Use of SNOMED CT to Represent Clinical Research Data: A Semantic Characterization of Data Items on Case Report Forms in Vasculitis Research
- Affiliations of the authors: Pediatrics Epidemiology Center (RLR, JPK), University of South Florida, Tampa, FL; School of Library and Information Science (JA), University of South Florida, Tampa, FL
- Correspondence and reprints: Rachel L. Richesson, PhD, MPH, Pediatrics Epidemiology Center, University of South Florida College of Medicine, Department of Pediatrics, 3650 Spectrum Blvd., Suite 100, Tampa, FL 33612; e-mail: <Rachel.Richesson{at}epi.usf.edu>
- Received 2 March 2006
- Accepted 12 June 2006
Abstract
Objective To estimate the coverage provided by SNOMED CT for clinical research concepts represented by the items on case report forms (CRFs), as well as the semantic nature of those concepts relevant to post-coordination methods.
Design Convenience samples from CRFs developed by rheumatologists conducting several longitudinal, observational studies of vasculitis were selected. A total of 17 CRFs were used as the basis of analysis for this study, from which a total set of 616 (unique) items were identified. Each unique data item was classified as either a clinical finding or procedure. The items were coded by the presence and nature of SNOMED CT coverage and classified into semantic types by 2 coders.
Measurements Basic frequency analysis was conducted to determine levels of coverage provided by SNOMED CT. Estimates of coverage by various semantic characterizations were estimated.
Results Most of the core clinical concepts (88%) from these clinical research data items were covered by SNOMED CT; however, far fewer of the concepts were fully covered (that is, where all aspects of the CRF item could be represented completely without post-coordination; 23%). In addition, a large majority of the concepts (83%) required post-coordination, either to clarify context (e.g., time) or to better capture complex clinical concepts (e.g., disease-related findings). For just over one third of the sampled CRF data items, both types of post-coordination were necessary to fully represent the meaning of the item.
Conclusion SNOMED CT appears well-suited for representing a variety of clinical concepts, yet is less suited for representing the full amount of information collected on CRFs.
Footnotes
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The project described was supported by grant number RR019259 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NCRR or NIH.
The authors wish to thank Dr. Peter Merkel, Principal Investigator of the Vasculitis Clinical Research Consortium (VCRC), Boston University School of Medicine, Ann Corbo, Project Manager (VCRC), and the investigators of the VCRC (NIH NCRC grant # 1 U54 RR019497) for sharing their data collection forms and expertise.
The authors are grateful to David Cuthbertson, Biostatistician/ Associate in Biostatistics, Pediatrics Epidemiology Center at the University of South Florida for helping to develop the Vasculitis Clinical Research Consortium case report forms and for providing background information. The authors also thank Alicia Livinski for her data management and editing contributions and Dr. Timothy Patrick, Assistant Professor, College of Health Sciences, University of Wisconsin-Milwaukee for his thoughtful reviews. The authors also wish to thank the JAMIA external reviewers for their constructive comments and assistance finalizing this manuscript.
