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Many major medical ontologies go through a regular (bi-annual, monthly, etc.) release cycle. A new release will contain corrections to the previous release, as well as genuinely new concepts that are the result of either user requests or new developments in the domain. New concepts need to be placed at the correct place in the ontology hierarchy. Traditionally, this is done by an expert modeling a new concept and running a classifier algorithm. We propose an alternative approach that is based on providing only the name of a new concept and using a Convolutional Neural Network-based machine learning method. We first tested this approach within one version of SNOMED CT and achieved an average 88.5% precision and an F1 score of 0.793. In comparing the July 2017 release with the January 2018 release, limiting ourselves to predicting one out of two or more parents, our average F1 score was 0.701.

The purpose of the Big Data to Knowledge (BD2K) initiative is to develop methods for discovering new knowledge from large amounts of data. However, if the resulting knowledge is so large that it resists comprehension, referred to here as Big Knowledge (BK), how can it be used properly and creatively? We call this secondary challenge, Big Knowledge to Use (BK2U). Without a high-level mental representation of the kinds of knowledge in a BK knowledgebase, effective or innovative use of the knowledge may be limited. We describe summarization and visualization techniques that capture the big picture of a BK knowledgebase, possibly created from Big Data. In this research, we distinguish between assertion BK and rule-based BK and demonstrate the usefulness of summarization and visualization techniques of assertion BK for clinical phenotyping. As an example, we illustrate how a summary of many intracranial bleeding concepts can improve phenotyping, compared to the traditional approach. We also demonstrate the usefulness of summarization and visualization techniques of rule-based BK for drug–drug interaction discovery.

The UMLS contains terms from many sources. Every update of a source requires reintegration. Each new term needs to be assigned to a preexisting UMLS concept, or a new concept must be created. Whenever the integration process unnecessarily creates a new concept, this is undesirable. We report on a method to detect such undesirable duplicate concepts. Terms are removed from the UMLS and reintegrated using "piecewise synonym generation." The concept of the reintegrated term is programmatically compared to the initial concept of the term (before removal). If they are different, this indicates an error, either in the integration process or in the initial concept. Thus, such a term-concept pair is deemed suspicious. A study of five hierarchies of the SNOMED found 7.7% suspicious matches. A human expert needs to evaluate the correctness of suspicious concepts. In a sample of 149 of those, 19% of concepts were found to be duplicates.

Concepts whose terms are of a similar word structure are expected to have similar logical representations. Anecdotal examples from SNOMED CT indicate that this may not always be the case. An investigation into the extent of inconsistent modeling in SNOMED CT hierarchies is carried out. A lexical methodology is used to identify sets of similar concepts. It is applied to one of the most attribute-rich hierarchies, Procedure, from which a random sample of 60 sets is derived. These sets are examined in regard to hierarchical, definitional, attribute, attribute/value, and role-group aspects. Thirty percent of the sample sets were found to have at least one type of modeling inconsistency. Their presence may interfere with the performance of terminology-driven applications. With the use of SNOMED expanding, such inconsistencies may eventually affect clinical care. Due to this, external auditing should be encouraged to identify such issues and complement IHTSDO's efforts.