Ontology of Pain

1. Ontology of Pain Barry Smith National Center for Ontological Research University at Buffalo

2. BFO A simple top-level ontology to support information integration in scientific research

3. Basic Formal Ontology Continuant Occurrent (Process, Event) Independent Continuant (thing, substance) Dependent Continuant http://ifomis.uni-saarland.de/bfo/

4. Continuant Independent Continuant Dependent Continuant Non-realizable Dependent Continuant (quality) Realizable Dependent Continuant (function, role, disposition) ..... .....

5. Specifically dependent continuants Examples: the height (quality) of this patient the disposition of this patient to experience diarrhea

6. Continuant Independent Continuant Dependent Continuant Non-realizable Dependent Continuant (quality) Realizable Dependent Continuant (function, disposition) ..... .....

7. depends_on Continuant Occurrent process Independent Continuant thing Dependent Continuant quality temperature depends on bearer .... ..... .......

8. universals, types, kinds Continuant Occurrent process, event Independent Continuant Dependent Continuant .... ..... ....... particulars, instances

9. the universal red the universal eye instantiates instantiates the particular case of redness (of this particular fly’s left eye) this instance of eye (in this particular fly) depends_on

10. color anatomical structure is_a is_a red eye instantiates instantiates this eye (in this particular fly) this particular case of redness depends on

11. the universal eye instantiates at t1 this particular eye (in this particular fly)

12. the universal eye instantiates at t1 instantiates at t2 instantiates at t3 this particular eye (in this particular fly)

13. Phase transitions portion of water portion of ice portion of liquid water portion of gas instantiates at t1 instantiates at t2 instantiates at t3 this portion of H20

14. human in nature, no sharp boundaries here embryo fetus neonate infant child adult instantiates at t1 instantiates at t2 instantiates at t3 instantiates at t4 instantiates at t5 instantiates at t6 John

15. temperature in nature, no sharp boundaries here in nature, no sharp boundaries here 37ºC 37.1ºC 37.2ºC 37.3ºC 37.4ºC 37.5ºC instantiates at t1 instantiates at t2 instantiates at t3 instantiates at t4 instantiates at t5 instantiates at t6 John’s temperature

16. Dependent Continuants Dependent Continuant if the bearer ceases to exist, then its quality, function, role ceases to exist the color of my skin the function of my heart to pump blood my weight Quality, Pattern Realizable Dependent Continuant

17. Realizable dependent continuants Disposition: fragility, virulence, susceptibility, genetic disposition to disease X Function: to pump (of the heart), to unlock (of the key)

18. OGMS Ontology for General Medical Science, http://code.google.com/p/ogms/

19. Big Picture

20. Disorder an independent continuant fiat object part of the whole organism (boundaries hard to specify)

21. Where does Mount Everest begin and end? Cf. Barry Smith and David M. Mark, “Do Mountains Exist?”, Environment and Planning B, 30, 2003.

22. Disorder A fiat object part of an organism which serves as the bearer of a disposition of a certain sort This fiat object may have no determinate boundaries (compare: Downtown Santa Barbara)

23. A disease is a disposition having as its bearer a physical disorder in the organism and realized in pathological processes. produces bears realized_in etiological process disorder disposition pathological process produces diagnosis interpretive process signs & symptoms abnormal bodily features produces used_in recognized_as

24. Influenza - infectious • Symptoms & Signs • used_in • Interpretive process • produces • Hypothesis - rule out influenza • suggests • Laboratory tests • produces • Test results - elevated serum antibody titers • used_in • Interpretive process • produces • Result - diagnosis that patient X has a disorder that bears the disease flu • Etiological process - infection of airway epithelial cells with influenza virus • produces • Disorder - viable cells with influenza virus • bears • Disposition (disease) - flu • realized_in • Pathological process - acute inflammation • produces • Abnormal bodily features • recognized_as • Symptoms - weakness, dizziness • Signs - fever

26. independent continuant dependent continuant occurrent process disposition disorder course of disease disease John’s disordered heart John’s coronary heart disease course of John’s disease

27. coronary heart disease coronary disease at the stage of early lesions and small fibrous plaques coronary disease at the stage of asymptomatic (‘silent’) infarction coronary disease the stage of surface disruption of plaque coronary disease at the stage of unstable angina coronary disease at the stage of stable angina instantiates at t1 instantiates at t2 instantiates at t3 instantiates at t4 instantiates at t5 John’s coronary heart disease time

28. OGMS:pathological process def. – A process in an organism that is clinically abnormal.* i) is not part of the life plan for an organism of the relevant type (unlike aging, pregnancy or menopause), ii) is causally linked to an elevated risk either of pain or other feelings of illness, or of death or dysfunction, and iii) is such that the elevated risk exceeds a certain threshold level. * ≠ statistically abnormal

29. OGMS:disease def. – A disposition (i) to undergo pathological processes that (ii) exists in an organism because of one or more disorders in that organism.

30. Big Picture

31. Ontology for Mental HealthWerner CeustersUniversity at Buffalo

33. Ontology for Mental Health V0.0001 Legend continuant representation process disjunction MHO BFO/OGMS some obvious links left out to aid readability

34. Ontology for Mental Health V0.0001 Legend continuant representation process disjunction MHO BFO/OGMS

35. Mental Process (L1,U) =def. BodilyProcess which brings into being, sustains or modifies a Cognitive Representation or a Behavior Inducing State

36. Mental Functioning Related Anatomical Structure (L1,U) • =def. AnatomicalStructure in which there inheres the Disposition to be the agent of a MentalProcess

37. Mental Functioning Related Anatomical Structure an independent continuant fiat object part of brain + central and peripheral nervous system

38. Mental Disorder=def. Disorderin one or more Mental Functioning RelatedAnatomicalStructures • Pathological Mental Process =def. PathologicalProcess which is the manifestation of a Mental Disorder • Mental Disease=def. a Disease which is a Disposition to undergo PathologicalMental Processes

39. Big Picture

40. Big Picture

41. Clinical Evaluation Terms • Sign =def. – A bodily feature of a patient that is observed in a physical examination and is deemed by the clinician to be of clinical significance. (Objectively observable features) • Symptom =def. – An experienced bodily feature of a patient that is observed by and observable only by the patient and is of the type that can be hypothesized by a patient to be a realization of a disease. (A restricted family of phenomena including: nausea, anger, drowsiness, itchiness, anguish, and pain, which are of their nature experienced in the first person) Symptoms are subjective. But this does not mean that there is no objective fact of the matter whether a given symptom exists

44. Pain Ontology (PN)

45. Closing remarks about borderline cases • The methodology of canonical ontology

46. Where does Mount Everest begin and end? Cf. Barry Smith and David M. Mark, “Do Mountains Exist?”, Environment and Planning B, 30, 2003.