Biomedical Engineering Reference
In-Depth Information
SNOMED CTR provides a complete conceptualization, and medical documen-
tation can be added as instances to such concepts and consists of 19 independent
hierarchies.
One of the interesting features of SNOMED is that it gives a detailed and linked
structural description of anatomical entities as well as micro-level entities, and the
chance to link instances of such structures to clinical procedures, reducing the vari-
ability in the way data are encoded and used for clinical care of patients and research.
Examples of micro-level entities are 'Cell structure' and 'Tissue structure' while the
relationships among these structures are subclasses of 'Anatomical organizational
patterns' (e.g. 'Cell to cell relationship' characterized by 'focal cell contact' is a
subclass of 'Cell to cell relationship, distinctive', which is a part of 'Cell structure').
In case of the example of the knee, it is described mainly based on its anatomy
and structure: there is no specific concept for 'Knee' but there is a 'Knee re-
gion structure', which is a subclass of 'Lower extremity part' which is in turn a
'Body part structure'. The concept 'Knee region structure' is further subdivided into
several constitutional parts, like 'Bone structure of knee', 'Knee joint structure',
'Muscle acting on knee joint' or 'Skin and subcutaneous tissue structure of knee'.
Some interesting attributes are assigned to the subclass 'Knee region structure' that
goes beyond pure anatomical and structural characteristics. For instance, the
'direct_procedure_site_of' attribute contains all the clinical operations which can
be performed over 'Knee region structure' (e.g. Combination therapy to knee, CT
of knee, Radiography of soft tissue of knee, MRI of knee, Arthroscopy and biopsy
of knee); the 'finding_site_of' attribute describes different kind of abnormalities or
diseases or injury of whole 'Knee region' (e.g. Acquired deformity of knee, Crushing
injury of knee, Open wound of knee).
SNOMED has a rich description of pathologies and procedures, and each of them
can be linked with instances of the specific 'Body Part'. In the case of 'Knee Region',
we can take the example of 'Knee disarticulation' (semantic type: Therapeutic or
Preventive Procedure) which is a subclass of 'Disarticulation'.
13.3.2 Foundational Model of Anatomy (FMA)
The Foundational Model of Anatomy [
10
] has been developed and is maintained by
the Structural Informatics Group at the University of Washington. The FMA repre-
sents anatomical entities ranging from biological macromolecules to cells, tissues,
organs, organ systems, and major body parts, including the entire body.
It is strictly constrained to pure anatomy, i.e. the structural organization of the
body: the FMA is concerned with the representation of classes and relationships
necessary for the symbolic modeling of the structure of the human body in a form
that is both understandable by humans and navigable by machine-based systems. It
can be considered as the reference domain ontology for the discipline of anatomy
and provides a template for evolving biomedical domain ontologies (e.g. PRO, the
Physiology Reference Ontology [
16
]).
