OWL to CTS2 Transformation for Medical Ontology ManagementA framework for transforming Web Ontology Language (OWL) ontologies into Common Terminology Service Release 2 (CTS2) terminology resources to enable temporal version management while preserving semantic richness, supporting the P5 medicine paradigm through machine-readable strategic coordination infrastructure.Submitter's Note: This StratML rendition was compiled from the source by ChatGPT and edited in the XForm at https://stratml.us/forms2/Part2Form.xmlUniversity of Genoa - Biomedical Informatics LaboratoryDIBRIS_9d542fb6-d2e0-11f0-9d4d-f22776babdf6Research laboratory developing interoperability solutions for healthcare information systems in support of personalized, preventive, predictive, participative, precision (P5) medicine.Sara MoraCo-AuthorCo-authored the article on which this plan is basedPerformerRoberta GazzarataCo-AuthorCo-authored the article on which this plan is basedPerformerBernd BlobelCo-AuthorCo-authored the article on which this plan is basedPerformerYlenia MurgiaCo-AuthorCo-authored the article on which this plan is basedPerformerMauro GiacominiCo-AuthorCo-authored the article on which this plan is basedPerformerSalvatore ScaccoEditorEdited the article on which this plan is basedPerformerDomain Ontology DevelopersHealthcare and biomedical researchers who create and maintain domain-specific ontologiesContent ProviderAuthors and maintains medical ontologies requiring temporal trackingPerformerHealthcare Information System IntegratorsOrganizations implementing interoperable health information systemsSolution ImplementerDeploys CTS2-compliant terminology servicesPerformerBeneficiaryP5 Medicine PractitionersHealthcare providers and researchers working in personalized medicine contextsEnd UserBenefits from accurate, versioned medical knowledge representationBeneficiaryEnable transparent coordination of medical knowledge evolution through machine-readable ontologies supporting P5 medicine ecosystems where semantic interoperability facilitates cross-domain collaboration and AI-assisted decision support._9d5431f0-d2e0-11f0-9d4d-f22776babdf6To develop and validate standardized methods for transforming ontological knowledge representations into versioned terminology resources that preserve semantic richness while enabling temporal tracking, supporting evidence-based medicine through rigorous knowledge management infrastructure._9d54338a-d2e0-11f0-9d4d-f22776babdf6Semantic PreservationMaintain the full expressiveness and logical relationships of ontologies during transformation to ensure no loss of domain knowledge.Standards ComplianceAdhere to international standards (ISO 23903, ISO/IEC 10746, ISO 17469 StratML, HL7 CTS2) to ensure interoperability and long-term sustainability.Temporal AccountabilityTrack every change to medical knowledge representations to support evidence evolution, regulatory compliance, and historical analysis.OWL & CTS2Transform OWL Ontologies to CTS2 Terminology Resources_9d5433ee-d2e0-11f0-9d4d-f22776babdf61Establish complete mapping between OWL ontological elements and CTS2 terminology resource components, preserving hierarchical relationships, annotation properties, object properties, and class axioms while enabling service-based access.Classes & EntitiesMap OWL Classes to CTS2 EntityDescriptions_9d543510-d2e0-11f0-9d4d-f22776babdf61.1Create bidirectional mappings for all OWL class elements including direct mappings (SubClassOf to Parent, EquivalentClass to EquivalentEntity) and property-based mappings for annotation and object properties.1.1.1OWL Element CoveragePercentage_9d543574-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_12024-06-30Status95All OWL elements except equivalent classes derived from restrictions mapped to CTS22024-06-3095Successfully mapped all ADO elements except subset with restriction-based equivalent classesPercentage of OWL elements successfully mapped1.1.2Semantic Fidelity_9d543600-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_22024-06-30Complete semantic equivalence verifiedStatusVerified2024-06-30Semantic equivalence verified for mapped elementsValidation StatusVerifiedExpert validation assessmentTransformation PipelineImplement Eight-Step Transformation Pipeline_9d54368c-d2e0-11f0-9d4d-f22776babdf61.2Execute structured process: (1) Create CodeSystem, (2) Create CodeSystemVersion, (3) Create EntityDescription, (4) Update EntityDescription, (5) Create MapCatalogEntry, (6) Create MapVersion, (7) Create MapEntry, (8) Update MapEntry.1.2.1Manual Intervention PointsNumber_9d54372c-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_32024-12-31StatusFully Automated0Pipeline Automation ~ Fully automated transformation from OWL XML to CTS2 resources[To be determined]Number of manual intervention pointsMapping CapabilityValidate Cross-Ontology Mapping Capability_9d5437d6-d2e0-11f0-9d4d-f22776babdf61.3Demonstrate mapping between ADO (Alzheimer's Disease Ontology) and ADA Lab ontology using CTS2 Map structures, establishing reusable patterns for inter-ontology coordination.1.3.1Cross-Ontology LinksNumber_9d543876-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_4Status2024-06-30Created3Proof-of-concept mappings between ADOV1 and AdaLab1 establishedNumber of MapEntry instances createdVersioningEnable Version Management and Temporal Tracking_9d543916-d2e0-11f0-9d4d-f22776babdf62Medical ResearchersScientists conducting longitudinal studies requiring historical concept definitionsHistorical Data ConsumerRequires access to concept definitions as they existed at specific points in timeBeneficiaryImplement CTS2's versioning infrastructure to track evolution of medical ontologies over time, maintaining historical records of concept changes essential for longitudinal research, regulatory compliance, and evidence-based practice.Version ManagementImplement CodeSystemVersion Management_9d54397a-d2e0-11f0-9d4d-f22776babdf62.1Enable creation, updating, and finalization of CodeSystemVersions with temporal metadata (StartDate, EndDate, PublicationDate) supporting immutable versioning once finalized.2.1.1Version State Management_9d5439d4-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_52024-12-31Support OPEN and FINAL states with immutability enforcementStatusSupported[To be determined]EntitiesImplement Entity History Services_9d543a38-d2e0-11f0-9d4d-f22776babdf62.2Deploy CTS2 Entity Description History Service and Map Entry History Service to enable visualization of concept evolution and mapping changes across versions.2.2.1CTS2 History OperationsNumber_9d543a9c-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_62025-06-30StatusImplemented2Entity Description History Service and Map Entry History Service fully operational[To be determined]Number of CTS2 history operations implementedChangesTrack Atomic-Level Changes_9d543b00-d2e0-11f0-9d4d-f22776babdf62.3Maintain change history at individual EntityDescription and MapEntry level, enabling granular tracking superior to whole-CodeSystem versioning approaches.2.3.1Granularity_9d543b6e-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_72025-12-31Single concept history retrieval demonstrably superior to FHIR Terminology Service and Protégé approachesStatusSuperior[To be determined]Comparative assessment vs. alternativesService InterfacesProvide Standardized Service Interfaces for Ontology Management_9d543bdc-d2e0-11f0-9d4d-f22776babdf63Deploy complete CTS2-compliant service architecture supporting Read, Query, Maintenance, and History operations through standardized APIs, enabling interoperable terminology service implementations.HQuantum TechnologyDeploy HQuantum Technology Service_9d543c4a-d2e0-11f0-9d4d-f22776babdf63.1Implement CTS2-compliant backend service providing all functional profiles: CodeSystem Catalog Maintenance, CodeSystemVersion Catalog Maintenance, Entity Description Maintenance, Map Catalog Maintenance, Map Version Maintenance, and Map Entry Maintenance.3.1.1CTS2 ProfilesNumber_9d543cc2-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_8Status2024-06-30Implemented6Six core CTS2 maintenance services operationalNumber of CTS2 functional profiles implementedWeb InterfaceDevelop Web Application Interface_9d543d3a-d2e0-11f0-9d4d-f22776babdf63.2Create ASP.NET web application providing user-friendly access to Read, Query, Maintenance, and Map sections with tree-view navigation, search capabilities, and entity editing interfaces.3.2.1Interface FunctionalityNumber_9d543db2-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_9Status2024-06-30Supported4Read, Query, Maintenance, and Map operations accessible via web interfaceNumber of user-facing operations supported3.2.2Usability/Navigation Quality_9d543e34-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_102025-06-30Hierarchical tree navigation enables intuitive ontology browsing without technical expertiseStatusHigh[To be determined]User experience assessmentEntity DescriptionsImplement Entity Description Transform Service_9d543ec0-d2e0-11f0-9d4d-f22776babdf63.3Move transformation logic from client application to service layer, enabling server-side OWL-to-CTS2 conversion with improved validation and error handling.3.3.1Architecture OptimizationPercentage_9d543f42-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_112025-12-31StatusOptimized100Complete transformation pipeline executing within CTS2 service[To be determined]Percentage of transformation logic server-sideConsole & Web ApplicationsIntegrate Console and Web Applications_9d543fd8-d2e0-11f0-9d4d-f22776babdf63.4Consolidate initial import functionality from console application into web interface, providing unified tool for all ontology operations.3.4.1Tool Consolidation_9d54406e-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_122026-06-30Single web application supports complete ontology lifecycle from import through maintenanceIntegration StatusComplete[To be determined]User workflow assessmentValidationValidate Approach with Real Medical Ontologies_9d5440fa-d2e0-11f0-9d4d-f22776babdf64Alzheimer's Research CommunityResearchers and clinicians working with Alzheimer's Disease knowledge representationsPilot UserProvides real-world validation and feedback on ADO transformationPerformerBeneficiaryApply transformation methodology to production medical ontologies, demonstrating practical utility for P5 medicine knowledge management and establishing reusable patterns for healthcare domain.Alzheimer's OntologyTransform Alzheimer's Disease Ontology_9d54419a-d2e0-11f0-9d4d-f22776babdf64.1Successfully convert ADO from OWL to CTS2 format, creating ADOV1 CodeSystemVersion with complete EntityDescription set accessible via HTS service.4.1.1ADO CoverageNumber_9d5442b2-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_13All ADO classes including Behavioral_therapies and hierarchical relationships successfully converted and accessible via web interfaceStatus02024-06-30[To be determined]Number of ADO classes convertedDemonstration ServicePublish Demonstration Service_9d544348-d2e0-11f0-9d4d-f22776babdf64.2Make transformed ontologies publicly accessible at http://www.medinfo.dibris.unige.it/VBC_CTS2/ for community validation and feedback.4.2.1Public Accessibility_9d54444c-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_14Service availability assessmentStatus2024-06-30Demonstration service publicly accessible with ADO and ADA Lab ontologiesPublication StatusAccessibleLimitations & Future WorkDocument Limitations and Future Work_9d5444f6-d2e0-11f0-9d4d-f22776babdf64.3Explicitly identify transformation constraints (equivalent classes from restrictions) and chart development roadmap for complete OWL coverage.4.3.1Transparency_9d5445a0-d2e0-11f0-9d4d-f22776babdf6PLACEHOLDER_15Documentation completenessStatusComplete2024-06-30Limitations clearly stated in peer-reviewed publication with future development priorities identifiedDocumentation StatusClearly Stated_9d5446ae-d2e0-11f0-9d4d-f22776babdf62024-06-242025-12-06https://doi.org/10.3390/jpm14070676_9d544762-d2e0-11f0-9d4d-f22776babdf6OwenAmburowen.ambur@verizon.net