DD-CEN-TS-14463-2003.pdf

DRAFT FOR DEVELOPMENT DD CEN/TS 14463:2003 Health informatics A syntax to represent the content of medical classification systems (CIaML) ICS 01.140.20; 11.020; 35.240.80 ? Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI DD CEN/TS 14463:2003 This Draft for Development was published under the authority of the Standards Policy and Strategy Committee on 8 August 2003 © BSI 8 August 2003 ISBN 0 580 42409 X National foreword This Draft for Development is the official English language version of CEN/TS 14463:2003. This publication is not to be regarded as a British Standard. It is being issued in the Draft for Development series of publications and is of a provisional nature because of the limited duration of the European Technical Specification. It should be applied on this provisional basis, so that information and experience of its practical application may be obtained. Comments arising from the use of this Draft for Development are requested so that UK experience can be reported to the European organization responsible for its conversion to a European Standard. A review of this publication will be initiated 2 years after its publication by the European organization so that a decision can be taken on its status at the end of its 3-year life. Notification of the start of the review period will be made in an announcement in the appropriate issue of Update Standards. According to the replies received by the end of the review period, the responsible BSI Committee will decide whether to support the conversion into a European Standard, to extend the life of the Technical Specification or to withdraw it. Comments should be sent in writing to the Secretary of BSI Technical Committee IST/35, Health informatics, at British Standards House, 389 Chiswick High Road, London W4 4AL, giving the document reference and clause number and proposing, where possible, an appropriate revision of the text. A list of organizations represented on this committee can be obtained on request to its secretary. Cross-references The British Standards which implement international or European publications referred to in this document may be found in the BSI Catalogue under the section entitled “International Standards Correspondence Index”, or by using the “Search” facility of the BSI Electronic Catalogue or of British Standards Online. Summary of pages This document comprises a front cover, an inside front cover, the CEN/TS title page, pages 2 to 21 and a back cover. The BSI copyright notice displayed in this document indicates when the document was last issued. Amendments issued since publication Amd. No. DateComments Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI TECHNICAL SPECIFICATION SPÉCIFICATION TECHNIQUE TECHNISCHE SPEZIFIKATION CEN/TS 14463 July 2003 ICS 01.140.20; 11.020; 35.240.80 English version Health informatics - A syntax to represent the content of medical classification systems (CIaML) This Technical Specification (CEN/TS) was approved by CEN on 26 April 2002 for provisional application. The period of validity of this CEN/TS is limited initially to three years. After two years the members of CEN will be requested to submit their comments, particularly on the question whether the CEN/TS can be converted into a European Standard. CEN members are required to announce the existence of this CEN/TS in the same way as for an EN and to make the CEN/TS available. It is permissible to keep conflicting national standards in force (in parallel to the CEN/TS) until the final decision about the possible conversion of the CEN/TS into an EN is reached. CEN members are the national standards bodies of Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Luxembourg, Malta, Netherlands, Norway, Portugal, Slovakia, Spain, Sweden, Switzerland and United Kingdom. EUROPEAN COMMITTEE FOR STANDARDIZATION COMITÉ EUROPÉEN DE NORMALISATION EUROPÄISCHES KOMITEE FÜR NORMUNG Management Centre: rue de Stassart, 36 B-1050 Brussels © 2003 CENAll rights of exploitation in any form and by any means reserved worldwide for CEN national Members. Ref. No. CEN/TS 14463:2003 E Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI Contents Page Foreword3 Introduction.4 1Scope 5 2Normative References.5 3Abbreviations.5 4Classification mark-up language6 Annex A (informative) Examples of usage of ClaML 9 Annex B (informative) Suggested Usage of ClaML-attributes.20 Bibliography21 Page 2 CEN/TS 14463:2003 Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI Foreword This document (CEN/TS 14463:2003) has been prepared by Technical Committee CEN /TC 251, “European Standardization of Health Informatics“, the secretariat of which is held by SIS. Annexes A and B are informative. According to the CEN/CENELEC Internal Regulations, the national standards organizations of the following countries are bound to announce this CEN Technical Specification : Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Luxembourg, Malta, Netherlands, Norway, Portugal, Slovakia, Spain, Sweden, Switzerland and the United Kingdom. Page 3 CEN/TS 14463:2003 Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI Introduction Many classification systems are still distributed in a form suitable for direct text processing like MSWord etc. This is a very dangerous format, because unwanted and unspotted mistakes are easily made. For example, the accidental deletion of a tab, makes a sibling rubric into a parent. Industry is faced with a variety of formats in which classification systems are delivered. Many different parsers have to be maintained, and yet, due to the informal nature of texts, a 100% guarantee for correct parsing into more formal structures is hard to give. For work on classification systems, revision work and especially when terminological tools are used for work on classification systems there is a need to store and transfer classification systems while maintaining the structure of codes, rubrics, comments, inclusion/exclusion criteria etc. A neutral format like plain ASCII files with comma separated value fields is widely used, but has insufficient structuring capabilities. XML is the chosen format for this Prestandard as a) XML provides the necessary structuring elements, and b) there are many readily available XML parsers in existence. Page 4 CEN/TS 14463:2003 Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI 1 Scope 1.1 Main purposes The main purpose of this Technical Specification is to support the transfer of the majority of hierarchical healthcare classification systems between organisations and dissimilar software products. The Prestandard should therefore be rich enough to uniquely identify and describe the structure and the relevant elements in those systems. This Prestandard does not intend to prescribe the meaning of structuring elements in classification systems. This Prestandard is not meant to be a direct format for printing or viewing the contents of a classification system. Views and prints can be derived from this representation by post processing. 1.2 Target groups of this Technical Specification This Technical Specification is applicable by a) developers of classification systems and terminologies, to assist in the dissemination and maintenance of a particular system, as well for comparisons among different versions; b) developers of information systems to assist in inclusion of mechanisms for unambiguous loading of classification systems in their applications; c) organisations responsible for updating classification systems; d) institutions receiving updated classification systems; 1.3 Topics considered outside the scope of this Technical Specification This Technical specification is not intended for a) providing a normative syntax on how a classification system should be constructed; b) supporting full mark-up information for final printed delivery of classification systems; c) defining link types between elements in a classification system, this is left to the developers of classification systems; d) providing a representation for direct viewing or printing. 2 Normative References This Technical Specification incorporates by dated or undated reference, provisions from other publications. These normative references are cited in the appropriate places in the text, and the publications are listed hereafter. For dated references, subsequent amendments and revisions of any of these publications apply to this Technical Specification only when incorporated in it by amendment and revision. For undated references, the latest edition of the publication referred to applies. Not applicable. 3 Abbreviations ClaML Classification Markup Language XML Extensible Markup Language 1.0 DTD Document Type Definition Page 5 CEN/TS 14463:2003 Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI 4 Classification mark-up language 4.1 Basis of the syntax The basis of the syntax is to represent the content of medical classification systems. The syntax defined in this Prestandard is called Classification Mark-up Language. It is defined here in the form of a Document Type Definition (DTD). The reference to this syntax will be headed to ClaML in the remainder of this document 4.2 Document Type Definition Page 6 CEN/TS 14463:2003 Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI NOTExml:lang - defines the language code in which the content of the element is written in. The attribute values of xml:lang should follow ISO-639-2 if they are three-letter codes, and ISO-3166 if they contain two-letter sub codes. Language identifiers registered with the IANA should contain the prefix “I-“ or “i-“. Any privately used codes should contain the prefix “X-“ or “x-“. 4.3 Explanation A coding scheme consists of: an optional name, this is a piece of free text an optional version identification, this can be a number or a piece of text an optional date, this is a piece of free text an optional title, this is a piece of free text an optional list of rubric kinds zero or more modifiers zero or more modifier classes zero or more classes A list of rubric kinds consists of: zero or more rubric kinds A modifier consists of: a mandatory symbol, this is a piece of free text zero or more rubrics A modifier class consists of: a mandatory symbol, this is a piece of free text exactly one mandatory super class, which identifies an existing modifier zero or more rubrics A class consists of: a mandatory kind identifier, e.g. chapter, block, category a mandatory symbol zero or more super classes, which identify existing classes within the same coding scheme zero or more modified by statements, which identify existing modifiers zero or more excludemodifier statements, which identify existing modifiers zero or more rubrics A rubric consists of: a mandatory language identifier Page 7 CEN/TS 14463:2003 Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI a mandatory kind identifier, e.g. preferred, includes, excludes free text, which may include: references to other codes within the coding scheme references to other codes in other coding schemes italic formatted text bold formatted text Page 8 CEN/TS 14463:2003 Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI Annex A (informative) Examples of usage of ClaML A.1 Introduction A coding scheme is a mapping between a set of code values and a set of code meanings. Central overall aspects of the coding scheme is described by metadata, using the tags Name, Version, Title, Date In this standard, each code value is represented as a Symbol element and the related code meaning is represented by a set of Rubric elements. Each such relation is represented in a Class element along with optional links to more general classes (pointed to by SuperClass elements), and optional modifiers (pointed to by ModifiedBy elements). The Class is further specified by a class kind which is specific for the classification in question and typically represents the Class's level in the hierarchy1. A rubric may contain text formatted in italics and bold, it may also contain references to classes within the same classification or in other, external classifications. It is mandatory to specifiy the kind (e.g. includes, excludes, preferred, etcetera) of rubric, and the language of the rubric. Classes can in some cases be further specified by one or more modifiers, referred to by a ModifiedBy element, and described in a Modifier element. Allowable values of such a modifier are described by ModifierClass elements, each of which has a symbol and a set of Rubric elements describing its meaning. A.2 References to different languages The next piece of ClaML demonstrates how the same rubric in different languages would be represented. ICD 10 2000-12-01 International Codes for Diseases, version 10 A00-B99 Certain infectious and parasitic diseases Bepaalde infectieziekten en parasitaire aandoeningen Bestimmte infektiöse und parasitäre Krankheiten A.3 Representing hierarchy The hierarchy in a classification system is represented by the SuperClass tag, as is demonstrated in the next piece of ClaML. A00-A09 1 For example, Class kinds used in ICD might include Chapter, Section and Block. Page 9 CEN/TS 14463:2003 Licensed Copy: London South Bank University, London South Bank University, Sat Dec 09 04:08:21 GMT+00:00 2006, Uncontrolled Copy, (c) BSI A00-B99 Intestinal infectious diseases A.4 Representing internal references The next piece of ClaML demonstrates how references to another class in the same classification system would be represented. A04 A00-A09 Other bacterial intestinal infections foodborne intoxications, bacterial (A05) tuberculous enteritis (A18.3) A.5 Representing the use of modifiers Several classification systems contain subclassifications that define codes and rubrics that may be added to specific categories in the main classification. For example, Chapter XIII of the ICD-10 defines the subclassification “Site of musculo-skeletal involvement“ as follows: Site of muscu