What is Terminology Binding?
In health information systems, data is often entered within structured contexts such as forms, templates, or EHR fields. The way in which terminology is bound to these data structures has a direct impact on:
What concepts can be entered (i.e., constraining the input)
How entered concepts should be interpreted (i.e., defining their meaning in context)
Terminology bindings are formal links between terminology components (e.g., SNOMED CT concepts, value sets, or expression constraints) and elements of an information model (e.g., fields, templates, or data entry sections).
There are two main types of terminology binding:
Value Set Binding – defines the allowable set of concepts that can be selected or entered in a specific context.
Meaning Binding – specifies how the entered concept should be interpreted within that context.
Value Set Binding vs. Meaning Binding
Definition
A terminology binding that represents the set of permitted values that can be used to populate a coded data item.
A terminology binding that represents the clinical meaning of a data item or collection of data items.
Practical Use in Data Entry Context
To constrain the range of concepts (or expressions) that can be entered in a particular data entry context.
To specify how the meaning of a concept or expression is affected by the data entry context in which it is entered.
Example
To constrain the values entered in a field labeled “Surgical operation” to concepts that represent subtypes of surgical procedures.
To specify that when a “disorder” concept is entered in a family history data entry form, this represents a “family history” of this disorder.
Representation
Each SNOMED CT value set binding should be represented using an expression constraint as specified in the Expression Constraint Language - Specification and Guide.
Each SNOMED CT meaning binding could be represented using a single SNOMED concept.
Example
Value Set Binding
< 387713003 |Surgical procedure (procedure)|A data entry context to which this constraint is applied would only permit the entry of concepts representing surgical procedures.
If a user searches for terms matching “append”, surgical procedure concepts such as:
80146002 | Excision of appendix (procedure)|
174036004 | Emergency appendectomy|
6025007 | Laparoscopic appendectomy (procedure)|
should be available for selection.
However, other concepts with matching terms such as:
74400008 | Appendicitis (disorder)|
47693006 | Rupture of appendix (disorder)|
66754008 | Appendix structure (body structure)|
should not be available in this data entry context.
Meaning Binding
416342005 |Procedure related observable (observable entity)|Summary
Definition
A terminology binding that represents the set of permitted values that can be used to populate a coded data item.
A terminology binding that represents the clinical meaning of a data item or collection of data items.
Purpose in Data Entry
To constrain the range of concepts (or expressions) that can be entered in a particular data entry context.
To specify how the meaning of a concept or expression is affected by the data entry context in which it is entered.
Example Use
Limiting the values in a field labeled “Surgical operation” to concepts that represent subtypes of surgical procedures.
Interpreting a disorder entered in a “Family History” section as a family history of that disorder rather than a diagnosis for the subject of the record.
Representation
Expressed using an expression constraint as defined in the SNOMED CT Expression Constraint Language
Represented using a single SNOMED CT concept that conveys the intended interpretation.
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