Essay Sample on Systemized Nomenclature of Medicine-Clinical Terms and Diagnostic and Statistical Manual

Introduction

Systemized Nomenclature of Medicine-Clinical Terms (SNOMED CT) refers to a scientifically structured assortment of medical terminologies. Therefore, the systematical organized medical terms provide definitions, synonyms, terms, and codes utilized in clinical reporting and documentation. Consequently, SNOMED CT is regarded as the most inclusive and multilingual healthcare terminologies used universally. Hence, the primary objective of SNOMED CT is to encrypt the health information terminologies required to support effective clinical records meant to improve the patient care services. Similarly, Diagnostic and Statistical Manual of Mental Disorders (DSM), is a diagnostic and taxonomic tool developed by the American Psychiatric Association. The DSM provides standard criteria and common language used in mental disorders classification especially in the United States. However, the DSM usage across the globe varies among the policymakers, pharmaceutical companies, health insurance firms, psychiatric regulation agencies, and clinicians. As a result, the controversy on the DSM usage has resulted in several revisions on the manuals based on psychiatric hospital statistics and census collection systems. Besides, the DSM coding system has been modified in an attempt to correspond with codes used in International Classification of Diseases (ICD). Hence, SNOMED CT and DSM aim at providing reliable electronic records that are vital in enhancing global patient care.

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SNOMED CT Historical Development

In 1965, SNOMED was launched as a Systematized Nomenclature of Pathology (SNOP) that was further modified to be a logic-based medical terminology. Nevertheless, SNOMED CT was developed in 1999 through the restructuring of the Clinical Terms Version 3 (CTV3) and SNOMED Reference Terminology (SNOMED RT) (Lee et al. 89). SNOMED's historical strength was linked with its vast medical specialties coverage. Besides, SNOMED RT had nearly 120,000 common reference concepts that were useful in the pathology healthcare data retrieval and aggregation by various individuals and organizations. Likewise, the CTV3 strength was in its general practice terminologies. For instance, almost 200,000 correlated CTV3 concepts were vital in storing structured patient-based data (Duarte et al. 1343). Currently, SNOMED CT encompasses approximately 311,000 functional concepts. Therefore, the consistent update on the SNOMED CT concepts provides crucial general terms used in maintaining the electronic health records.

In 2003, the National Library of Medicine signed an agreement with the College of American Pathologists to deliver free SNOMEND CT services to the Americans. The United States users used the Unified Medical Language Systems to access either the English and Spanish versions of the SNOMED CT and its regular updates. Similarly, in 2007, the College of American Pathologists transferred the SNOMED CT property rights to the International Health Terminology Development Organization (IHTSDO). According to Lee et al., the IHTSDO had the mandate to promote the usage and adoption of SNOMED CT internationally (94). Therefore, the IHTSDO is liable for the distribution, development, and maintenance of SNOMED CT to enhance universal e-health services.

SNOMED CT Structure

SNOMED CT has four core components. Firstly, the SNOMED CT concept codes are categorized into defined and primitive clinical terms based on numerical codes organized in various hierarchies. Secondly, it has the descriptions on the textual concept codes. Thirdly, the SNOMED CT has interrelated concept codes that are characterized by similar meanings. Finally, the SNOMED CT has reference sets that are used to classify descriptions and concepts into cross-maps linked to other standards and classifications. Therefore, the SNOMED CT codes are representational components that classify all concepts that distinguish the recorded healthcare processes. For instance, roughly 311,000 concepts are identified through their unique concept ID (Duarte et al. 1348). Moreover, all the SNOMED CT components are categorized based on their taxonomic hierarchies. Hence, concepts with numerous parents have a taxonomic structure that records and retrieves data through different aggregation levels. As a result, SNOMED CT components are correlated to almost 1,360,000 links that are used to express the preferred terms among clinicians as the most appropriate way to denote the concepts' meanings.

DSM Historical Development

Most of the American psychiatrists participated in the treatment, assessment, and selection of the soldiers during World War II. Hence, in 1943 Medical 203 was developed but it was later modified by the US Navy before it was adopted by the Armed Forces as the most suitable mental disorder nomenclature. Likewise, in 1949, the World Health Organization incorporated mental disorders for the first time in their 6th International Statistical Classification of Diseases (ICD). Consequently, the American Psychiatric Association (APA) was given the obligation to develop a standard version of the mental disorders to be used within the American jurisdiction. In 1950, a consultation and review process was initiated by the APA Committee. Subsequently, in 1951, the Diagnostic and Statistical Manual of Mental Disorders (DSM-1) was approved and published in 1952 (Blashfield et al. 28). Therefore, The DSM-1 conceptual and structural framework resembled the Medical 203 with almost 106 mental disorders that served as a common reference to the American clinicians.

In1968, DSM-II was published, it comprised nearly 182 disorders. Moreover, DSM-II and DSM-I were characterized by the psychodynamic psychiatry and biological perspectives from Kraepelin's classification system. Similarly, biological and sociological knowledge was incorporated into the DSM-II model although it did not have a precise distinction between abnormality and normality. Consequently, resulting in protests from gay activists that led to the exclusion of homosexuality from DSM-II's disorder list. In 1980, the final DSM-III publication was released. It had nearly 265 diagnostic orders. The DSM-III version was endorsed internationally by various stakeholders due to the psychiatry revolution. Nonetheless, DSM-III was criticized to have catered for about 30% of the global population (Regier et al. 93). Hence, it had an insignificant impact on the medicalization of the mental disorders from a global perspective.

DSM-IV was launched in 1994 with approximately 297 mental disorders. The steering committee conducted several multicenter trials on mental diagnoses to evaluate their clinical results. Therefore, the key changes in DSM-III focused on significant clinical distress, occupational impairment, and social distress in most of the mental disorders. Furthermore, the DSM-IV-TR was released in 2000 to give additional information on every disorder and ensure that the DSM diagnostic codes were consistent with the ICD codes. Finally, in May 2013, DSM-5 was published. The prominent alterations in DSM-5 were the elimination of the schizophrenia subtypes, Asperger syndrome reconceptualization, and the exclusion of the axis system (Blashfield et al. 39). However, a majority of the health critics claimed that most of the DSM-5 revisions lacked empirical evidence. Hence, the DSM classification updates outline the clinical recommendations under its various versions that have had a significant impact on the mental disorder treatment.

DSM-5 diagnostic Classification

The DSM diagnostic classification varies among its different publications especially DSM-IV and DSM-5. Despite the inclusion and exclusion of various mental disorders in DSM-5, it is the most recent DSM publication that most clinicians should use. For instance, the neurodevelopmental disorders incorporated motor disorders that encompassed tic disorders, stereotypic movement disorder, and developmental coordination disorder. Additionally, all the schizophrenia spectrum disorders such as catatonic and paranoid were excluded from the psychotic disorders (Regier et al. 96). Nonetheless, the delusional disorder was merged with the shared delusional disorder. Finally, bereavement was excluded from depressive disorders while the disruptive mood dysregulation disorder was incorporated the dominant distress among teenagers. Moreover, premenstrual dysphoric disorder and dysthymia were acknowledged as the new depressive disorder. Therefore, the DSM alterations aim at providing consistent and reliable disorder diagnostic classification.

Conclusion

SNOMED CT contains systematical health terminologies that provide codes, synonyms, and terms that are crucial in clinical documentation. Likewise, DSM offers standardized criteria and common language that is used to classify the mental disorders. Additionally, the DSM publications and SNOMED CT versions have been modified regularly to ensure their diagnostic codes and classifications on each disorder are consistent with the ICD codes and concepts. Therefore, the numerous revisions on the DSM and SNOMED CT are fundamental in ensuring that they provide reliable e-health records that will enhance global patient care on various mental disorders.

Works Cited

Blashfield, Roger K. et al. "The Cycle of Classification: DSM-I through DSM-5". Annual Review of Clinical Psychology, vol 10, no. 1, 2014, pp. 25-51. Annual Reviews, doi: 10.1146/annurev-clinpsy-032813-153639.

Duarte, Julio et al. "Improving Quality of Electronic Health Records With SNOMED". Procedia Technology, vol 16, 2014, pp. 1342-1350. Elsevier BV, doi:10.1016/j.protcy.2014.10.151.

Lee, Dennis et al. "A Survey of SNOMED CT Implementations". Journal of Biomedical Informatics, vol 46, no. 1, 2013, pp. 87-96. Elsevier BV, doi:10.1016/j.jbi.2012.09.006.

Regier, Darrel A. et al. "The DSM-5: Classification and Criteria Changes". World Psychiatry, vol 12, no. 2, 2013, pp. 92-98. Wiley, doi:10.1002/wps.20050.