Development of an ontology to characterize mental functioning

Abstract

Purpose of the article

This article describes a conceptual and methodological approach to integrating functional information into an ontology to categorize mental functioning, which to date is an under-developed area of classification, and supports our work with the United States (U.S.) Social Security Administration (SSA).

Design and Methodological procedures

Conceptualizing and defining mental functioning was paramount to develop natural language processing (NLP) tools to support our use case. The International Classification of Functioning, Disability, and Health (ICF) was the framework used to conceptualize mental functioning at the activities and participation level in clinical records. To address challenges that arose when applying the ICF as to what should or should not be classified as mental functioning, a mental functioning domain ontology was developed that rearranged, reclassified and incorporated all ICF key components, concepts, classifications, and their definitions.

Conclusions

Challenges emerged in the extent to which we could directly align components in the ICF into an applied ontology of mental functioning. These conceptual challenges required rearrangement of ICF components to adequately support our use case within the social security disability determination process. Findings also have implications to support future NLP efforts for behavioral health outcomes and policy research.

IMPLICATIONS FOR REHABILITATION

• Mental functioning in everyday life is an important area of inquiry from the perspectives of public health, health policy, healthcare, and overall individual level health and well-being.

• A domain ontology of mental functioning that defines concepts and their relationships, and provides a common terminology with definitions, would enable interdisciplinary communication, research, and collaboration.

• A clearer conceptual model of mental functioning can improve the development of software that can identify, codify, and organize mental functioning information within clinical records into data that can be analyzed.

• The International Classification of Functioning, Disability and Health was utilized to conceptualize mental functioning and to guide the development of a proposed domain ontology of mental functioning.

Keywords:

• clinical informatics
• international classification of functioning, disability and health
• mental functioning
• mental health
• ontology

Acknowledgements

The authors thank our colleagues in the NIH, Rehabilitation Medicine Department, Section of Epidemiology and Biostatistics, and external collaborators who have contributed to discussions concerning this paper and its development. We thank and acknowledge Drs. Beth Marfeo and Howard Goldman who provided an in-dept review, conceptual discussions, and editing.

Disclosure statement

All authors, Maryanne Sacco, Guy Divita, and Elizabeth Rasch report no conflicts of interest.

Additional information

Funding

This research was supported by the Intramural Research Program of the National Institutes of Health, Clinical Research Center.