Extensions of SNOMED taxonomy abstraction networks supporting auditing and complexity analysis

The Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT) has been widely used as a standard terminology in various biomedical domains. The enhancement of the quality of SNOMED contributes to the improvement of the medical systems that it supports. In previous work, the Structural Analysis of Biomedical Ontologies Center (SABOC) team has defined the partial-area taxonomy, a hierarchical abstraction network consisting of units called partial-areas. Each partial-area comprises a set of SNOMED concepts exhibiting a particular relationship structure and being distinguished by a unique root concept. In this dissertation, some extensions and applications of the taxonomy framework are considered. Some concepts appearing in multiple partial-areas have been designated as complex due to the fact that they constitute a tangled portion of a hierarchy and can be obstacles to users trying to gain an understanding of the hierarchy’s content. A methodology for partitioning the entire collection of these so-called overlapping complex concepts into singly-rooted groups was presented. A novel auditing methodology based on an enhanced abstraction network is described. In addition, the existing abstraction network relies heavily on the structure of the outgoing relationships of the concepts. But some of SNOMED hierarchies (or subhierarchies) serve only as targets of relationships, with few or no outgoing relationships of their own. This situation impedes the applicability of the abstraction network. To deal with this problem, a variation of the above abstraction network, called the converse abstraction network (CAN) is defined and derived automatically from a given SNOMED hierarchy. An auditing methodology based on the CAN is formulated. Furthermore, a preliminary study of the complementary use of the abstraction network in description logic (DL) for quality assurance purposes pertaining to SNOMED is presented. Two complexity measures, a structural complexity measure and a hierarchical complexity measure, based on the abstraction network are introduced to quantify the complexity of a SNOMED hierarchy. An extension of the two measures is also utilized specifically to track the complexity of the versions of the SNOMED hierarchies before and after a sequence of auditing processes

Using structural and semantic methodologies to enhance biomedical terminologies

Biomedical terminologies and ontologies underlie various Health Information Systems (HISs), Electronic Health Record (EHR) Systems, Health Information Exchanges (HIEs) and health administrative systems. Moreover, the proliferation of interdisciplinary research efforts in the biomedical field is fueling the need to overcome terminological barriers when integrating knowledge from different fields into a unified research project. Therefore well-developed and well-maintained terminologies are in high demand. Most of the biomedical terminologies are large and complex, which makes it impossible for human experts to manually detect and correct all errors and inconsistencies. Automated and semi-automated Quality Assurance methodologies that focus on areas that are more likely to contain errors and inconsistencies are therefore important. In this dissertation, structural and semantic methodologies are used to enhance biomedical terminologies. The dissertation work is divided into three major parts. The first part consists of structural auditing techniques for the Semantic Network of the Unified Medical Language System (UMLS), which serves as a vocabulary knowledge base for biomedical research in various applications. Research techniques are presented on how to automatically identify and prevent erroneous semantic type assignments to concepts. The Web-based adviseEditor system is introduced to help UMLS editors to make correct multiple semantic type assignments to concepts. It is made available to the National Library of Medicine for future use in maintaining the UMLS. The second part of this dissertation is on how to enhance the conceptual content of SNOMED CT by methods of semantic harmonization. By 2015, SNOMED will become the standard terminology for EH R encoding of diagnoses and problem lists. In order to enrich the semantics and coverage of SNOMED CT for clinical and research applications, the problem of semantic harmonization between SNOMED CT and six reference terminologies is approached by 1) comparing the vertical density of SNOM ED CT with the reference terminologies to find potential concepts for export and import; and 2) categorizing the relationships between structurally congruent concepts from pairs of terminologies, with SNOMED CT being one terminology in the pair. Six kinds of configurations are observed, e.g., alternative classifications, and suggested synonyms. For each configuration, a corresponding solution is presented for enhancing one or both of the terminologies. The third part applies Quality Assurance techniques based on “Abstraction Networks” to biomedical ontologies in BioPortal. The National Center for Biomedical Ontology provides B ioPortal as a repository of over 350 biomedical ontologies covering a wide range of domains. It is extremely difficult to design a new Quality Assurance methodology for each ontology in BioPortal. Fortunately, groups of ontologies in BioPortal share common structural features. Thus, they can be grouped into families based on combinations of these features. A uniform Quality Assurance methodology design for each family will achieve improved efficiency, which is critical with the limited Quality Assurance resources available to most ontology curators. In this dissertation, a family-based framework covering 186 BioPortal ontologies and accompanying Quality Assurance methods based on abstraction networks are presented to tackle this problem

Missing lateral relationships in top‑level concepts of an ontology

Background: Ontologies house various kinds of domain knowledge in formal structures, primarily in the form of concepts and the associative relationships between them. Ontologies have become integral components of many health information processing environments. Hence, quality assurance of the conceptual content of any ontology is critical. Relationships are foundational to the definition of concepts. Missing relationship errors (i.e., unintended omissions of important definitional relationships) can have a deleterious effect on the quality of an ontology. An abstraction network is a structure that overlays an ontology and provides an alternate, summarization view of its contents. One kind of abstraction network is called an area taxonomy, and a variation of it is called a subtaxonomy. A methodology based on these taxonomies for more readily finding missing relationship errors is explored. Methods: The area taxonomy and the subtaxonomy are deployed to help reveal concepts that have a high likelihood of exhibiting missing relationship errors. A specific top-level grouping unit found within the area taxonomy and subtaxonomy, when deemed to be anomalous, is used as an indicator that missing relationship errors are likely to be found among certain concepts. Two hypotheses pertaining to the effectiveness of our Quality Assurance approach are studied. Results: Our Quality Assurance methodology was applied to the Biological Process hierarchy of the National Cancer Institute thesaurus (NCIt) and SNOMED CT’s Eye/vision finding subhierarchy within its Clinical finding hierarchy. Many missing relationship errors were discovered and confirmed in our analysis. For both test-bed hierarchies, our Quality Assurance methodology yielded a statistically significantly higher number of concepts with missing relationship errors in comparison to a control sample of concepts. Two hypotheses are confirmed by these findings. Conclusions: Quality assurance is a critical part of an ontology’s lifecycle, and automated or semi-automated tools for supporting this process are invaluable. We introduced a Quality Assurance methodology targeted at missing relationship errors. Its successful application to the NCIt’s Biological Process hierarchy and SNOMED CT’s Eye/vision finding subhierarchy indicates that it can be a useful addition to the arsenal of tools available to ontology maintenance personnel

Designing novel abstraction networks for ontology summarization and quality assurance

Biomedical ontologies are complex knowledge representation systems. Biomedical ontologies support interdisciplinary research, interoperability of medical systems, and Electronic Healthcare Record (EHR) encoding. Ontologies represent knowledge using concepts (entities) linked by relationships. Ontologies may contain hundreds of thousands of concepts and millions of relationships. For users, the size and complexity of ontologies make it difficult to comprehend “the big picture” of an ontology\u27s content. For ontology editors, size and complexity make it difficult to uncover errors and inconsistencies. Errors in an ontology will ultimately affect applications that utilize the ontology. In prior studies abstraction networks (AbNs) were developed to provide a compact summary of an ontology\u27s content and structure. AbNs have been shown to successfully support ontology summarization and quality assurance (QA), e.g., for SNOMED CT and NCIt. Despite the success of these previous studies, several major, unaddressed issues affect the applicability and usability of AbNs. This thesis is broken into five major parts, each addressing one issue. The first part of this dissertation addresses the scalability of AbN-based QA techniques to large SNOMED CT hierarchies. Previous studies focused on relatively small hierarchies. The QA techniques developed for these small hierarchies do not scale to large hierarchies, e.g., Procedure and Clinical finding. A new type of AbN, called a subtaxonomy, is introduced to address this problem. Subtaxonomies summarize a subset of an ontology\u27s content. Several types of subtaxonomies and subtaxonomy-based QA studies are discussed. The second part of this dissertation addresses the need for summarization and QA methods for the twelve SNOMED CT hierarchies with no lateral relationships. Previously developed SNOMED CT AbN derivation methodologies, which require lateral relationships, cannot be applied to these hierarchies. The Tribal Abstraction Network (TAN) is a new type of AbN derived using only hierarchical relationships. A TAN-based QA methodology is introduced and the results of a QA review of the Observable entity hierarchy are reported. The third part focuses on the development of generic AbN derivation methods that are applicable to groups of structurally similar ontologies, e.g., those developed in the Web Ontology Language (OWL) format. Previously, AbN derivation techniques were applicable to only a single ontology at a time. AbNs that are applicable to many OWL ontologies are introduced, a preliminary study on OWL AbN granularity is reported on, and the results of several QA studies are presented. The fourth part describes Diff Abstraction Networks, which summarize and visualize the structural differences between two ontology releases. Diff Area Taxonomy and Diff Partial-area Taxonomy derivation methodologies are introduced and Diff Partial-area taxonomies are derived for three OWL ontologies. The Diff Abstraction Network approach is compared to the traditional ontology diff approach. Lastly, tools for deriving and visualizing AbNs are described. The Biomedical Layout Utility Framework is introduced to support the automatic creation, visualization, and exploration of abstraction networks for SNOMED CT and OWL ontologies

Structural indicators for effective quality assurance of snomed ct

The Standardized Nomenclature of Medicine -- Clinical Terms (SNOMED CT -- further abbreviated as SCT) has been endorsed as a premier clinical terminology by many national and international organizations. The US Government has chosen SCT to play a significant role in its initiative to promote Electronic Health Record (EH R) country-wide. However, there is evidence suggesting that, at the moment, SCT is not optimally modeled for its intended use by healthcare practitioners. There is a need to perform quality assurance (QA) of SCT to help expedite its use as a reference terminology for clinical purposes as planned for EH R use. The central theme of this dissertation is to define a group-based auditing methodology to effectively identify concepts of SCT that require QA. As such, similarity sets are introduced which are groups of concepts that are lexically identical except for one word. Concepts in a similarity set are expected to be modeled in a consistent way. If not, the set is considered to be inconsistent and submitted for review by an auditor. Initial studies found 38% of such sets to be inconsistent. The effectiveness of these sets is further improved through the use of three structural indicators. Using such indicators as the number of parents, relationships and role groups, up to 70% of the similarity sets and 32.6% of the concepts are found to exhibit inconsistencies. Furthermore, positional similarity sets, which are similarity sets with the same position of the differing word in the concept’s terms, are introduced to improve the likelihood of finding errors at the concept level. This strictness in the position of the differing word increases the lexical similarity between the concepts of a set thereby increasing the contrast between lexical similarities and modeling differences. This increase in contrast increases the likelihood of finding inconsistencies. The effectiveness of positional similarity sets in finding inconsistencies is further improved by using the same three structural indicators as discussed above in the generation of these sets. An analysis of 50 sample sets with differences in the number of relationships reveal 41.6% of the concepts to be inconsistent. Moreover, a study is performed to fully automate the process of suggesting attributes to enhance the modeling of SCT concepts using positional similarity sets. A technique is also used to automatically suggest the corresponding target values. An analysis of 50 sample concepts show that, of the 103 suggested attributes, 67 are manually confirmed to be correct. Finally, a study is conducted to examine the readiness of SCT problem list (PL) to support meaningful use of EHR. The results show that the concepts in PL suffer from the same issues as general SCT concepts, although to a slightly lesser extent, and do require further QA efforts. To support such efforts, structural indicators in the form of the number of parents and the number of words are shown to be effective in ferreting out potentially problematic concepts in which QA efforts should be focused. A structural indicator to find concepts with synonymy problems is also presented by finding pairs of SCT concepts that map to the same UMLS concept

STRUCTURAL AND LEXICAL METHODS FOR AUDITING BIOMEDICAL TERMINOLOGIES

Biomedical terminologies serve as knowledge sources for a wide variety of biomedical applications including information extraction and retrieval, data integration and management, and decision support. Quality issues of biomedical terminologies, if not addressed, could affect all downstream applications that use them as knowledge sources. Therefore, Terminology Quality Assurance (TQA) has become an integral part of the terminology management lifecycle. However, identification of potential quality issues is challenging due to the ever-growing size and complexity of biomedical terminologies. It is time-consuming and labor-intensive to manually audit them and hence, automated TQA methods are highly desirable. In this dissertation, systematic and scalable methods to audit biomedical terminologies utilizing their structural as well as lexical information are proposed. Two inference-based methods, two non-lattice-based methods and a deep learning-based method are developed to identify potentially missing hierarchical (or is-a) relations, erroneous is-a relations, and missing concepts in biomedical terminologies including the Gene Ontology (GO), the National Cancer Institute thesaurus (NCIt), and SNOMED CT. In the first inference-based method, the GO concept names are represented using set-of-words model and sequence-of-words model, respectively. Inconsistencies derived between hierarchical linked and unlinked concept pairs are leveraged to detect potentially missing or erroneous is-a relations. The set-of-words model detects a total of 5,359 potential inconsistencies in the 03/28/2017 release of GO and the sequence-of-words model detects 4,959. Domain experts’ evaluation shows that the set-of-words model achieves a precision of 53.78% (128 out of 238) and the sequence-of-words model achieves a precision of 57.55% (122 out of 212) in identifying inconsistencies. In the second inference-based method, a Subsumption-based Sub-term Inference Framework (SSIF) is developed by introducing a novel term-algebra on top of a sequence-based representation of GO concepts. The sequence-based representation utilizes the part of speech of concept names, sub-concepts (concept names appearing inside another concept name), and antonyms appearing in concept names. Three conditional rules (monotonicity, intersection, and sub-concept rules) are developed for backward subsumption inference. Applying SSIF to the 10/03/2018 release of GO suggests 1,938 potentially missing is-a relations. Domain experts’ evaluation of randomly selected 210 potentially missing is-a relations shows that SSIF achieves a precision of 60.61%, 60.49%, and 46.03% for the monotonicity, intersection, and sub-concept rules, respectively. In the first non-lattice-based method, lexical patterns of concepts in Non-Lattice Subgraphs (NLSs: graph fragments with a higher tendency to contain quality issues), are mined to detect potentially missing is-a relations and missing concepts in NCIt. Six lexical patterns: containment, union, intersection, union-intersection, inference-contradiction, and inference-union are leveraged. Each pattern indicates a potential specific type of error and suggests a potential type of remediation. This method identifies 809 NLSs exhibiting these patterns in the 16.12d version of NCIt, achieving a precision of 66% (33 out of 50). In the second non-lattice-based method, enriched lexical attributes from concept ancestors are leveraged to identify potentially missing is-a relations in NLSs. The lexical attributes of a concept are inherited in two ways: from ancestors within the NLS, and from all the ancestors. For a pair of concepts without a hierarchical relation, if the lexical attributes of one concept is a subset of that of the other, a potentially missing is-a relation between the two concepts is suggested. This method identifies a total of 1,022 potentially missing is-a relations in the 19.01d release of NCIt with a precision of 84.44% (76 out of 90) for inheriting lexical attributes from ancestors within the NLS and 89.02% (73 out of 82) for inheriting from all the ancestors. For the non-lattice-based methods, similar NLSs may contain similar quality issues, and thus exhaustive examination of NLSs would involve redundant work. A hybrid method is introduced to identify similar NLSs to avoid redundant analyses. Given an input NLS, a graph isomorphism algorithm is used to obtain its structurally identical NLSs. A similarity score between the input NLS and each of its structurally identical NLSs is computed based on semantic similarity between their corresponding concept names. To compute the similarity between concept names, the concept names are converted to vectors using the Doc2Vec document embedding model and then the cosine similarity of the two vectors is computed. All the structurally identical NLSs with a similarity score above 0.85 is considered to be similar to the input NLS. Applying this method to 10 different structures of NLSs in the 02/12/2018 release of GO reveals that 38.43% of these NLSs have at least one similar NLS. Finally, a deep learning-based method is explored to facilitate the suggestion of missing is-a relations in NCIt and SNOMED CT. Concept pairs exhibiting a containment pattern is the focus here. The problem is framed as a binary classification task, where given a pair of concepts, the deep learning model learns to predict whether the two concepts have an is-a relation or not. Positive training samples are existing is-a relations in the terminology exhibiting containment pattern. Negative training samples are concept-pairs without is-a relations that are also exhibiting containment pattern. A graph neural network model is constructed for this task and trained with subgraphs generated enclosing the pairs of concepts in the samples. To evaluate each model trained by the two terminologies, two evaluation sets are created considering newer releases of each terminology as a partial reference standard. The model trained on NCIt achieves a precision of 0.5, a recall of 0.75, and an F1 score of 0.6. The model trained on SNOMED CT achieves a precision of 0.51, a recall of 0.64 and an F1 score of 0.56

A Core Reference Hierarchical Primitive Ontology for Electronic Medical Records Semantics Interoperability

Currently, electronic medical records (EMR) cannot be exchanged among hospitals, clinics, laboratories, pharmacies, and insurance providers or made available to patients outside of local networks. Hospital, laboratory, pharmacy, and insurance provider legacy databases can share medical data within a respective network and limited data with patients. The lack of interoperability has its roots in the historical development of electronic medical records. Two issues contribute to interoperability failure. The first is that legacy medical record databases and expert systems were designed with semantics that support only internal information exchange. The second is ontological commitment to the semantics of a particular knowledge representation language formalism. This research seeks to address these interoperability failures through demonstration of the capability of a core reference, hierarchical primitive ontological architecture with concept primitive attributes definitions to integrate and resolve non-interoperable semantics among and extend coverage across existing clinical, drug, and hospital ontologies and terminologies

Applications of big knowledge summarization

Advanced technologies have resulted in the generation of large amounts of data ( Big Data ). The Big Knowledge derived from Big Data could be beyond humans\u27 ability of comprehension, which will limit the effective and innovative use of Big Knowledge repository. Biomedical ontologies, which play important roles in biomedical information systems, constitute one kind of Big Knowledge repository. Biomedical ontologies typically consist of domain knowledge assertions expressed by the semantic connections between tens of thousands of concepts. Without some high-level visual representation of Big Knowledge in biomedical ontologies, humans cannot grasp the big picture of those ontologies. Such Big Knowledge orientation is required for the proper maintenance of ontologies and their effective use. This dissertation is addressing the Big Knowledge challenge - How to enable humans to use Big Knowledge correctly and effectively (referred to as the Big Knowledge to Use (BK2U) problem) - with a focus on biomedical ontologies. In previous work, Abstraction Networks (AbNs) have been demonstrated successful for the summarization, visualization and quality assurance (QA) of biomedical ontologies. Based on the previous research, this dissertation introduces new AbNs of various granularities for Big Knowledge summarization and extends the applications of AbNs. This dissertation consists of three main parts. The first part introduces two advanced AbNs. One is the weighted aggregate partial-area taxonomy with a parameter to flexibly control the summarization granularity. The second is the Ingredient Abstraction Network (IAbN) for the National Drug File - Reference Terminology (NDF-RT) Chemical Ingredients hierarchy, for which the previously developed AbNs for hierarchies with outgoing relationships, are not applicable. Since NDF-RT\u27s Chemical Ingredients hierarchy has no outgoing relationships. The second part describes applications of the two advanced AbNs. A study utilizing the weighted aggregate partial-area taxonomy for the identification of major topics in SNOMED CT\u27s Specimen hierarchy is reported. A multi-layer interactive visualization system of required granularity for ontology comprehension, based on the weighted aggregate partial-area taxonomy, is demonstrated to comprehend the Neoplasm subhierarchy of National Cancer Institute thesaurus (NCIt). The IAbN is applied for drug-drug interaction (DDI) discovery. The third part reports eight family-based QA studies on NCIt\u27s Neoplasm, Gene, and Biological Process hierarchies, SNOMED CT\u27s Infectious disease hierarchy, the Chemical Entities of Biological Interest ontology, and the Chemical Ingredients hierarchy in NDF-RT. There is no one-size-fits-all QA method and it is impossible to find a QA method for each individual ontology. Hence, family-based QA is an effective way, i.e., one QA technique could be applicable to a whole family of structurally similar ontologies. The results of these studies demonstrate that complex concepts and uncommonly modeled concepts are more likely to have errors. Furthermore, the three studies on overlapping concepts in partial-area taxonomies reported in this dissertation combined with previous three studies prove the success of overlapping concepts as a QA methodology for a whole family of 76 similar ontologies in BioPortal

Structural auditing methodologies for controlled terminologies

Several auditing methodologies for large controlled terminologies are developed. These are applied to the Unified Medical Language System XXXX and the National Cancer Institute Thesaurus (NCIT). Structural auditing methodologies are based on the structural aspects such as IS-A hierarchy relationships groups of concepts assigned to semantic types and groups of relationships defined for concepts. Structurally uniform groups of concepts tend to be semantically uniform. Structural auditing methodologies focus on concepts with unlikely or rare configuration. These concepts have a high likelihood for errors. One of the methodologies is based on comparing hierarchical relationships between the META and SN, two major knowledge sources of the UMLS. In general, a correspondence between them is expected since the SN hierarchical relationships should abstract the META hierarchical relationships. It may indicate an error when a mismatch occurs. The UMLS SN has 135 categories called semantic types. However, in spite of its medium size, the SN has limited use for comprehension purposes because it cannot be easily represented in a pictorial form, it has many (about 7,000) relationships. Therefore, a higher-level abstraction for the SN called a metaschema, is constructed. Its nodes are meta-semantic types, each representing a connected group of semantic types of the SN. One of the auditing methodologies is based on a kind of metaschema called a cohesive metaschema. The focus is placed on concepts of intersections of meta-semantic types. As is shown, such concepts have high likelihood for errors. Another auditing methodology is based on dividing the NCIT into areas according to the roles of its concepts. Moreover, each multi-rooted area is further divided into pareas that are singly rooted. Each p-area contains a group of structurally and semantically uniform concepts. These groups, as well as two derived abstraction networks called taxonomies, help in focusing on concepts with potential errors. With genomic research being at the forefront of bioscience, this auditing methodology is applied to the Gene hierarchy as well as the Biological Process hierarchy of the NCIT, since processes are very important for gene information. The results support the hypothesis that the occurrence of errors is related to the size of p-areas. Errors are more frequent for small p-areas