The Belgian Bilingual
Biclassified Thesaurus
Michel De Jonghe
University of Brussels
Department of General Practice
Introduction
The thesaurus
In 2001, the Ministery of Health asked two
universities (Ghent and Brussels) to make
a thesaurus.
 Obligations :

– Bilingual : Dutch / French
– Must include 2 classifications :
 ICD-10
 ICPC-2
– Information integrity in case of communication of
medical information between two praticians.
Why biclassified ?
In general practice, the patient’s
electronic record requires :
The possibility to analyse the activity in
general practice: ICPC-2
 diagnosis specificity: ICD-10

(combined in one tool: ICPC2-ICD10 thesaurus)
At the same moment :
The labellisation of the medical
software
Obligation of structuration (SOAP and EPR
architecture)
 Use of ICPC and ICD-10
 Use of a medication data bank
 Exportation of personal information :
security and confidentiality

Why a medical software ?

For
 For
 For
 For
the patient
the GP
micro-epidemiology
macro-epidemiology

The aim = quality of health
First point
The structuration
The contact (SOAP)
Subjective :
– Reason for encounter
 Objective :
– Medical examination, laboratories, referrals, …
 Assessment :
– Clinical labelling
 Plan :
– Process, terms

Proposal for Belgian
EPR architecture
7 Basic concepts per patient record
H ea lth C are
E le m e nt
C ontact
1..1
1..1
1..*
H ea lth
A pp roac h
1..*
1..1
1..*
S ubco ntact
1..*
n ..*
H ea lth
A ge nt
1..*
Service
1..1
Integration of all classical
concepts in a simple format
Chronological registration of all services
and diagnoses (hospitalization record)
 SOAP
 List of the problems and list of the
episodes
 Episodes registration

Second point
Important concepts
4 fundamentals definitions
Ordonner des objets
d ’après une structure
et avec un objectif
Classification
e
Nomenclature
Jargon professionnel,
termes, mots
Définition de critères
d ’inclusion
Terminologie
Toutes les entrées et
synonymes avec un ou
plusieurs codes
Thesaurus
The Belgian thesaurus
At the beginning
– Amsterdam (Henk Lamberts)
– 125 000 lines
– Translation from Dutch to French but no link
between the two languages
– DOS (A1 = A2 ; A1 = B+C ; A2 = C+B)
 “Lobular pneumonia” = lobular + pneumonia
 “Lobular pneumonia” = pneumonia +lobular
The thesaurus structure









IBUI = Unique number for identification for each line of the
thesaurus (8 characters)
Clinical labelling_FR = FR_CLINICA
Clinical labelling_NL = NL_CLINICA
ICPC_code
ICPC_labelling
ICD-10_code
ICD-10_labelling
FR_REF_IBUI
NL_REF_IBUI
– +

Search-terms (= relevant words of all the labellings) = other file
Difficulties
Perfect translation from Dutch into French
with respect of the two languages
 Clinical label
 management of double
 Correlation between the clinical labelling
and the ICD-10 labelling
 Correlation between ICD-10 and ICPC-2
(mapping : WICC)

Specificity of the Belgian thesaurus

The REF_IBUI :
– Makes it possible to respect the specificity of
each language (Dutch / FR) :
Fr_CLINICA
Nl_CLINICA
shigellose
à Shigella
sonnei
shigellose
à Shigella
sonnei
Sonne
infectie,
Shigella,
sonnei
Fr_REF_IB Nl_REF_IB IBUI
UI
UI
10091295
10091295
10116328
The validation

The validation of the clinical labelling’s wording
– Via UNINE
(http://taurus.unine.ch:8080/icd10?term=&sel
ect=0#select)

The validation of the choice of the ICD-10 code
– Via UNINE
– 2005 T4 thésau\double non identss manif etio.mdb

The validation of the correlation between
ICD-10 and ICPC-2
– « Traitement de l’information médicale par la
classification internationale des Soins
Primaires CISP-2 (deuxième version) »
– “International classification of Primary Care
ICPC-2-R (revised second edition)”
– Revision from CISP-Club’s members
Exemple 1



Myocardite thyphique :
ICPC-2 : K70 (remplace D70)
ICD-10 : I41.0 (remplace A01.1)
Exemple 2

Intoxication alimentaire par crustacés :

ICD-10 : T61.2 (remplace A05.9). Il
faut noter que aussi bien dans l’intitulé
français que néerlandais, il n’est pas fait
allusion à une infection bactérienne).
The search terms
Words of the FR_CLINICA
 Words of the ICPC label
 Words of the ICD label
 Synonymous terms
 acronyms

Application in a medical
software
PRICARE
Thank you for your
attention
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The Belgian Bilingual Biclassified thesaurus