Enhancing Clinical Terminology to Enable Precision Mental Healthcare

PROJECT SUMMARY/ABSTRACT The primary, long-term goal of this project is to improve outcomes for people living with mental health conditions by enhancing technologies for semantic representation of mental, behavioral, and social phenomena thereby enabling researchers, clinicians, and consumers to leverage the growing landscape of computational methods and clinical decision support technologies to accelerate the rate of knowledge acquisition and translation. This research will address gaps in both the content and ontological representation of mental, behavioral, and social constructs. Ontologic representations are formal, explicit, computer-readable definitions of the meaning of entities and occurrences in some domain. This research seeks to develop, build, and evaluate high quality, machine-readable semantic models for mental, behavioral, and social processes, findings (signs, symptoms, exposures, disorders), assessment instruments, and interventions. Focusing on two highly important and diverse diagnostic constructs as test cases, borderline personality disorder (BPD) and psychosis, the proposed work will cover a broad and representative sample of clinical constructs, processes, findings, assessment instruments, and interventions that can be applied to many mental health conditions. Data sources include electronic health records, publication metadata, narrative text in published, peer reviewed research, existing terminologies and ontologies, and mental health subject matter experts, including patients and families. Qualitative methods, including focus groups, the Nominal Group Technique (NGT), and Delphi Method will be used to reach consensus about relevant concepts (clinical ideas), terms (clinical labels), definitions, and relationships. Methods and Materials include ontology development methods and software which will be used to physically build machine-readable ontologic models and terms. Models, terms, and definitions created will be evaluated by domain experts, and shared with publishers of widely adopted national and international clinical terminologies. The career development plan will focus on acquiring knowledge and skills in formal terminology development methods, qualitative methods, ontology definition languages, as well as conceptual models of both normative and pathological mental functioning and psychological assessment methods. By creating ontologic models capable of fully expressing the meaning of, and relationships among, mental, behavioral, and social constructs, this project will create a foundation upon which additional clinical findings, disorders, assessments, and interventions for mental, behavioral, and social constructs can be built. The substantial number of terms, concepts, definitions, and relationships created through this study will be published and made available to researchers, clinicians, and health systems for use in knowledge discovery and translation paradigms. This work directly addresses the strategic goal of the National Institute of Mental Health (NIMH) to develop new methods and tools to accelerate discovery and translation of new knowledge in behavioral science.