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First published June 25, 2008 as JAMIA PrePrint; doi:10.1197/jamia.M2531
Journal of the American Medical Informatics Association 2008;15(5):687-700
© 2008 American Medical Informatics Association

A more recent version of this article appeared on September 1, 2008
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Submitted on June 13, 2007
Accepted on May 30, 2008

Development and Application of a Framework for Maintenance of Medical Terminological Systems

Ferishta Bakhshi-Raiez MSc1*, Ronald Cornet PhD1, and Nicolette F. de Keizer PhD1

Affiliation of the authors: 1 Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands

* To whom correspondence should be addressed.

Objective Terminological Systems (TSs) need to be maintained in order to sustain their utility. This paper describes a study aiming at the standardization of the maintenance processes of medical TSs by capturing the criteria for the management of the maintenance processes into a framework. Furthermore, this paper describes application of the framework, which sheds light on the current practice of TS maintenance.

Design Observational study

Measurements By means of a literature study, criteria for the maintenance of TSs were obtained and categorized into a framework. The current practice of TS maintenance was explored by a survey among organizations that maintain a TS. Results were stratified by the size of the TS being maintained.

Results From sixty-three relevant articles, criteria for the maintenance processes of TSs were extracted and organized into four components. The primary component "Execution" concerns the core activities of the maintenance process. The other three components "Process management", "Change specifications" and, "Editing tools" support the core activities of the component "Execution". The survey had a response rate of 40% (37 of 93). The answers reflect the large variation in the number of criteria that are satisfied for the participating organizations. Overall, maintenance of larger TSs seems to satisfy more criteria.

Conclusions The framework is an important step towards standardization of the maintenance of medical TSs and can be used to eliminate shortcomings in this process. Surveying the current practice showed that there is ample room to improve the maintenance processes of medical TSs, especially for the smaller TSs.






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