Toward Vocabulary Control for Chief Complaint

Abstract

The chief complaint (CC) is the data element that documents the patient's reason for visiting the emergency department (ED). The need for a CC vocabulary has been acknowledged at national meetings and in multiple publications, but to our knowledge no groups have specifically focused on the requirements and development plans for a CC vocabulary.The national consensus meeting ''Towards Vocabulary Control for Chief Complaint'' was convened to identify the potential uses for ED CC and to develop the framework for CC vocabulary control. The 10-point consensus recommendations for action were 1) begin to develop a controlled vocabulary for CC, 2) obtain funding, 3) establish an infrastructure, 4) work with standards organizations, 5) address CC vocabulary characteristics for all user communities, 6) create a collection of CC for research, 7) identify the best candidate vocabulary for ED CCs, 8) conduct vocabulary validation studies, 9) establish beta test sites, and 10) plan publicity and marketing for the vocabulary.ACADEMIC EMERGENCY MEDICINE 2008; 15:476-482 ª

Chief Complaint–Based Performance Measures: A New Focus for Acute Care Quality Measurement

“…This was followed in 2006 by a multi-stakeholder meeting and publication “Towards Vocabulary Control for Chief Complaint,” which made consensus recommendations to this end. 21 …”

“…Some authors have proposed use of standardized coded complaints with free text modifiers. 27,30 Other studies have processed free text for syndromic surveillance using the Emergency Medical Text Processor (EMT-P) system, which uses the UMLS tools described above and a manually compiled synonym list, to process free text into standardized categories. 29,31 It is not hard to imagine a similar approach substituting medical conditions for syndromes to identify conditions for which measures of evidence-based care would apply.…”

Making Recording and Analysis of Chief Complaint a Priority for Global Emergency Care Research in Low‐income Countries

“…The need for standardization of chief complaint data in emergency care settings is well recognized in high‐income countries. In the United States, it was first put on the emergency medicine research agenda more than a decade ago, including at the Academic Emergency Medicine 2004 consensus conference ‘‘Informatics and Technology in Emergency Care,’’ the Frontlines of Medicine Project, Data Elements for Emergency Department Systems, the National Center for Health Statistics, the National Syndromic Surveillance conferences, the Canadian Association of Emergency Physicians, and the Victorian Emergency Minimum Dataset Overview . Such efforts focused simultaneously on development of systems for clinical use and research of emergency care while maintaining a capability for syndromic surveillance.…”

Consensus Development of a Modern Ontology of Emergency Department Presenting Problems – the HierArchical Presenting Problem ontologY (HaPPy)

“…Over the last 15 years attempts have been made to create a standardized method of recording chief complaints 4 . Prior attempts have failed to gain widespread acceptance for various reasons: they may not be freely sharable or may not have had the right level of specificity, structure, and clinical relevance to gain acceptance by the larger emergency medicine community 5 . Emergency department information system (EDIS) vendors and other commercial vendors 6 offer vocabularies, but they cannot be used to compare data across EDs who do not have access to these proprietary vocabularies.…”