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The Read Clinical Classification.

Joan M. Chisholm
Published 1990 · Medicine
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Last month the Secretary of State for Health acquired for the NHS the Read clinical classification-an event of considerable importance for information strategy within the service.' Dr James Read, a general practitioner in Loughborough, has been developing his system of classification for the past eight years, and it is now the most comprehensive medical coding system in the world, with over 250 000 codes, including 150 000 synonyms, and it is still evolving. The classification codes not only diseases but also history and symptoms; examination findings and signs; diagnostic procedures; preventive , operative, therapeutic, and administrative procedures ; drugs and appliances; and occupations and social information. The classification of clinical data has three main purposes.2 It can help in clinical care-by aiding the recording and retrieval of information held as part of a medical record. It can make it easier to analyse data statistically for planning and research purposes. Thirdly, it is a key element in the electronic transmission of data from one computer to another. A standard coding system should ensure that data are transferred reproducibly and received in the form in which they are sent, without corruption or loss of accuracy; whereas if different classifications are used by sender and receiver serious communication problems can arise. The Read clinical classification was developed as a thesaurus of medical terms and a computerised medical language with six key criteria: it is designed to be comprehensive , hierarchical, coded, computerised, cross referenced, and dynamic. It also includes and is cross referenced to all of the widely used standard classifications.* The Read codes are five character alphanumeric codes. At each level the code may be a lower (small) or upper case (capital) letter or a number. There are 58 available characters at each level and so a theoretical maximum of 656 356 768 available codes. Such a large set of possible codes is needed to provide sufficient flexibility and space to incorporate and follow the structure of the large subset classifications included and to allow for the addition of new codes within the existing framework without disturbing the hierarchies. In other words, there is sufficient redundancy in the coding system to cope with any reasonable expansion of entities and synonyms. The advantages of the Read codes were recognised in 1988 by the technical working party of the Joint Computing Group of the Royal College of General Practitioners and by the General Medical …
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