ISO/DIS 25664-1

ISO/TC 215

Secretariat: ANSI

Date: 2025-11-19

Health informatics — Categorial structure for semantic representation in TCM informatics —

Part 1:
Framework

DIS stage

Warning for WD’s and CD’s

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Contents

Foreword

Introduction

Scope

Normative references

Terms and definitions

General

Characterizing categories

Categorial structure for representation in TCM informatics

Framework

Semantic link

Bibliography

Foreword

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This document was prepared by Technical Committee TC 215 Health informatics.

A list of all parts in the ISO 25664 series can be found on the ISO website.

Any feedback or questions on this document should be directed to the user’s national standards body. A complete listing of these bodies can be found at www.iso.org/members.html.

Introduction

Information science methods are applied to study on Traditional Chinese Medicine (TCM) in TCM informatics, enhancing the utilization of TCM information and improving individual health levels. The development of TCM informatics has facilitated the modernization and standardization of

TCM, playing a significant role in optimizing TCM resource management, strengthening clinical decision-making, and promoting scientific innovation. It accelerates the globalization and interdisciplinary integration of TCM. The technological advancement of TCM informatics requires theoretical support. Establishing a semantic classification framework for TCM informatics helps clarify the TCM information process, accelerate the integration, utilization, and dissemination of TCM knowledge, enhance clinical decision support, improve the consistency and interoperability of TCM information, and promote international communication and cooperation in TCM.

The sources of Traditional Chinese Medicine (TCM) information are diverse, encompassing various fields such as healthcare, pharmaceutical and clinical research and distribution. The data formats vary, and the volume of information is vast. This not only provides rich resources for the development of TCM informatics but also poses significant challenges in processing TCM information. Concurrently, the rise of artificial intelligence (AI) offers new ideas and methods for addressing these difficulties. The establishment of a semantic classification framework in TCM informatics lays the foundation for the application of AI in the field of TCM, leveraging AI to tackle complex issues in TCM information research.

Based on the aforementioned uses, this document establishes a semantic classification framework for the field of traditional Chinese Medicine (TCM) Informatics , aimed at guiding the development of TCM informatics and enhancing the influence of TCM in the global healthcare system.

This document clarifies the semantic classification structure framework in the field of TCM informatics, intended to guide and promote the development of TCM informatics.

This document serves as a standardized semantic expression standard in the field of TCM informatics research. It is designed to provide support for researchers in TCM informatics and developers of related information systems. The series is composed of seven parts:

Part 1: Framework

Part 2: Individuals

Part 3: TCM practitioner Individual

Part 4: Clusters

Part 5: Homeostasis

Part 6: Allo-organization for clinical decision

Part 7: Elements

The 25664 series is not applicable to the field of medical informatics, nor to other traditional medicine informatics fields.

Health informatics — Categorial structure for semantic representation in TCM informatics —

Part 1:
Framework

This document defines the top-level semantic architecture of Traditional Chinese Medicine (TCM) informatics as a discipline.

It establishes a unified framework for representing and organizing TCM knowledge — including theoretical concepts, diagnostic reasoning, treatment principles, and related terminology — in a form understandable to both humans and computer systems.

The framework incorporates a categorial structure to formalize the relationships among concepts and knowledge entities within TCM, providing the semantic basis for data interoperability, knowledge sharing, and computational reasoning.

It supports consistent exchange and integration of TCM information across clinical documentation, research databases, education systems, and AI-driven decision-support applications.

The following documents are referred to in the text in such a way that some or all of their content constitutes requirements of this document. For dated references, only the edition cited applies. For undated references, the latest edition of the referenced document (including any amendments) applies.

ISO 1087:2019, Terminology work and terminology science — Vocabulary

ISO 17115:2020, Health informatics — Representation of categorial structures of terminology (CatStructure)

For the purposes of this document, the following terms and definitions apply.

ISO and IEC maintain terminological databases for use in standardization at the following addresses:

• IEC Electropedia: available at http://www.electropedia.org/
• ISO Online browsing platform: available at http://www.iso.org/obp

concept

unit of knowledge created by a unique combination of characteristics

[SOURCE: ISO 1087, 3.2.7, modified notes deleted]

categorial structure

minimal set of domain constraints for representing concept systems in a subject field.

[SOURCE: ISO 17115:2020, 3.1.1, modified]

category

concept represented by a formal definition

Note 1 to entry: Adapted from ISO 17115, definition 2.5.3.

characterizing category

category (3.3) of characteristics which serves as the criterion of subdivision when establishing concept systems

EXAMPLE The type of characteristics ‘colour’ includes being red, blue, green, etc. The type of characteristics ‘material’ includes made of wood, metal, etc.

[SOURCE: ISO 17115, 3.1.3, modified]

semantic link

formal representation of a directed associative relation or partitive relation between two concepts.

EXAMPLE is Cause Of (with inverse has Cause); has Location (with inverse is Location Of).

Note 1 to entry: This includes all relations except the generic relation.

Note 2 to entry: A semantic link always has an inverse, i.e. another semantic link with the opposite direction.

[SOURCE: ISO 17115:2020, 3.2.5]

traditional Chinese Medicine (TCM) Informatics

an emerging interdisciplinary field dedicated to the study of individual homeostasis information, investigates the laws governing the movement of this information, employs methods from TCM informatics, and aims to enhance the utilization of TCM information.

Note 1 to entry: The methodology of TCM Informatics integrates TCM thinking methods with systems science theory and information science technology, establishing a unique approach to the study of TCM informatics. The overarching research objective is to improve the utilization of TCM information, with the aim of enhancing the steady-state levels of individuals, thereby contributing to their optimal health and well-being.

The information that arises from objective existence, representing the state and changes of things, independent of human existence.

The information that emerges from the cognition of ontological information by humans or machines, existing contingent upon the perception and understanding of these entities.

In TCM informatics, elements cover natural environment elements (such as weather elements and geographical environment elements) and human elements (such as social elements and artificiality).

NOTE including all the element information that humans have recognized and that that humans have not yet recognized.

EXAMPLE wind, rain , animal, fossil, tongue diagnosis instrument

Human system centered on holistic integration and dynamic balance.

NOTE 1 It emphasizes the organic unity of the human being with the natural and social environment, as well as the uniqueness of each individual’s physiological and pathological characteristics.

NOTE 2 Each natural person is a concrete instance of individuals.

EXAMPLE an individual's physical condition, personality, temperament, abilities, interests, values, and attitudes

a professional who primarily engages in the study of the transformation rules between health and disease within human life activities, as well as prevention, diagnosis, treatment, rehabilitation, and health care, based on the theory and practical experience of TCM.

NOTE Each TCM practitioner is a concrete instance of Traditional Chinese Medicine Practitioners.

A device or theoretical construct with known or specified performance characteristics but unknown or unspecified constituents and means of operation.

NOTE In TCM theory, the human body is considered a black box, and the study of the human body system in TCM employs the black-box methodology.

environmental or other elements, or activities that may affect physical health.

EXAMPLE wind evil (a concept in TCM referring to pathogenic factors), Chinese materialmedica, food and other synthetic chemicals.

[SOURCE: ISO 11655, 3.1, modified]

the physical appearance and the mental activities.

NOTE The robust physical appearance and sound vitality is the sign of body-mind wellness.

EXAMPLE Yang deficiency state.

[SOURCE:^[4],465, modified]

the process by which a system forms an orderly structure automatically, without external instruction, through internal mutual coordination among its components.

NOTE Self-organization is the process by which the body regulates itself.

State of balance among all the body systems needed for the body to survive and function.

NOTE 1 Refers to a state of an individual .

NOTE 2 which is the state of the output information of the human individual's ontological information system.

NOTE 3 Homeostasis may be either a normal state (high-level balance) or an abnormal state (low-level balance).

EXAMPLE Yang excess state, heart blood deficiency state.

mental actions or processes of acquiring knowledge and understanding through thought, experience, and the senses.

NOTE Specific cognitive functions include; perception, attention, memory, linguistic functions (verbal, non-verbal), reasoning, planning, problem solving, decision making, reading and calculating. Cognition interacts with global mental functions (e.g. consciousness, energy, motivation) and affective functions (e.g. emotion, mood and self-regulation).

EXAMPLE Reading, memory;

[SOURCE: ISO 21801-1, 3.2,modified]

knowledge or skill acquired over time through practical contact with and observation of facts or events.

the reflection of objective reality in the human mind arises from social practice and represents, marking the beginning of understanding.

NOTE 1 Refers to the individual experience of a TCM practitioners.

NOTE 2 Experience elevates to theorywhich originates from practicewhich in turn tests theory, in a cyclical and evolving process.

EXAMPLE Liu Duzhou's experience in diagnosing and treating abdominal pain.

[SOURCE: ISO 10303-2,3.1.32]

patterns and regularities produced under the influence of external factors, through external control and intervention.

NOTE distinct from self-organization.

a holistic regulation schedule formulated by the TCM practitioner based on recognition of the individual and TCM knowledge to achieve the individual's steady-state information, which is the output of the TCM individual's epistemological information system.

NOTE The intervention regimen is to transform the core diagnosis and treatment link of traditional Chinese medicine, namely "how to intervene" (including what to intervene in, what to use for intervention, how to use it, for how long, and the expected result), into a structured information object that computers can understand, process, transmit and apply.

EXAMPLE A chinese medicine therapy: Ephedra 10g, almond 10g, gypsum 20g, licorice 6g. 7 doses, one dose per day, decocted in water for oral administration, divided into two doses in the morning and evening.

a foundational medical-philosophical framework that posits the human body as an indivisible, dynamic microcosm harmonizing with the macrocosm of nature, governed by the interplay of Yin-Yang forces, the cyclical transformations of the Five Phases (Wu Xing), and the uninterrupted flow of Qi (vital energy) through meridians, wherein health arises from equilibrium among physical form, sensory orifices, visceral functions, emotions, and environmental rhythms.

NOTE In TCM informatics, the “wholeness”is used to represent the attributes of homeostasis, referring to the indibility of individual homeostasis in the human body, the dynamic balance of homeostasis, and the unity of the individual and the environment.

EXAMPLE the unity of heaven and humanity, encompassing heaven, earth, and human beings.

A cognitive methodology framework, whose essence is to replace the binary logic of "either/or" in classical set theory with continuous membership degrees. It systematically encompasses fuzziness, gradual boundaries, and context-dependent classifications, and in the diagnosis and treatment of diseases, it abandons binary distinctions (such as healthy/diseased) and instead adopts dynamic imbalance spectra (such as qi deficiency/ qi abundance, yin-yang deficiency/fullness), where diagnostic signs (such as pulse patterns, tongue coating) and treatment strategies are interpreted through relationship patterns (syndrome, Zheng Hou) rather than absolute thresholds, reflecting the irreducible complexity of the human physiological system interacting with cosmic and emotional variables as an open system. This mathematical framework handles uncertainty and imprecision by using fuzzy sets and continuous membership functions.

EXAMPLE Multimodal fuzzy control, fuzzy self-organizing control, fuzzy optimal control.

The categorial structure in the field of traditional Chinese Medicine (TCM) Informatics includes a classification structure of Characterizing categories (3.2) and semantic links (4.2).

The outline of those characterizing categories and semantic links is illustrated in Figure1.

Figure 1 — Categorial structure for semantic representation in TCM informatics

Characteristic of, or quality of.^[7]

It expresses the semantic link between elements and ontological information, elements and epistemological information, individuals and ontological information,TCM practitioners and epistemological information, as well as homeostasis and wholeness , intervention regimen and fuzzy theory.

EXAMPLE The influence of acupuncture operations on an individual's homeostatic information is ambiguous and imprecise.

Composes, with one or more other physical units, some larger whole. This includes component of, division of, portion of, fragment of, section of, and layer of. ^[7]

It expresses the semantic link between elements and causative agents, between causative agents and individuals, between body and mind and individuals, between self-orgnization and individuals, between homeostasis and individuals,as well as between cognition and TCM practitioners,between experience and TCM practitioners, between allo-organization and TCM practitioners, between intervention regimen and TCM practitioners.

EXAMPLE Heart is part of a individual.

to know to be something that has been perceived before.

It expresses the semantic link between cognition and elements.

EXAMPLE A TCM Practitioner’s cognition recognize natural elements,such as moisture.

NOTE Cognition is a part of the information model of a traditional Chinese medicine doctor, who recognizes the external environment based on his own cognition.

Produces a direct effect on. Implied here is the altering or influencing of an existing condition, state, situation, or entity. This includes has a role in, alters, influences, predisposes, catalyses, stimulates, regulates, depresses, impedes, enhances, contributes to, leads to, and modifies. ^[7]

It expresses the semantic link between causative agents and body and mind,between experience and intervention regimen.

EXAMPLE Dampness affect knee.

the action or process of converting or altering one state into another, typically through a series of steps or stages.

It expresses the semantic link between cognition and experience.

EXAMPLE A TCM Practitioner’s cognition transform experiences in treating abdominal pain.

To put through the steps of a prescribed procedure.

It expresses the semantic link between self-organization and body and mind, as well as allo-organization and experience.

EXAMPLE A TCM Practitioner’ allo-organization process experiences in treating abdominal pain.

To advance, cause, or create. ^[7]

It expresses the semantic link between self-organization and homeostasis , between allo-organization and intervention regimen.

EXAMPLE A TCM Practitioner’ allo-organization produce a specific acupuncture regimen,such as needling Zusanli, Sanyinjiao, Taichong . Flat needling, keeping the needles for 30 minutes, with two intermittent needling sessions.

To exert a direct effect, indicating a change or influence on existing conditions, states, situations, or entities.

It expresses the semantic link between intervention regimen and causative agents.

EXAMPLE A specific acupuncture regimen act on acupuncture needle , or a specific Chinese medicines therapy regimen act on some Chinese herbal decoction pieces.

To obtain or gain.

It expresses the semantic link between cognition and homeostasis.

EXAMPLE Doctor Cui’s cognition acquire an individual’s homeostasis.

That part of a phenomenon which is directly observable or concretely or visibly expressed, or which gives evidence to the underlying process. This includes expression of, display of, and exhibition of.^[7]

It expresses the semantic link between homeostasis and body and mind.

EXAMPLE Yang deficiency state is a manifestation of an individual’s body and mind.

Bibliography

[1] ISO 1087:2019, Terminology work and terminology science — Vocabulary

[2] ISO 17115:2020, Health informatics — Representation of categorial structures of terminology (CatStructure)

[3] ISO 11655:1995, Measurement of liquid flow in open channels — Method of specifying performance of hydrometric equipment

[4] WHO 2022

[5] ISO 21801-1:2020, Cognitive accessibility — Part 1: General guidelines

[6] ISO 10303-2:2024, Industrial automation systems and integration — Product data representation and exchange — Part 2: Vocabulary

[7] UMLS