{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:22:50Z","timestamp":1771028570525,"version":"3.50.1"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:p>\n            Objective\u2003Numerous attempts have been made to create a standardized \u201cpresenting problem\u201d or \u201cchief complaint\u201d list to characterize the nature of an emergency department visit. Previous attempts have failed to gain widespread adoption as they were not freely shareable or did not contain the right level of specificity, structure, and clinical relevance to gain acceptance by the larger emergency medicine community. Using real-world data, we constructed a presenting problem list that addresses these challenges.<\/jats:p><jats:p>\n            Materials and Methods\u2003We prospectively captured the presenting problems for 180,424 consecutive emergency department patient visits at an urban, academic, Level I trauma center in the Boston metro area. No patients were excluded. We used a consensus process to iteratively derive our system using real-world data. We used the first 70% of consecutive visits to derive our ontology, followed by a 6-month washout period, and the remaining 30% for validation. All concepts were mapped to Systematized Nomenclature of Medicine\u2013Clinical Terms (SNOMED CT).<\/jats:p><jats:p>\n            Results\u2003Our system consists of a polyhierarchical ontology containing 692 unique concepts, 2,118 synonyms, and 30,613 nonvisible descriptions to correct misspellings and nonstandard terminology. Our ontology successfully captured structured data for 95.9% of visits in our validation data set.<\/jats:p><jats:p>\n            Discussion and Conclusion\u2003We present the HierArchical Presenting Problem ontologY (HaPPy). This ontology was empirically derived and then iteratively validated by an expert consensus panel. HaPPy contains 692 presenting problem concepts, each concept being mapped to SNOMED CT. This freely sharable ontology can help to facilitate presenting problem-based quality metrics, research, and patient care.<\/jats:p>","DOI":"10.1055\/s-0039-1691842","type":"journal-article","created":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T23:21:29Z","timestamp":1560381689000},"page":"409-420","source":"Crossref","is-referenced-by-count":17,"title":["Consensus Development of a Modern Ontology of Emergency Department Presenting Problems\u2014The Hierarchical Presenting Problem Ontology (HaPPy)"],"prefix":"10.1055","volume":"10","author":[{"given":"Steven","family":"Horng","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States"},{"name":"Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States"}]},{"given":"Nathaniel R.","family":"Greenbaum","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States"},{"name":"Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States"}]},{"given":"Larry A.","family":"Nathanson","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States"},{"name":"Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States"}]},{"given":"James C.","family":"McClay","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States"}]},{"given":"Foster R.","family":"Goss","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Colorado Hospital, University of Colorado School of Medicine, Aurora, Colorado, United States"}]},{"given":"Jeffrey A.","family":"Nielson","sequence":"additional","affiliation":[{"name":"Northeastern Ohio Medical University, University Hospitals Samaritan Medical Center, Ashland, Ohio, United States"}]}],"member":"194","published-online":{"date-parts":[[2019,6,12]]},"container-title":["Applied Clinical Informatics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1691842.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T23:21:30Z","timestamp":1560381690000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1691842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5]]},"references-count":0,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2019,5,29]]},"published-print":{"date-parts":[[2019,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1691842","relation":{},"ISSN":["1869-0327"],"issn-type":[{"value":"1869-0327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5]]}}}