Speaking the Same Language

Terms are words and compound words or multiword expressions that in specific contexts are given specific meanings. Within the clinical sciences, we use terms to describe findings, diagnoses, diseases, and treatments. Terminology is the discipline of designating terms within a particular field. A standardized terminology provides an established comprehensive set of recommended terms. Within the clinical sciences, standardized terminologies are generally established by consensus agreement to the judgment reached by a group as a whole. The system of choosing or revising names of terms is nomenclature. Nomenclature is the naming of terms (from the Latin nomen [name] + calator [caller]). Although sometimes used as a synonym for terminology, we understand nomenclature to be the system for devising or choosing names, which are the body of named terms that belong to a specific terminology. A classification is the systematic grouping and organization of the terms of a specific terminology into classes or categories, based on characteristics in common. A clinical practice guideline is a comprehensive, consensus, or evidence-based aid for clinicians managing patients with abnormal findings, cytology, histopathology, or clinical diagnosis. Often, clinical practice guidelines use a precise nomenclature and may seek to establish a standardized terminology for a specific field of clinical science.1–3 There are many standardized terminologies within the field of anourogenital diseases. These are continuously evolving and typically updated every few years as understanding increases. Although intended to provide comprehensive and unambiguous classification, some of the terminologies overlap and may differ from one another in measuring magnitude of change from normal to abnormal. As a consequence, some clinical research was conducted at the time of 1 terminology and published after a newer standardized terminology has taken hold. Expert colleagues belonging to different specialties and cultures may not agree on the standardized terminology during a given period. Readers of journals may be confused by competing terms for similar or related conditions. As examples, the terms “Pap smear” and “Pap test” may be replaced by “cervical cytology”4 and the term “dysplasia” has been replaced by “intraepithelial lesion.” As 1 example, the Lower Anogenital Squamous Terminology (LAST) recommendations standardized biologically relevant histopathologic terminology for human papillomavirus–associated squamous intraepithelial lesions and superficially invasive squamous carcinomas across all lower anogenital tract sites detailed the appropriate use of specific biomarkers to clarify histologic interpretations and enhance diagnostic accuracy.5–7 A standardized terminology will facilitate the ability of 2 or more clinicians, sites of care, healthcare systems, or countries to exchange and apply health research and information in a meaningful way for their patients. The importance of a standardized terminology is highlighted by these following aspects: Documentation of clinical detail over time. Structuring coded data entry and retrieval for medical records and for billing. Shared understanding across the continuum of care (different specialties, clinicians, sites of care, languages, systems). Decision support (common links to clinical knowledge bases). Enabling reporting to and retrieval from a database or registry. The exercise of developing the terminology is educational for the group members and the scientific societies. Enabling research reporting and synthesis. A building block for patient safety, quality improvement, and evidence-based practice. The Journal of Lower Genital Tract Disease (JLGTD) adopts the relevant standardized terminology updates in the field of lower ano-urogenital tract disease. This consistency will benefit readers and researchers. Prospective authors are encouraged to choose standardized terminology consistent with the resources and citations in Table 1. Whenever standardized terminologies are updated, JLGTD will be part of conversation, either by primary publication or editorial and commentary.TABLE 1: Recommended Standardized Terminology ResourcesDuring times of transition between an older and newer terminology, JLGTD will accept either; authors using an older terminology are encouraged to map the older to the newer terminology. In the case of 2 standardized terminologies that differ, authors should choose the most appropriate for the research, describe appropriately, and mention the alternative terminology. Jeffrey Campbell Andrews, MD, FRCSC Frederick, MD Fabrizio Bogliatto, MD, PhD European College for the Study of Vulval Disease Department of Gynecology, Chivasso Civic Hospital Torino, Italy Herschel W.