Concept dictionary creation and maintenance under resource constraints: lessons from the AMPATH Medical Record System

AMIA Annu Symp Proc. 2007 Oct 11;2007:791-5.


The challenges of creating and maintaining concept dictionaries are compounded in resource-limited settings. Approaches to alleviate this burden need to be based on information derived in these settings. We created a concept dictionary and evaluated new concept proposals for an open source EMR in a resource-limited setting. Overall, 87% of the concepts in the initial dictionary were used. There were 5137 new concepts proposed, with 77% of these proposed only once. Further characterization of new concept proposals revealed that 41% were due to deficiency in the existing dictionary, and 19% were synonyms to existing concepts. 25% of the requests contained misspellings, 41% were complex terms, and 17% were ambiguous. Given the resource-intensive nature of dictionary creation and maintenance, there should be considerations for centralizing the concept dictionary service, using standards, prioritizing concept proposals, and redesigning the user-interface to reduce this burden in settings with limited resources.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Dictionaries, Medical as Topic*
  • HIV Infections / therapy
  • Humans
  • Kenya
  • Medical Records Systems, Computerized*
  • Subject Headings*
  • Vocabulary, Controlled