The Unified Medical Language System

D. A. B. Lindberg; B. L. Humphreys; A. T. McCray

doi:10.1055/s-0038-1637976

Yearbook of Medical Informatics, Inhaltsverzeichnis

Yearb Med Inform 1993; 02(01): 41-51
DOI: 10.1055/s-0038-1637976

Review Article

Georg Thieme Verlag KG Stuttgart

The Unified Medical Language System

Authors

D. A. B. Lindberg

¹National Library of Medicine, Bethesda MD, USA
B. L. Humphreys

¹National Library of Medicine, Bethesda MD, USA
A. T. McCray

¹National Library of Medicine, Bethesda MD, USA

Abstract

In 1986, the National Library of Medicine began a long-term research and development project to build the Unified Medical Language System^® (UMLS^®). The purpose of the UMLS is to improve the ability of computer programs to “understand” the biomedical meaning in user inquiries and to use this understanding to retrieve and integrate relevant machine-readable information for users. Underlying the UMLS effort is the assumption that timely access to accurate and up-to-date information will improve decision making and ultimately the quality of patient care and research. The development of the UMLS is a distributed national experiment with a strong element of international collaboration. The general strategy is to develop UMLS components through a series of successive approximations of the capabilities ultimately desired. Three experimental Knowledge Sources, the Metathesaurus^®, the Semantic Network, and the Information Sources Map have been developed and are distributed annually to interested researchers, many of whom have tested and evaluated them in a range of applications. The UMLS project and current developments in high-speed, high-capacity international networks are converging in ways that have great potential for enhancing access to biomedical information.

Key-Words

Unified Medical Language System - UMLS - Semantic Network - National Library of Medicine - NLM - Telecommunication - Information Management - IAIMS

Volltext

Referenzen

References
1 Lindberg DAB, Humphreys BL. Computer systems that understand medical meaning. In: Computerized Natural Medical Language Processing for Knowledge Representation Scherrer JR, Cote RA, Mandil SH. (eds). Amsterdam: Elsevier Science Publishers; 1989: 5-17.
2 Bunting A. The Nation’s Health Information Network: History of the Regional Medical Library Program, 1965-1985. Bull Med Libr Assoc 1987; 75 (Suppl. 03) 1-62.
3 Integrated Academic Information Management Systems (IAIMS) model development Bull Med Libr Assoc. 1988; 76: 221-67.
4 Lorenzi NM. (ed). Symposium: A decade of IAIMS. Bull Med Libr Assoc 1992; 80: 241-93.
5 Hlimphreys BL, Lindberg DAB. The UMLS project: Making the conceptual connection between users and the information they need. Bull Med Libr Assoc 1992; 81 (02) 170-7.
6 Lindberg DAB, Siegel ER, Rapp BA, Wallingford KT, Wilson SR. Use of MEDLINE by physicians for clinical problem solving. JAMA 1993; 269: 3124-9.
7 Marshall JG. The impact of the hospital library on clinical decision making: The Rochester Study. Bull Med Libr Assoc 1992; 80: 169-78.
8 Rossi Mori A, Berrauer J, Pakarinen V. et al. Models for representation of terminologies and coding systems in medicine. In: De Moor GJE, McDonald CJ, Noothoven van Goor J. (eds). Progress in Standardization in Health Care Informatics. Amsterdam: IOS Press; 1993: 92-104.
9 McDonald CJ. ANSI’s Health Informatics Planning Panel (HISPP) – The Purpose and Progress. In: Progress in Standardization in Health Care Informatics De Moor GJE, McDonald CJ, Noothoven van Goor J. (eds) Amsterdam: IOS Press; 1993: 14-9.
10 ASN. 1 Specifications. Bethesda MD: National Center for Biotechnology Information, Nov 1991
11 Dutcher GA. DOCLINE: A national automated interlibrary loan request routing and referral system. Inf Technol Libr 1989; 8: 359-70.
12 Humphreys BL, Lindberg DAB. The Unified Medical Language System Project: a distributed experiment in improving access to biomedical information. In: MEDINFO 92 Proceedings of the 7th World Congress on Medical Informatics. Amsterdam: North-Holland Publ Comp; 1992: 1496-1500.
13 Humphreys BL, Lindberg DAB, Hole WT. Assessing and enhancing the value of the UMLS Knowledge Sources. In: Proceedings of the 15th Annual Symposium on Computer Applications in Medical Care. Clayton PD. (ed) New York: McGraw Hill; 1991: 78-82.
14 Humphreys BL, Lindberg DAB. Building the Unified Medical Language System. In: Kingsland LC III. (ed). Proceedings of the 13th Annual Symposium on Computer Applications in Medical Care. New York: IEEE Computer Society Press; 1989: 475-80.
15 Masarie Jr FE, Miller RA, Bouhaddou O, Giuse NB, Warner HR. An in terlingua for electronic interchange of medical information: using frames to map between clinical vocabularies. Comput Biomed Res 1991; 24: 379-400.
16 Evans DA. Pragmatically-stmctured, lexicalsemantic knowledge bases for Unified Medical Language Systems. In: Greenes RA. (ed). Proceedings of the 12th Annual Symposium on Computer Applications in Medical Care. New York: IEEE Computer Society Press; 1988: 169-73.
17 Barr CE, Komorowski HJ, Pattison-Gordon E, Greenes RA. Conceptual modeling for the Unified Medical Language System. In: Greenes RA. (ed). Proceedings of the 12th Annual Symposium on Computer Applications in Medical Care . IEEE Computer Society Press; 1988: 148-51.
18 Tuttle MS, Blois MS, Erlbaum MS, Nelson SJ, Sherertz DD. Toward a biomedical thesaurus: building the foundation of the UMLS. In: Greenes RA. (ed). Proceedings of the 12th Annual Symposium on Computer Applications in Medical Care. New York: IEEE Computer Society Press; 1988: 191-5.
19 Sherertz DD, Thttle MS, Blois MS, Erlbaum MS. Intervocabulaiy mapping within the UMLS: the role of lexical matching. In: Greenes RA. ( ed). Proceedings of the 12th Annual Symposium on Computer Applications in Medical Care. New York: IEEE Computer Society Press; 1988: 201-6.
20 Cimino JJ, Mallon LJ, Barnett GO. Automated extraction of medical knowledge from MEDLINE citations. In: Greenes RA. ( ed). Proceedings of the 12th Annual Symposium on Computer Applications in Medical Care. New York: IEEE Computer Society Press; 1988: 180-4.
21 Musen MA. Dimensions of knowledge sharing and reuse. Comp Biomed Res 1992; 25: 435-67.
22 McCray AT., The UMLS. semantic network. In: Kingsland LCIII. (ed). Proceedings of the 13th Annual Symposium on Computer Applications in Medical Care. New York: IEEE Computer Society Press; 1989: 503-7.
23 McCray AT, Hole WT. The scope and structure of the first version of the UMLS semantic network. In: Miller RA. (ed). Proceedings of the 14th Annual Symposium on Computer Applications in Medical Care. New York: IEEE Computer Society Press; 1990: 126-30.
24 McCray AT. Representing Biomedical Knowledge in the UMLS Semantic Network. In : Broering NC. (ed). High Performance Medical Libraries. Westport CT: Meckler Publ; 1993. (in press)
25 Masys DR, Humphreys BL. Structure and function of the UMLS Information Sources Map. In: MEDINFO 92 Proceedings of the 7th World Congress on Medical Informatics. Lun KC, Degoulet P, Piemme TE, Rienhoff O. (eds). Amsterdam: North-Holland Publ Comp; 1992: 1518-21.
26 Lindberg DAB, Humhreys BL. The UMLS knowledge sources: tools for building better user interfaces. In: Proceedings of the 14th Annual Symposium on Computer Applications in Medical Care. Miller RA. (ed). New York: IEEE Computer Society Press; 1990: 121-5.
27 Tuttle MS, Sperzel WD, Olson NE. et al. The homogenization of the Metathesaurus schema and distribution format. In: Proceedings of the 16th Annual Symposium on Computer Applications in Medical Care. Frisse ME. (ed). New York: McGraw Hill; 1992: 299-303.
28 Tuttle M, Sherertz D, Erlbaum M, Olson N, Nelson S. Implementing Meta-l: the first version of the UMLS Metathesaurus. In: Proceedings of the 13th Annual Symposium on Computer Applications in Medical Care. Kingsland LC III. (ed). New York: IEEE Computer Society Press; 1989: 483-7.
29 Sherertz DD, Olson NE, Tuttle MS, Erlbaum MS. Source inversion and matching in the UMLS Metathesaurus. In: Proceedings of the 14th Annual Symposium on Computer Applications in Medical Care. Miller RA. (ed). New York: IEEE Computer Society Press; 1990: 141-5.
30 Sherertz DD, Olson NE, Thttle MS, Sperzel WD, Erlbaum MS, Fuller LF. The META-l* Engine: a database methodology used in building the UMLS Metathesaurus. In: MEDINFO 92: Proceedings of the 7th World Congress on Medical Informatics. Lun KC, Degoulet P, Pieinme TE, Rienhoff O. (eds). Amsterdam: North-Holland Publ Comp; 1992: 144-9.
31 Sperzel D, Erlbaum M, Fuller L. et al. Editing the UMLS Metathesaurus: review and enhancement of a computed knowledge source. In: Proceedings of the 14th Annual Symposium on Computer Applications in Medical Care. Miller RA. (ed). New York: IEEE Computer Society Press; 1990: 136-40.
32 Sperzel WD, Tuttle MS, Olson NE. et al. The Meta-1.2 engine: a refined strategy for linking biomedical vocabularies. In: Proceedings of the 16th Annual Symposium on Computer Applications in Medical Care. Frisse ME. (ed). New York: McGraw Hill; 1992: 204-6.
33 Tuttle MS, Sherertz DD, Nelson SJ. et al. Adding your terms and relationships to the UMLS Metathesaurus. In: Proceedings of the 15th Annual Symposium on Computer Applications in Medical Care. Clayton PD. (ed). New York: McGraw Hill; 1991: 219-23.
34 Humphreys BL, Schuyler PL. The Unified Medical Language System: Moving Beyond the Vocabulary of Bibliographic Retrieval. In: Broering NC. (ed). High Performance Medical Libraries. Westport CT: Meckler Publ; 1993. (in press)
35 Schuyler PL, Hole WT, Tuttle MS, Sherertz DD. The UMLS Metathesaurus: Representing different views of biomedical concepts. Bull Med Libr Assoc 1993; 81: 217-22.
36 Metathesaurus vocabularies are listed in the UMLS documentation: UMLS Knowledge Sources. 3^rd Experimental Edition – August 1992. Documentation Bethesda Md: National Library of Medicine;
37 Roget’s International Thesaurus Fourth Edition. New York: Harper & Row Publ; 1984
38 Neslon SJ, Tuttle MS, Cole WG. et al. From meaning to term: semantic locality in the UMLS Metathesaurus. In: Proceedings of the 15th Annual Symposium on Computer Applications in Medical Care. Clayton PD. (ed). New York: McGraw Hill; 1991: 209-13.
39 Dorland’s lllustrated Medical Dictionary 27th edition. Philadelphia: W. B. Saunders Company; 1988
40 Byrd RJ, Klavans JL, Aronoff M, Ansher F. Computer methods for morphological analysis. In: Proceedings of the 24th Annual Meeting of the ACL. Morristown NJ: Association for Computational Linguistic; 1986: 120-7.
41 See the extensive References listed in: Morphology and Computation. Sproat R. (ed) Cambridge Ma: MIT Press; 1992
42 The UMLS documentation includes the C code that generates the word index: UMLs Knowledge Sources 3rd. Experimental Edition – August 1992. Documentation Bethesda Md: National Library of Medicine;
43 Schuyler PL, McCray AT, Schoolman HM. A test collection for experimentation in bibliographic retrieval. In: MEDINFO 89: Proceedings of the Sixth Conference on Medical Informatics. Barber B, Cao D, Qin D, Wagner G. (eds). Amsterdam: North-Holland Publ Comp; 1989: 910-12.
44 Miller PL, Barwick KW, Morrow JS, Powsner SM, Riely CA. Semantic relationship and medical bibliographic retrieval: a preliminary assessment. Comput Biomed Res 1987; 21: 64-77.
45 Miller RA, Masarie Jr FE. The demise of the “Greek Oracle” model for medical diagnostic systems. Meth Inf Med 1990; 29: 1-2.
46 Lowe HJ, Barnett GO. MicroMeSH: a microcomputer system for searching and exploring the National Library of Medicine’s Medical Subject Headings (MeSH) vocabulary. In: Proceedings of the 11th Annual Symposium on Computer Applications in Medical Care. Stead WE. (ed). New York: IEEE Computer Society Press; 1987: 717-20.
47 Lowe H, Barnett GO, Scott J, Mallon L, Ryan-Blewett D. Remote access Micro-Me SH: evaluation of a microcomputer system for searching the MEDLINE database. In: Proceedings of the 13th Annual Symposium on Computer Applications in Medical Care. Kingsland LC III. (ed). New York: IEEE Computer Society Press; 1989: 445-7.
48 Sherertz DD, Tuttle M, Cole W, Erlbaum M, Olson N, Nelson S. A HyperCard implementation of Meta-1: the first version of the UMLS Metathesaurus. In: Proceedings of the 13th Annual Symposium on Computer Applications in Medical Care. Kingsland LC III. (ed). New York: IEEE Computer Society Press; 1989: 1017-18.
49 Sherertz DD, Tuttle MS, Erlbaum MS, Sperzel WD, Fuller LF, Nelson SJ. in-CD: a HyperCard interface to Meta-1 on a CDROM. In: Proceedings of the 14th Annual Symposium on Computer Applications in Medical Care. Miller RA. (ed). New York: IEEE Computer Society Press; 1990: 1052-3.
50 Komorowski HJ, Greenes RA, Barr C, Pattison-Gordon E. Browsing and authoring tools for a Unified Medical Language System. In: Proceedings of RIAO 88 Conference on User-oriented Content-based Text and Image Handling. Fluhr C, Walker D. (eds). Cambridge Ma: MIT Press; 1988: 624-41.
51 Hersh WR. Evaluation of Meta-1 for a concept-based approach to the automated indexing and retrieval of bibliographic and full-text databases. Med Decis Making 1991; 11 (Suppl. 04) 120-4.
52 McCray AT. Extending a natural language parser with UMLS knowledge. In: Proceedings of the 15th Annual Symposium on Computer Applications in Medical Care. Clayton PD. (ed). Applications in Medical Care. New York: McGraw Hill; 1991: 194-8.
53 McCray AT, Aronson AR, Browne AC. et al. UMLS knowledge for biomedical language processing. Bull Med Libr Assoc 1993; 81: 184-94.
54 Kingsland LC III, Syed EJ, Lindberg DAB. COACH: an expert searcher program to assist Grateful Med users searching MEDLINE. In: MEDINFO 92: Proceedings of the 7th World Congress on Medical Informatics. Lun KC, Degoulet P, Piemme TE, Rienhoff O. (eds). Amsterdam: NorthHolland Publ Comp; 1992: 382-6.
55 Kingsland LC, Harbourt AM, Syed EJ, Schuyler PL. Applying the UMLS Knowledge Sources in an expert searcher environment. Bull Med Libr Assoc 1993; 81: 178-83.
56 Powsner SM, Miller PL. Linking bibliographic retrieval to clinical reports: Psych-Topix. In: Proceedings of the 13th Annual Symposium on Computer Applications in Medical Care. Kingsland LCIII. (ed). New York: IEEE Computer Society Press; 1989: 431-5.
57 Cimino C, Barnett GO, Hassan L, Blewett DR, Piggins JL. Interactive Query Workstation: Standardizing access to computerbased medical resources. Comput Meth Progr Biomed 1991; 35: 293-9.
58 Merz RA, Cimino C, Barnett GO. et al. Q & A: a query formulation assistant. In: Proceedings of the 16th Annual Symposium on Computer Applications in Medical Care. Frisse ME. (ed). New York: McGraw Hill; 1992: 498-504.
59 Cimino JJ, Aguirre A, Johnson SB, Peng P. Generic Queries for Meeting Clinical Information Needs. Bull Med Libr Assoc 1993; 81: 195-206.
60 Powsner SM, Miller PL. From patient reports to bibliographic retrieval: a Meta-l front-end. In: Proceedings of the 15th Annual Symposium on Computer Applications in Medical Care. Clayton PD. ( ed). New York: McGraw Hill; 1991: 526-30.
61 Cimino JJ, Johnson SB, Aguirre A, Roderer N, Clayton PD. The Medline button. In: Proceedings of the 16th Annual Symposium on Computer Applications in Medical Care. Frisse ME. (ed). New York: McGraw Hill; 1992: 81-5.
62 Yount RJ, Vries JK, Council CD. The Medical Archival System: An information retrieval system based on distributed parallel processing. Inform Processing Management 1991; 27: 379-91.
63 Miller RA, Gieszczykiewicz FM, Vries JI, Cooper GF. CHARTLINE: providing bibliographic References relevant to patient charts using the UMLS Methathesaurus Knowledge Sources. In: Proceedings of the 16th Annual Symposium on Computer Applications in Medical Care. Frisse ME. (ed). New York: McGraw Hill; 1993: 91-8.
64 Nelson SJ, Sherertz DD, Tuttle MS, Erlbaum MS, Smith LG. Browsing MIM. PDQ, CDD, and MEDLINE using MetaCard. In: Proceedings of the 14th Annual Symposium on Computer Applications in Medical Care. Miller RA. (ed). New York: IEEE Computer Society Press; 1990: 1054-5.
65 Nelson SJ, Sherertz DD, Tuttle MS. Issues in the development of an information retrieval system: The Physician’s Information Assistant. In: MEDINFO 92: Proceedings of the 7th World Congress on Medical Informatics. Lun KC, Degoulet P, Piemme TE, Rienhoff O. (eds). Amsterdam: NorthHolland Publ Comp; 1992: 371-5.
66 Miller PL, Wright LW, Frawley SJ, Clyman JI, Powsner SM. Selecting relevant information resources in a network-based environment: the UMLS Information Sources Map. In: MEDINFO 92: Proceedings of the 7th World Congress on Medical Informatics. Lun KC, Degoulet P, Piemme TE, Rienhoff O. (eds). Amsterdam: North Holland Publ Comp; 1992: 1512-7.
67 Masys DR. The evaluation of the source selection elements of the prototype UMLS Information Sources Map. In: Proceedings of the 16th Annual Symposium on Computer Applications in Medical Care. Frisse ME. (ed). New York: McGraw Hill; 1992: 295-8.
68 Clyman JI, Powsner SM, Paton JA, Miller PL. Using a network menu and the UMLS Information Sources Map to facilitate access to online reference materials. Bull Med Libr Assoc 1993; 81: 207-16.
69 Wagner MM, Cooper GF. Evaluation of a Meta-l-based automatic indexing method for medical documents. Comput Biomed Res 1992; 25: 336-49.
70 Chute CG, Yang Y, Evans DA. Latent Semantic Indexing of medical diagnoses using UMLS semantic structures. In: Proceedings of the 15th Annual Symposium on Computer Applications in Medical Care. Clayton PD. ( ed). New York: McGraw Hill; 1992: 185-9.
71 Humphrey SM. Indexing biomedical documents: From thesaural to knowledge-based retrieval systems. Artif Intell Med 1992; 4: 29-56.
72 Eisner J. The developing Electronic Curriculum Consortium. J Dent Educ, 1990; 54: 598-9.
73 Bishop CW, Ewing P. Presenting medical knowledge: Reconciling the present or creating the future?. MD Comput 1992; 9: 218-25.
74 Lindberg DAB, Humphreys BL. The Unified Medical Language System (UMLS) and computer-based patient records. In: Aspects of the Computer-based Patient Record. Ball MJ, Collen MF. (eds). New York: Springer-Verlag; 1992: 165-75.
75 Cimino JJ, Hripcsak G, Johnson SB, Friedman C, Fink DJ, Clayton PD. UMLS as knowledge base – a rule-based expert system approach to controlled medical vocabulary management. In: Proceedings of the 14th Annual Symposium on Computer Applications in Medical Care. Miller RA. (ed). New York: IEEE Computer Society Press; 1990: 175-9.
76 Campbell JR, Kallenberg GA, Sherrick RC. The clinical utility of META: an analysis for hypertension. In: Proceedings of the 16th Annual Symposium on Computer. Applications in Medical Care. Frisse ME. (ed). New York: McGraw Hill; 1992: 397-404.
77 Chute CG, Yang Y, Thttle MS, Sherertz DD, Olson NE, Erlbaum MS. A preliminary evaluation of the UMLS Meta thesaurus for patient record classification. In: Proceedings of the 14th Annual Symposium on Computer Applications in Medical Care. Miller RA. (ed). New York: IEEE Computer Society Press; 1990: 161-5.
78 Cimino JJ. Representation of clinical laboratory terminology in the Unified Medical Language System. In: Proceedings of the 15th Annual Symposium on Computer Applications in Medical Care. Clayton PD. (ed). New York: McGraw Hill; 1991: 199-203.
79 Friedman C. The UMLS coverage of clinical radiology. In: Proceedings of the 16th Annual Symposium on Computer Applications in Medical Care. Frisse ME. (ed). New York: McGraw Hill; 1992: 307-16.
80 Huff SM, Warner HR. A comparison of Meta-l and HELP terms: implications for clinical data. In: Proceedings of the 14th Annual Symposium on Computer Applications in Medical Care. Miller RA. (ed). New York: IEEE Computer Society Press; 1990: 166-9.
81 Zielstorff RD, Cimino C, Barnett GO, Hassan L, Blewett DR. Representation of nursing terminology in the UMLS Metathesaurus: a pilot study. In: Proceedings of the 16th Annual Symposium on Computer Applications in Medical Care. Frisse ME. (ed). New York: McGraw Hill; 1992: 392-6.
82 Sato L, McClure RC, Rouse RL, Schatz CA, Greenes RA. Enhancing the Metathesaurus with clinically relevant concepts: anatomic representations. In: Proceedings of the 16th Annual Symposium on Computer Applications in Medical Care. Frisse ME. (ed). New York: McGraw Hill; 1992: 388-91.
83 SchwartZ MF, Emtage A, Kahle B, Neuman BC. A comparison of Internet resource discovery approaches. Comput Systems 1992; 5: 461-93.