance, a single numerical identifier representing the concept of Myocardial Infarction can be assigned to a group of related terms such as heart attack, infarction of heart, MI, and cardiac infarction (Trusko et al. 795).

Therefore, the importance of the SNOMED-CT system of codifying clinical concepts and terms is that it creates a set of standardized and structured clinical terminologies that can be made available to different categories of clinicians through electronic medical records. This will, in turn, reduce ambiguity and inconsistencies in the manner in which different clinicians, health care providers, or researchers communicate and interact with the aim of providing evidence-based care.

Moreover, the existence of a common clinical terminology reference system such as SNOMED-CT reduces the differences that exist in the way medical information is indexed, stored, retrieved, collected, compared, and shared in different care settings and hospitals. Most importantly, the codification of clinical data into a standardized and structured language eliminates or reduces the challenges experienced by clinicians, researchers, and other stakeholders in the utilization of clinical data. Overall, there is the need to encourage the implementation of health information technologies such as SNOMED-CT in the contemporary health care practice to improve efficiency, workflow, productivity, and satisfaction while maintaining the required safety and quality standards.

Unanswered Questions

The current study is limited to the extent that it addresses the representation of very few clinical terms and concepts related to different aspects of PTSD in the SNOMED-CT controlled medical terminologies. Hence, the study does not address a lot of PTSD terms and concepts, especially those related to stressors, functional assessment, treatment/interventions, and other symptoms of PTSD.

Therefore, future studies should employ the same approach as the one used in this study with the aim of expanding the number of clinical terms and concepts of PTSD that can be mapped to the overall SNOMED-CT concept coverage. Further, the issue of concept synonymy in the area of mental health is not clearly articulated in this research. As a result, future studies should address this issue by implementing the SNOMED-CT terminology system in the retrieval and codification of more clinical information related to PTSD and other mental health complications.

Works Cited

Trusko, Brett, et al. Are Posttraumatic Stress Disorder Mental Health Terms Found in SNOMED-CT Medical Terminology? Journal of Traumatic Stress 23.6 (2010): 794-801. Print.

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