title: Concept dictionary creation and maintenance under resource constraints: lessons from the AMPATH Medical Record System.
abstract: The challenges of creating and maintaining concept dictionaries are compounded in resource-limited settings. Approaches to alleviate this burden need to be based on information derived in these settings. We created a concept dictionary and evaluated new concept proposals for an open source EMR in a resource-limited setting. Overall, 87% of the concepts in the initial dictionary were used. There were 5137 new concepts proposed, with 77% of these proposed only once. Further characterization of new concept proposals revealed that 41% were due to deficiency in the existing dictionary, and 19% were synonyms to existing concepts. 25% of the requests contained misspellings, 41% were complex terms, and 17% were ambiguous. Given the resource-intensive nature of dictionary creation and maintenance, there should be considerations for centralizing the concept dictionary service, using standards, prioritizing concept proposals, and redesigning the user-interface to reduce this burden in settings with limited resources.
authors.affiliation: Regenstrief Institute Inc.
authors.forename: Martin C
authors.initials: MC
authors.lastname: Were
authors.forename: Burke W
authors.initials: BW
authors.lastname: Mamlin
authors.forename: William M
authors.initials: WM
authors.lastname: Tierney
authors.forename: Ben
authors.initials: B
authors.lastname: Wolfe
authors.forename: Paul G
authors.initials: PG
authors.lastname: Biondich
mesh_terms: D004018:Dictionaries, Medical as Topic; D015658:HIV Infections / Q000628:therapy; D006801:Humans; D007630:Kenya; D016347:Medical Records Systems, Computerized; D013358:Subject Headings; D018875:Vocabulary, Controlled