THE BASES OF KNOWLEDGE ARE TAXONOMY, CLASSIFICATION AND MEASURMENT

I seem to be in disagreement with some of my colleagues about the importance of standards, taxonomy and measurement as underlying requirements for the application of “Knowledge for Development”. Take for example the following organization:

The InterNational Committee for Information Technology Standards
INCITS is, according to its website, "the primary U.S. focus of standardization in the field of Information and Communications Technologies (ICT), encompassing storage, processing, transfer, display, management, organization, and retrieval of information. As such, INCITS also serves as ANSI's (American National Standards Institute's) Technical Advisory Group for ISO/IEC Joint Technical Committee 1. JTC 1 is responsible for International standardization in the field of Information Technology." The website provides many resources relevant to ICT standards.

I assume that everyone interested in the topic of Knowledge for Development knows that the Internet is made possible by widely used standards that allow computers to connect to networks, and networks to interchange data. Without these standards and others of concern to INCITIS, we would not be seeing a World Summit on the Information Society, or even having a blog on Knowledge for Development.

Look at some of the other institutions involved in standards that are important resources for building knowledge economies in developing nations:

The American National Standards Institute

The Office of International Affairs of the U.S. National Institute of Standards and Technology

The International Standards Organization

In may days as a health planner, I discovered that large numbers of people seeing a doctor on an outpatient basis never had their disease fully diagnosed. A lot of health problems clear up without medical help, and a lot are treated in a generic basis with requiring a detailed diagnosis. Moreover, different doctors may give different diagnoses for the same patient with the same presenting conditions. One of the most common diagnoses where I worked was GADEJO, or (cleaned up), “the desire to take off work”.

The situation was improving all those many years ago, and an important function of the World Health Organization was developing, maintaining and publishing the international classification of diseases, and harmonizing disease reporting systems among nations.

Now with the desire to create large scale health data bases, and to exchange medical records more consistently, a number of organizations are confronting the need for better classification systems. See for example:

The Clinical Data Interchange Standards Consortium
CDISC is an open, multidisciplinary, non-profit organization committed to the development of industry standards to support the electronic acquisition, exchange, submission and archiving of clinical trials data and metadata for medical and biopharmaceutical product development. The mission of CDISC is to lead the development of global, vendor-neutral, platform independent standards to improve data quality and accelerate product development in our industry.

MedDRA
This is the webpage of the Eudra Vigilance website that deals with MedDRA. MedDRA is the Medicinal Dictionary for Regulatory Activities. It has been developed as a clinically validated international medical terminology for regulatory authorities. MedDRA is also used in the regulated pharmaceutical industry for data entry, retrieval, evaluation and presentation during all phases of the regulatory process, from pre- to post- marketing phases. These processes include clinical studies, reports of spontaneous adverse reactions, events, regulatory submissions and regulated product information.

SNOMED Clinical Terms
SNOMED Clinical Terms® (SNOMED CT®) is a comprehensive and precise clinical reference terminology that health care providers, health care information technology suppliers, providers, payers, purchasers and institutional researchers can use to improve the comparability of data. It provides a common language that makes health care information accessible and usable, whenever and wherever it is needed, to improve health care across primary and specialty medicine settings internationally. Government entities and healthcare organizations in over 30 countries have adopted SNOMED CT since its release in January 2002.

Logical Observation Identifiers Names and Codes (LOINC®)
The purpose of the LOINC database is to facilitate the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research. Currently, most laboratories and other diagnostic services use HL7 to send their results electronically from their reporting systems to their care systems. However, most laboratories and other diagnostic care services identify tests in these messages by means of their internal and idiosyncratic code values. Thus, the care system cannot fully "understand" and properly file the results they receive unless they either adopt the producer's laboratory codes (which is impossible if they receive results from multiple sources), or invest in the work to map each result producer's code system to their internal code system. LOINC codes are universal identifiers for laboratory and other clinical observations that solve this problem.

Health Level Seven
Health Level Seven is one of several American National Standards Institute (ANSI) accredited Standards Developing Organizations (SDOs) operating in the healthcare arena. Most SDOs produce standards (sometimes called specifications or protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance (claims processing) transactions. Health Level Seven’s domain is clinical and administrative data. Its mission is: "To provide standards for the exchange, management and integration of data that support clinical patient care and the management, delivery and evaluation of healthcare services. Specifically, to create flexible, cost effective approaches, standards, guidelines, methodologies, and related services for interoperability between healthcare information systems."

Thus in the health field, there is a major effort under way to standardize definitions of terms, and to find ways to assure the quality of information produced using these terms. These efforts will make epidemiological statistics a lot more meaningful – as health systems increasingly report their information according to defined standards, with increasingly carefully planned categories of reporting.

I would be willing to bet that similar efforts are under way in many fields. And in many fields as a result statistics will become much better sources of knowledge that can be applied for social and economic development and for the reduction of poverty.

I would also note that it is not always easy to evaluate whether or not a thing observed is an instance of a given category of things. Perhaps a table is easy to identify as a table, but to identify a contaminated food item as an instance of a particular kind of contamination, or to identify a polluted piece of soil as an example of a specific kind of pollution event may not be so easy. One important resource that could be used to help developing countries carry out such determinations is:

AOAC International
“As the ‘Association of Analytical Communities,’ AOAC INTERNATIONAL is committed to be a proactive, worldwide provider and facilitator in the development, use, and harmonization of validated analytical methods and laboratory quality assurance programs and services. AOAC also serves as the primary resource for timely knowledge exchange, networking, and high-quality laboratory information for its members.”

The point is that it is important to have good, widely accepted taxonomies. It is important to have clear means of classifying items according to these taxonomies. And it is important to have the scientific and technological capacity to use these means well. Without such infrastructure, “knowledge for development” approaches will be crippled. And consequently, it is important that the resources available to develop this infrastructure be recognized by people in developing nations, and their importance appreciated.