Read Code quality assurance: from simple syntax to semantic stability.

As controlled clinical vocabularies assume an increasing role in modern clinical information systems, so the issue of their quality demands greater attention. In order to meet the resulting stringent criteria for completeness and correctness, a quality assurance system comprising a database of more than 500 rules is being developed and applied to the Read Thesaurus. The authors discuss the requirement to apply quality assurance processes to their dynamic editing database in order to ensure the quality of exported products. Sources of errors include human, hardware, and software factors as well as new rules and transactions. The overall quality strategy includes prevention, detection, and correction of errors. The quality assurance process encompasses simple data specification, internal consistency, inspection procedures and, eventually, field testing. The quality assurance system is driven by a small number of tables and UNIX scripts, with "business rules" declared explicitly as Structured Query Language (SQL) statements. Concurrent authorship, client-server technology, and an initial failure to implement robust transaction control have all provided valuable lessons. The feedback loop for error management needs to be short.

Symbolic anatomic knowledge representation in the Read Codes version 3: structure and application.

The Read Thesaurus (Version 3 of the Read Codes) is a controlled medical vocabulary produced during the Clinical Terms Projects with the involvement of over 2,000 health care professionals from all United Kingdom specialties. In addition to allowing the transfer of clinical information in a meaningful way, it supports analysis of this information and provides a basis for the development of shareable medical knowledge bases. The thesaurus includes a comprehensive, dynamic set of over 7,000 gross anatomic concepts richly linked in a network with over 16,000 operative procedures and 40,000 disorders. The representation of anatomic concepts aims to balance the requirements for expressivity, clearness, and simplicity. The underlying directed acyclic graph hierarchy is independent of the alphanumeric code and enables continued refinement and expansion. A template table allows semantic definition, qualification, and linkage of concepts.

Semantic quality through semantic definition: refining the Read Codes through internal consistency.

Checks of internal consistency in controlled medical vocabularies facilitate their development and assist refinement of the underlying terminological model. Two simple checks of consistency between knowledge in the subtype hierarchy and that in semantic definitions of concepts are described. It is proposed that these checks are a helpful adjunct to, but not a replacement for, large-scale involvement of domain experts in construction of controlled vocabularies.

Anatomical characterisation of surgical procedures in the Read Thesaurus.

Each concept in the surgical operations chapter of the Read Thesaurus has been analysed to determine its anatomical site component. The underlying structure of this chapter and its relationship to the anatomy chapter are explored. The defined anatomical sites have been included as atomic maps in the Read Code template table, one of the key component files of the Thesaurus, relevant features of which are described. The analysis methodology is outlined and the value of an anatomically characterised surgical procedure terminology is discussed together with the implications of semantically defining a wider range of characteristics of surgical procedures.

Parental problems influencing the academic achievement of medical students: a prospective study.

The 227 students offered places in the 1988 medical student intake at the University of Queensland were surveyed regarding their demographic characteristics. This was correlated with the students' subsequent performance and persistence during the first year of the medical course. Coming from a lower socioeconomic background and having family problems were both associated with either a decreased academic performance or an increased attrition rate. The results are discussed, relevant literature is reviewed and suggestions for further research are made.