Armando and Ahmad
>
> >Come to think of it,  why is the need for such "comprehensiveness"?
The future electronic NHS needs to be able to communicate. Clearly
different subject areas (GP or Urology etc) and differening
disiplines (GP or Nurse etc) have differing levels of what they would
like to retrieve (for audit, record structuring or decision support)
and therefore code ala Read or what they would like to code in
natural language.


> >Main morbidities and more are well catered for in ICPC,  for example
> >(Armando:  I've become a convert!).
I use ICPC regularly for the purpose it was designed for ....
classification. It is indaquate for clinical purposes. Hopefully Nick
Booth will contribute to this thread as he highlited some years ago
classifications are conceptually non-overlapping coding scheme for
analysis of population based date. Nomenclatures/Thesuarsus are for
record and retrieving data at a patient level. Read is one of only
two nomenclatures in the world; the other being Snomed.
Classification should be mapped to Nomenclatures.

> I still know little about Read but, by the discussions about it in GP-UK, it
> seems to me that codes are being created for classifying things to a great
> detail.
Read is to code things at a detail required by the clinician. It does
not classify as there is often conceptual overlap. You need mapped
classification for this purpose.

> After a point, I ask, what is the difference between the code and
> the object it is supposed to describe? Is Read trying to convert *every*
> tiny expression into an individual coding string? And if it is so, what's
> the use?
Natural language is coding system as you righly point out. Read is a
detailed medical one. For some people it goes to far in certain areas
.... the new version applies specialty sub-sets to the overall
nomencalture.

Ahmad says later:

>The Read coding system has five,  yes,  five layers of detail.
Sometimes not deep enough

>So,  you can start with a simple term like "chest infection",  which
>to mind,  is quite sufficient for my daily bread and olive oil,  down
>to "somethingcoccal infection of the bottom left hand corner alveoli
>but one with purple to greenish highlights exudate belonging to a
>patient who has a one eyed dog with a limp"  (not quite,  just trying
>to make a point).
You are using the 5 byte version2 set I presume. The concept of Read
(ie nomenclature) was corrupted in this version by trying to give
secondary care a version of Read by adding ICD9. All of the crazy
terms in Read v2 are from ICD9.

Read 3.1 comes back to being a nomneclature.

>Alas,  Armando,  we are stuck with something worse than a Catholic
>marriage,  and,  I fear there is no way out,  EXCEPT,  for a rogue
>like me to declare UDI and dump it.
All the crap in the press is irrelvant to the fact we need a working
version of Read 3.1. We haven't got one yet but we (GP SWG) are
trying hard to do the work instead of politics.

I hope this clarifies things ? Support is needed for Read 3.1 ...
which does not mean support for the CCC (no I am not saying there is
anything not worth supporting here ... I am not entering that
arguement but highlighting the issues are different).

Ian




Dr Ian Purves (Director)
Sowerby Unit for Primary Care Informatics
University of Newcastle, UK
Phone: +44 (0)191 222 7884
Fax:   +44 (0)191 222 6043
http://www.ncl.ac.uk/~nphcare/Sowerby//ian.html
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