Medical data standards: Controlled terminology for clinically-relevant indexing and selective retrieval of biomedical images

Existing clinical nomenclatures do not provide comprehensive, detailed coverage for multispecialty biomedical imaging. To address clinical needs in this area, the College of American Pathologists (CAP), secretariat of the Systematized Nomenclature of Human and Veterinary Medicine (SNOMED), has entered into partnership with the DICOM (Digital Imaging and Communications in Medicine) Standards Committee, the American College of Radiology, the American Dental Association, the American Academy of Ophthalmology, the American Society for Gastrointestinal Endoscopy, the American Academy of Neurology, the American Veterinary Medical Association, and other professional specialty organizations to develop the controlled terminology that is needed for diagnostic imaging applications. Terminology development is coordinated with ongoing development and maintenance of the DICOM Standard. SNOMED content is being enhanced in two general areas: 1) imaging procedure descriptions and 2) diagnostic observations. The SNOMED DICOM Microglossary (SDM) has been developed to provide context-dependent value sets (SDM Context Groups) for DICOM coded-entry data elements, and semantic content specifications (SDM Templates) for reports and other structures composed of multiple data elements. The capability of storing explicitly-labeled coded descriptors from the SDM in DICOM images and reports improves the potential for selective retrieval of images and related information. A pilot test of distributed multispecialty terminology development using a World Wide Web (WWW) application was performed in 1997, demonstrating the feasibility of large-scale distributed development of SDM terminology.