Semantic interoperability of controlled vocabularies in medicine: A case study of the International Statistical Classification of Diseases ‘Tuberculosis’ subset

• Standard vocabularies are proposed to achieve semantic interoperability in e-health.
• Multilevel modelling is proven to achieve semantic interoperability.
• The multilevel modelling specifications bind domain models to standard vocabularies.
• We present how to model standard vocabulary terms in a XML-based multilevel model.
• We implemented a ‘Tuberculosis’ term subset as Concept Constraint Definition schemas.

Controlled vocabularies have been promoted for the achievement of semantic interoperability in e-health. However, the current implementations of healthcare information systems struggle with the remaining encoded semantics inside each particular data model. Multilevel modelling has been proposed for overcoming the challenges of semantic interoperability in healthcare, with different approaches for binding domain models to standard vocabularies; however, proofs of concept are still needed. This paper presents the fundamentals of knowledge modelling with standard vocabularies using the Multilevel Healthcare Information Modelling (MLHIM) specifications. The implementation of one term subset (‘Tuberculosis’) of the 10th Revision of the International Classification of Diseases (ICD-10) in MLHIM domain models, the Concept Constraint Definitions (CCD), is described, using the Brazilian mortality and hospital information systems as use cases. Technical details of the semantic validation of data instances generated according to the XML instances that include this ICD-10 term set, as well as the correspondent migration of the original databases to MLHIM-compliant databases, are presented.

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