Travers Debbie A, Haas Stephanie W
School of Nursing, University of North Carolina, Chapel Hill, NC, USA.
Acad Emerg Med. 2006 Dec;13(12):1319-23. doi: 10.1197/j.aem.2006.06.054. Epub 2006 Nov 1.
Emergency department (ED) chief-complaint (CC) data increasingly are important for clinical-care and secondary uses such as syndromic surveillance. There is no widely used ED CC vocabulary, but experts have suggested evaluation of existing health-care vocabularies for ED CC.
To evaluate the ED CC coverage in existing biomedical vocabularies from the Unified Medical Language System (UMLS).
The study sample included all CC entries for all visits to three EDs over one year. The authors used a special-purpose text processor to clean CC entries, which then were mapped to UMLS concepts. The UMLS match rates then were calculated and analyzed for matching concepts and nonmatching entries.
A total of 203,509 ED visits was included. After cleaning with the text processor, 82% of the CCs matched a UMLS concept. The authors identified 5,617 unique UMLS concepts in the ED CC data, but many were used for only one or two visits. One thousand one hundred thirty-six CC concepts were used more than ten times and covered 99% of all the ED visits. The largest biomedical vocabulary in the UMLS is the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT), which included concepts for 79% of all ED CC entries. However, some common CCs were not found in SNOMED CT.
The authors found that ED CC concepts are well covered by the UMLS and that the best source of vocabulary coverage is from SNOMED CT. There are some gaps in UMLS and SNOMED CT coverage of ED CCs. Future work on vocabulary control for ED CCs should build upon existing vocabularies.
急诊科（ED）的主诉（CC）数据对于临床护理以及诸如症状监测等二次应用越来越重要。目前尚无广泛使用的急诊科CC词汇表，但专家建议对现有的医疗保健词汇表进行急诊科CC评估。
评估统一医学语言系统（UMLS）中现有生物医学词汇表对急诊科CC的覆盖情况。
研究样本包括一年内三家急诊科所有就诊的所有CC条目。作者使用专用文本处理器清理CC条目，然后将其映射到UMLS概念。然后计算并分析UMLS匹配率，以确定匹配的概念和不匹配的条目。
共纳入203,509次急诊科就诊。使用文本处理器清理后，82%的CC与UMLS概念匹配。作者在急诊科CC数据中识别出5617个独特的UMLS概念，但许多概念仅被使用一两次。1136个CC概念被使用超过十次，覆盖了所有急诊科就诊的99%。UMLS中最大的生物医学词汇表是医学临床术语系统命名法（SNOMED CT），其中包含所有急诊科CC条目中79%的概念。然而，SNOMED CT中未发现一些常见的CC。
作者发现UMLS很好地覆盖了急诊科CC概念，词汇覆盖的最佳来源是SNOMED CT。UMLS和SNOMED CT在急诊科CC覆盖方面存在一些差距。未来关于急诊科CC词汇控制的工作应基于现有词汇表展开。
