From Classifications and Coding systems to Ontology: the role of a CEN standard: The categorial structure

The presentation recalls the limits of terminologies of 2 coding systems for surgical interventions: the French CCAM and the Australian international ICHI as assessed by Galen ontology driven tools. Such an ontology associated with natural language processing allows to analyse inconsistencies and ambiguities of natural language expressions when considering the reality of surgical interventions .On the other hand there is an increasing need for international comparisons and cooperation across the most advanced and less developed countries for instance for Electronic Health Record safety , trans border migration of population, case mix and procedure payment et . As no reasonable person is proposing to standardise the linguistic expressiveness of different health care professionals and of the citizens the European Standard Body CEN has developed since 1990 through is Technical committee 251 and its working group 2 an approach named Categorial structure which is presented here with the different application fields. The role of this tool is addressed in relation with ontology. It is proposed not as ontology but as a step to link biomedical terminology to ontology. Such a standard is an easy and provisional condition to evolve from functional to full semantic interoperability which needs a rigorous ontology.