M Mukherjee1,2, J C Wyatt3, C R Simpson4, A Sheikh4. 1. Edinburgh Clinical Trials Unit (ECTU), The University of Edinburgh, Edinburgh, UK. mome.mukherjee@ed.ac.uk. 2. Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK. mome.mukherjee@ed.ac.uk. 3. Faculty of Medicine, Wessex Institute of Health & Research, University of Southampton, Southampton, UK. 4. Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
Abstract
BACKGROUND: The UK's NHS intends to move from the current Read code system to the international, detailed Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to facilitate more clinically appropriate coding of conditions and associated risk factors and outcomes. Given concerns about coding behaviour of general practitioners, we sought to study the current coding patterns in allergies and identify lessons for the future migration to SNOMED-CT. METHODS: Data from 2 014 551 primary care consultations in over 100 000 patients with one or more of 11 potentially allergic diseases (anaphylaxis, angioedema, asthma, conjunctivitis, drug allergies, eczema, food allergy, rhinitis, urticaria, venom allergy and other probable allergic disorders) from the Scottish Primary Care Clinical Informatics Unit Research (PCCIU-R) database were descriptively analysed and visualized to understand Read code usage patterns. RESULTS: We identified 352 Read codes for these allergic diseases, but only 36 codes (10%) were used in 95% of consultations; 73 codes (21%) were never used. Half of all usage was for Quality and Outcomes Framework codes for asthma. Despite 149 detailed codes (42%) being available for allergic triggers, these were infrequently used. CONCLUSIONS: This analysis of Read codes use suggests that introduction of the more detailed SNOMED-CT, in isolation, will not improve the quality of allergy coding in Scottish primary care. The introduction of SNOMED-CT should be accompanied by initiatives aimed at improving coding quality, such as the definition of terms/codes, the availability of terminology browsers, a recommended list of codes and mechanisms to incentivize detailed coding of the condition and the underlying allergic trigger.
BACKGROUND: The UK's NHS intends to move from the current Read code system to the international, detailed Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to facilitate more clinically appropriate coding of conditions and associated risk factors and outcomes. Given concerns about coding behaviour of general practitioners, we sought to study the current coding patterns in allergies and identify lessons for the future migration to SNOMED-CT. METHODS: Data from 2 014 551 primary care consultations in over 100 000 patients with one or more of 11 potentially allergic diseases (anaphylaxis, angioedema, asthma, conjunctivitis, drug allergies, eczema, food allergy, rhinitis, urticaria, venom allergy and other probable allergic disorders) from the Scottish Primary Care Clinical Informatics Unit Research (PCCIU-R) database were descriptively analysed and visualized to understand Read code usage patterns. RESULTS: We identified 352 Read codes for these allergic diseases, but only 36 codes (10%) were used in 95% of consultations; 73 codes (21%) were never used. Half of all usage was for Quality and Outcomes Framework codes for asthma. Despite 149 detailed codes (42%) being available for allergic triggers, these were infrequently used. CONCLUSIONS: This analysis of Read codes use suggests that introduction of the more detailed SNOMED-CT, in isolation, will not improve the quality of allergy coding in Scottish primary care. The introduction of SNOMED-CT should be accompanied by initiatives aimed at improving coding quality, such as the definition of terms/codes, the availability of terminology browsers, a recommended list of codes and mechanisms to incentivize detailed coding of the condition and the underlying allergic trigger.
Authors: Derk L Arts; Stephanie K Medlock; Henk C P M van Weert; Jeremy C Wyatt; Ameen Abu-Hanna Journal: PLoS One Date: 2018-04-19 Impact factor: 3.240
Authors: Clare MacRae; Hannah Whittaker; Mome Mukherjee; Luke Daines; Ann Morgan; Chukwuma Iwundu; Mohammed Alsallakh; Eleftheria Vasileiou; Eimear O'Rourke; Alexander T Williams; Philip W Stone; Aziz Sheikh; Jennifer K Quint Journal: Pragmat Obs Res Date: 2022-02-16