Standards and frameworks
Suzanne R. Bakken · Journal of the American Medical Informatics Association · 2024
Much of the current buzz in our field is around large language models and generative artificial intelligence (AI), and these topics are reflected in all issues of the Journal of the American Medical Informatics Association (JAMIA) this year including the forthcoming September 2024 focus issue on ChatGPT and Large Language Models. However, in this editorial, I highlight 5 publications that focus on the foundational elements of standards and frameworks that have been regularly featured throughout JAMIA’s 30-year history. Motivated by a long-standing collaborative arrangement between SNOMED International and the World Health Organization (WHO) to support interoperability between the International Classification of Diseases (ICD) and SNOMED CT,1 Fung and his co-authors conducted a pilot project that bidirectionally mapped endocrine concepts between SNOMED CT and the ICD-11 Foundation.2 In phase 1 mapping from ICD-11 to SNOMED CT, they found that 59% of 637 ICD-11 Foundation entities had an exact match in SNOMED CT. In phase 2 mapping from SNOMED CT to ICD-11, only 32% of 1893 SNOMED CT concepts had an exact match in the ICD-11 Foundation with post-coordination of concepts resulting in an additional 15% of exact matches. The authors encountered challenges such as non-synonymous synonyms, mismatches in granularity, composite conditions, and residual categories. Based on the mapping pilot, the authors make 3 recommendations related to mapping between the coding systems: (1) clarify goals and use cases; (2) provide adequate resources; and (3) set up a road map. Most importantly, they recommend that if “the ultimate goal is to maximize interoperability between SNOMED CT and ICD-11, the direct use of SNOMED CT as an ontology to build the ICD-11 Foundation is a better solution than a map.”