Browsing by Subject "Terminology"

Now showing 1 - 3 of 3
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    Breast lesions of uncertain malignant nature and limited metastatic potential: proposals to improve their recognition and clinical management
    (Wiley, 2016-08-16) Rakha, Emad A.; Badve, Sunil; Eusebi, Vincenzo; Reis-Filho, Jorge S.; Fox, Stephen B.; Dabbs, David J.; Decker, Thomas; Hodi, Zsolt; Ichihara, Shu; Lee, Andrew HS.; Palacios, José; Richardson, Andrea L.; Vincent-Salomon, Anne; Schmitt, Fernando C.; Tan, Puay-Hoon; Tse, Gary M.; Ellis, Ian O.; Department of Pathology and Laboratory Medicine, IU School of Medicine
    Breast lesions comprise a family of heterogeneous entities with variable patterns of presentation, morphology and clinical behaviour. The majority of breast lesions are classified traditionally into benign and malignant conditions and their behaviour can, in the vast majority of cases, be predicted with a reasonable degree of accuracy. However, there remain lesions which show borderline features and lie in a grey zone between benign and malignant, as their behaviour cannot be predicted reliably. Defined pathological categorization of such lesions is challenging, and for some entities is recognized to be subjective and include a range of diagnoses, and forms of terminology, which may trigger over- or undertreatment. The rarity of these lesions makes the acquisition of clinical evidence problematic and limits the development of a sufficient evidence base to support informed decision-making by clinicians and patients. Emerging molecular evidence is providing a greater understanding of the biology of these lesions, but this may or may not be reflected in their clinical behaviour. Herein we discuss some breast lesions that are associated with uncertainty regarding classification and behaviour, and hence management. These include biologically invasive malignant lesions associated with uncertain metastatic potential, such as low-grade adenosquamous carcinoma, low-grade fibromatosis-like spindle cell carcinoma and encapsulated papillary carcinoma. Other lesions of uncertain malignant nature remain, such as mammary cylindroma, atypical microglandular adenosis, mammary pleomorphic adenoma and infiltrating epitheliosis. The concept of categories of (1) breast lesions of uncertain malignant nature and (2) breast lesions of limited metastatic potential are proposed with details of which histological entities could be included in each category, and their management implications are discussed.
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    Enhancing narrative clinical guidance with computer-readable artifacts: Authoring FHIR implementation guides based on WHO recommendations
    (Elsevier, 2021) Shivers, Jennifer; Amlung, Joseph; Ratanaprayul, Natschja; Rhodes, Bryn; Biondich, Paul; Herron School of Art and Design
    Introduction: Narrative clinical guidelines often contain assumptions, knowledge gaps, and ambiguities that make translation into an electronic computable format difficult. This can lead to divergence in electronic implementations, reducing the usefulness of collected data outside of that implementation setting. This work set out to evolve guidelines-based data dictionaries by mapping to HL7 Fast Health Interoperability Resources (FHIR) and semantic terminology, thus progressing toward machine-readable guidelines that define the minimum data set required to support family planning and sexually transmitted infections. Material and methods: The data dictionaries were first structured to facilitate mapping to FHIR and semantic terminologies, including ICD-10, SNOMED-CT, LOINC, and RxNorm. FHIR resources and codes were assigned to data dictionary terms. The data dictionary and mappings were used as inputs for a newly developed tool to generate FHIR implementation guides. Results: Implementation guides for core data requirements for family planning and sexually transmitted infections were created. These implementation guides display data dictionary content as FHIR resources and semantic terminology codes. Challenges included the use of a two-dimensional spreadsheet to facilitate mapping, the need to create FHIR profiles and resource extensions, and applying FHIR to a data dictionary that was created with a user interface in mind. Conclusions: Authoring FHIR implementation guides is a complex and evolving practice, and there are limited examples for this groundbreaking work. Moving toward machine-readable guidelines by mapping to FHIR and semantic terminologies requires a thorough understanding of the context and use of terminology, an applied information model, and other strategies for optimizing the creation and long-term management of implementation guides. Next steps for this work include validation and, eventually, real-world application. The process for creating the data dictionary and for generating implementation guides should also be improved to prepare for this expanding work.
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    Is a Universal Term for Older Adults Culturally Appropriate? Considering Preferred Terms in Africa
    (Oxford University Press, 2024-12-31) Adamek, Margaret; Ashirifi, Gifty; Adeniji, Dolapo; Teshome, Abraham; School of Social Work
    Terminology matters. For consistency’s sake, one may argue that aging scholars should use one universal term for older adults regardless of what part of the world they are studying. Others may argue that the terms used by scholars in the Global South to refer to older adults should not be dictated by scholars in the Global North. If the term “elder” is a term of respect for older adults in Sub-Saharan Africa, should African scholars writing about aging be required to use the preferred term of the Global North? Can a universal term for older adults be culturally appropriate globally? With such questions in mind, we conducted a mixed methods study of preferred terms for older adults. Respondents included 78 African scholars and practitioners who completed an online survey. For this study we analyzed responses of 13 scholars from 6 African nations who participated in online focus groups. Using descriptive narrative analysis, our results indicate a wide variety of preferred terms for older adults including elder (Ethiopia), elderly, senior citizen, seniors, pensioners, and golden agers (Malawi). Many terms for older adults exist in local dialects—some connoting respect for elders, others that are derogatory. Respondents indicated older Africans prefer terms that convey respect, honor, and endearment. In scholarly dissemination efforts, we recommend a balanced approach with a universal term such as older adults for international audiences and yet leeway for native scholars to use the term for older people (e.g., “elder”) that is a best fit for their culture.