TopIntroduction
Traditional logic is informal about the production of terms and sentences, and even worse, often avoids to clearly describe how terms latively appear in sentences, i.e., how sentences proceed from terms, and are in fact constructed using terms. Continuing that lativity towards entailment and provability, it is clear that sentences appear in provability, but provability as a statement should not be seen as a sentence. This creates self-referentiality which leads to peculiar situations, both theoretically as well as in WHO’s classifications on health.
Logic, as a structure, contains signatures, terms, sentences, theoremata (as structured sets of sentences, or ‘structured premises’), entailments, algebras, satisfactions, axioms, theories and proof calculi. This chapter also shows how the notion of signature often needs to be expanded to levels of signatures, in particular when dealing with type constructors. Lative logic produces a huge potential of applications using terminology, nomenclature and ontology in particular in social and health care. WHO classifications are logically lative. The reference classifications ICD and ICF then appear in structured relation with each other. Similar transformations can be made for the derived classifications as well as for the related classifications ICPC-2, ICECI, ISO9999, ATC/DDD and ICNP.
Formal mappings, e.g., between ICD and ICF are rare, and this is mostly due to a lack of understanding terminology and nomenclature as terms in a logic. ATC/DDD for drugs embraces ‘dose’ but not ‘intervention’, which means that drug-drug interactions are possible to describe whereas drug-condition is more complicated. IHTSDO’s SNOMED CT subdivides ‘concepts’ within its hierarchy consisting e.g. of clinical findings disorders, body structure, pharmaceutical/biologic product, social context, staging and scales, and qualifier values, but has been developed only with intuitive connections with WHO classifications. Further, SNOMED’s assumption that “health ontology” needs the same or a similar underlying logic as “web ontology”, is a fatal mistake not promoting the “dialogue and interrelation of classifications and nomenclature” in useful application oriented directions.
The pillars and underlying observations of the chapter are the following:
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Modern type theory is not formal enough to recognize the need to arrange type constructors in a level of signatures.
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This provides tools to establish generalized relations as formal concepts, and also as substitution theory required to manage nomenclature and ontology in health care.
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Signatures and terms for nomenclatures and terms are in turn building blocks used in sentences that appear in guidelines and recommendations in social and health care.
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WHO and other international organizations as well as national authorities do not embrace a formal logic that is required in particular to develop relations and mapping between nomenclatures.
There are lots of “Yes, we can!” claims within authorities and industry about such nomenclatures and their intertwining, and this chapter very clearly shows “No, you cannot!, unless we first properly clean the logic mess appearing around nomenclatures in health.
The lack of regional strategies together with scattered and unstructured guidelines for prevention, detection and intervention related to older persons decline in cognitive and functional capabilities is the most serious threats against a sustainable development of supportive environments for the older persons. Further, the lack of well-structured guidelines and well-organized utility of assessment and, in particular, rigorous assessment based decision-making and care provisioning, leads to overlaps and inefficiency, and even worse, to subjective decision-making and care processes that cannot be measured nor evaluated. Socio-economic modelling of the social welfare effect due to demographic change is therefore of utmost importance, on the one hand, for municipality resource planning and objective decision making, and on the other hand, for enabling required accuracy of business models as used by public and private actors in the social sector.