Axiomatizing SNOMED CT Disorders: Should There Be Room for Interpretation?

SNOMED CT is a large -based terminology designed according to epistemic, semantic and pragmatic principles relevant to clinicians. Its goal is structured clinical reporting in electronic healthcare records (EHRs). The Basic Formal Ontology (BFO) is an ontology designed on the basis of claimed to exist in reality based on a domain-independent ontological theory. Its goal is faithful representation of reality within that theory. The Ontology for General Medical Science (OGMS) extends the BFO by providing definitions for types relevant within the clinical domain. Combining SNOMED CT with the ontological rigor of BFO and OGMS might improve clinical reporting by, f.i., preventing data entry mistakes and inconsistencies, and make EHRs more comparable. To that end, we are developing a framework capable of exploiting what SNOMED CT offers and realism-based ontologies such as the BFO and the OGMS by means of bridging axioms compatible with the BFO, and expressed in the same CLIF-dialect as used in its axiomatization in first order logic. In this paper, we report on our attempts to detect in the combinations of binary relations that are used in the definition of SNOMED CT's definitions of disorder concepts patterns which might at least partially automate the construction of such axioms. Our findings suggest that this partial automation is indeed possible, but to a smaller extent than we had hoped for. We compare our approach with a recent proposal that seeks to bring SNOMED CT and BFO closer together by reinterpreting SNOMED CT disorders as clinical occurrents. The proposal has its merit in providing a realist underpinning for that part of SNOMED CT's concept model in terms of the BFO, but is not discriminatory enough for an automatic translation into OGMS. Key problem is the lack of face validity of SNOMED CT disorder terms as compared to the formal definitions they are given and this in absence of textual definitions.