A NATIONAL PUBLIC HEALTH LANGUAGE FOR THE UK

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A NATIONAL PUBLIC HEALTH LANGUAGE FOR THE UK

• Marta Calonge Contreras
• Information Specialist
• National Institute for Health and Clinical
  Excellence (United Kingdom)

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The context Public Health

• Public health has been defined as the organised
  process by society of mobilising local, national
  and international resources to protect, promote
  and improve the health or population and
  communities (Oxford Textbook of Public Health)
• Public Health is multidisciplinary many of the
  factors influencing health fall within
  disciplines outside health itself such as
  housing, education, employment, etc
• Information gathering is crucial for public
  health practice finding out the extent of health
  problems, who suffers from them and what causes
  them in a population is the basis of public
  health work.

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The context Public Health organisations in
England

• Public Health Observatories (PHOs) created in
  2000 to strengthen the analysis of public health
  information at regional level across the whole of
  England.
• The Health Development Agency (HDA) established
  in 2000 with the purpose of building the evidence
  base in Public Health. On the 1st of April 2004
  it was merged with the National Institute for
  Clinical Excellence and now has the remit of
  producing public health guidance for England

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The need for a National Public Health Language in
the UK

• Conversations between HDA and PHOs started in
  2003 about
• Information on the web on public health was
  fragmented and scattered through a huge number of
  resources
• Public Health professionals often had to trawl
  through a lot of resources to find the
  information they needed
• Need to develop a single source of readily
  available information that could meet all their
  knowledge needs.
• This could be achieved through interoperability.
• For interoperability to work, it was necessary
  that all the public health websites and resources
  had
• Common metadata
• A common language or unified set of keywords to
  describe resources in a consistent way.

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The beginnings of the language

• Two significant thesauri available in the England
  in the field of public health
• Public Health Information Thesaurus, used by the
  Health Development Agency
• Public Health Information Tagging System, used by
  the Public Health Observatories
• Both vocabularies had strengths and weaknesses
• They complemented each other
• Work started in July 2003 to merge both
  vocabularies to create a single National Public
  Health Language (NPHL) for the UK
• The NPHL was officially launched in December 2004

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The objectives of the NPHL

• Provide a common and consistent set of terms for
  indexing and cataloguing public health data and
  activities
• Provide a tool for communication on how public
  health information can be structured and
  organised
• Facilitate interoperability between a variety of
  public health websites in the UK
• Allow seamless searching and structured retrieval
  across the internet for relevant public health
  data, evidence and records of practice.

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NPHL key features

• ISO 2788 compliant (International standards for
  thesaurus construction)
• Managed in MultiTes thesaurus management software
• Contains circa 3000 terms, including synonyms
• Arranged in hierarchical order under 10 top level
  terms.
• Multi-hierarchical structure (terms can appear in
  more than one place in the hierarchy)
• 2 major releases a year
• UK wide currently adopted by several public
  health organisations in England, Ireland and Wales

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NPHL Top Level Terms

• Health, public health and health promotion
• Determinants of health
• Death, disease and disability
• People and populations
• Settings and places
• Health services and their management
• Public health methods, theory and research
• Communications and knowledge
• Time factors
• Equipment

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Example of an exploded top term

• Determinants of health
• NT1 Economics, finance and industry
• NT1 Education, employment and skills
• NT1 Environmental determinants
• NT2 Causes of harm
• NT3 Accidents
• NT4 Falls
• NT4 Traffic accidents
• NT4 Burns
• NT3 Alcohol misuse
• NT3 Crime
• NT3 Smoking
• Ect
• NT1 Food and Nutrition
• Etc

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Example of NPHL term

• COMMUNICABLE DISEASES
• SN Communicable diseases are caused by
  bacteria and viruses, which can be passed
  between people either directly, through coughs
  and sneezes, or indirectly through food and water
  or from insects bites.
• BT DEATH, DISEASE AND DISABILITY
• NT CHICKENPOX
• HIV INFECTION
• MEASLES
• MUMPS
• POLIO
• RUBELLA
• TUBERCULOSIS
• RT IMMUNISATION
• INFECTION CONTROL
• SEXUALLY TRANSMITTED INFECTIONS

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Management of the NPHL

• NPHL Steering Group
• To steer, manage and oversee the development of
  the language, and promote its implementation and
  use among public health organisations in the UK
• Formed by representatives from NICE, the
  Association of Public Health Observatories, the
  Department of Health, the Health Protection
  Agency, primary care trusts, and public health
  organisations from Ireland, Wales and Scotland.
• Meets three times a year
• NPHL Editorial Board
• To manage suggestions from users for changes to
  the thesaurus in a way that is transparent and
  systematic (adding new terms, deleting terms,
  moving terms)

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Methods and processes for development of the NPHL

• Web platform where NPHL users will be able to
  register
• All registered users encouraged to submit changes
• All validated requests will be considered by
  Editorial Board
• Accepted changes will be included in the next
  release
• Reason will be given for rejected changes
• Transparency process documented all along
• Minor releases every 3 months (i.e. Version 1.1,
  1.2 ect)
• Major releases every 6 months (i.e. Version 2, 3,
  etc.

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Future developments

• Still in relatively early stages of
  developmentinput from users is crucial!
• Integration with SNOMED CT
• Translation to Welsh language
• Mapping to Mesh
• Development of a web portal for the NPHL
• Promotion and dissemination among UK public
  health organisations

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Can YOU talk Population Health? Have YOU heard of
the National Public Health Language?

• What is the aim of this project?
• To integrate
• The PHO language for interoperable websites
• The HDA/NICE language
• The Department of Health Thesaurus
• The Integrated Public Sector Vocabulary
• The new EU Public Health Portal (Europa website)
• to ensure that a National Library for Public
  Health works efficiently consistently using a
  National, (or even International) Public Health
  Language

Introduction For too long, as public health
professionals, we have worked with an
unsystematic set of keywords to describe and
frame our discipline. The explosion of
opportunities in knowledge management has meant
that a more systematic approach to describing our
work has become necessary. Over the past few
years in the UK and Australia there has emerged a
developing Public Health Language. Help it
develop be part of the future!
Early examples in use

• Who is contributing to this work?
• Department of Health
• Public Health
• Observatories in Scotland, Wales, Ireland and
  England
• - National Institute for Health and Clinical
  Excellence
• PCTs and Public Health Networks
• E-Government,
• YOU?
• AND there is similar work in Australia (Public
  Health Classifications Project) see
  http//www.nphp.gov.au/workprog/phi/index.htm

What could I use a population health language
for? Tagging resources in a population health
knowledge management system Labelling the filing
cabinets in my department Checking our CPD
programme is comprehensive Ensuring my personal
development plan is broad as well as deep
Consistent but flexible libraries and languages
are essential to help us develop a National
Knowledge Service For Public Health Sir J A
Muir Gray
More details fromPeter Cornelissen
(peter.cornelissen_at_rdd-phru.cam.ac.uk) or David
Pencheon (david.pencheon_at_rdd-phru.cam.ac.uk).East
ern Region Public Health Observatory.
www.erpho.org.uk
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NPHL can be found athttp//www.nphl.nhs.uk/
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Contact details

• Marta Calonge Contreras
• Information Specialist
• Tel [phone]
• E-mail mcalonge-contreras_at_nice.org.uk