Examining SNOMED from the perspective of formal ontological principles: Some preliminary analysis and observations

The Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT) is a terminological resource designed to support electronic applications in health and medicine. Its design has evolved over a period of more than thirty years, and continues to evolve. Recently several authors working on formal ontological theory have observed that applying certain principles and constraints to terminology construction may result in a more consistent and useful terminology. In this paper we report on a preliminary analysis of SNOMED CT by two of its developers, from the perspective of a few such formal ontological principles, giving examples of prior design decisions that appear to be supported by these principles as well as examples of prior design decisions that may be at variance with them. We believe that design changes suggested by formal ontological principles have great potential for improving consistency. Empirical evidence of usefulness should accompany theoretically-inspired moves towards more fine-tuned representations of reality.