  Biomedical taxonomies, thesauri and ontologies in the form of the
International Classification of Diseases (ICD) as a taxonomy or the National
Cancer Institute Thesaurus as an OWL-based ontology, play a critical role in
acquiring, representing and processing information about human health. With
increasing adoption and relevance, biomedical ontologies have also
significantly increased in size. For example, the 11th revision of the ICD,
which is currently under active development by the WHO contains nearly 50,000
classes representing a vast variety of different diseases and causes of death.
This evolution in terms of size was accompanied by an evolution in the way
ontologies are engineered. Because no single individual has the expertise to
develop such large-scale ontologies, ontology-engineering projects have evolved
from small-scale efforts involving just a few domain experts to large-scale
projects that require effective collaboration between dozens or even hundreds
of experts, practitioners and other stakeholders. Understanding how these
stakeholders collaborate will enable us to improve editing environments that
support such collaborations. We uncover how large ontology-engineering
projects, such as the ICD in its 11th revision, unfold by analyzing usage logs
of five different biomedical ontology-engineering projects of varying sizes and
scopes using Markov chains. We discover intriguing interaction patterns (e.g.,
which properties users subsequently change) that suggest that large
collaborative ontology-engineering projects are governed by a few general
principles that determine and drive development. From our analysis, we identify
commonalities and differences between different projects that have implications
for project managers, ontology editors, developers and contributors working on
collaborative ontology-engineering projects and tools in the biomedical domain.
