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Re: [Gnumed-devel] Data pack for ICD-9 :-)

From: Karsten Hilbert
Subject: Re: [Gnumed-devel] Data pack for ICD-9 :-)
Date: Tue, 27 Sep 2011 20:39:09 +0200

> >> and maybe the indices in ref.data_source bear reviewing because
> >> [...] maybe each of the middle two warrant the insertion [...] of
> >>    , lang
> > 
> > .lang is only intended to be descriptive (rather than definitory).
> We then need some other 'definitory' way to distinguish, within a single
> coding system (e.g. ICD-9), terms which get multiply defined -- in that
> there will end up one-to many relationships between a code which has a 
> distinct
> health-related meaning (e.g. 401) and the multiple terms which will end up
> matching that code.

I don't at all understand the problem.

> I can see some value to permitting / supporting such a one-to-many,
> because if we are going to allow, within a single GNUmed praxis, the 
> co-existence
> of codes in more than one language
> ref.data_source r.d_s
> ------------------------------
> pk    name_short
> 1     ICD-9
> 2     ICD-9
> where in ref.icd9 we would have
> -----------------------------------------------------------------------
>     401     Essential hypertension
>     401     Hypertension artérielle essentielle
> then we can foresee
> 1) that in some cases, patients and clinicians might together attach onto
> that patient's record the english code, whereas other pairings of patient
> and doctor might apply the french code. We now have codes in two different
> language for the same health condition.

I don't grasp the problem with that ?

> 2) when we want to identify patients in the praxis with essential
> hypertension, whether for descriptive statistics or to benefit from 
> computational
> decision support, it will be helpful to be able to search on
>       code2patient (whether encounter or episode)
>       where the value of the code is '410' and
>               (via ref.coding_system_root) the name_short
>               keyed through
>               matches 'ICD-9'

Yes, I agree.

> but surely, for any one language, we don't want the same code and term to
> exist in the *reference* tables multiple times.

I agree ("any one language - same code/term not multiple times in the
reference table") but I fail the see the connection with the above
statement (we want to search on codes) ?


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