Hi Peter, Yes, we'll definitely want to model the FHIR instance expression in such a way that it closes the world (or at least allow for a closed world form) in a similar manner to what I did for v3.
-------------------------------------- Lloyd McKenzie +1-780-993-9501 Note: Unless explicitly stated otherwise, the opinions and positions expressed in this e-mail do not necessarily reflect those of my clients nor those of the organizations with whom I hold governance positions. On Sat, Dec 20, 2014 at 6:20 PM, <[email protected]> wrote: > > I can think of two reasons why (except maybe in an academic paper or PHD > thesis) we would not put SNOMED and the information model in one RDF/OWL > Ontology. > > One is the idea of keeping the information model, specifically FIHR, very > small. The goal is to keep it under 200 resources, closer to 100 even > better. > SNOMED has over half a million classes. I have argued with others who > want to put it all in one Ontology that you are adding an ocean to a > puddle. You don't need or want all those millions of extra triples riding > around in your FHIR. > > The other idea has to do with the way people think. Less than one person > in 2000 who does clinical models thinks "open world" and OWL. Domains and > Ranges would be thought of as constraints. Differently named resources > would be assumed to be different. There would be many unpredictable > modeling and logic errors if people who clearly think in "closed world" > database and UML were to start mixing OWL DL logic in the same model. Since > the whole mixed ontology would be OWL and not UML or FHIR, there would be > many false and unintended problems. > > I believe we should not add the "open world" OWL / SNOMED models into the > closed world UML, DB, FHIR models for these two different reasons. OK to > put FHIR into RDF or even OWL (after you do all the extra work of making > all the disjoint assertions) but keep the connection with the vocabulary > the way it is now, via bindings to coded concepts. > > Thanks > > > > > > > *NOTICE TO RECIPIENT:* If you are not the intended recipient of this > e-mail, you are prohibited from sharing, copying, or otherwise using or > disclosing its contents. If you have received this e-mail in error, please > notify the sender immediately by reply e-mail and permanently delete this > e-mail and any attachments without reading, forwarding or saving them. > Thank you. > > > > > > > From: "Vipul Kashyap" <[email protected]> > To: Peter Hendler/CA/KAIPERM@KAIPERM > Cc: <[email protected]>, <[email protected]>, < > [email protected]>, <[email protected]>, <[email protected]>, > "'Vipul Kashyap'" <[email protected]> > Date: 12/20/2014 02:06 PM > Subject: RE: Minutes of last week's (Dec 2) HL7 ITS RDF Subgroup / > W3C HCLS COI call -- Review of FHIR ontology approaches (cont.) > ------------------------------ > > > > Hi Peter, > > Thanks for your email below – If I may summarize: > > Clinical Models capture the “who, when, where, why” > Snomed/Medical Terminogies – capture the “what” > > Agree with your suggestion that Snomed should not be used for the former – > The underlying motivation for my suggestion – as has been suggested by > other medical informatics researchers is to > “combine” both information models and terminologies is a common > “model/ontology” and leverage the semantic expressiveness of OWL > for the purpose. > > I think that primary reason divergence appears to be whether Snomed is > viewed as a set of codes which can be used as “tags” or “values” > or Snomed is a full fledged ontology with classes, properties, > relationships and instances of those classes. Based on the perspective > taken, > Of course there are pros and cons of these approaches and can lead us to > different choices of how we model clinical information and knowledge. > > ---Vipul > > > > *From:* [email protected] [mailto:[email protected] > <[email protected]>] > * Sent:* Saturday, December 13, 2014 5:31 PM > * To:* [email protected] > * Cc:* [email protected]; [email protected]; > [email protected]; [email protected]; [email protected] > * Subject:* RE: Minutes of last week's (Dec 2) HL7 ITS RDF Subgroup / W3C > HCLS COI call -- Review of FHIR ontology approaches (cont.) > > SNOMED can not and should not map to FHIR resources. This is the > difference between clinical models that capture who, when where and why > with the medical terminologies like SNOMED that are only the what. > In HL7 V3, the information model has the entities in roles that > participate in acts. That is perfectly what should be in a clinical model. > Then the "what" part of the clinical model may go only as far as say it is > an "observation". > SNOMED does not, and should not ever deal with who when where or why. It > only deals with what. > > The medical terminology such as SNOMED supplies the "value" of the > Observation. Which might be "diabetes". > > There is no one to one between a FHIR observation and a SNOMED concept. > They don't overlap. The FHIR, just like the HL7 V3 tells you who when where > why but the what stops at "observation". The medical terminology which is > linked to that observation resource then can be SNOMED diabetes. You would > not make a FHIR resource for Diabetes. You use the FHIR observation and > then code it with a SNOMED value. > > The FHIR Observation does not get subclassed to Diabetes. It is only ever > Observaiton. The specific "value" of the Observation is the medical > terminology part supplied for example by SNOMED. > > So I would never see it being appropriate to create any SNOMED terms to > represent FHIR resources. > > Thanks > > > > > > > > * NOTICE TO RECIPIENT:* If you are not the intended recipient of this > e-mail, you are prohibited from sharing, copying, or otherwise using or > disclosing its contents. If you have received this e-mail in error, please > notify the sender immediately by reply e-mail and permanently delete this > e-mail and any attachments without reading, forwarding or saving them. > Thank you. > > > > > > > From: "Vipul Kashyap" <*[email protected]* > <[email protected]>> > To: "'Grahame Grieve'" <*[email protected]* > <[email protected]>>, "'Lloyd McKenzie'" < > *[email protected]* <[email protected]>> > Cc: "'David Booth'" <*[email protected]* <[email protected]>>, "'w3c > semweb HCLS'" <*[email protected]* > <[email protected]>>, "'HL7 ITS'" <*[email protected]* > <[email protected]>> > Date: 12/13/2014 10:41 AM > Subject: RE: Minutes of last week's (Dec 2) HL7 ITS RDF Subgroup / > W3C HCLS COI call -- Review of FHIR ontology approaches (cont.) > > ------------------------------ > > > > > > If every FHIR element was mapped to a snomed term, then you could > represent that in RDF no problems. > > VK> Would propose that FHIR could be the hub – and we could leverage > RDF/OWL constructs to map FHIR elements to Snomed, MedDRA, ICD11, RxNorm, > etc.? > > However the problem with this is that we already have a slot for mapping > an element to it's snomed code, but there are hardly any snomed codes that > are appropriate. > > VK> Not sure if I understand this – If no Snomed codes are appropriate for > a particular FHIR element – then we can request the IHTSDO folks to create > a new one, no? > Also, if the RDF/OWL metamodel gives us the language to express > more general relationships – we may not want to use a specific slot for a > Snomed code? Or we can perhaps > Create an axiom linking the values of the snomed code based on the > sameAs/subClassOf relationship for a particular terminology, e.g., Snomed? > > Thanks, > > ---Vipul > >
