Comparison of terminology mapping methods for nursing wound care knowledge representation.

Background: Standardized clinical terminologies are increasingly used to design and support advanced information systems. In order to examine the representativeness of these terminologies for different professional groups or clinical areas, researchers may perform different methods of terminology mapping.
Objective: The purpose of this study was to evaluate the ability of four mapping methods to identify concepts related to wound care in SNOMED CT.
Methods: A class diagram of 107 concepts was developed to represent the nursing context of wound assessment, wound diagnosis, and goal of care for wound management. All concepts were mapped to SNOMED CT and identified as a direct match, a one-to-many match, or no match using four mapping methods (manual, automated, comparison, and concordance). The manual, automated and comparison methods produced candidate lists of SNOMED CT concepts, which were then used by two nursing wound care experts. The experts completed concordance mapping, which produced the final list. The SNOMED CT concepts from the manual, automated and comparison mappings were compared to the concordance mapping to generate a proportion of representation by each mapping method.
Results: The manual, automated and comparison mappings produced partial lists of unique candidate concept matches not found in the other mapping methods. The concordance mapping produced a final list which included: 43 terms (40%) that had direct matches, 2 terms (2%) that had one-to-many matches, and 62 terms (58%) that had no matches to SNOMED CT. All mapping methods were necessary to achieve the representativeness captured in the final list.
Conclusion: To increase the representativeness of candidate mapping lists, multiple mapping methods and considerations may be necessary.
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