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Holger Stenzhorn

    Holger Stenzhorn

    Abstract: The desideratum of semantic interoperability has been intensively discussed in medical informatics circles in recent years. Originally it was assumed by many that this issue could be addressed simply by insisting on the... more
    Abstract: The desideratum of semantic interoperability has been intensively discussed in medical informatics circles in recent years. Originally it was assumed by many that this issue could be addressed simply by insisting on the application of shared clinical terminologies. More recently however the use of the term 'ontology'has been steadily growing. We here address the issue of the degree to which the use of ontologies represents any real advance on the road to semantic interoperability. Keywords: Clinical Ontologies, Knowledge ...
    In any real–world application scenario, natural language gen-eration (NLG) systems have to employ grammars consisting of tremendous amounts of rules. Detecting and fixing errors in such grammars is therefore a highly tedious task. In this... more
    In any real–world application scenario, natural language gen-eration (NLG) systems have to employ grammars consisting of tremendous amounts of rules. Detecting and fixing errors in such grammars is therefore a highly tedious task. In this work we present a data mining ...
    Quality assurance and audit issues play a major role in maintening large biomedical terminology, such as SNOMED CT. Several automatized techniques have been proposed to facilitate the identification of weak spots and suggest adequate... more
    Quality assurance and audit issues play a major role in maintening large biomedical terminology, such as SNOMED CT. Several automatized techniques have been proposed to facilitate the identification of weak spots and suggest adequate improvements.In this study, we address a well-known issue within SNOMED CT: Albeit the wording of many free-text concept descriptions suggests a connection to other concepts, they are often not referred to in the logical concept definition.To detect such inconsistencies, we use a semantic indexing approach which maps free text onto a sequence of semantic identifiers. Applied to SNOMED CT concepts without attributes, our technique spots refinable concepts and suggests appropriate attributes, i.e., connections to other concepts. Based on a manual analysis of random samples, we estimate that approximately 18,000 refinable concepts can be found.
    Introduction The pharmaceutical industry has historically focused on the development of novel blockbuster drugs. There is now an increasing focus on personalized medicines, requiring the right patients to receive the right drug at the... more
    Introduction The pharmaceutical industry has historically focused on the development of novel blockbuster drugs. There is now an increasing focus on personalized medicines, requiring the right patients to receive the right drug at the right dose. In order to develop a tailored drug, ...
    ICBO: International Conference on Biomedical Ontology July 24-26, 2009▪ Buffalo, New York, USA Towards an Ontology of Biomedical Educational Objectives Martin Boeker, Holger Stenzhorn, Felix Balzer, Stefan Schulz Freiburg University... more
    ICBO: International Conference on Biomedical Ontology July 24-26, 2009▪ Buffalo, New York, USA Towards an Ontology of Biomedical Educational Objectives Martin Boeker, Holger Stenzhorn, Felix Balzer, Stefan Schulz Freiburg University Medical Center, Freiburg i. Br., ...
    The challenges regarding seamless integration of distributed, heterogeneous and multilevel data arising in the context of contemporary, post-genomic clinical trials cannot be effectively addressed with current methodologies. An urgent... more
    The challenges regarding seamless integration of distributed, heterogeneous and multilevel data arising in the context of contemporary, post-genomic clinical trials cannot be effectively addressed with current methodologies. An urgent need exists to access data in a uniform manner, to share information among different clinical and research centers, and to store data in secure repositories assuring the privacy of patients. Advancing Clinico-Genomic Trials (ACGT) was a European Commission funded Integrated Project that aimed at providing tools and methods to enhance the efficiency of clinical trials in the -omics era. The project, now completed after four years of work, involved the development of both a set of methodological approaches as well as tools and services and its testing in the context of real-world clinico-genomic scenarios. This paper describes the main experiences using the ACGT platform and its tools within one such scenario and highlights the very promising results obt...
    Zusammenfassung: In der biomedizinischen Forschung werden besonders in den letzten Jahren vermehrt enorme Mengen an neuen Daten produziert und diese in Folge verstärkt per Internet veröffentlicht. Viele Experten sehen in dieser... more
    Zusammenfassung: In der biomedizinischen Forschung werden besonders in den letzten Jahren vermehrt enorme Mengen an neuen Daten produziert und diese in Folge verstärkt per Internet veröffentlicht. Viele Experten sehen in dieser Vorge-hensweise die Chance zur ...
    ABSTRACT Improving the initial diagnosis and the assessment of response to treatment in malignant gliomas, while avoiding invasive methods as much as justifiable, is one major aspect actual research is focusing on. Imaging studies are... more
    ABSTRACT Improving the initial diagnosis and the assessment of response to treatment in malignant gliomas, while avoiding invasive methods as much as justifiable, is one major aspect actual research is focusing on. Imaging studies are used to calculate tumor volume and define vital, necrotic and cystic areas within a tumor. Though the visual interpretation of magnetic resonance (MR) images is based on qualitative observation of variation in signal intensity, a correlation of signal intensities with histological features of a tumor is not possible. Better methods are needed for a reliable interpretation of follow-up studies in single patients. Histograms of signal intensities might serve as a method adding quantitative data to the description of a tumor. Using DoctorEye software, tumors can be easily rendered and histograms of the signal intensities within a tumor as well as mean and median signal intensities are possible to calculate. Our results in glioblastoma suggest that these histograms are an innovative method of gaining new tumor-specific information without performing additional investigations in a patient. It can be an additional diagnostic tool in differentiating various intracranial lesions from each other, as well as in assessing response to treatment or progression of malignant glioma.
    In this paper we present XtraGen, a XML-and Java-based software system for the flexible, real-time generation of natural language that is easily inte-grated and used in real-world applications. We de-scribe its grammar formalism and... more
    In this paper we present XtraGen, a XML-and Java-based software system for the flexible, real-time generation of natural language that is easily inte-grated and used in real-world applications. We de-scribe its grammar formalism and implementation in detail, depict ...
    Clinical documentation needs to be fine-grained to truthfully represent the history, development, and treatment of a patient. But natural language, as the main inform ation carrier, is characterized by many issues, like idiosyncratic... more
    Clinical documentation needs to be fine-grained to truthfully represent the history, development, and treatment of a patient. But natural language, as the main inform ation carrier, is characterized by many issues, like idiosyncratic terminology, spelling and grammar errors, and a l ack of gra mmatical structure. Therefore coding systems, like ICD-10, have been introduced, but their use varies highly among
    Abstract: The desideratum of semantic interoperability has been intensively discussed in medical informatics circles in recent years. Originally it was assumed by many that this issue could be addressed simply by insisting on the... more
    Abstract: The desideratum of semantic interoperability has been intensively discussed in medical informatics circles in recent years. Originally it was assumed by many that this issue could be addressed simply by insisting on the application of shared clinical terminologies. More recently however the use of the term 'ontology'has been steadily growing. We here address the issue of the degree to which the use of ontologies represents any real advance on the road to semantic interoperability.
    The challenge of modelling cancer presents a major opportunity to improve our ability to reduce mortality from malignant neoplasms, improve treatments and meet the demands associated with the individualization of care needs. This is the... more
    The challenge of modelling cancer presents a major opportunity to improve our ability to reduce mortality from malignant neoplasms, improve treatments and meet the demands associated with the individualization of care needs. This is the central motivation behind the ContraCancrum project. By developing integrated multi-scale cancer models, ContraCancrum is expected to contribute to the advancement of in silico oncology through the optimization of cancer treatment in the patient-individualized context by simulating the response to various therapeutic regimens. The aim of the present paper is to describe a novel paradigm for designing clinically driven multi-scale cancer modelling by bringing together basic science and information technology modules. In addition, the integration of the multi-scale tumour modelling components has led to novel concepts of personalized clinical decision support in the context of predictive oncology, as is also discussed in the paper. Since clinical adapt...
    We present an information system, which was developed within the project MIETTA (Multilingual Information Extraction for Tourism and Travel Assistance), a project in the Language Engineering Sector of the Telematics Application Program of... more
    We present an information system, which was developed within the project MIETTA (Multilingual Information Extraction for Tourism and Travel Assistance), a project in the Language Engineering Sector of the Telematics Application Program of the European Commission. MIETTA facilitates multilingual information access in a number of languages (English, Finnish, French, German, Italian) to the tourist information (web documents and database information)
    Clinical Trial Management Systems promise to help researchers in managing the large amounts of data occurring in clinical trials. In such systems Case Report Forms for capturing all patient data can usually be defined freely for a given... more
    Clinical Trial Management Systems promise to help researchers in managing the large amounts of data occurring in clinical trials. In such systems Case Report Forms for capturing all patient data can usually be defined freely for a given trial. But if database definitions are automatically derived from such trial-specific definitions then the collected data cannot be easily compared to or integrated into other trials. We address this interoperability issue with an approach based on ontology and semantic data mediation. This resulted in the development of the ObTiMA system which is composed of a component for setting-up clinical trials and another for handling patient data during trials. Both components offer data reusability by relying on shared concepts defined in an ontology covering the whole cancer care and research spectrum.
    Semantic interoperability is a major desideratum in health care for computer-based documentation and communication through electronic health records. They require structured data ideally represented via standardized information models,... more
    Semantic interoperability is a major desideratum in health care for computer-based documentation and communication through electronic health records. They require structured data ideally represented via standardized information models, e.g., HL7 RIM or openEHR, connected to standardized terminologies or ontologies, e.g., SNOMED CT or LOINC. But since natural language is seen by health professionals as their most natural and effective form
    Classifying biological entities in terms of species and taxa is an important endeavor in biology. But even though many statements within current biomedical ontologies are indeed taxon-dependent, no standard way exists to properly... more
    Classifying biological entities in terms of species and taxa is an important endeavor in biology. But even though many statements within current biomedical ontologies are indeed taxon-dependent, no standard way exists to properly introduce taxon or species information into current ontological architectures. Therefore we discuss various practices to represent such information by applying a biomedical top-level ontology combined with other standard approaches like description logics or the OBO Foundry.
    We present ten principles for clinical ontologies that describe the authors' opinion about what should be understood by the notion of clinical ontologies and what not. In contrast to clinical terminology systems, clinical ontologies... more
    We present ten principles for clinical ontologies that describe the authors' opinion about what should be understood by the notion of clinical ontologies and what not. In contrast to clinical terminology systems, clinical ontologies are considered to be semantic reference systems and for that--first of all--strive to account for the properties of the domain entities themselves and their proper formal definitions--rather than just linking clinical terms together.
    In this paper we present the ongoing development and extension work on BioTop--a top-domain ontology for linking biomedical domain ontologies. We start by making the case for the application of a common ontology to interface independent... more
    In this paper we present the ongoing development and extension work on BioTop--a top-domain ontology for linking biomedical domain ontologies. We start by making the case for the application of a common ontology to interface independent biomedical domain ontologies by introducing a set of more general classes. Then we briefly depict the relation of BioTop to the GENIA ontology as starting point of its initial developement. Afterwards we propose our distinction of ontologies into top, top-domain and domain ones and describe our approach to the integration of the top ontology BFO into BioTop. Then we present our plans to join the OBO and OBO Foundry repository of ontologies and list its admission principles in relation to our ontology. Some actual BioTop interface classes are shown subsequently. We conclude by detailing on some planned BioTop usages in the area of BioNLP and cancer research and show some further intended improvements.
    The application of upper ontologies has been repeatedly advocated for supporting interoperability between domain ontologies in order to facilitate shared data use both within and across disciplines. We have developed BioTop as a... more
    The application of upper ontologies has been repeatedly advocated for supporting interoperability between domain ontologies in order to facilitate shared data use both within and across disciplines. We have developed BioTop as a top-domain ontology to integrate more specialized ontologies in the biomolecular and biomedical domain. In this paper, we report on concrete integration problems of this ontology with the domain-independent Basic Formal Ontology (BFO) concerning the issue of fiat and aggregated objects in the context of different granularity levels. We conclude that the third BFO level must be ignored in order not to obviate cross-granularity integration.
    The @neurIST ontology is currently under development within the scope of the European project @neurIST intended to serve as a module in a complex architecture aiming at providing a better understanding and management of intracranial... more
    The @neurIST ontology is currently under development within the scope of the European project @neurIST intended to serve as a module in a complex architecture aiming at providing a better understanding and management of intracranial aneurysms and subarachnoid hemorrhages. Due to the integrative structure of the project the ontology needs to represent entities from various disciplines on a large spatial and temporal scale. Initial term acquisition was performed by exploiting a database scaffold, literature analysis and communications with domain experts. The ontology design is based on the DOLCE upper ontology and other existing domain ontologies were linked or partly included whenever appropriate (e.g., the FMA for anatomical entities and the UMLS for definitions and lexical information). About 2300 predominantly medical entities were represented but also a multitude of biomolecular, epidemiological, and hemodynamic entities. The usage of the ontology in the project comprises termin...
    Usability testing methods are nowadays integrated into the design and development of health-care software, and the need for usability in health-care information technology (IT) is widely accepted by clinicians and researchers. Usability... more
    Usability testing methods are nowadays integrated into the design and development of health-care software, and the need for usability in health-care information technology (IT) is widely accepted by clinicians and researchers. Usability assessment starts with the identification of specific objectives that need to be tested and continues with the definition of evaluation criteria and monitoring procedures before usability tests are performed to assess the quality of all services and tasks. Such a process is implemented in the p-medicine environment and gives feedback iteratively to all software developers in the project. GCP (good clinical practice) criteria require additional usability testing of the software. For the p-medicine project (www.p-medicine.eu), an extended usability concept (EUC) was developed. The EUC covers topics like ease of use, likeability, and usefulness, usability in trial centres characterised by a mixed care and research environment and by extreme time constra...
    The desideratum of semantic interoperability has been intensively discussed in medical informatics circles in recent years. Originally, experts assumed that this issue could be sufficiently addressed by insisting simply on the application... more
    The desideratum of semantic interoperability has been intensively discussed in medical informatics circles in recent years. Originally, experts assumed that this issue could be sufficiently addressed by insisting simply on the application of shared clinical terminologies or clinical information models. However, the use of the term 'ontology' has been steadily increasing more recently. We discuss criteria for distinguishing clinical ontologies from clinical terminologies and information models. Then, we briefly present the role clinical ontologies play in two multicentric research projects. Finally, we discuss the interactions between these different kinds of knowledge representation artifacts and the stakeholders involved in developing interoperational real-world clinical applications. We provide ontology engineering examples from two EU-funded projects.
    The increasing need for advanced ontology-based knowledge manage- ment in the life sciences is generally being acknowledged but, up until now, the development of biological ontologies lacks adherence to foundational principles of ontology... more
    The increasing need for advanced ontology-based knowledge manage- ment in the life sciences is generally being acknowledged but, up until now, the development of biological ontologies lacks adherence to foundational principles of ontology design. This is particularly true of so-called upp er-level ontologies such as the GENIA ontology which covers biological continuants and has mainly been devised for corpus annotation
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    Clinical documentation needs to be fine-grained to truthfully represent the history, development, and treatment of a patient. But natural language, as the main inform ation carrier, is characterized by many issues, like idiosyncratic... more
    Clinical documentation needs to be fine-grained to truthfully represent the history, development, and treatment of a patient. But natural language, as the main inform ation carrier, is characterized by many issues, like idiosyncratic terminology, spelling and grammar errors, and a l ack of gra mmatical structure. Therefore coding systems, like ICD-10, have been introduced, but their use varies highly among
    In the life sciences, there is an ample need for semantic interoperability of d ata. Thus shared vocabularies are needed for consistently expressing meta data in terms of semantic annotations as well as for querying bibliographic... more
    In the life sciences, there is an ample need for semantic interoperability of d ata. Thus shared vocabularies are needed for consistently expressing meta data in terms of semantic annotations as well as for querying bibliographic information systems. In the past years, lots of highly specialized, yet also fragmented terminolog ies have evolved. However, they lack principled forms of conceptual
    The application of upper ontologies has been repeatedly advocated for to support the interoperability between different domain ontologies for facilitating the shared use of data within and across disciplines. BioTop is an upper domain... more
    The application of upper ontologies has been repeatedly advocated for to support the interoperability between different domain ontologies for facilitating the shared use of data within and across disciplines. BioTop is an upper domain ontology that aims at aligning more specialized biomolecular and biomedical ontologies. The integration of BioTop and the upper ontology Basic Formal Ontology (BFO) is the objective of this study. BFO was manually integrated into BioTop, observing both its free text and formal definitions. BioTop classes were attached to BFO classes as children and BFO classes were reused in the formal definitions of BioTop classes. A description logics reasoner was used to check the logical consistency of this integration. The domain adequacy was checked manually by domain experts. Logical inconsistencies were found by the reasoner when applying the BFO classes for fiat and aggregated objects in some of the BioTop class definitions. We discovered that the definition of those particular classes in BFO was dependent on the notion of physical connectedness. Hence we suggest ignoring a BFO subbranch in order not to hinder cross-granularity integration. Without introducing a more sophisticated theory of granularity, the described problems cannot be properly dealt with. Whereas we argue that an upper ontology should be granularity-independent, we illustrate how granularity-dependent domain ontologies can still be embedded into the framework of BioTop in combination with BFO.

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