Feedback from Harold Solbrig, Division of Biomedical Statistics and Informatics at the Mayo Clinic to Barry Smith, NCBO

The ICBO meeting impressed me by how much of it focused on the science of biomedicine itself, using the language of ontology for clarification and communication.  This was a refreshing change from many of the earlier meetings in this subject area, where the discussion centered primarily on whether one person's opinion on the organization and naming of a subject area was any better or worse than another's and whether we had a right to even say.
Specifically, I was pleased to overhear a discussion between you and Kent Spackman on the characterization of diseases and disorders, where you appeared to be converging on what sounded like a consistent and independently verifiable model – one that accounted for both the observation and the thing being observed. In my opinion, this is a significant step towards transforming SNOMED-CT into something that will have genuine clinical applicability.  The emerging SNOMED-CT "observables" model has already shown some real potential for use in the CDISC community for the consistent and reproducible definitions of measurement variables.
When I first started working on the NCBO project I didn't fully buy in to the realist approach. The process of resolving your critique of the
NCI Thesaurus, however, convinced me that from a purely pragmatic perspective the approach (mostly) worked. Since then, I have continued to apply some of the basic organizational principles and have been pleasantly surprised at how useful they have been in defining, organizing and classifying all sorts of knowledge resources.  Somewhere along the way it just became intuitive and obvious – science is about describing reality, and the primary point of agreement has to be on the things being described.  I have to admit that I still don't agree with some of the techniques that have been used to publicize this approach, but it is obvious, however, that what you have been doing is working.