alt.metadata.health: Ontological Context for Data Use and Integration

Abstract

Increasingly powerful computers and increased emphasis on evidence based decision making are creating a demand for merging and integrating data from different sources into a single data set. The demand for data is outstripping our ability to ensure data integrity, and sometimes analysis is performed on data that are not appropriate for the purposes they are used for. Here we describe problems that arise when data from different sources are merged, and we suggest that one way to add context to data so that users can make informed decisions about their ontological context is through ontology-based metadata. Examples of the problem are taken from health data with emphasis on difficulties in standardizing Emergency Room wait times. We describe eight fields that can be used to capture contextual metadata. These fields are captured using ethnographic methods from users and database stewards who frequently understand precisely how context and institutional usage have shaped interpretation of semantic fields. We argue that attaching a portable archive of ontological context to travel with data—based on information from users and developers—is a means of ensuring that data are integrated and compared in multiple contexts with greater integrity and more robust results.

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FIGURE 1

Notes

  1. 1.

    “Informational continuity reflects the notion that details on past events are available and used to inform current care. Management continuity means that care is clinically consistent over time, that someone is managing the case, or that the management responsibility is efficiently and effectively transferred, and that as a result duplication of procedures and communications are kept to a minimum. Relational continuity means that ongoing patient provider relationships are nurtured in order to bridge healthcare events and create an expectation for future care” (Reid et al. 2004, p.2)

  2. 2.

    Bingham, J. W. (2004, Oct. 29). Director, Health Reports and Analysis Canadian Institute for Health Information. Personal Communication (by e-mail).

  3. 3.

    ER wait time data more often than not are reported in the press without reference to CTAS scores, which reflect how ill a patient is, and hence to what extent they urgently require care. For patients who are not ill at all long wait times are not inappropriate. The frequent failure to include CTAS scores in press coverage of ER wait times reflects an overly simplistic understanding of both the politics of health care and the complexities of data.

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Correspondence to Nadine Schuurman.

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Schuurman, N., Balka, E. alt.metadata.health: Ontological Context for Data Use and Integration. Comput Supported Coop Work 18, 83–108 (2009). https://doi.org/10.1007/s10606-008-9084-5

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Key words

  • data integration
  • data quality
  • health informatics
  • indicators
  • ontology
  • semantic interoperability