The Belgian Bilingual The Belgian Bilingual Biclassified Biclassified ThesaurusThesaurus

Michel De JongheMichel De JongheUniversity of BrusselsUniversity of Brussels

Department of General PracticeDepartment of General Practice

IntroductionIntroduction

The thesaurusThe thesaurus

In 2001, the Ministery of Health asked two In 2001, the Ministery of Health asked two universities (Ghent and Brussels) to make a universities (Ghent and Brussels) to make a thesaurus.thesaurus.

Obligations : Obligations : – Bilingual : Dutch / FrenchBilingual : Dutch / French– Must include 2 classifications : Must include 2 classifications :

ICD-10 ICD-10 ICPC-2ICPC-2

– Information integrity in case of communication of medical Information integrity in case of communication of medical information between two praticians.information between two praticians.

Why biclassified ?Why biclassified ?

In general practice, the patient’s In general practice, the patient’s electronic record requireselectronic record requires : :

The possibility to analyse the activity The possibility to analyse the activity in general practice: in general practice: ICPC-2ICPC-2

diagnosis specificity: ICD-10 diagnosis specificity: ICD-10 (combined in one tool: ICPC2-ICD10 (combined in one tool: ICPC2-ICD10

thesaurus)thesaurus)

At the same moment :At the same moment :The labellisation of the medical The labellisation of the medical

softwaresoftware Obligation of structuration (SOAP and Obligation of structuration (SOAP and

EPR architecture)EPR architecture) Use of ICPC and ICD-10Use of ICPC and ICD-10 Use of a medication data bankUse of a medication data bank Exportation of personal information : Exportation of personal information :

security and confidentiality security and confidentiality

Why a medical software ?Why a medical software ?

For the patientFor the patient For the GPFor the GP For micro-epidemiologyFor micro-epidemiology For macro-epidemiologyFor macro-epidemiology

The aim = quality of healthThe aim = quality of health

First pointFirst point

The The structurationstructuration

SubjectiveSubjective : : – Reason for encounterReason for encounter

ObjectiveObjective : : – Medical examination, laboratories, Medical examination, laboratories,

referrals, …referrals, … AssessmentAssessment ::

– Clinical labellingClinical labelling PlanPlan : :

– Process, termsProcess, terms

The contact (SOAP)The contact (SOAP)

Proposal for Belgian Proposal for Belgian EPR architectureEPR architecture

1..*

1..*

1..1

1..*

1..1 1..*

1..1

n..*

1..1

1..*

Health Care Element

Health Agent

Health Approach

Subcontact

Service

Contact

7 Basic concepts per patient record

Integration of all classical Integration of all classical concepts in a simple concepts in a simple

formatformat Chronological registration of all Chronological registration of all

services and diagnoses services and diagnoses (hospitalization record) (hospitalization record)

SOAPSOAP List of the problems and list of the List of the problems and list of the

episodesepisodes Episodes registrationEpisodes registration

Second pointSecond point

Important Important conceptsconcepts

Classification

e Terminologie

Thesaurus

NomenclatureJargon professionnel,

termes, mots

Ordonner des objets d ’après une structure

et avec un objectif

Toutes les entrées et synonymes avec un ou

plusieurs codes

Définition de critères d ’inclusion

4 fundamentals definitions4 fundamentals definitions

The Belgian The Belgian thesaurusthesaurus

At the beginning At the beginning

– Amsterdam (Henk Lamberts)Amsterdam (Henk Lamberts)– 125 000 lines125 000 lines– Translation from Dutch to French but no Translation from Dutch to French but no

link between the two languageslink between the two languages– DOS (A1 = A2 ; A1 = B+C ; A2 = C+B)DOS (A1 = A2 ; A1 = B+C ; A2 = C+B)

““Lobular pneumonia” = lobular + Lobular pneumonia” = lobular + pneumoniapneumonia

““Lobular pneumonia” = pneumonia +lobularLobular pneumonia” = pneumonia +lobular

The thesaurus structureThe thesaurus structure IBUI = Unique number for identification for each line of the IBUI = Unique number for identification for each line of the

thesaurus (8 characters)thesaurus (8 characters) Clinical labelling_FR = FR_CLINICAClinical labelling_FR = FR_CLINICA Clinical labelling_NL = NL_CLINICAClinical labelling_NL = NL_CLINICA ICPC_codeICPC_code ICPC_labellingICPC_labelling ICD-10_codeICD-10_code ICD-10_labellingICD-10_labelling FR_REF_IBUIFR_REF_IBUI NL_REF_IBUINL_REF_IBUI

– ++ Search-terms (= relevant words of all the labellings) = Search-terms (= relevant words of all the labellings) =

other fileother file

DifficultiesDifficulties

Perfect translation from Dutch into Perfect translation from Dutch into French with respect of the two French with respect of the two languages languages

Clinical labelClinical label management of doublemanagement of double Correlation between the clinical Correlation between the clinical

labelling and the ICD-10 labelling labelling and the ICD-10 labelling Correlation between ICD-10 and ICPC-2 Correlation between ICD-10 and ICPC-2

(mapping : WICC)(mapping : WICC)

Specificity of the Belgian Specificity of the Belgian thesaurusthesaurus

The REF_IBUI :The REF_IBUI :– Makes it possible to respect the Makes it possible to respect the

specificity of each language (Dutch / FR) specificity of each language (Dutch / FR) ::Fr_CLINICAFr_CLINICA Nl_CLINICANl_CLINICA Fr_REF_IBFr_REF_IB

UIUINl_REF_INl_REF_IBUIBUI

IBUIIBUI

shigellosshigellose à e à Shigella Shigella sonneisonnei

SonneSonne 1009129100912955

shigellosshigellose à e à Shigella Shigella sonneisonnei

infectie, infectie, Shigella, Shigella, sonneisonnei

1009129100912955

1011632101163288

The validationThe validation

The validation of the clinical labelling’s The validation of the clinical labelling’s wordingwording– Via UNINE (Via UNINE (

http://taurus.unine.ch:8080/icd10?term=&shttp://taurus.unine.ch:8080/icd10?term=&select=0#selectelect=0#select))

The validation of the choice of the ICD-10 The validation of the choice of the ICD-10 codecode– Via UNINEVia UNINE– 2005 T4 2005 T4 thésauthésau\double non \double non identssidentss manif manif etioetio..

mdbmdb

The validation of the correlation The validation of the correlation between ICD-10 and ICPC-2between ICD-10 and ICPC-2– « Traitement de l’information médicale « Traitement de l’information médicale

par la classification internationale des par la classification internationale des Soins Primaires CISP-2 (deuxième Soins Primaires CISP-2 (deuxième version) »version) »

– ““International classification of Primary International classification of Primary Care ICPC-2-R (revised second edition)”Care ICPC-2-R (revised second edition)”

– Revision from CISP-Club’s membersRevision from CISP-Club’s members

Exemple 1Exemple 1

Myocardite thyphique : Myocardite thyphique : ICPC-2 : K70 (remplace D70)ICPC-2 : K70 (remplace D70) ICD-10 : I41.0 (remplace A01.1)ICD-10 : I41.0 (remplace A01.1)

Exemple 2Exemple 2

Intoxication alimentaire par Intoxication alimentaire par crustacés : crustacés :

ICD-10 : T61.2 (remplace A05.9). ICD-10 : T61.2 (remplace A05.9). Il faut noter que aussi bien dans Il faut noter que aussi bien dans l’intitulé français que néerlandais, il l’intitulé français que néerlandais, il n’est pas fait allusion à une infection n’est pas fait allusion à une infection bactérienne).bactérienne).

The search termsThe search terms

Words of the FR_CLINICAWords of the FR_CLINICA Words of the ICPC labelWords of the ICPC label Words of the ICD labelWords of the ICD label Synonymous termsSynonymous terms acronymsacronyms

Application in a Application in a medical softwaremedical software

PRICAREPRICARE

Thank you for your Thank you for your attentionattention