Introduction
Our Ontological Reference Framework
Particulars (DOLCE)
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Endurants5 are entities “enduring in time”, which are primarily directly related to space. Physical objects (e.g. a pen, a printed copy of an article) are typical Endurants. Besides Physical objects, DOLCE considers a class of Non-physical Objects. The distinction between Physical Objects and Non-physical Objects corresponds to the difference between two realities or modes of existence. Basically, Non-Physical Objects exist insofar as agents conventionally create them and speak about them. The domain of Non-Physical Objects covers entities whose existence depends on either an individual (Mental Objects, e.g. a private mnemonic method, or the content of this sentence that you interpret) or a community of agents (Social Objects, e.g. a company, the stipulations of a law).
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Perdurants are entities “occurring in time”, which are primarily directly related to time. Perdurants are generated by Endurants: the latter temporarily participate in (participatesInDuring) the former.
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Endurants and Perdurants have Qualities that we perceive and/or measure (e.g. the weight of a printed copy of this article and the time spent reading this article). Note that Qualities are inherent to the entity that bears them, since they are characteristic of their bearer and present throughout its existence.
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Qualities temporarily occupy positions within Regions. Some Regions called Qualia (Quale in the singular) are defined as atomic Regions (e.g. “25 g in weight” and “20 min in duration”). Other Regions are mereological sums (sums of parts) of Qualia. For instance, the Region of colors named ‘red’ may be considered as having for parts the Qualia named “Scarlet” and “Crimson”. The sum of all Qualia associated with a Quality kind is called a (Quality) Space. Spaces in DOLCE are similar to Gärdenfors’ conceptual spaces (Gärdenfors, 2000).
Inscriptions, Expressions, and Conceptualizations
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Inscriptions (e.g. printed texts and computer files) are physical knowledge forms materialized by a substance (e.g. ink or an electrical field) and inscribed on a physical support (e.g. a sheet of paper or a hard disk). In addition to their materiality, one important characteristic of Inscriptions lies in their “intentional” nature (meaning that these entities count as other entities). For example, Inscriptions count as Expressions.
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Expressions (e.g. texts and logical formulae) are non-physical knowledge forms ordered by a communication language. Expressions are physicallyRealizedBy Inscriptions and, like Inscriptions, they are intentional entities conveying contents for agents.
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Conceptualizations consist of the ultimate means by which agents can reason about a world. Two kinds of Conceptualizations are distinguished: Propositions, as a means of describing states of affairs, and Concepts, as a means of classifying entities. Note that, as for the practical semiotics6 introduced in the SUMO ontology (Pease and Niles 2002), Propositions may encompass the content expressed by sentences, theories, books and even libraries.
Actions and Participation Roles
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Actions are Perdurants controlled by an intention. They contrast with Happenings, which lack an intentional cause.
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Deliberate Actions are premeditated actions. According to current philosophical theories of actions, Deliberate Actions are controlled by a prior intention that consists in planning the action (before its initiation) and then in controlling it in a rational way (Pacherie 2000).
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According to another classification dimension, Physical Actions (whose effects bear on Physical Endurants, e.g. curing a patient) are distinct from Conceptual Actions (whose effects bear on Conceptualizations, e.g. acquiring data from subjects).
Artifacts
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Artifacts are the result of an intentional production and thus have an Author.
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Artifacts are produced for a certain reason. Various kinds of reasons (and hence various types of Artifacts) are considered: to convey an emotion and be of aesthetic interest (for works of art) or enable their author (or another agent) to do something (for “functional” or Technical Artifacts). The latter are Artifacts to which a Function is ascribed, given that a Function is defined as an “acknowledged capacity to enable the realization of a kind of action” (Kassel 2010).
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Within Technical Artifacts, Private Artifacts are distinguished from Social Artifacts according to whether the function in question is ascribed by an individual or a community of agents.
A Core Ontology of Assessment Instruments
Instrument-Based Assessment
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Intangible, i.e. propositional contents, including “clearly defined methods and instructions for administration or responding, a standard format for data collection, and well-documented methods for scoring, analysis, and interpretation of results” [CDISC, 2008].8
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Functional, i.e. tools enabling to explore entities related to the Subject’s state. These categories of entities correspond to the Instrument's Domain(s).
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Social, i.e. intentionally created, adopted for use, adapted and maintained by a community that ascribes them with the status of a standard.
Variable Assessment
Domain Ontologies for Three Specific Instruments: The MMS, EDSS and CDR
The Mini-Mental State as an Example of a Neuropsychological Instrument
Instrument acronym | Variable acronym | Domain explored by variable | Maximum numerical value |
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Instrument name | Quality measured by variable | ||
MMS | MMSv1 | Global cognitive efficiency | 30 |
Mini Mental State | Cognitive mental status | ||
MMS-1 | MMS-1v1 | Orientation | 10 |
MMS Orientation | Performance on orientation | ||
MMS-1-1 | MMS-1-1v1 | Orientation to time | 5 |
MMS Orientation to time | Performance on orientation to time | ||
MMS-1-2 | MMS-1-2v1 | Orientation to place | 5 |
MMS Orientation to place | Performance on orientation to place | ||
MMS-2 | MMS-2v1 | Short term verbal memory | 3 |
MMS Registration | Performance on registration of three objects | ||
MMS-3 | MMS-3v1 | Attention | 5 |
MMS Attention and Calculation | Performance on counting backwards by 7 | ||
MMS-4 | MMS-4v1 | Long term verbal memory | 3 |
MMS Recall | Performance on recall of three objects | ||
MMS-5 | MMS-5v1 | Language | 8 |
MMS Language tests | Language performance | ||
MMS-5-1 | MMS-5-1v1 | Oral language production | 2 |
MMS Language naming | Performance on naming of two objects | ||
MMS-5-2 | MMS-5-2v1 | Oral language production | 1 |
MMS Language repetition | Performance on repetition of a sentence | ||
MMS-5-3 | MMS-5-3v1 | Oral language comprehension | 3 |
MMS Language 3 stage command | Performance on execution of a 3 stage command | ||
MMS-5-4 | MMS-5-4v1 | Written language comprehension | 1 |
MMS Language reading | Performance on reading a sentence | ||
MMS-5-5 | MMS-5-5v1 | Written language production | 1 |
MMS Language writing | Performance on writing a sentence | ||
MMS-6 | MMS-6v1 | Motor component of constructional functions | 1 |
MMS Copy design | Copy accuracy |
The Expanded Disability Status Scale as an Example of a Neurological Instrument
Instrument model acronym | Variable model acronym | Domain explored by variable |
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Instrument model name | Quality measured by variable | |
EDSS | EDSSv1 | Neurologic functions |
Expanded Disability Status Scale | Disability status | |
EDSS-1 | EDSS-1v1 | Visual Function |
EDSS Visual optic functions | Optic function performance | |
EDSS-2 | EDSS-2v1 | Cranial Nerves Function |
EDSS Cranial nerve examination | Brainstem function performance | |
EDSS-3 | EDSS-3v1 | Motor Function |
EDSS Pyramidal functions | Pyramidal function performance | |
EDSS-4 | EDSS-4v1 | Cerebellar Functions |
EDSS Cerebellar examination | Cerebellar function performance | |
EDSS-5 | EDSS-5v1 | Sensory Function |
EDSS Sensory examination | Sensory function performance | |
EDSS-6 | EDSS-6v1 | Bowel and Bladder Function |
EDSS Bowel bladder functions | Bowel bladder function performance | |
EDSS-7 | EDSS-7v1 | Cerebral Functions |
EDSS Mental status examination | Cerebral function performance | |
EDSS-8 | Ambulation | |
EDSS Ambulation | EDSS-8v1 | Ambulation performance without assistance |
EDSS-8v2 | Ambulation performance with unilateral assistance | |
EDSS-8v3 | Ambulation performance with bilateral assistance |
Min-value | Max-value | Number referred to by quantitative scale item | Value of quantitative scale item code | Value of qualitative scale item code |
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Yes | No | 0.0 | 0.0 | Normal neurologic exam (all grade 0 in all Functional System (FS) scores). |
No | No | 1.0 | 1.0 | No disability, minimal signs in one FS (i.e., grade 1). |
No | No | 1.5 | 1.5 | No disability, minimal signs in more than one FS (more than 1 FS grade 1). |
No | No | 2.0 | 2.0 | Minimal disability in one FS. |
No | No | 2.5 | 2.5 | Minimal disability in two FSs. |
No | No | 3.0 | 3.0 | Moderate disability in one FS or mild disability in three or four FS though fully ambulatory. |
No | No | 3.5 | 3.5 | Fully ambulatory but with moderate disability in one FS and one or two FSs grade 2. |
No | No | 4.0 | 4.0 | Fully ambulatory without aid, self-sufficient, able to walk without aid or rest some 500 m. |
No | No | 4.5 | 4.5 | Fully ambulatory without aid; able to walk without aid or rest some 300 m. |
No | No | 5.0 | 5.0 | Ambulatory without aid or rest for about 200 m; disability severe enough to impair full daily activities. |
No | No | 5.5 | 5.5 | Ambulatory without aid for about 100 m. |
No | No | 6.0 | 6.0 | Intermittent or unilateral constant assistance required to walk about 100 m with or without resting. |
No | No | 6.5 | 6.5 | Constant bilateral assistance required to walk about 20 m without resting. |
No | No | 7.0 | 7.0 | Unable to walk beyond approximately 5 m even with aid, essentially restricted to wheelchair. |
No | No | 7.5 | 7.5 | Unable to take more than a few steps; restricted to wheelchair; may need aid in transfer. |
No | No | 8.0 | 8.0 | Essentially restricted to bed or chair or perambulated in wheelchair; generally has effective use of arms. |
No | No | 8.5 | 8.5 | Essentially restricted to bed much of day; has some effective use of arm(s); retains some self-care functions. |
No | No | 9.0 | 9.0 | Helpless bed patient; can communicate and eat. |
No | No | 9.5 | 9.5 | Totally helpless bed patient; unable to communicate effectively or eat/swallow. |
No | Yes | 10.0 | 10.0 | Death due to MS. |
The Clinical Dementia Rating as an Example of a Behavioral Instrument
Instrument model acronym | Variable model acronym | Domain expolred by variable |
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Instrument model name | Quality measured by variable | |
CDR | CDR-SoBv1 | Dementia |
Severity of dementia (numerical Value [0,18]) | ||
CDR scale | CDR-GBv1 | Dementia |
Severity of dementia (five-point scale) | ||
CRD-M | CDR-Mv1 | Memory |
CDR-Memory | Severity of memory loss | |
CDR-O | CDR-Ov1 | Orientation |
CDR-Orientation | Severity of orientation difficulty | |
CDR-J | CDR-Jv1 | Problem solving judgment |
CDR-Judgment and problem solving | Severity of impairment in solving problems | |
CDR-CA | CDR-CAv1 | Community-activities |
CDR-Community affairs | Severity of impairment in community activities | |
CDR-HH | CDR-HHv1 | Home-activities |
CDR-Home activities and hobbies | Severity of impairment in home activities | |
CDR-PC | CDR-PCv1 | Personal care |
CDP-personal care | Level of dependency |
Min-value | Max-value | Number referred to by quantitative scale item | Value of quantitative scale item code | Value of qualitative scale item code |
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Yes | no | 0 | CDR-0 | No evidence of dementia |
No | no | 0.5 | CDR-0.5 | Questionable dementia |
No | no | 1 | CDR-1 | Mild dementia |
No | no | 2 | CDR-2 | Moderate dementia |
No | yes | 3 | CDR-3 | Severe dementia |