Which is better coding system to use for tissue site & clinical diagnosis? Please let us know your feedback about ICD vs SNOMED or any other.
Thanks,
Poornima
Which is better coding system to use for tissue site & clinical diagnosis? Please let us know your feedback about ICD vs SNOMED or any other.
Thanks,
Poornima
Inputs from Jack London from TJU:
Clinical diagnosis
Clinical diagnoses from EMRs will usually be ICD-9/ICD-10 coded. Pathologists use both SNOMED coding and ICD-/ICD-10 coding. Given the need to reconcile pathology with the main corpus of patient data, ICD-9/ICD-10 coding is preferable. BTW, I believe the requirement for ICD-9 to ICD-10 conversion is now targeted for October 2015. Also, we see ICD-9 coding in our HL7 pathology report feeds as well as SNOMED.
Tissue Site
Pathologists use SNOMED. ICD-O-3 is used by cancer registries, and may not cover all anatomic sites as well as SNOMED. For biobanks, I feel SNOMED is preferable (the SNOMED coding usually comes over in the HL7 report feed).
Inputs from Jitendra from UNSW:
In general ICD is used for registries. In other words ICD is used mostly for Public health purposes, which means they don’t have the granularity required for clinical purposes.
SNOMED on the other side is very comprehensive. ICD-O-3 tissue site is more at patient level and not suitable so much for few cancers at specimen level.
This is similar situation like Diagnosis for patient and morphological abnormality for specimen. Patient can have multiple diagnoses but that doesn’t represent the characteristics of a specimen. Similar the problem with ICD-O-3 is in few situations they don’t represent specimen, instead they represent at a higher level.
My suggestion for future development of OS is to implement SNOMED/ICD/relevant ontologies in the backend. Please refer to BioPortal API. Now a days almost every LIMS I came across implemented them to just avoid situations like this.