Aligning Biomedical Terminologies in French: Towards Semantic Interoperability in Medical Applications

In health, there exist practically as many different terminologies, controlled vocabularies, thesauri and classification systems as there are fields of application. In fact, terminologies play important roles in clinical data capture, annotation, reporting, information integration, indexing and retrieval. These knowledge sources havemostly different formats and purposes. For example, among many other knowledge sources, the Systematized NOmenclature of MEDicine International (SNOMED Int) is used for clinical coding, the French CCAM for procedures, the 10th revision of the International Classification of Diseases (ICD10) and the Anatomical Therapeutic Chemical (ATC) Classification for drugs are used for epidemiological and medico-economic purposes and the Medical Subject Headings (MeSH) thesaurus for indexing bibliographic databases. Given the great number of terminologies, existing tools, such as search engines, coding systems or decision support systems, are limited in dealing with “syntactic” and “semantic” divergences in spite of their great storage capacity and quick processing of data. Faced with this reality and the increasing need to allow cooperation with/between the various health actors and their related health information systems, it appears necessary to link and connect these terminologies to make them “interoperable”. The objective is to allow the different actors to speak the same language while using different representations of the same things. As it is essential to render these terminologies “interoperable”, this involves establishing a joint semantic repository to allow effective interaction with a minimum loss of meaning. This semantic interoperability requires a shared model, i.e. a common representation of terms and concepts, whatever the original terminology or repository is but it also requires the development of methods to allow connection between equivalent terms or relations from each terminology.