Language Standards

Without language standards, information systems must employ expensive translators that may or may not translate accurately. Building translation capability is both time-consuming and expensive. A common or standard language greatly facilitates construction of biosurveillance systems.

You should have a working knowledge of language standards because (1) you may need to talk with hospitals or other organizations about sharing their data; (2) you may need to evangelize at the local and national level to encourage hospitals and other organizations (including perhaps the organization where you work) to use standards so you can eventually build the types of systems you need; and (3) because the components you are using to build your biosurveillance system will be nonstandard for the foreseeable future, and you will need to create and/or purchase adaptors.

4.1. Vocabulary Standards

Standard vocabularies provide names for things, actions, and states of being (henceforth referred to collectively as concepts). Standard vocabularies assign a unique code to each concept. For example, the code 11389007 means the disease respiratory anthrax in "SNOMED-CT-ese.''

Because code numbers are meaningless to humans, standard vocabularies also include one or more English labels for each concept. For example, SNOMED-CT associates "respiratory anthrax'' and "Woolsorters' disease'' with concept 11389007. The computers use the codes, and people tend to use the English labels.

There are many standard vocabularies, and none strive to be comprehensive. Each vocabulary fills a niche. For example,

LOINC provides codes for laboratory tests and clinical observations such as vital signs. This was a deliberate choice on the part of the creators of LOINC, which they designed from the outset to be a vocabulary of laboratory tests and clinical observations.

Because vocabularies specialize, you need to know which standard vocabularies provide codes for which types of data. Table 32.2 lists many types of data used in biosurveillance and standard vocabularies that provide codes for each. Table 32.3 lists the standard vocabularies that we discuss in this chapter and, for each, tells whether it requires a license fee for use, the organization that created and maintains it, and the year in which the organization first created it.

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