Sunday, December 4, 2022

A Translational research project to hold all current projects in Medicine department : creating a dynamic user driven ontology toward improved medical cognition

This meta project has rapidly evolved from humble beginnings in just listing different areas one may work on in our field of interest (shared earlier here : https://medicinedepartment.blogspot.com/2022/06/linking-students-to-our-departmental.html?m=0) toward developing improved medical cognition to actually trying to cover all major areas of Medicine that need medical cognition tools. 


For our past sharings around medical cognition and it's tools please read more here : https://userdrivenhealthcare.blogspot.com/2022/10/medical-cognition-tools-to-resolve.html?m=0

Translational research in medicine is an area that is still developing through the last few decades and it requires the integration of knowledge using heterogeneous data from health care to the life sciences so that one may be able to translate bedside patient requirements into solutions from the bench. Over the last decade there have been attempts to create a Translational Medicine Ontology (TMO) as a unifying ontology to integrate chemical, genomic and proteomic data with disease, treatment, and electronic health records and is detailed here : https://jbiomedsem.biomedcentral.com/articles/10.1186/2041-1480-2-S2-S1

One of the commonest natural ways medical education works to creating ontologies in the minds of health professional trainees (natural intelligence), is through their introduction to primer texts in Medicine that contain the must know areas that they have to cover and once they have mastered the must knows they go on adding more and more flesh to this skeleton throughout their lives spent in patient encounters and event driven experiential learning that continues life long. 

So for every medical student and consultant who continues to practice and learn medicine, there are multiple topics and subtopics that they must revisit once in a while in their daily workflow and new learning points are always generated when they find newer questions albeit around similar patients they may have seen earlier particularly around unique ontological relations around those similar patients. 

A word around ontology is in order here :

"Ontology is the theory of objects and their ties. It provides criteria for distinguishing different types of objects (concrete and abstract, existent and nonexistent, real and ideal, independent and dependent) and their ties (relations, dependencies and predication)."

ONTOLOGY. From onto-logos, the science of being. A surprisingly late coinage. The Latin term ontologia was felicitously invented in 1607"


Every medical student may remember how important it was to know the relations of every organ in their first introduction to medicine through human anatomy. 
In clinical medicine, "Ontologies are systematic representations of knowledge that can be used to integrate and analyze large amounts of heterogeneous data, allowing precise classification of a patient." More here : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503847/and please make sure you read their concluding paragraph that talks about the future of ontologies where they hint at it's likelihood of becoming user driven toward case based reasoning although they haven't exactly spelt that out but you can read more about case based reasoning here : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC544898/). 

We were in a dilemma as to which primer to choose to enter all our projects into and a textbook table of contents such as here : https://catalog.lib.uchicago.edu/vufind/Record/10377410/TOC
was the first choice but then a recent tryst with "medicine curriculum requirements" (more here: https://medicinedepartment.blogspot.com/2022/07/cbme-general-medicine-topics-and.html?m=0), has made us choose a topic and subtopic approach delineated in a competency based medical education document prepared by national policy makers (national medical council NMC)  on medical education downloadable freely from their website here : https://www.nmc.org.in/information-desk/for-colleges/ug-curriculum/ 
and we present a skeletal structure of the topics below to eventually add more flesh to it gradually with all our patient centered projects that continues to evolve with the living patients they represent. The topic list below is coded by NMC in a manner that it enables delivery of the curriculum by each lecturer who just needs to key in the topic code covered for the day for the academic administration to keep a tab on what remains to be covered in terms of medical student learning. For a complete list of the NMC codes borrowed from the NMC web page where it's open access click here : https://medicinedepartment.blogspot.com/2022/10/nmc-competency-based-topic-and-subtopic.html?m=0

Eventually as is the nature of a dynamic ontology it will continue to evolve for the individual depending on their context and the idea is to finally create a case based reasoning system that may allow anyone in the world to enter their situation and receive a solution to their current requirements based on their entered situation. 

More about case based reasoning here : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC544898/