I'm not in a position to advise anyone if SCT coding is useful to them or not 
in the context their personal needs and work practices. I can say that the 
delivery of comprehensive analytics is much enhanced by coding and we can 
deliver much better tools in that context. Also  we are researchers in 
computational linguistics (among other things) and are interested in making a 
contribution by devising techniques for analysing free text in clinical notes. 
we can't make any promises but if you want to see an example of what we have 
achieved in the past these web pages might give you some encouragement that 
there is a chance of us doing something of value.

http://www.cs.usyd.edu.au/~lkmrl/scamseek.htm
http://www.amonline.net.au/eureka/communications_technology/2005_winner.htm
cheers
jon

    Date:       Mon, 13 Feb 2006 23:59:59 +1000
    From:       john dooley <[EMAIL PROTECTED]>

    But the only thing that would get a snomed is the diagnosis on the
    summary line for me (id say Im representative of the general masses).
    Does not every histology report have _some_ summary????   Its kind of
    like not answering the question without a summary???? "unfinished business"
    
    (any more than snomeding a summary of my time and im retiring now) -
    would you want to snomed each patient consult for 5 variables even if it
    was off a pick list?
    
    The rest of your questions with margins being clear etc means you are
    wading anyway even with a snomed code to start and will still require 2
    neurones to fire to interpret context.  I can't see a future at all
    where free text pathology reports routinely come with snomeded margin
    status ...
    
    If only you had those 2000 reports in electronic format.... ? Get your
    pathology provider to just send everything you ever requested
    electronically retrospectively ;)
    
    I am _confident_ you could code a solution in about 20 mins that would
    get around most of the freetext issues.  (eg restrict kw search to
    summary line, check for not|no|etc issues, extract SCC|BCC|Solar K and
    then add in a little rules based analysis of the rest of the message
    based on the summary diagnosis - if SCC|BCC then find margin, parse line
    for usual combination of margins comments  "clear of" "extends up to"
    "involves", make a best guess based on that and present iffy ones for
    validation by yourself)
    
    I dont know how you solve the problem of site specific terminology
    either eg nose|alar|columella|cheek|nasal bridge could all simply =
    "nose"....Im a simple man...to me thats "skin, not otherwise specified"
    T01000.
    
    Then for audits you are scrambling to match clinical description of site
    with whats actually on the jar and then even whats snomed'ed in the
    summary.  All too often there are infact left nose, right nose and right
    upper nose all in the one group.  Plus its all too common to see "L
    nose" in the notes, "l alar" on the jar.  I refuse to start poring over
    25 codes describing various names for nose bits and trying to marry
    those up consistently.  (I figure in life you have a finite upper limit
    on the number of decisions your brain can make in a day before it goes
    to jelly, and I would rather save it for the diagnostic loop than
    agonising over snomed codes which <0.5% of any population group looking
    at the reports ever uses anyway)
    
    now lets not even think about opening the can of worms discussing
    synoptic reports (the ultimate picklist/proscribed format) completely
    replacing free text...
    
    I think you definitely lose the nuance of interpretation (which is the
    not quite black and white art of histology reporting) with a synoptic
    report (unless you pollute its purity with free text mods).
    
    JD
    
    > 
    > Emphasis on the *not* - such text are common, and if there is no dedicate
    d 
    > "diagnosis" section in the text that's parseable, free text analysis hunt
    ing 
    > just for key words out of context is problematic.
    > 
    > I'd love to have coded histopath - I am currently in the process of wadin
    g 
    > manually through more than 2000 reports to review my own performance 
    > regarding pre-op diagnostic accuracy, free margins, and wound infection r
    ate 
    > depending on site and size (well, actually my poor daughter does most of 
    the 
    > wading in order to resuscitate her ailing bank account)
    > 
    > Horst
    > _______________________________________________
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    > 
    > 
    
    
    -- 
    =================================================
    dr john dooley mbbs frcpa
    
    aka "ron"
    
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Jon
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