Is there any documentation of this "free utterance" idea. Surely language and syntax of the user is a major factor in software interpretation of the 'facts'.
David de Bhál www.v-practice.com ________________________________ -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of kuang oon Sent: Friday, July 21, 2006 10:32 AM To: General Practice Computing Group Talk Subject: Re: [GPCG_TALK] SNOMED Project Proposal G'day, I agree with Ian's comments. "Free text utterance" means more expressivity and simultaneously the need to capture multifaceted clinical information. We can embede / link numerical values such as clinical duration, frequency and magnitudes of all sorts into codes . Using a text editor for input, rather than from a pick list - is desirable and doable. Free text entry can solve the problem of coding for useful clinical scenarios that stretch across a plurality of codes that explodes in a combinatorial fashion. Useful examples of such combinations are i) an illness - a drug treatment - patient's outcome to the drug treatment pattern and ii) test - test result pattern. A code for each conceivable scenario is paving a road to enumerated combinatorial hell. BTW I have been looking at Duncan's 'troponitis' - it is really 3 atomic concepts: 1)the serum troponin test 2)the test result and 3) negative criteria - in short a classic molecular concept code. One can just assign an arbitrary number code for "troponitis". Here we have the fork in the road. In an emergent coding system, such as DOCLE, you have to make more from less. Using this refactored solution, the troponitis code is constructed pro re nata from a palette of already available docle codes. Hence by feeding a tiny fragment of natural language oriented SHEEP thru its parser : ModelSheepService new sheepParse: '[sh problems troponin find: abnormal high no: acute myocardiac infarction sh]' gives doclescript output of: OrderedCollection ('&[EMAIL PROTECTED]@trop-onin],find[abnormal,high],no [myocardialInfarction]') with the canonizer gives the docle code for troponitis: [EMAIL PROTECTED]:eval,find:abno,high,no:myoci From the programming viewpoint, the docle code is amenable to 1) pattern searches on SQL 2)be exploded into their respective atomic concepts 3)visual confirmation of veracity of the code generated from natural text. The docle code is auto-reflective and explains its own meaning. Note also that "free text entry problem " and "level 4 ehr interoperability problem" are the same or essentially the same as they both can be addressed from a single SHEEP perspective. HTH kuang P.S. BTW Duncan, your cardiology input is appreciated and never taken for granted. The use case for "troponitis" is as real and relevant as it gets. On 20/07/2006, at 10:48 PM, Ian Cheong wrote: > Actually, the preferred method is to record the "free text > utterance" of the clinician and attach a coded term to that. > > Recording only a coded term loses richness and therefore usefulness > for human decision makers. > > Text can be coded after the fact with well designed tools. > > Loss of specific information is much harder to recreate. > > > Ian. > > At 5:20 pm +1000 20/7/06, Greg Twyford wrote: >> Michael Tooth wrote: >>> Peter Machell wrote: >>>> On 20/07/2006, at 12:13 PM, Greg Twyford wrote: >>>> >>>>> GPs are already coding data in programs like MD. It's >>>>> diagnosis/ past >>>>> history dialogues have forced them to consciously avoid using the >>>>> available coded entries if they don't want to use them, and enter >>>>> uncoded stuff instead. >>>> >>>> Most of the MD users I see enter free text for all notes, and >>>> are offended when I suggest they first use the 'Reason' button. >>>> Isn't it time that coded diagnosis be made the default entry >>>> method, with free text a last resort? >>> >>> You might remember that MD originally only had the coded option, but >>> that the ability to put uncoded in was really the result of there >>> not >>> being enough DOCLE codes. >>> >> >> Michael, >> >> Originally it MD it was much easier for GPs to end up with their >> own search entries like 'dia' in their notes, which were >> meaningless in terms of coding, when trying to bring up the coded >> diagnosis 'diabetes', for example. >> >> The dialogue was changed to reduce the likelihood of this by >> placing the free text box down the bottom and by changing the >> action of the search entry box at the top. It's new action ensured >> that one of the coded diagnoses was entered from the list when a >> search entry like 'dia' was used in the default search entry box >> at the top. >> >> This effectively forced selection of a coded diagnosis/reason/past >> history item unless the bottom 'free text' box was consciously >> clicked on. >> >> They also included the diagnosis coding tool in maintenance to >> allow uncoded or meaningless entries in the database to be >> corrected or linked with coded ones. >> >> Greg >> -- >> Greg Twyford >> Information Management & Technology Program Officer >> Canterbury Division of General Practice >> E-mail: [EMAIL PROTECTED] >> Ph.: 02 9787 9033 >> Fax: 02 9787 9200 >> >> PRIVATE & CONFIDENTIAL >> ********************************************************************* >> ** >> The information contained in this e-mail and their attached files, >> including replies and forwarded copies, are confidential and intended >> solely for the addressee(s) and may be legally privileged or >> prohibited >> from disclosure and unauthorised use. If you are not the intended >> recipient, any form of reproduction, dissemination, copying, >> disclosure, >> modification, distribution and/or publication or any action taken or >> omitted to be taken in reliance upon this message or its >> attachments is >> prohibited. >> >> All liability for viruses is excluded to the fullest extent >> permitted by >> law. >> ********************************************************************* >> ** >> >> _______________________________________________ >> Gpcg_talk mailing list >> [email protected] >> http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk > > > -- > Dr Ian R Cheong, BMedSc, FRACGP, GradDipCompSc, MBA(Exec) > Health Informatics Consultant, Brisbane, Australia > Internet: [EMAIL PROTECTED] > (for urgent matters, please send a copy to my practice email as > well: [EMAIL PROTECTED]) > > PRIVACY NOTE > I am happy for others to forward on email sent by me to public > email lists. > Please ask my permission first if you wish to forward private email > to other parties. > _______________________________________________ > Gpcg_talk mailing list > [email protected] > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk -- No virus found in this incoming message. 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