Standardized Annotation of Clinical Narratives with SNOMED CT and FHIR

Riedel A, Kreuzthaler M, Schulz S (2026)


Publication Type: Journal article

Publication year: 2026

Journal

Book Volume: 336

Pages Range: 1212-1216

DOI: 10.3233/SHTI260391

Abstract

A semantic framework for manual annotation of clinical narratives using SNOMED CT and FHIR has been created. To test the guideline, two medical annotators independently annotated 20 selected diverse clinical text fragments. Quantitatively, we detect a fair IAA (Cohen's kappa) for concept (κ = 0.32) and a substantial IAA for predicate annotations (κ = 0.78), with 7.97 times faster annotation speed (p<0.001) for predicates and a typical head-tail distribution for concept annotations. Qualitative analysis revealed five factors affecting performance: focus and compliance with annotation guidelines, terminology limitations, contextual information, and tooling support for manual annotation. We conclude that a motivated balance between precise guidelines, automated rule violation checks and pre-annotations, as well as knowledge graph-based IAA, is necessary for a correct semantic annotation of clinical narratives according to international standards.

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APA:

Riedel, A., Kreuzthaler, M., & Schulz, S. (2026). Standardized Annotation of Clinical Narratives with SNOMED CT and FHIR. Studies in Health Technology and Informatics, 336, 1212-1216. https://doi.org/10.3233/SHTI260391

MLA:

Riedel, Andrea, Markus Kreuzthaler, and Stefan Schulz. "Standardized Annotation of Clinical Narratives with SNOMED CT and FHIR." Studies in Health Technology and Informatics 336 (2026): 1212-1216.

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