Heterogeneous but "standard" coding systems for adverse events: Issues in achieving interoperability between apples and oranges

Contemp Clin Trials. 2008 Sep;29(5):635-45. doi: 10.1016/j.cct.2008.02.004. Epub 2008 Mar 5.


Monitoring adverse events (AEs) is an important part of clinical research and a crucial target for data standards. The representation of adverse events themselves requires the use of controlled vocabularies with thousands of needed clinical concepts. Several data standards for adverse events currently exist, each with a strong user base. The structure and features of these current adverse event data standards (including terminologies and classifications) are different, so comparisons and evaluations are not straightforward, nor are strategies for their harmonization. Three different data standards - the Medical Dictionary for Regulatory Activities (MedDRA) and the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) terminologies, and Common Terminology Criteria for Adverse Events (CTCAE) classification - are explored as candidate representations for AEs. This paper describes the structural features of each coding system, their content and relationship to the Unified Medical Language System (UMLS), and unsettled issues for future interoperability of these standards.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adverse Drug Reaction Reporting Systems*
  • Biomedical Research*
  • Clinical Trials as Topic
  • Forms and Records Control / methods*
  • Human Experimentation
  • Humans
  • Medical Informatics Computing
  • Medical Record Linkage
  • Medical Records Systems, Computerized
  • Systematized Nomenclature of Medicine*
  • Terminology as Topic
  • Unified Medical Language System*
  • Vocabulary, Controlled