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NCI EVS has extensive external partnerships to develop terminology standards, content, technology, and operational support, greatly broadening the base of adoption and having a major impact on the wider biomedical community.

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U.S. Food and Drug Administration (FDA)

FDA has worked with EVS since 2001, with formal Memoranda of Understanding starting in 2004, to develop and harmonize terminology content, standards and systems in areas of mutual interest such as drugs, devices, patient safety, and clinical trials. FDA has chosen EVS and NCIt for developing and publishing many important terminology sets; some 15,000 FDA terms in over 20 defined subsets are now maintained in NCIt and required for regulatory reporting and other purposes. These include:

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(For more information, visit the NCI website http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/FDA.)

Clinical Data Interchange Standards Consortium (CDISC)

All CDISC controlled terminology – more than 9,800 terms – is maintained and published as NCIt subsets, as part of a partnership started in 2002 to develop and support global data standards for medical research. This includes four main terminology efforts:

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The CDISC Shared Health and Research Electronic Library (SHARE) project is also building a collaborative authoring platform for harmonizing data elements from multiple organizations, using LexWiki for its initial prototype. CDISC has created a data element curation process, including terminology linking, using the LexWiki and LexGrid technologies; this process provides a collaborative framework and platform for representation and harmonization of clinical study data elements. CDISC will use open tools created by NCI as the basis for developing SHARE.

National Council of Prescription Drug Providers (NCPDP)

NCPDP is a not-for-profit, ANSI-accredited, Standards Development Organization with over 1,600 members representing virtually every sector of the pharmacy services industry. NCPDP creates and promotes the transfer of data related to medications, supplies, and services within the healthcare system through the development of standards and industry guidance. In 2009, NCPDP decided to partner with EVS to use NCIt subsets to support two of those standards, employed by some 200 vendors serving approximately 15,000 pharmacies nationwide:

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(For more information, visit the NCI website http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/ncpdp.)

Federal Medication Terminologies (FMT)

Work started in 2002 as an interagency collaboration between NCI EVS, FDA, VHA, and NLM – joined later by AHRQ, CMS, DoD, and EPA – to improve the exchange and public availability of medication information with coordinated development of terminology standards. The initial FMT terminology set has been endorsed by U.S. Federal standards efforts including the National Committee on Vital and Health Statistics (NCVHS), Consolidated Health Informatics (CHI), the Healthcare Information Technology Standards Panel (HITSP), and the Office of the National Coordinator for Health Information Technology (ONC) within the Department of Health and Human Services (HHS). (For more information, visit the NCI website http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/fmt.)

Veterans Health Administration (VHA)

VHA has worked closely with EVS since 2002. Under an ongoing Memorandum of Understanding, VHA works with EVS on collaborative terminology policy and products, including content collaboration and publication of the VA's National Drug File Reference Terminology (NDF-RT), used by both agencies as a drug information reference resource.

The VHA also performed a thorough comparison of the functional capabilities of LexEVS to those of other terminology servers. The VA provided the results to the VKC, which transformed the matrix into a document that can be used by potential adopters of LexEVS as they evaluate the capabilities of the system. This is an example of a valuable contribution from the community that is not code-based; in an open source model, contributions of documentation can be as important as contributions of code.

Health Level 7 (HL7)

EVS supports terminology content for the Regulated Clinical Research Information Management (RCRIM) committee of HL7, and for other committees as appropriate including Patient Safety, Pharmacy, Clinical Genomics, and the Clinical Interoperability Council.

World Health Organization (WHO)

WHO requested in June, 2009, a Classification Markup Language (ClaML) LexEVS data processing program that could be used to render ICD-10 in preparation for, and as the foundation of, ICD-11. This is an example of an international standards organization using NCI's open source tooling to support the development of a new version of a major international terminology standard.

WHO work on ICD-11 is also using NCI Thesaurus as an important source of cancer terminology and definitions.

MedDRA

MedDRA (Medical Dictionary for Regulatory Activities) is an ICH standard for regulatory reporting. EVS contributes to updates of the cancer domain for this widely employed international terminology. The NCI Thesaurus is used as the basis to update MedDRA neoplastic terminology. MedDRA is translated into 11 languages, with approximately 3,000 institutional subscribers from 60 countries.

The Taiwan Cancer Registry

The Taiwan Cancer Registry, a population-based cancer registry founded in 1979, uses NCI Thesaurus terminology. Hospitals with greater than 50-bed capacity that provide outpatient and hospitalized cancer care are recruited to participate in reporting all newly diagnosed malignant neoplasms to this registry.

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