Re: [Troll] Terminology bindings ... again

[Philippe Ameline]

Le 16/03/2018 à 13:11, Thomas Beale a écrit :

> Ad hoc negation, in German ;)
>
> But that's not really the fault of ICD10; it's a misuse of it. One
> might argue that it occurs because ICD10 doesn't provide a proper way
> of representing exclusions, only positive identifications. And that's
> an old, long debate...
>

Not certain to get your point here.

"Geometrically", a classification is a pavement of a domain (for ICD10,
the diseases), each sector being delimited by inclusion and exclusion
rules (in the same way frontiers are defined for countries). "Rag bags"
(of the kind "other X") are used to fill existing interstices.

Hence, every code is by construction exclusive from any other code...
and using a classification to "describe" can only come from confusing a
point of the domain (say "type 2 diabetes") with the delimited sector
that comes with the same name (say, depending on inclusion and exclusion
criteria, all hyperglycemia that cannot be qualified as type 1 diabetes).

Of course, is it possible to forget all this and use a classification as
a lexicon... but that would be plainly evil ;-)

Philippe


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Re: [Troll] Terminology bindings ... again

[Thomas Beale]

Ad hoc negation, in German ;)

But that's not really the fault of ICD10; it's a misuse of it. One might 
argue that it occurs because ICD10 doesn't provide a proper way of 
representing exclusions, only positive identifications. And that's an 
old, long debate...


- thomas


On 16/03/2018 07:41, Karsten Hilbert wrote:

On Wed, Mar 14, 2018 at 11:56:07PM +, Mikael Nyström wrote:


Yes, of cause it is! My main point was that a statistical
classification is a simpler product than a clinical ontology
and it is therefore also easier to implement a statistical
classification than a clinical ontology.

And it is also dangerous to your health if used for clinical
care (never mind that that's mandatory in Germany):

If I rule out AIDS in a patient I can - in Germany - attach
to the EHR the relevant ICD-10 appended with an "A" for
"Ausschluß" (as in "ruled out"). When said patient travels to
the United States many people will understandably ignore the
"A" (as it has no meaning to them and it does not belong to
the core definition of ICD-10), et voila, we've got a
manufactured HIV infection.

Even more dangerous situations could be construed.

Karsten


--
Thomas Beale
Principal, Ars Semantica 
Consultant, ABD Team, Intermountain Healthcare 

Management Board, Specifications Program Lead, openEHR Foundation 

Chartered IT Professional Fellow, BCS, British Computer Society 

Health IT blog  | Culture blog 

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Re: [Troll] Terminology bindings ... again

[Karsten Hilbert]

On Wed, Mar 14, 2018 at 11:56:07PM +, Mikael Nyström wrote:

> Yes, of cause it is! My main point was that a statistical
> classification is a simpler product than a clinical ontology
> and it is therefore also easier to implement a statistical
> classification than a clinical ontology.

And it is also dangerous to your health if used for clinical
care (never mind that that's mandatory in Germany):

If I rule out AIDS in a patient I can - in Germany - attach
to the EHR the relevant ICD-10 appended with an "A" for
"Ausschluß" (as in "ruled out"). When said patient travels to
the United States many people will understandably ignore the
"A" (as it has no meaning to them and it does not belong to
the core definition of ICD-10), et voila, we've got a
manufactured HIV infection.

Even more dangerous situations could be construed.

Karsten
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E167 67FD A291 2BEA 73BD  4537 78B9 A9F9 E407 1346

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