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Whose knowledge? Whose questions? Whose answers? Conflicting Preconceptions for Knowledge Intensive Systems
Alan RectorSchool of Computer Science, University of ManchesterNorthwest institute of BioHealth Informatics
Open
GALEN
© University of Manchester
with thanks to Jeremy Rogers, Anthony Nowlan,and the SWBP, OWL, CO-ODE & Protégé teams
2
This should be the age of knowledge acquisition
• The Web– Social computing & Web II– The Semantic Web/Grid
• Service oriented Architectures and discovery– Digital libraries, repositories, ...– Semantic computing
• “Ontologies with everything”
• ...
• ...“... but couldn’t we just get back to 1985”
• Solution space– Logics– Rules– Frames– Planners– Logic programming– Bayes nets– Decision theory– Fuzzy sets– Open / closed world– …
• Problem space– Answer questions– Advising on actions– Hazard monitoring– Creating forms– Discovering resources– Constraint actions– Assess risk– …
• Solution space– Logics– Rules– Frames– Planners– Logic programming– Bayes nets– Decision theory– Fuzzy sets– Open / closed world– …
• Problem space– Answer questions– Advising on actions– Hazard monitoring– Creating forms– Discovering resources– Constraint actions– Assess risk– …
Knowledge Acquisition
Problem space & solution space
``
Guidelines, Patterns, Tools,... Knowledge Acquisition
Problem space
Solutionspace
The knowledge principle
• A system exhibits intelligent understanding and action at a high level of competence primarily because of the specific knowledge that it contains about its domain of endeavor.– Ed Feigenbaum: The Age of Intelligent Machines:
Knowledge Processing--From File Servers to Knowledge Servers, 1990
• Knowledge comes from domain experts:Derived from and delivered to the problem space
…and a Key Reference Point
• We argue that logical soundness, completeness, and worst-case complexity are inadequate measures for evaluating the utility of representation services, and that this evaluation should employ the broader notions of utility and rationality …”
– Two theses of knowledge representation: Language restrictions, taxonomic classification and the utility of representation services.Doyle, J and Patil, R, Artificial Intelligence, 1991. 48: p. 261-297
Where I come from
Best Practice
Clinical Terminology
Data Entry
Clinical Record
Clinical research &Decision Support
Best Practice
Data Entry
Electronic Health
Records
GALEN Ontologies
&Description
logics
Healthcare
Mr Ivor BigunMr Ivor BigunDun RoaminDun RoaminAnytownAnytownAny countryAny country4431 3654 902734431 3654 90273
Clinical research
Decision Support &Knowledge Presentation
By way of User Centred DesignOntologies were a solution, not a goal
… and now to• BioOntologies, Anatomy, and Molecular Pathways
– Capturing biologists knowledge– Reconciling diverse views / Avoiding ontological dogmatism– Integrating ≥500 sources
• Healthcare record standards: Data models and Terminology– Improving the rigour of “UML” based message standards– Binding of terminology to data models
• Medical terminologies / ontologies– GALEN, SNOMED, NCI thesaurus
• Forms generation for clinical trials, data entry & entry and decision support.
– PEN&PAD Revisited
• User oriented Ontology Tools - CO-ODE/Protégé-OWL
• Semantic Web Best Practice WG & Healthcare & Life Sciences SIG(& campaigner for OWL 1.1 and beyond)
Some Recent User Experiences
• Two companies building clinical systems– Intelligent forms creation and constraint management
• Mastering a combinatorial explosion of ≥107
– Workshops, Training and subcontracting
• NHS National Programme for IT: – Additional constraints to UML and between UML and
terminology/ontology• Different implementation of the standard don’t fit
– Managing SNOMED• Large ≥450K ters DL based terminology
• Biologists research groups– Many clinics and workshops
• indefinitely many emails on HCLSig
• The Anatomy community– Workshops towards a common vertebrate anatomy
• “Can’t we just get back to 1985”
What are my prejudices?
• “First do the right thing; then do it right”– and hope that by the time you know what to do
someone else can show you how
• “There is no one way!”– “Society for the Promotion of Secular Ontology”
• “Better” is better than “best”– The best is often the enemy of the good
• Unobtrusive assistance is better than advice– “Shedding light” rather than “uttering prophecies”
• “It doesn’t make the coffee!”– Nothing does everything - the secret is in factoring
the solution space to fit the problem space
Who are my users?
• Intermediate users– Clinical terminologies developers
• GO, SNOMED, GALEN, CCAM, FMA, …
– IT staff configuring clinical systems• NHS, Healthcare information systems staff
– Standards developers• BioPAX, HL7, ??ML,…,
• Near to end users– Bioinformaticians– Trialists and other specialist healthcare informaticians
• End users– Biolomedical scientists– Clinicians, carers and patients
The rest of the talk
• Our experiences– Our original application:
Fractal tailoring of data input forms– Building large terminologies
• Logic as the clips for “Conceptual Lego”• Untangling and normalisation
– Working with biologists
• Observations on Knowledge Resources and “Ontologies”– Things we have found – Things we need
Where we started:A Vision
• Useful and Usable clinical systems– Information when and where you need it
• to make better decisions– “Shedding light”– “Cuing”
– In your own language
• Aggregated data as a byproduct of clinical
• …without getting caught in the combinatorial explosion
Clinergy/ Pen&PAD
• Nice product, bad timing.
Forms
and more forms
Generated Text
And automatic (Read) code generation
One of the greatmissed opportunities today
See Donia Scott’swork at OU
But there are combinatorially many possible forms
• The PROMIS system was discontinued in 1987 at 70K forms and accelerating– A major influence on our work
• For us KR is a way to avoid combinatorial explosions
• A supplier recently expanded all XML forms for data capture in one clinic to 107
Fractal tailoring of reusable resources:example of data collection forms for trials
Renin dependent Hypertension at
St Stevens Hospitals for the National
Hypertension Survey
Hypertension Renin Dependent
Hypertension`In St Stevens Hospital
National Hypertension Survey
Problems:
The exploding bicycle(codes for injuries involving cyclists)• 1972 ICD-9 (E826) 8
• READ-2 (T30..) 81
• READ-3 87
• 1999 ICD-10 ……
ICD = International Classification of diseases
topClassI Certain infectious and parasitic diseasesII NeoplasmsIII Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanismIV Endocrine, nutritional and metabolic diseasesV Mental and behavioural disordersVI Diseases of the nervous systemVII Diseases of the eye and adnexaVIII Diseases of the ear and mastoid processIX Diseases of the circulatory systemsX Diseases of the respiratory systemXI Diseases of the digestive systemXII Diseases of the skin and subcutaneous tissueXIII Diseases of the musculoskeletal system and connective tissueXIV Diseases of the genitourinary systemXV Pregnancy, childbirth and the puerperiumXVI Certain conditions originating in the perinatal periodXVII Congenital malformations, deformations and chromosomal abnormalitiesXVIII Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classifiedXIX Injury, poisoning and certain other consequences of external causesXX External causes of morbidity and mortality
V01-V99 Transport accidentsV01-V09 Pedestrian injured in transport accidentV10-V19 Pedal cyclist injured in transport accident
V10 Pedal cyclist injured in collision with pedestrian or animalV10.0 Pedal cyclist injured in collision with pedestrian or animal, driver, nontraffic accident
V10.00 Pedal cyclist injured in collision with pedestrian or animal, driver, nontraffic accident, while engaged in sports activityV10.01 Pedal cyclist injured in collision with pedestrian or animal, driver, nontraffic accident, while engaged in leisure activityV10.02 Pedal cyclist injured in collision with pedestrian or animal, driver, nontraffic accident, while working for an incomeV10.03 Pedal cyclist injured in collision with pedestrian or animal, driver, nontraffic accident, while engaged in other types of workV10.04 Pedal cyclist injured in collision with pedestrian or animal, driver, nontraffic accident, while resting, sleeping, eating or engaging in other vital activitiesV10.08 Pedal cyclist injured in collision with pedestrian or animal, driver, nontraffic accident, while engaged in other specified activitiesV10.09 Pedal cyclist injured in collision with pedestrian or animal, driver, nontraffic accident, during unspecified activity
V10.1 Pedal cyclist injured in collision with pedestrian or animal, passenger, nontraffic accidentV10.10 Pedal cyclist injured in collision with pedestrian or animal, passenger, nontraffic accident, while engaged in sports activityV10.11 Pedal cyclist injured in collision with pedestrian or animal, passenger, nontraffic accident, while engaged in leisure activityV10.12 Pedal cyclist injured in collision with pedestrian or animal, passenger, nontraffic accident, while working for an incomeV10.13 Pedal cyclist injured in collision with pedestrian or animal, passenger, nontraffic accident, while engaged in other types of workV10.14 Pedal cyclist injured in collision with pedestrian or animal, passenger, nontraffic accident, while resting, sleeping, eating or engaging in other vital activitiesV10.18 Pedal cyclist injured in collision with pedestrian or animal, passenger, nontraffic accident, while engaged in other specified activitiesV10.19 Pedal cyclist injured in collision with pedestrian or animal, passenger, nontraffic accident, during unspecified activity
V10.2 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, nontraffic accidentV10.20 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, nontraffic accident, while engaged in sports activityV10.21 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, nontraffic accident, while engaged in leisure activityV10.22 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, nontraffic accident, while working for an incomeV10.23 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, nontraffic accident, while engaged in other types of workV10.24 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activitiesV10.28 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, nontraffic accident, while engaged in other specified activitiesV10.29 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, nontraffic accident, during unspecified activity
V10.3 Pedal cyclist injured in collision with pedestrian or animal, while boarding or alightingV10.30 Pedal cyclist injured in collision with pedestrian or animal, while boarding or alighting, while engaged in sports activityV10.31 Pedal cyclist injured in collision with pedestrian or animal, while boarding or alighting, while engaged in leisure activityV10.32 Pedal cyclist injured in collision with pedestrian or animal, while boarding or alighting, while working for an incomeV10.33 Pedal cyclist injured in collision with pedestrian or animal, while boarding or alighting, while engaged in other types of workV10.34 Pedal cyclist injured in collision with pedestrian or animal, while boarding or alighting, while resting, sleeping, eating or engaging in other vital activitiesV10.38 Pedal cyclist injured in collision with pedestrian or animal, while boarding or alighting, while engaged in other specified activitiesV10.39 Pedal cyclist injured in collision with pedestrian or animal, while boarding or alighting, during unspecified activity
V10.4 Pedal cyclist injured in collision with pedestrian or animal, driver, traffic accidentV10.40 Pedal cyclist injured in collision with pedestrian or animal, driver, traffic accident, while engaged in sports activityV10.41 Pedal cyclist injured in collision with pedestrian or animal, driver, traffic accident, while engaged in leisure activityV10.42 Pedal cyclist injured in collision with pedestrian or animal, driver, traffic accident, while working for an incomeV10.43 Pedal cyclist injured in collision with pedestrian or animal, driver, traffic accident, while engaged in other types of workV10.44 Pedal cyclist injured in collision with pedestrian or animal, driver, traffic accident, while resting, sleeping, eating or engaging in other vital activitiesV10.48 Pedal cyclist injured in collision with pedestrian or animal, driver, traffic accident, while engaged in other specified activitiesV10.49 Pedal cyclist injured in collision with pedestrian or animal, driver, traffic accident, during unspecified activity
V10.5 Pedal cyclist injured in collision with pedestrian or animal, passenger, traffic accidentV10.50 Pedal cyclist injured in collision with pedestrian or animal, passenger, traffic accident, while engaged in sports activityV10.51 Pedal cyclist injured in collision with pedestrian or animal, passenger, traffic accident, while engaged in leisure activityV10.52 Pedal cyclist injured in collision with pedestrian or animal, passenger, traffic accident, while working for an incomeV10.53 Pedal cyclist injured in collision with pedestrian or animal, passenger, traffic accident, while engaged in other types of workV10.54 Pedal cyclist injured in collision with pedestrian or animal, passenger, traffic accident, while resting, sleeping, eating or engaging in other vital activitiesV10.58 Pedal cyclist injured in collision with pedestrian or animal, passenger, traffic accident, while engaged in other specified activitiesV10.59 Pedal cyclist injured in collision with pedestrian or animal, passenger, traffic accident, during unspecified activity
V10.9 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, traffic accidentV10.90 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, traffic accident, while engaged in sports activityV10.91 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, traffic accident, while engaged in leisure activityV10.92 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, traffic accident, while working for an incomeV10.93 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, traffic accident, while engaged in other types of workV10.94 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, traffic accident, while resting, sleeping, eating or engaging in other vital activitiesV10.98 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, traffic accident, while engaged in other specified activitiesV10.99 Pedal cyclist injured in collision with pedestrian or animal, unspecified pedal cyclist, traffic accident, during unspecified activity
V11 Pedal cyclist injured in collision with other pedal cycleV11.0 Pedal cyclist injured in collision with other pedal cycle, driver, nontraffic accident
V11.00 Pedal cyclist injured in collision with other pedal cycle, driver, nontraffic accident, while engaged in sports activityV11.01 Pedal cyclist injured in collision with other pedal cycle, driver, nontraffic accident, while engaged in leisure activityV11.02 Pedal cyclist injured in collision with other pedal cycle, driver, nontraffic accident, while working for an incomeV11.03 Pedal cyclist injured in collision with other pedal cycle, driver, nontraffic accident, while engaged in other types of workV11.04 Pedal cyclist injured in collision with other pedal cycle, driver, nontraffic accident, while resting, sleeping, eating or engaging in other vital activitiesV11.08 Pedal cyclist injured in collision with other pedal cycle, driver, nontraffic accident, while engaged in other specified activitiesV11.09 Pedal cyclist injured in collision with other pedal cycle, driver, nontraffic accident, during unspecified activity
V11.1 Pedal cyclist injured in collision with other pedal cycle, passenger, nontraffic accidentV11.10 Pedal cyclist injured in collision with other pedal cycle, passenger, nontraffic accident, while engaged in sports activityV11.11 Pedal cyclist injured in collision with other pedal cycle, passenger, nontraffic accident, while engaged in leisure activityV11.12 Pedal cyclist injured in collision with other pedal cycle, passenger, nontraffic accident, while working for an incomeV11.13 Pedal cyclist injured in collision with other pedal cycle, passenger, nontraffic accident, while engaged in other types of workV11.14 Pedal cyclist injured in collision with other pedal cycle, passenger, nontraffic accident, while resting, sleeping, eating or engaging in other vital activitiesV11.18 Pedal cyclist injured in collision with other pedal cycle, passenger, nontraffic accident, while engaged in other specified activitiesV11.19 Pedal cyclist injured in collision with other pedal cycle, passenger, nontraffic accident, during unspecified activity
V11.2 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, nontraffic accidentV11.20 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, nontraffic accident, while engaged in sports activityV11.21 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, nontraffic accident, while engaged in leisure activityV11.22 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, nontraffic accident, while working for an incomeV11.23 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, nontraffic accident, while engaged in other types of workV11.24 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activitiesV11.28 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, nontraffic accident, while engaged in other specified activitiesV11.29 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, nontraffic accident, during unspecified activity
V11.3 Pedal cyclist injured in collision with other pedal cycle, while boarding or alightingV11.30 Pedal cyclist injured in collision with other pedal cycle, while boarding or alighting, while engaged in sports activityV11.31 Pedal cyclist injured in collision with other pedal cycle, while boarding or alighting, while engaged in leisure activityV11.32 Pedal cyclist injured in collision with other pedal cycle, while boarding or alighting, while working for an incomeV11.33 Pedal cyclist injured in collision with other pedal cycle, while boarding or alighting, while engaged in other types of workV11.34 Pedal cyclist injured in collision with other pedal cycle, while boarding or alighting, while resting, sleeping, eating or engaging in other vital activitiesV11.38 Pedal cyclist injured in collision with other pedal cycle, while boarding or alighting, while engaged in other specified activitiesV11.39 Pedal cyclist injured in collision with other pedal cycle, while boarding or alighting, during unspecified activity
V11.4 Pedal cyclist injured in collision with other pedal cycle, driver, traffic accidentV11.40 Pedal cyclist injured in collision with other pedal cycle, driver, traffic accident, while engaged in sports activityV11.41 Pedal cyclist injured in collision with other pedal cycle, driver, traffic accident, while engaged in leisure activityV11.42 Pedal cyclist injured in collision with other pedal cycle, driver, traffic accident, while working for an incomeV11.43 Pedal cyclist injured in collision with other pedal cycle, driver, traffic accident, while engaged in other types of workV11.44 Pedal cyclist injured in collision with other pedal cycle, driver, traffic accident, while resting, sleeping, eating or engaging in other vital activitiesV11.48 Pedal cyclist injured in collision with other pedal cycle, driver, traffic accident, while engaged in other specified activitiesV11.49 Pedal cyclist injured in collision with other pedal cycle, driver, traffic accident, during unspecified activity
V11.5 Pedal cyclist injured in collision with other pedal cycle, passenger, traffic accidentV11.50 Pedal cyclist injured in collision with other pedal cycle, passenger, traffic accident, while engaged in sports activityV11.51 Pedal cyclist injured in collision with other pedal cycle, passenger, traffic accident, while engaged in leisure activityV11.52 Pedal cyclist injured in collision with other pedal cycle, passenger, traffic accident, while working for an incomeV11.53 Pedal cyclist injured in collision with other pedal cycle, passenger, traffic accident, while engaged in other types of workV11.54 Pedal cyclist injured in collision with other pedal cycle, passenger, traffic accident, while resting, sleeping, eating or engaging in other vital activitiesV11.58 Pedal cyclist injured in collision with other pedal cycle, passenger, traffic accident, while engaged in other specified activitiesV11.59 Pedal cyclist injured in collision with other pedal cycle, passenger, traffic accident, during unspecified activity
V11.9 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, traffic accidentV11.90 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, traffic accident, while engaged in sports activityV11.91 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, traffic accident, while engaged in leisure activityV11.92 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, traffic accident, while working for an incomeV11.93 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, traffic accident, while engaged in other types of workV11.94 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, traffic accident, while resting, sleeping, eating or engaging in other vital activitiesV11.98 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, traffic accident, while engaged in other specified activitiesV11.99 Pedal cyclist injured in collision with other pedal cycle, unspecified pedal cyclist, traffic accident, during unspecified activity
V12 Pedal cyclist injured in collision with two- or three-wheeled motor vehicleV12.0 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, nontraffic accident
V12.00 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, nontraffic accident, while engaged in sports activityV12.01 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, nontraffic accident, while engaged in leisure activityV12.02 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, nontraffic accident, while working for an incomeV12.03 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, nontraffic accident, while engaged in other types of workV12.04 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, nontraffic accident, while resting, sleeping, eating or engaging in other vital activitiesV12.08 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, nontraffic accident, while engaged in other specified activitiesV12.09 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, nontraffic accident, during unspecified activity
V12.1 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, nontraffic accidentV12.10 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, nontraffic accident, while engaged in sports activityV12.11 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, nontraffic accident, while engaged in leisure activityV12.12 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, nontraffic accident, while working for an incomeV12.13 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, nontraffic accident, while engaged in other types of workV12.14 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, nontraffic accident, while resting, sleeping, eating or engaging in other vital activitiesV12.18 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, nontraffic accident, while engaged in other specified activitiesV12.19 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, nontraffic accident, during unspecified activity
V12.2 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accidentV12.20 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in sports activityV12.21 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in leisure activityV12.22 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, while working for an incomeV12.23 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in other types of workV12.24 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activitiesV12.28 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in other specified activitiesV12.29 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, during unspecified activity
V12.3 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, while boarding or alighting
V12.30 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, while boarding or alighting, while engaged in sports activity
V12.31 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, while boarding or alighting, while engaged in leisure activity
V12.32 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, while boarding or alighting, while working for an income
V12.33 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, while boarding or alighting, while engaged in other types of work
V12.34 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, while boarding or alighting, while resting, sleeping, eating or engaging in other vital activities
V12.38 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, while boarding or alighting, while engaged in other specified activities
V12.39 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, while boarding or alighting, during unspecified activity
V12.4 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, traffic accident
V12.40 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, traffic accident, while engaged in sports activity
V12.41 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, traffic accident, while engaged in leisure activity
V12.42 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, traffic accident, while working for an income
V12.43 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, traffic accident, while engaged in other types of work
V12.44 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V12.48 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, traffic accident, while engaged in other specified activities
V12.49 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, driver, traffic accident, during unspecified activity
V12.5 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, traffic accident
V12.50 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, traffic accident, while engaged in sports activity
V12.51 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, traffic accident, while engaged in leisure activity
V12.52 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, traffic accident, while working for an income
V12.53 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, traffic accident, while engaged in other types of work
V12.54 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V12.58 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, traffic accident, while engaged in other specified activities
V12.59 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, passenger, traffic accident, during unspecified activity
V12.9 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, traffic accident
V12.90 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, traffic accident, while engaged in sports activity
V12.91 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, traffic accident, while engaged in leisure activity
V12.92 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, traffic accident, while working for an income
V12.93 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, traffic accident, while engaged in other types of work
V12.94 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V12.98 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, traffic accident, while engaged in other specified activities
V12.99 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, traffic accident, during unspecified activity
V13 Pedal cyclist injured in collision with car, pick-up truck or van
V13.0 Pedal cyclist injured in collision with car, pick-up truck or van, driver, nontraffic accident
V13.00 Pedal cyclist injured in collision with car, pick-up truck or van, driver, nontraffic accident, while engaged in sports activity
V13.01 Pedal cyclist injured in collision with car, pick-up truck or van, driver, nontraffic accident, while engaged in leisure activity
V13.02 Pedal cyclist injured in collision with car, pick-up truck or van, driver, nontraffic accident, while working for an income
V13.03 Pedal cyclist injured in collision with car, pick-up truck or van, driver, nontraffic accident, while engaged in other types of work
V13.04 Pedal cyclist injured in collision with car, pick-up truck or van, driver, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V13.08 Pedal cyclist injured in collision with car, pick-up truck or van, driver, nontraffic accident, while engaged in other specified activities
V13.09 Pedal cyclist injured in collision with car, pick-up truck or van, driver, nontraffic accident, during unspecified activity
V13.1 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, nontraffic accident
V13.10 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, nontraffic accident, while engaged in sports activity
V13.11 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, nontraffic accident, while engaged in leisure activity
V13.12 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, nontraffic accident, while working for an income
V13.13 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, nontraffic accident, while engaged in other types of work
V13.14 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V13.18 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, nontraffic accident, while engaged in other specified activities
V13.19 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, nontraffic accident, during unspecified activity
V13.2 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, nontraffic accident
V13.20 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, nontraffic accident, while engaged in sports activity
V13.21 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, nontraffic accident, while engaged in leisure activity
V13.22 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, nontraffic accident, while working for an income
V13.23 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, nontraffic accident, while engaged in other types of work
V13.24 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V13.28 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, nontraffic accident, while engaged in other specified activities
V13.29 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, nontraffic accident, during unspecified activity
V13.3 Pedal cyclist injured in collision with car, pick-up truck or van, while boarding or alighting
V13.30 Pedal cyclist injured in collision with car, pick-up truck or van, while boarding or alighting, while engaged in sports activity
V13.31 Pedal cyclist injured in collision with car, pick-up truck or van, while boarding or alighting, while engaged in leisure activity
V13.32 Pedal cyclist injured in collision with car, pick-up truck or van, while boarding or alighting, while working for an income
V13.33 Pedal cyclist injured in collision with car, pick-up truck or van, while boarding or alighting, while engaged in other types of work
V13.34 Pedal cyclist injured in collision with car, pick-up truck or van, while boarding or alighting, while resting, sleeping, eating or engaging in other vital activities
V13.38 Pedal cyclist injured in collision with car, pick-up truck or van, while boarding or alighting, while engaged in other specified activities
V13.39 Pedal cyclist injured in collision with car, pick-up truck or van, while boarding or alighting, during unspecified activity
V13.4 Pedal cyclist injured in collision with car, pick-up truck or van, driver, traffic accident
V13.40 Pedal cyclist injured in collision with car, pick-up truck or van, driver, traffic accident, while engaged in sports activity
V13.41 Pedal cyclist injured in collision with car, pick-up truck or van, driver, traffic accident, while engaged in leisure activity
V13.42 Pedal cyclist injured in collision with car, pick-up truck or van, driver, traffic accident, while working for an income
V13.43 Pedal cyclist injured in collision with car, pick-up truck or van, driver, traffic accident, while engaged in other types of work
V13.44 Pedal cyclist injured in collision with car, pick-up truck or van, driver, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V13.48 Pedal cyclist injured in collision with car, pick-up truck or van, driver, traffic accident, while engaged in other specified activities
V13.49 Pedal cyclist injured in collision with car, pick-up truck or van, driver, traffic accident, during unspecified activity
V13.5 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, traffic accident
V13.50 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, traffic accident, while engaged in sports activity
V13.51 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, traffic accident, while engaged in leisure activity
V13.52 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, traffic accident, while working for an income
V13.53 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, traffic accident, while engaged in other types of work
V13.54 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V13.58 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, traffic accident, while engaged in other specified activities
V13.59 Pedal cyclist injured in collision with car, pick-up truck or van, passenger, traffic accident, during unspecified activity
V13.9 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, traffic accident
V13.90 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, traffic accident, while engaged in sports activity
V13.91 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, traffic accident, while engaged in leisure activity
V13.92 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, traffic accident, while working for an income
V13.93 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, traffic accident, while engaged in other types of work
V13.94 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V13.98 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, traffic accident, while engaged in other specified activities
V13.99 Pedal cyclist injured in collision with car, pick-up truck or van, unspecified pedal cyclist, traffic accident, during unspecified activity
V14 Pedal cyclist injured in collision with heavy transport vehicle or bus
V14.0 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, nontraffic accident
V14.00 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, nontraffic accident, while engaged in sports activity
V14.01 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, nontraffic accident, while engaged in leisure activity
V14.02 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, nontraffic accident, while working for an income
V14.03 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, nontraffic accident, while engaged in other types of work
V14.04 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V14.08 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, nontraffic accident, while engaged in other specified activities
V14.09 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, nontraffic accident, during unspecified activity
V14.1 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, nontraffic accident
V14.10 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, nontraffic accident, while engaged in sports activity
V14.11 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, nontraffic accident, while engaged in leisure activity
V14.12 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, nontraffic accident, while working for an income
V14.13 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, nontraffic accident, while engaged in other types of work
V14.14 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V14.18 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, nontraffic, while engaged in other specified activities accident
V14.19 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, nontraffic, during unspecified activity accident
V14.2 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, nontraffic accident
V14.20 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, nontraffic accident, while engaged in sports activity
V14.21 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, nontraffic accident, while engaged in leisure activity
V14.22 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, nontraffic accident, while working for an income
V14.23 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, nontraffic accident, while engaged in other types of work
V14.24 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V14.28 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, nontraffic accident, while engaged in other specified activities
V14.29 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, nontraffic accident, during unspecified activity
V14.3 Pedal cyclist injured in collision with heavy transport vehicle or bus, while boarding or alighting
V14.30 Pedal cyclist injured in collision with heavy transport vehicle or bus, while boarding or alighting, while engaged in sports activity
V14.31 Pedal cyclist injured in collision with heavy transport vehicle or bus, while boarding or alighting, while engaged in leisure activity
V14.32 Pedal cyclist injured in collision with heavy transport vehicle or bus, while boarding or alighting, while working for an income
V14.33 Pedal cyclist injured in collision with heavy transport vehicle or bus, while boarding or alighting, while engaged in other types of work
V14.34 Pedal cyclist injured in collision with heavy transport vehicle or bus, while boarding or alighting, while resting, sleeping, eating or engaging in other vital activities
V14.38 Pedal cyclist injured in collision with heavy transport vehicle or bus, while boarding or alighting, while engaged in other specified activities
V14.39 Pedal cyclist injured in collision with heavy transport vehicle or bus, while boarding or alighting, during unspecified activity
V14.4 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, traffic accident
V14.40 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, traffic accident, while engaged in sports activity
V14.41 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, traffic accident, while engaged in leisure activity
V14.42 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, traffic accident, while working for an income
V14.43 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, traffic accident, while engaged in other types of work
V14.44 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V14.48 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, traffic accident, while engaged in other specified activities
V14.49 Pedal cyclist injured in collision with heavy transport vehicle or bus, driver, traffic accident, during unspecified activity
V14.5 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, traffic accident
V14.50 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, traffic accident, while engaged in sports activity
V14.51 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, traffic accident, while engaged in leisure activity
V14.52 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, traffic accident, while working for an income
V14.53 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, traffic accident, while engaged in other types of work
V14.54 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V14.58 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, traffic accident, while engaged in other specified activities
V14.59 Pedal cyclist injured in collision with heavy transport vehicle or bus, passenger, traffic accident, during unspecified activity
V14.9 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, traffic accident
V14.90 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, traffic accident, while engaged in sports activity
V14.91 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, traffic accident, while engaged in leisure activity
V14.92 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, traffic accident, while working for an income
V14.93 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, traffic accident, while engaged in other types of work
V14.94 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V14.98 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, traffic accident, while engaged in other specified activities
V14.99 Pedal cyclist injured in collision with heavy transport vehicle or bus, unspecified pedal cyclist, traffic accident, during unspecified activity
V15 Pedal cyclist injured in collision with railway train or railway vehicle
V15.0 Pedal cyclist injured in collision with railway train or railway vehicle, driver, nontraffic accident
V15.00 Pedal cyclist injured in collision with railway train or railway vehicle, driver, nontraffic accident, while engaged in sports activity
V15.01 Pedal cyclist injured in collision with railway train or railway vehicle, driver, nontraffic accident, while engaged in leisure activity
V15.02 Pedal cyclist injured in collision with railway train or railway vehicle, driver, nontraffic accident, while working for an income
V15.03 Pedal cyclist injured in collision with railway train or railway vehicle, driver, nontraffic accident, while engaged in other types of work
V15.04 Pedal cyclist injured in collision with railway train or railway vehicle, driver, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V15.08 Pedal cyclist injured in collision with railway train or railway vehicle, driver, nontraffic accident, while engaged in other specified activities
V15.09 Pedal cyclist injured in collision with railway train or railway vehicle, driver, nontraffic accident, during unspecified activity
V15.1 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, nontraffic accident
V15.10 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, nontraffic accident, while engaged in sports activity
V15.11 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, nontraffic accident, while engaged in leisure activity
V15.12 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, nontraffic accident, while working for an income
V15.13 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, nontraffic accident, while engaged in other types of work
V15.14 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V15.18 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, nontraffic accident, while engaged in other specified activities
V15.19 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, nontraffic accident, during unspecified activity
V15.2 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, nontraffic accident
V15.20 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in sports activity
V15.21 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in leisure activity
V15.22 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, nontraffic accident, while working for an income
V15.23 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in other types of work
V15.24 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V15.28 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in other specified activities
V15.29 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, nontraffic accident, during unspecified activity
V15.3 Pedal cyclist injured in collision with railway train or railway vehicle, while boarding or alighting
V15.30 Pedal cyclist injured in collision with railway train or railway vehicle, while boarding or alighting, while engaged in sports activity
V15.31 Pedal cyclist injured in collision with railway train or railway vehicle, while boarding or alighting, while engaged in leisure activity
V15.32 Pedal cyclist injured in collision with railway train or railway vehicle, while boarding or alighting, while working for an income, while working for an income
V15.33 Pedal cyclist injured in collision with railway train or railway vehicle, while boarding or alighting, while engaged in other types of work
V15.34 Pedal cyclist injured in collision with railway train or railway vehicle, while boarding or alighting, while resting, sleeping, eating or engaging in other vital activities
V15.38 Pedal cyclist injured in collision with railway train or railway vehicle, while boarding or alighting, while engaged in other specified activities
V15.39 Pedal cyclist injured in collision with railway train or railway vehicle, while boarding or alighting, during unspecified activity
V15.4 Pedal cyclist injured in collision with railway train or railway vehicle, driver, traffic accident
V15.40 Pedal cyclist injured in collision with railway train or railway vehicle, driver, traffic accident, while engaged in sports activity
V15.41 Pedal cyclist injured in collision with railway train or railway vehicle, driver, traffic accident, while engaged in leisure activity
V15.42 Pedal cyclist injured in collision with railway train or railway vehicle, driver, traffic accident, while working for an income
V15.43 Pedal cyclist injured in collision with railway train or railway vehicle, driver, traffic accident, while engaged in other types of work
V15.44 Pedal cyclist injured in collision with railway train or railway vehicle, driver, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V15.48 Pedal cyclist injured in collision with railway train or railway vehicle, driver, traffic accident, while engaged in other specified activities
V15.49 Pedal cyclist injured in collision with railway train or railway vehicle, driver, traffic accident, during unspecified activity
V15.5 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, traffic accident
V15.50 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, traffic accident, while engaged in sports activity
V15.51 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, traffic accident, while engaged in leisure activity
V15.52 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, traffic accident, while working for an income
V15.53 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, traffic accident, while engaged in other types of work
V15.54 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V15.58 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, traffic accident, while engaged in other specified activities
V15.59 Pedal cyclist injured in collision with railway train or railway vehicle, passenger, traffic accident, during unspecified activity
V15.9 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, traffic accident
V15.90 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, traffic accident, while engaged in sports activity
V15.91 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, traffic accident, while engaged in leisure activity
V15.92 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, traffic accident, while working for an income
V15.93 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, traffic accident, while engaged in other types of work
V15.94 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V15.98 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, traffic accident, while engaged in other specified activities
V15.99 Pedal cyclist injured in collision with railway train or railway vehicle, unspecified pedal cyclist, traffic accident, during unspecified activity
V16 Pedal cyclist injured in collision with other nonmotor vehicle
V16.0 Pedal cyclist injured in collision with other nonmotor vehicle, driver, nontraffic accident
V16.00 Pedal cyclist injured in collision with other nonmotor vehicle, driver, nontraffic accident, while engaged in sports activity
V16.01 Pedal cyclist injured in collision with other nonmotor vehicle, driver, nontraffic accident, while engaged in leisure activity
V16.02 Pedal cyclist injured in collision with other nonmotor vehicle, driver, nontraffic accident, while working for an income
V16.03 Pedal cyclist injured in collision with other nonmotor vehicle, driver, nontraffic accident, while engaged in other types of work
V16.04 Pedal cyclist injured in collision with other nonmotor vehicle, driver, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V16.08 Pedal cyclist injured in collision with other nonmotor vehicle, driver, nontraffic accident, while engaged in other specified activities
V16.09 Pedal cyclist injured in collision with other nonmotor vehicle, driver, nontraffic accident, during unspecified activity
V16.1 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, nontraffic accident
V16.10 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, nontraffic accident, while engaged in sports activity
V16.11 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, nontraffic accident, while engaged in leisure activity
V16.12 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, nontraffic accident, while working for an income
V16.13 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, nontraffic accident, while engaged in other types of work
V16.14 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V16.18 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, nontraffic accident, while engaged in other specified activities
V16.19 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, nontraffic accident, during unspecified activity
V16.2 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, nontraffic accident
V16.20 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in sports activity
V16.21 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in leisure activity
V16.22 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, nontraffic accident, while working for an income
V16.23 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in other types of work
V16.24 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V16.28 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, nontraffic accident, while engaged in other specified activities
V16.29 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, nontraffic accident, during unspecified activity
V16.3 Pedal cyclist injured in collision with other nonmotor vehicle, while boarding or alighting
V16.30 Pedal cyclist injured in collision with other nonmotor vehicle, while boarding or alighting, while engaged in sports activity
V16.31 Pedal cyclist injured in collision with other nonmotor vehicle, while boarding or alighting, while engaged in leisure activity
V16.32 Pedal cyclist injured in collision with other nonmotor vehicle, while boarding or alighting, while working for an income
V16.33 Pedal cyclist injured in collision with other nonmotor vehicle, while boarding or alighting, while engaged in other types of work
V16.34 Pedal cyclist injured in collision with other nonmotor vehicle, while boarding or alighting, while resting, sleeping, eating or engaging in other vital activities
V16.38 Pedal cyclist injured in collision with other nonmotor vehicle, while boarding or alighting, while engaged in other specified activities
V16.39 Pedal cyclist injured in collision with other nonmotor vehicle, while boarding or alighting, during unspecified activity
V16.4 Pedal cyclist injured in collision with other nonmotor vehicle, driver, traffic accident
V16.40 Pedal cyclist injured in collision with other nonmotor vehicle, driver, traffic accident, while engaged in sports activity
V16.41 Pedal cyclist injured in collision with other nonmotor vehicle, driver, traffic accident, while engaged in leisure activity
V16.42 Pedal cyclist injured in collision with other nonmotor vehicle, driver, traffic accident, while working for an income
V16.43 Pedal cyclist injured in collision with other nonmotor vehicle, driver, traffic accident, while engaged in other types of work
V16.44 Pedal cyclist injured in collision with other nonmotor vehicle, driver, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V16.48 Pedal cyclist injured in collision with other nonmotor vehicle, driver, traffic accident, while engaged in other specified activities
V16.49 Pedal cyclist injured in collision with other nonmotor vehicle, driver, traffic accident, during unspecified activity
V16.5 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, traffic accident
V16.50 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, traffic accident, while engaged in sports activity
V16.51 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, traffic accident, while engaged in leisure activity
V16.52 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, traffic accident, while working for an income
V16.53 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, traffic accident, while engaged in other types of work
V16.54 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V16.58 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, traffic accident, while engaged in other specified activities
V16.59 Pedal cyclist injured in collision with other nonmotor vehicle, passenger, traffic accident, during unspecified activity
V16.9 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, traffic accident
V16.90 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, traffic accident, while engaged in leisure activity
V16.91 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, traffic accident, while engaged in sports activity
V16.92 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, traffic accident, while working for an income
V16.93 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, traffic accident, while engaged in other types of work
V16.94 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V16.98 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, traffic accident, while engaged in other specified activities
V16.99 Pedal cyclist injured in collision with other nonmotor vehicle, unspecified pedal cyclist, traffic accident, during unspecified activity
V17 Pedal cyclist injured in collision with fixed or stationary object
V17.0 Pedal cyclist injured in collision with fixed or stationary object, driver, nontraffic accident
V17.00 Pedal cyclist injured in collision with fixed or stationary object, driver, nontraffic accident, while engaged in sports activity
V17.01 Pedal cyclist injured in collision with fixed or stationary object, driver, nontraffic accident, while engaged in leisure activity
V17.02 Pedal cyclist injured in collision with fixed or stationary object, driver, nontraffic accident, while working for an income
V17.03 Pedal cyclist injured in collision with fixed or stationary object, driver, nontraffic accident, while engaged in other types of work
V17.04 Pedal cyclist injured in collision with fixed or stationary object, driver, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V17.08 Pedal cyclist injured in collision with fixed or stationary object, driver, nontraffic accident, while engaged in other specified activities
V17.09 Pedal cyclist injured in collision with fixed or stationary object, driver, nontraffic accident, during unspecified activity
V17.1 Pedal cyclist injured in collision with fixed or stationary object, passenger, nontraffic accident
V17.10 Pedal cyclist injured in collision with fixed or stationary object, passenger, nontraffic accident, while engaged in sports activity
V17.11 Pedal cyclist injured in collision with fixed or stationary object, passenger, nontraffic accident, while engaged in leisure activity
V17.12 Pedal cyclist injured in collision with fixed or stationary object, passenger, nontraffic accident, while working for an income
V17.13 Pedal cyclist injured in collision with fixed or stationary object, passenger, nontraffic accident, while engaged in other types of work
V17.14 Pedal cyclist injured in collision with fixed or stationary object, passenger, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V17.18 Pedal cyclist injured in collision with fixed or stationary object, passenger, nontraffic accident, while engaged in other specified activities
V17.19 Pedal cyclist injured in collision with fixed or stationary object, passenger, nontraffic accident, during unspecified activity
V17.2 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, nontraffic accident
V17.20 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, nontraffic accident, while engaged in sports activity
V17.21 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, nontraffic accident, while engaged in leisure activity
V17.22 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, nontraffic accident, while working for an income
V17.23 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, nontraffic accident, while engaged in other types of work
V17.24 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V17.28 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, nontraffic accident, while engaged in other specified activities
V17.29 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, nontraffic accident, during unspecified activity
V17.3 Pedal cyclist injured in collision with fixed or stationary object, while boarding or alighting
V17.30 Pedal cyclist injured in collision with fixed or stationary object, while boarding or alighting, while engaged in sports activity
V17.31 Pedal cyclist injured in collision with fixed or stationary object, while boarding or alighting, while engaged in leisure activity
V17.32 Pedal cyclist injured in collision with fixed or stationary object, while boarding or alighting, while working for an income
V17.33 Pedal cyclist injured in collision with fixed or stationary object, while boarding or alighting, while engaged in other types of work
V17.34 Pedal cyclist injured in collision with fixed or stationary object, while boarding or alighting, while resting, sleeping, eating or engaging in other vital activities
V17.38 Pedal cyclist injured in collision with fixed or stationary object, while boarding or alighting, while engaged in other specified activities
V17.39 Pedal cyclist injured in collision with fixed or stationary object, while boarding or alighting, during unspecified activity
V17.4 Pedal cyclist injured in collision with fixed or stationary object, driver, traffic accident
V17.40 Pedal cyclist injured in collision with fixed or stationary object, driver, traffic accident, while engaged in sports activity
V17.41 Pedal cyclist injured in collision with fixed or stationary object, driver, traffic accident, while engaged in leisure activity
V17.42 Pedal cyclist injured in collision with fixed or stationary object, driver, traffic accident, while working for an income
V17.43 Pedal cyclist injured in collision with fixed or stationary object, driver, traffic accident, while engaged in other types of work
V17.44 Pedal cyclist injured in collision with fixed or stationary object, driver, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V17.48 Pedal cyclist injured in collision with fixed or stationary object, driver, traffic accident, while engaged in other specified activities
V17.49 Pedal cyclist injured in collision with fixed or stationary object, driver, traffic accident, during unspecified activity
V17.5 Pedal cyclist injured in collision with fixed or stationary object, passenger, traffic accident
V17.50 Pedal cyclist injured in collision with fixed or stationary object, passenger, traffic accident, while engaged in sports activity
V17.51 Pedal cyclist injured in collision with fixed or stationary object, passenger, traffic accident, while engaged in leisure activity
V17.52 Pedal cyclist injured in collision with fixed or stationary object, passenger, traffic accident, while working for an income
V17.53 Pedal cyclist injured in collision with fixed or stationary object, passenger, traffic accident, while engaged in other types of work
V17.54 Pedal cyclist injured in collision with fixed or stationary object, passenger, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V17.58 Pedal cyclist injured in collision with fixed or stationary object, passenger, traffic accident, while engaged in other specified activities
V17.59 Pedal cyclist injured in collision with fixed or stationary object, passenger, traffic accident, during unspecified activity
V17.9 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, traffic accident
V17.90 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, traffic accident, while engaged in sports activity
V17.91 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, traffic accident, while engaged in leisure activity
V17.92 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, traffic accident, while working for an income
V17.93 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, traffic accident, while engaged in other types of work
V17.94 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V17.98 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, traffic accident, while engaged in other specified activities
V17.99 Pedal cyclist injured in collision with fixed or stationary object, unspecified pedal cyclist, traffic accident, during unspecified activity
V18 Pedal cyclist injured in noncollision transport accident
V18.0 Pedal cyclist injured in noncollision transport accident, driver, nontraffic accident
V18.00 Pedal cyclist injured in noncollision transport accident, driver, nontraffic accident, while engaged in sports activity
V18.01 Pedal cyclist injured in noncollision transport accident, driver, nontraffic accident, while engaged in leisure activity
V18.02 Pedal cyclist injured in noncollision transport accident, driver, nontraffic accident, while working for an income
V18.03 Pedal cyclist injured in noncollision transport accident, driver, nontraffic accident, while engaged in other types of work
V18.04 Pedal cyclist injured in noncollision transport accident, driver, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V18.08 Pedal cyclist injured in noncollision transport accident, driver, nontraffic accident, while engaged in other specified activities
V18.09 Pedal cyclist injured in noncollision transport accident, driver, nontraffic accident, during unspecified activity
V18.1 Pedal cyclist injured in noncollision transport accident, passenger, nontraffic accident
V18.10 Pedal cyclist injured in noncollision transport accident, passenger, nontraffic accident, while engaged in sports activity
V18.11 Pedal cyclist injured in noncollision transport accident, passenger, nontraffic accident, while engaged in leisure activity
V18.12 Pedal cyclist injured in noncollision transport accident, passenger, nontraffic accident, while working for an income
V18.13 Pedal cyclist injured in noncollision transport accident, passenger, nontraffic accident, while engaged in other types of work
V18.14 Pedal cyclist injured in noncollision transport accident, passenger, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V18.18 Pedal cyclist injured in noncollision transport accident, passenger, nontraffic accident, while engaged in other specified activities
V18.19 Pedal cyclist injured in noncollision transport accident, passenger, nontraffic accident, during unspecified activity
V18.2 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, nontraffic accident
V18.20 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, nontraffic accident, while engaged in sports activity
V18.21 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, nontraffic accident, while engaged in leisure activity
V18.22 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, nontraffic accident, while working for an income
V18.23 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, nontraffic accident, while engaged in other types of work
V18.24 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V18.28 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, nontraffic accident, while engaged in other specified activities
V18.29 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, nontraffic accident, during unspecified activity
V18.3 Pedal cyclist injured in noncollision transport accident, while boarding or alighting
V18.30 Pedal cyclist injured in noncollision transport accident, while boarding or alighting, while engaged in sports activity
V18.31 Pedal cyclist injured in noncollision transport accident, while boarding or alighting, while engaged in leisure activity
V18.32 Pedal cyclist injured in noncollision transport accident, while boarding or alighting, while working for an income
V18.33 Pedal cyclist injured in noncollision transport accident, while boarding or alighting, while engaged in other types of work
V18.34 Pedal cyclist injured in noncollision transport accident, while boarding or alighting, while resting, sleeping, eating or engaging in other vital activities
V18.38 Pedal cyclist injured in noncollision transport accident, while boarding or alighting, while engaged in other specified activities
V18.39 Pedal cyclist injured in noncollision transport accident, while boarding or alighting, during unspecified activity
V18.4 Pedal cyclist injured in noncollision transport accident, driver, traffic accident
V18.40 Pedal cyclist injured in noncollision transport accident, driver, traffic accident, while engaged in sports activity
V18.41 Pedal cyclist injured in noncollision transport accident, driver, traffic accident, while engaged in leisure activity
V18.42 Pedal cyclist injured in noncollision transport accident, driver, traffic accident, while working for an income
V18.43 Pedal cyclist injured in noncollision transport accident, driver, traffic accident, while engaged in other types of work
V18.44 Pedal cyclist injured in noncollision transport accident, driver, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V18.48 Pedal cyclist injured in noncollision transport accident, driver, traffic accident, while engaged in other specified activities
V18.49 Pedal cyclist injured in noncollision transport accident, driver, traffic accident, during unspecified activity, during unspecified activity
V18.5 Pedal cyclist injured in noncollision transport accident, passenger, traffic accident
V18.50 Pedal cyclist injured in noncollision transport accident, passenger, traffic accident, while engaged in sports activity
V18.51 Pedal cyclist injured in noncollision transport accident, passenger, traffic accident, while engaged in leisure activity
V18.52 Pedal cyclist injured in noncollision transport accident, passenger, traffic accident, while working for an income, while working for an income
V18.53 Pedal cyclist injured in noncollision transport accident, passenger, traffic accident, while engaged in other types of work
V18.54 Pedal cyclist injured in noncollision transport accident, passenger, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V18.58 Pedal cyclist injured in noncollision transport accident, passenger, traffic accident, while engaged in other specified activities
V18.59 Pedal cyclist injured in noncollision transport accident, passenger, traffic accident, during unspecified activity, during unspecified activity
V18.9 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, traffic accident
V18.90 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, traffic accident, while engaged in sports activity
V18.91 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, traffic accident, while engaged in leisure activity
V18.92 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, traffic accident, while working for an income, while working for an income
V18.93 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, traffic accident, while engaged in other types of work
V18.94 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, traffic accident, while resting, sleeping, eating or engaging in other vital activities
V18.98 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, traffic accident, while engaged in other specified activities
V18.99 Pedal cyclist injured in noncollision transport accident, unspecified pedal cyclist, traffic accident, during unspecified activity, during unspecified activity
V19 Pedal cyclist injured in other and unspecified transport accidents
V19.0 Driver injured in collision with other and unspecified motor vehicles in nontraffic accident
V19.00 Driver injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in sports activity
V19.01 Driver injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in leisure activity
V19.02 Driver injured in collision with other and unspecified motor vehicles in nontraffic accident, while working for an income
V19.03 Driver injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in other types of work
V19.04 Driver injured in collision with other and unspecified motor vehicles in nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V19.08 Driver injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in other specified activities
V19.09 Driver injured in collision with other and unspecified motor vehicles in nontraffic accident, during unspecified activity
V19.1 Passenger injured in collision with other and unspecified motor vehicles in nontraffic accident
V19.10 Passenger injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in sports activity
V19.11 Passenger injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in leisure activity
V19.12 Passenger injured in collision with other and unspecified motor vehicles in nontraffic accident, while working for an income
V19.13 Passenger injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in other types of work
V19.14 Passenger injured in collision with other and unspecified motor vehicles in nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V19.18 Passenger injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in other specified activities
V19.19 Passenger injured in collision with other and unspecified motor vehicles in nontraffic accident, during unspecified activity
V19.2 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in nontraffic accident
V19.20 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in sports activity
V19.21 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in leisure activity
V19.22 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in nontraffic accident, while working for an income
V19.23 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in other types of work
V19.24 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V19.28 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in nontraffic accident, while engaged in other specified activities
V19.29 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in nontraffic accident, during unspecified activity
V19.3 Pedal cyclist [any] injured in unspecified nontraffic accident
V19.30 Pedal cyclist [any] injured in unspecified nontraffic accident, while engaged in sports activity
V19.31 Pedal cyclist [any] injured in unspecified nontraffic accident, while engaged in leisure activity
V19.32 Pedal cyclist [any] injured in unspecified nontraffic accident, while working for an income
V19.33 Pedal cyclist [any] injured in unspecified nontraffic accident, while engaged in other types of work
V19.34 Pedal cyclist [any] injured in unspecified nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
V19.38 Pedal cyclist [any] injured in unspecified nontraffic accident, while engaged in other specified activities
V19.39 Pedal cyclist [any] injured in unspecified nontraffic accident, during unspecified activity
V19.4 Driver injured in collision with other and unspecified motor vehicles in traffic accident
V19.40 Driver injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in sports activity
V19.41 Driver injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in leisure activity
V19.42 Driver injured in collision with other and unspecified motor vehicles in traffic accident, while working for an income
V19.43 Driver injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in other types of work
V19.44 Driver injured in collision with other and unspecified motor vehicles in traffic accident, while resting, sleeping, eating or engaging in other vital activities
V19.48 Driver injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in other specified activities
V19.49 Driver injured in collision with other and unspecified motor vehicles in traffic accident, during unspecified activity
V19.5 Passenger injured in collision with other and unspecified motor vehicles in traffic accident
V19.50 Passenger injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in sports activity
V19.51 Passenger injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in leisure activity
V19.52 Passenger injured in collision with other and unspecified motor vehicles in traffic accident, while working for an income
V19.53 Passenger injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in other types of work
V19.54 Passenger injured in collision with other and unspecified motor vehicles in traffic accident, while resting, sleeping, eating or engaging in other vital activities
V19.58 Passenger injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in other specified activities
V19.59 Passenger injured in collision with other and unspecified motor vehicles in traffic accident, during unspecified activity
V19.6 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in traffic accident
V19.60 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in sports activity
V19.61 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in leisure activity
V19.62 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in traffic accident, while working for an income
V19.63 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in other types of work
V19.64 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in traffic accident, while resting, sleeping, eating or engaging in other vital activities
V19.68 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in traffic accident, while engaged in other specified activities
V19.69 Unspecified pedal cyclist injured in collision with other and unspecified motor vehicles in traffic accident, during unspecified activity
V19.8 Pedal cyclist [any] injured in other specified transport accidents
V19.80 Pedal cyclist [any] injured in other specified transport accidents, while engaged in sports activity
V19.81 Pedal cyclist [any] injured in other specified transport accidents, while engaged in leisure activity
V19.82 Pedal cyclist [any] injured in other specified transport accidents, while working for an income
V19.83 Pedal cyclist [any] injured in other specified transport accidents, while engaged in other types of work
V19.84 Pedal cyclist [any] injured in other specified transport accidents, while resting, sleeping, eating or engaging in other vital activities
V19.88 Pedal cyclist [any] injured in other specified transport accidents, while engaged in other specified activities
V19.89 Pedal cyclist [any] injured in other specified transport accidents, during unspecified activity
V19.9 Pedal cyclist [any] injured in unspecified traffic accident
V19.90 Pedal cyclist [any] injured in unspecified traffic accident, while engaged in sports activity
V19.91 Pedal cyclist [any] injured in unspecified traffic accident, while engaged in leisure activity
V19.92 Pedal cyclist [any] injured in unspecified traffic accident, while working for an income
V19.93 Pedal cyclist [any] injured in unspecified traffic accident, while engaged in other types of work
V19.94 Pedal cyclist [any] injured in unspecified traffic accident, while resting, sleeping, eating or engaging in other vital activities
V19.98 Pedal cyclist [any] injured in unspecified traffic accident, while engaged in other specified activities
V19.99 Pedal cyclist [any] injured in unspecified traffic accident, during unspecified activity
1999 ICD10: 587 codes
•V31.22 Occupant of three-wheeled motor vehicle injured in collision with pedal cycle, person on outside of vehicle, nontraffic accident, while working for income
•W65.40 Drowning and submersion while in bath-tub, street and highway, while engaged in sports activity
•X35.44 Victim of volcanic eruption, street and highway, while resting, sleeping, eating or engaging in other vital activities
•V31.22 Occupant of three-wheeled motor vehicle injured in collision with pedal cycle, person on outside of vehicle, nontraffic accident, while working for income
•W65.40 Drowning and submersion while in bath-tub, street and highway, while engaged in sports activity
•X35.44 Victim of volcanic eruption, street and highway, while resting, sleeping, eating or engaging in other vital activities
Building large Terminologies Logic for “Conceptual Lego”
hand
extremity
body
acute
chronic
abnormalnormal
ischaemicdeletion
bacteriumpolymorphism
cell
protein
gene
infection
inflammation
Lung
expression
virusmucus
polysacharide
Logic as the clips for “Conceptual Lego”
“SNPolymorphism of CFTRGene causing Defect in MembraneTransport of Chloride Ion causing Increase in Viscosity of Mucus in CysticFibrosis…”
“Hand which isanatomically normal”
Build complex representations from modularisedprimitives
GenesSpecies
Protein
Function
Disease
Protein coded bygene in humans
Function ofProtein coded bygene in humans
Disease caused by abnormality inFunction ofProtein coded bygene in humans
Gene in humans
Normalising (untangling) Ontologies
StructureFunction
Part-wholeStructure Function
Part-w
hole
Untangling and EnrichmentUsing a classifier to make life easier
Substance- Protein- - ProteinHormone- - - Insulin- Steroid- - SteroidHormone- - - Cortisol- Hormone- -ProteinHormone- - - Insulin- - SteroidHormone- - - Cortisol- Catalyst- - Enzyme- - - ATPase
- PhsioloicRole- - HormoneRole- - CatalystRole
- Substance- - Protein- - - Insulin- - - ATPase- Steroid- - Cortisol
Hormone ≡ Substance & playsRole-someValuesFrom HormoneRole
ProteinHormone ≡ Protein & playsRole someValuesFrom HormoneRole
SteroidHomone ≡ Steroid & playsRole someValuesFrom HormoneRole
Catalyst ≡ Substance & playsRole someValuesFrom CatalystRole
Enzyme ≡ Protein & playsRole someValuesFrom CatalystRole
Insulin → playsRole someValuesFrom HormoneRole
Cortisol → playsRole someValuesFrom HormoneRole
ATPase → playsRole someValuesFrom CatalystRole
Substance- Protein- - ProteinHormone- - - Insulin- - Enzyme- - - ATPase- Steroid- - SteroidHomone^- - - Cortisol-Hormone- - ProteinHormone^- - - Insulin^- - SteroidHormone^- - - Cortisol^- Catalyst- - Enzyme^- - - ATPase^
Modularised into structure and function ontologies (all primitive)
Unified ontology after classification
Ontology normalisation:Enforced modularity
• All primitives form disjoint trees
• All polyhierarchies formed by inference from definitions– No arbitrary subclass axioms
• Therefore– All concepts have most specific primitive ancestor– No disjunctions in domain and range constraints
• Consequences– Changes occur in exactly one place– Defeasible inheritance can be constrained so that each
property inherited only along one taxonomy• The same property cannot apply from two different sources
that unless one subsumes the other
Led almost by accident to methods for Integrating multiple big vocabularies
And to real world problemsThe Coding of ChocolateAn international conversion guide
C-F0811
C-F0816
C-F0817
C-F0819
C-F081A
C-F081B
C-F081C
C-F0058
SNOMED-CT
UbOVv
UbOW2
UbOW3
UbOW4
UbOW5
UbOW6
UbOW7
Ub1pT
CTV3
Bounty barCrème egg
Kit KatMars Bar
Milky WaySmarties
TwixSnicker
Term
?
…but logic & formal ontology
scare users• Require months to train even to a minimal
level
• People make errors– Even experienced people
• Logic inferences can be directly contrary to language maxims
• Make logic (& formal ontology) the “assembly language”– Give users high level languages
• Ideally built with meta-authoring language construction kit
– Use “Intermediate Representations”
Intermediate Representations“Close to user forms”Before:
hasSpecificSubprocess (‘SurgicalAccessing’
hasSurgicalOpenClosedness (SurgicalOpenClosedness which
hasAbsoluteState surgicallyOpen))
(‘SurgicalProcess’ which
isMainlyCharacterisedBy (performance which
isEnactmentOf (‘SurgicalFixing’ which
actsSpecificallyOn (PathologicalBodyStructure which <
involves Bone
hasUniqueAssociatedProcess FracturingProcess
hasSpecificLocation (Collum which
isSpecificSolidDivisionOf (Femur which
hasLeftRightSelector leftSelection))>))))
Intermediate Representations“Close to user forms”After:
“Open fixation of a fracture of the neck of the left femur”
– MAIN fixing
ACTS_ON fracture
HAS_LOCATION neck of long bone
IS_PART_OF femur
HAS_LATERALITY left
HAS_APPROACH open
From 3-6 monthsmonths training to 3-6 daysdays training
“Fixation of fracture of neck of left femur by open approach”
global cycle &work at centre
local cycles: work by users
Supports Loosely coupled distributedontology development
From authoring to meta-authoringFrom 80% central/global effort
to 10% central/global effort
User effort cut by 75% compared with manual methodsMostly in reduced committee meetings & arguments
A simple recent example: “Manchester OWL syntax”
• ∃owns.Dog someValuesFrom(owns,Dog) owns SOME Dog
• ∀owns.Dog allValuesFrom(owns,Dog) owns ONLY Dog
Or for one client just:
Users face a complex landscape
Courtesy of Hodgson, TopQuadran via Carole Goble
Inhabited by many tribes,Each tribe in its own teepee
Descriptionlogic
Fuzziness
BeliefRevision
Bayesiananalysis
NaturalLanguage
KR Logics
Logic programming
Complexity theory
Defaultlogics
Argumentation
and what feel like class divides
The chain of theorem envy
Too scruffytoo ad hocDoesn’t understand!
Too neat Too academic!Doesn’t understand!
ApplicationBuilder
Knowledge Engineer
KR Researcher
PureLogician/Mathematician
Too scruffytoo ad hocDoesn’t understand!
Too nea! Too academic!Doesn’t understand!
Too scruffytoo ad hocDoesn’t understand!
Too neat Too academic!Doesn’t understand!
Too scruffytoo ad hocDoesn’t understand!
Too neat Too academic!Doesn’t understand!
The chain of value
No one person can understand it all - must manage the chain
Incomplete! Undecidable!Higher order! No semantics!Not realistic! Not ontocleaned!
… but logicians and ontologists are often seen as policemen
… and seem to insist on solving harder problems than the user actually has
… often without examples of why not
…or insist users understand the solution space
And don’t come back until you have the semantics clear
The opportunity & challenge of knowledge acquisition Meet users where they are
Remember: logic is hard &most users are symbolophobes
• How many OWL experts here could get all of the following in the correct subsumption hierarchy first time?
– p some A
– p some ASub
– pSub some A
– pSub some ASub
– p only A
– p only ASub
– pSub only A
– pSub only ASub
– p exactly 1 A
– p exactly 1 ASub
– pSub exactly 1 A
– pSub exactly 1 ASub
I didn’t:Why I need tools and a classifier
Matching problems and solutions The science & craft of KA
• Patterns, guidelines and tools
• Reformulations of users’ “solutions”
• Collaborations betwee behavioural & domain scientists
• Challenges and demonstrations
Some observations…
Working with users:The basics - I hope I am “teaching grandma to suck eggs”
• Do something useful - First do the right thing!
• Make it usable– Find a champion & early adopters– Embrace users’ attempts at solution
• At least it is probably useful– an example; a working specification
– Watch, ask, listen, and believe• There is no point in arguing with somebody that it is easy• There Is no point in arguing with somebody that they understand• Get help -
– Involve behavioural scientists– Use language and images - involve linguists
• Involve the implementers• Build for feedback
• Accept that clever things may be useless
The interesting may not be useful
• Of medical decision support systems in the literature in 1995– 70% addressed diagnosis
• Success rate of evaluated medical decision support systems in the literature in 1995– Alarms 75%– Treatment Management 65%– Diagnosis 17%
And you can only tell if its useful if you know “What’s it for?”
• Tens of Millions spent on SNOMED’s 450K codes– Only 10K have ever been used
• Many applications find 50%-75% missing
• Hard to predict users’ needs– So build it “just in time” if possible– And based on evidence
• Mine the web• Mine corpora• Observe users• Build in feedback
Some arguments only have answers wrt problems
• Open vs closed world reasoning– Querying Rail Timetable:
“Is there a train from Podebrady that gets me to Prague tonight?”
• “No”– Possibly false, but useful
» I can’t get better information• “Might be”
– True but not useful & possibly misleading
– Querying FoaF“Does Alan have any friends?”
• “Don’t know”– At least not misleading
• “No”– Wrong
(I hope)
…which emphasizes again that:
Metaknowledge is knowledge
• The railway timetable is presumed complete– But how do I know?
• Do I trust the resource to tell me or depend on my experience?
• Biographies in FoaF are probably incomplete– But how do I know?
• What about some other data somewhere on the Semantic Web?
• Need some new metadata standards urgently
Get the user’s to own it
• The Gene Ontology is the most successful “ontology”/ “thesaurus”– Not rigorous; many faults– But owned by the biologists and does their job
• The Gene Ontology Next Generation project accepts and delivers in their format– The OWL is just another quality assurance tool
QA with users:The Logical answer isn’t always the right answer
“Slashed wrist”
“Cardiovascular Disorder”
The user is right - fix the axioms:
“Cardiovascular Disorder”
“Disorder or injury of Heart or Great Vessels or arterial system as a whole”
“Self inflicted laceration of radial artery”
“Disorder or injury of Heart or blood vessel”
…but may have to deal with differences in logic and language
• Logically:Four limbed animals do not subsume four legged animals– unless we represent explicitly our background
knowledge that four legged animals have no other limbs
• but we never say it• how to convey the intuitions to users?
Expressivity is more important than constraints
• Draw all the inference the user expects from “sensible” premises– Users won’t mind if wrong inferences could have
been drawn from nonsense premises• Provided the nonsense premises can’t get in by
accident
Find a way to do it: nonstandard reasoning:
Commonalities and differences
• Classify all the proteins with phosphatase1 activities– Identify all the features in common
• Simple subgraph algorithm
– Create the generic abstraction– Classify again to find more phosphatases
• 20 new phosphatases– Some probably implicated in disease
– Classify by which tissue they come from• Repeat
– Try to understand why some tissues suffer from disease and some don’t
1”Phosphate-ase” - enzyme that breaks down phosphate bonds; the primarysource of energy in cells; can drive super-oxidation; prime source ofdamage in diabetes, extreme inflammation in Intensive Care Units, atherosclerosis, and probably much else
Hide formalisms Focus on meta-modelling
• Make the logic the assembly language– Build “compiler compilers” for close to user forms
• Ought to be a major focus of our research
– Transformations, import, export
• Support implementors and localisers– Tools to build user oriented special purpose tools,
languages and interfaces
• Build quick tools for common patterns– Tabbed outlines for taxonomies– Easy visualisation and specification of disjoints– Wizards and Patterns for features & value sets– Special tools for lists– …
Help users to work together
• Science is CooperativeE-Science is e-Cooperative
• Supporting cooperation requires new kinds of knowledge– Modularisation– Dependencies– Communication– User profiles – Views– Transforms– …
59
Develop the whole chain of Knowledge Acquisition
• Language → informal →Semi-formal → Formal ↙ Language ← informal ←Semi-formal
60
Language Generation(an often forgotten technology)
• Even simple language generation helps– Even logicians may find it easier to work in
pseudo-natural language
• If not natural language at least intuitive syntax– Syntax matters to understanding
Seek evidence
• Use corpora, NLP & the Web– Experts often wrong about what really happens
• Beware of committee views• Beware of dogma
Find a sweet spot even if “trivial”
Prioritize issues to users’ requirements - thank you OWL 1.1
• Role assertions– “Fracture of neck of femur” is a kind of “Fracture
of Femur”• hasLocus o isPartOf →hasLocus
– Accept repurposing• There are alternative solutions for anatomy but
essential for other cases– “Uncle”– “Reified relations” (Ontological “qualities”)
Test at scale
• Many users’ problems are BIG– Biological examples ≥ 10K concepts – Medical examples 20K…500K concepts
Use � the tricks of the trade (especially to reduce arguments)
• “Pericardium” (covering of the heart) & “Heart”: – To anatomists: they are two different organs– To the clinicians: they are parts of the same
functional unit
• The role hierarchy can let us support both views is_clinical_part_of
← is_structural_part_of
…but hide them from (most)
users• Neither the anatomist nor the surgeon need
to know about the other– In GALEN we had several different variants of
the intermediate representation compiler to deal with intractable arguments
• QA always passed by all
Make representations maintainable & evolvable(basic software engineering)
• Don’t be too clever(Avoid “Write once read never”)
– “Shortest S-Expression for a function”“Maximum code in a C ‘for’ statement”
– “Clever” inference in an OWL KB• Avoid
– Making inferences from domains/range» May better to check before inference * Or do inference in multiple step
– Complex disjoint axioms and disjunctions
• Design so all changes made in only one place– Normalise ontologies
• Be systematic - follow patterns
• Provide regression testing from the beginning– Preferably before building
• Support debugging
Remember: Your part is only one source of errorIt will require empirical testing
• Errors come from– Errors & low inter-rater reliability in input
• Often under 80%
– Implementation errors in applicxations– The perversity of the universe - the Rumsfeld effect
• It is going to require empirical testing– The ONLY test that will be accepted for most
applications is empirical• Whether or not the algorithms are complete
My top next priority for OWL:
“What is it sensible…
• To ask– Everything is permitted unless it is forbidden
• Natural open world logical view– Sets of constraints
• To tell (sanctioning)– Everything is forbidden unless it is permitted
• Natural frames/OO/UML view– Sets of templates
But the basis for intelligent user interfaces
Needed by every user we have encountered
• It is sensible to ask about “Green entities”– There are entities that are green
• It is not sensible to ask about “Green dreams”– No: dreams have no colour
• The more I know the less it is sensible to ask
• Is it sensible to tell that balls are green?– If it might sensibly be green
• The more I know, the more it is sensible to tell– A hard/impossible notion to capture in first order theories
Related: “Optional”
• What are the semantics of :– 0..n in UML?– or canonical graphs in Conceptual Graphs?– or sensible sanctions in GRAIL?– or slot attachment in Frames?– or minCardinality(0) in OWL?
• Supported by every formalism any user will ever have used– There must be something to it
• Even if it isn’t first order
• Needed by every data application we have encountered
Related but different:“May”
• May – “What may cause pneumonia?”
What classes of bacteria may cause pneumonia?• Hard to express in DLs/OWL
– Need richer relations amongst properties» causes → may_cause
Almost captures it» “Anything that acts has the potential to act”
“Anything that does not have the potential to act, cannot act”…is there additional semantics?
» Very messy without special tools and operators in user language
… others needs for a better
match to biomedical knowledge
• Prototypical knowledgeThe heart is generally on the left but sometimes on the right
– Normative solutions OK for some things• “The normal hand has five digits”
• “The normal heart is on the left”
– Simple explicit exceptions OK for some things• “All human cells have nuclei except red blood cells”
– But otherwise need prototypical knowledge & exceptions• “Typically birds fly”
• “Typically gram positive bacteria are penicillin sensitive”
• Uncertainty - another step? a different formalism?– 70% of appendices are in right lower abdomen
• Can fuzziness/probability/… be contained in the same framework or do we need a true hybrid system?
– Needs to link to utilities and decision theory
Summary: Help fill the gap
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Guidelines, Patterns, Tools, Modularity,Views, Environmentsmetadata, work arounds, hybrid systems, …
Problem space
Solutionspace Fit solutions to
problems
Support meta users & application builders
Watch, ask, listen to, & believe users
embrace users’ partial solutions as requirements
Design for modularity, maintenance & evolution
Look to user requirements forimplementation priorities
![Constructing Knowledge Representation Systems with First ...whose background knowledge is a combination of description logic axioms/assertions and clauses [2]-[4]. However, these are](https://img.pdfslide.net/doc/110x75/5f09daea7e708231d428d17d/constructing-knowledge-representation-systems-with-first-whose-background-knowledge.jpg)
