title: Cross-terminology mapping challenges: a demonstration using medication terminological systems.
abstract: Standardized terminological systems for biomedical information have provided considerable benefits to biomedical applications and research. However, practical use of this information often requires mapping across terminological systems-a complex and time-consuming process. This paper demonstrates the complexity and challenges of mapping across terminological systems in the context of medication information. It provides a review of medication terminological systems and their linkages, then describes a case study in which we mapped proprietary medication codes from an electronic health record to SNOMED CT and the UMLS Metathesaurus. The goal was to create a polyhierarchical classification system for querying an i2b2 clinical data warehouse. We found that three methods were required to accurately map the majority of actively prescribed medications. Only 62.5% of source medication codes could be mapped automatically. The remaining codes were mapped using a combination of semi-automated string comparison with expert selection, and a completely manual approach. Compound drugs were especially difficult to map: only 7.5% could be mapped using the automatic method. General challenges to mapping across terminological systems include (1) the availability of up-to-date information to assess the suitability of a given terminological system for a particular use case, and to assess the quality and completeness of cross-terminology links; (2) the difficulty of correctly using complex, rapidly evolving, modern terminologies; (3) the time and effort required to complete and evaluate the mapping; (4) the need to address differences in granularity between the source and target terminologies; and (5) the need to continuously update the mapping as terminological systems evolve.
authors: The University of Texas School of Biomedical Informatics at Houston, 7000 Fannin Suite 600, Houston, TX 77030, USA. hsaitwal@Apelon.com
authors: Himali
authors: H
authors: Saitwal
authors: David
authors: D
authors: Qing
authors: Stephen
authors: S
authors: Jones
authors: Elmer V
authors: EV
authors: Bernstam
authors: Christopher G
authors: CG
authors: Chute
authors: Todd R
authors: TR
authors: Johnson
mesh_terms: D059019:Clinical Coding; D057286:Electronic Health Records; D006801:Humans; D008490:Medical Informatics / Q000379:methods* / Q000592:standards*; D004364:Pharmaceutical Preparations / Q000145:classification*; D015203:Reproducibility of Results; D018875:Vocabulary, Controlled
chemical_list: D004364:Pharmaceutical Preparations