## 5 Conclusions
CWA  
Closed World Assumption; according to which something not known to be true is false. DL  
Description Logic; a structured knowledge-representation language. HER  
Electronic Health Record. ENCR  
European Network of Cancer Registries. EU  
European Union. ICD-O-3  
International Classification of Diseases for Oncology, 3 rd edition; provides a set of codes for describing tumours. MPT  
Multiple Primary Tumour; describes CR patients having more than one independent primary tumour. NCIt  
NCIthesaurus. NEXPTIME  
Non-deterministic Exponential Time; computational complexity class for solving a particular set of problems. PSPACE  
Polynomial Space; computational complexity class for solving a particular set of problems. OBO  
Open Biological and Biomedical Ontologies Foundry. OWA  
Open World Assumption; according to which something cannot be assumed to be false unless it has explicitly been stated as false. OWL  
Web Ontology Language; a language specification for developing ontologies for the sematic web. OWL-API  
OWL Application Programming Interface; a set of methods for interfacing a computer programme with an OWL ontology. RDF  
Resource Description Framework. SHACL  
Shapes Constraint Language. ShEx  
Shape Expressions. SWRL  
Semantic Web Rule Language. TBox  
Terminology part of a knowledge base; a set of concepts and roles. URI  
Uniform Resource Identifier; a unique identifier of a web resource. Topography codes:  
c150:C150  
c269:C269  
c768:C768  
Morphology codes:  
m9705_3M_9705_3  
m8020_3M_8020_3  
Tumours:  
p1_t1:ICD0 STumour  
p1_t2:ICD0 STumour  
p1_t3:ICD0 STumour  
(p1_t1,m9705_3)hasMorphology \(\sqcap\)  
(p1_t1,c150)hasTopography  
(p1_t2,m8020_3)hasMorphology \(\sqcap\)  
(p1_t2,c269)hasTopography  
(p1_t3,m8020_3)hasMorphology \(\sqcap\)  
(p1_t3,c768)hasTopography  
Tumour permutations:  
p1_tPM1: TumourPermutationMorphology \(\sqcap\)  
\(\exists\)hasMorphology.(\(\exists\)hasMorphology\({}^{-}\). (p1_t1)) \(\sqcap\)  
\(\exists\)hasMorphology.(\(\exists\)hasMorphology\({}^{-}\). (p1_t2))  
p1_tPT1: TumourPermutationTopography \(\sqcap\)  
\(\exists\)hasTopography.(\(\exists\)hasTopography\({}^{-}\). (p1_t1)) \(\sqcap\)  
\(\exists\)hasTopography.(\(\exists\)hasTopography\({}^{-}\). (p1_t2))  
p1_tPM2: TumourPermutationMorphology \(\sqcap\)  
\(\exists\)hasMorphology.(\(\exists\)hasMorphology\({}^{-}\). (p1_t1)) \(\sqcap\)  
\(\exists\)hasMorphology.(\(\exists\)hasTopography\({}^{-}\). (p1_t3))  
\(\exists\)hasTopography.(\(\exists\)hasTopography\({}^{-}\). (p1_t3))  
\(\exists\)hasTopography.(\(\exists\)hasTopography\({}^{-}\). (p1_t3))  
p1_tPM3: TumourPermutationMorphology \(\sqcap\)  
\(\exists\)hasMorphology.ICD03 Morphology \(\sqcap\)  
\(\forall\)hasMorphology.(\(\exists\)hasMorphology\({}^{-}\). (p1_t2))  
p1_tPT3: TumourPermutationTopography \(\sqcap\)  
\(\exists\)hasTopography.(\(\exists\)hasTopography\({}^{-}\). (p1_t3))  
Tumour couples:  
p1_tcl:TumourCouplet  
p1_tcl:p1_tM1):hasTumourPermutationMorphology \(\sqcap\)  
(p1_tcl,p1_tPT1):hasTumourPermutationTopography  
(p1_tcl,p1_tPT2):hasTumourPermutationMorphology \(\sqcap\)  
(p1_tcl,p1_tPT3):hasTumourPermutationTopography  
Patient:  
p1_ENCRPatient  
(p1_p1_tcl):hasTumourCouplet \(\sqcap\) (p1,  
p1_tcl2):hasTumourCouplet \(\sqcap\)  
(p1_p1_tcl3):hasTumourCouplet  
The case in which a patient has at least one duplicate tumour can be flagged using the TBox equivalent statement:  
DUPLICATE_PRIMARY_CASE \(\equiv\)  
\(\exists\)hasTumourCouplet.DUPLICATE_PRIMARY_TUMOURAxiom (A2) provides a convenient means for screening violations of the multiple primary rules at the patient level without having to look individually at all tumour-couplet instances.