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Mondo: integrating disease terminology across communities

Precision medicine aims to enhance diagnosis, treatment, and prognosis by integrating multimodal data at the point of care. However, challenges arise due to the vast number of diseases, differing methods of classification, and conflicting terminological coding systems and practices used to represent molecular definitions of disease. This lack of interoperability artificially constrains the potential for diagnosis, clinical decision support, care outcome analysis, as well as data linkage across research domains to support the development or repurposing of therapeutics. There is a clear and pressing need for a unified system for managing disease entities⁠—including identifiers, synonyms, and definitions. To address these issues, we created the Mondo disease ontology—a community-driven, open-source, unified disease classification system that harmonizes diverse terminologies into a consistent, computable framework. Mondo integrates key medical and biomedical terminologies, including Online Mendelian Inheritance in Man (OMIM), Orphanet, Medical Subject Headings (MeSH), National Cancer Institute Thesaurus (NCIt), and more, to provide a comprehensive and accurate representation of disease concepts with fully provenanced and attributed links back to the sources. Mondo can be used as the handle for curation of gene–disease associations utilized in diagnostic applications, research applications such as computational phenotyping, and in clinical coding systems in clinical decision support by pointing the clinician to the numerous knowledge resources linked to the Mondo identifier. Mondo's community-centric approach, stewarded by the Monarch Initiative's expertise in ontologies, ensures that the ontology remains adaptable to the evolving needs of biomedical research and clinical communities, as well as the knowledge providers.

biomedical informatics↗

Evolving language of pediatric anxiety in electronic health records

Objectives This study aimed to identify and quantify semantic drift (ie, the change in semantic meaning over time) within expert-defined anxiety-related (AR) terminology and compare it to common electronic health record (EHR) vocabulary across longitudinal pediatric clinical notes. Materials and Methods A corpus of pediatric clinical notes from 2009 to 2022 was analyzed using computational methods. Semantic drift for each term was quantified using cosine similarity between annual temporal word embeddings. Contextual meaning was examined through changes in nearest neighbors across years. The Laws of Semantic Change were applied to assess the influence of word frequency and polysemy. Vocabulary terms were categorized as AR or common EHR. Results 98% of AR terminology maintained a cosine similarity between 0.00 and 0.50, indicating moderate semantic stability, whereas 90% of common EHR terms remained between 0.00 and 0.25, showing greater contextual stability overall. Frequent terms exhibited minimal change (Frequency Coefficient = 0.04), whereas highly polysemous or abbreviated terms showed less stability (Polysemy Coefficient = 0.630). AR terminology drifted more slowly than general EHR vocabulary (Type Coefficient = −0.179), further supported by significant year–type interactions (Coef = −0.09 to −0.523). Discussion Although anxiety-related terminology demonstrates slower semantic drift than general EHR vocabulary, subtle contextual shifts still occur that may affect downstream interpretability and retrieval in automated systems. Conclusion Continuous linguistic monitoring and adaptive modeling are essential to maintain semantic fidelity and ensure the long-term reliability of clinical decision support systems as healthcare documentation evolves.

Pediatric anxiety disorders↗