Monday, June 30, 2008

Biomedicine in the Post-Information Age: 6

This is part six of a multi-part blog on biomedicine in the post-information age.

In the post-information age, solo experts will use three tools (universal access to information, computational power, and the world-wide communications infrastructure) to be innovative and productive, without being employed by bricks-and-mortar institutions.

What is an example of a post-information age innovation? I'll give you an example from my personal experience.

Governments advocate the development of a standard biomedical vocabulary that will put an end to the profusion of non-standard vocabularies that are used to annotate biomedical tests. Text annotation (sometimes called text coding) is a necessary step for data retrieval, indexing, classification, integration, etc.

So, instead of having lots of separate nomenclatures, the governments prefer a single , standard nomenclature that everyone uses. In the U.S., England and much of Europe, there is a push to use SNOMED-CT as the standard medical vocabulary.

There is one problem with this. It has proven impossible to build a single nomenclature that includes all of the terminology used in specialty domains. A specialist in the domain of dermatologic diseases (in which there are many thousands of obscure diseases and multiple synonyms for individual diseases, and very little biological research to relate these diseases with other skin diseases or with systemic diseases) is unlikely to be satisfied with a general disease nomenclature.

In my area of specialty (tumor biology), this is also true. I found the standard nomenclatures (ICD-O, SNOMED-CT, NCI Thesaurus, UMLS metathesaurus) to have only a small number of the neoplasms that can be found in the biomedical literature. In addition, the relationships among the different neoplasms were, in my opinion, not adequately expressed in these standard nomenclatures.

So, I built my own specialty nomenclature, the Developmental Classification and Taxonomy of Neoplasms (usally called the Neoplasm Classification), with includes its own biological hierarchy of neoplasms and which has about ten-fold the number of neoplasm terms as the standard nomenclatures.

Anyone who wants to use a comprehensive, biologically classified list of neoplasms, is welcome to use the nomenclature that I, as a post-information age solo expert, developed. This is an open source document available in gzipped XML format at:

Or in zipped XML format at:

Do you need to abandon the standard nomenclature? No. Use both. I have written extensively on autocoding, double autocoding (autocoding with two or more nomenclatures), re-coding (autocoding again and again to satisfy the requirements of a particular project), and on-the-fly coding. My papers are linked to full-text articles on my publications page.

This is just one example showing how an post-information age individual can contribute in areas that large groups and institutions have ignored.

- Copyright (C) 2008 Jules J. Berman

key words: biomedical informatics, medical informatics, health coverage, health insurance, medical insurance
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