A structured approach to recording AIDS-defining illnesses in Kenya: A SNOMED CT based solution
2015 (English)In: Journal of Biomedical Informatics, ISSN 1532-0464, E-ISSN 1532-0480, Vol. 56, 387-394 p.Article in journal (Refereed) Published
Introduction: Several studies conducted in sub-Saharan Africa (SSA) have shown that routine clinical data in HIV clinics often have errors. Lack of structured and coded documentation of diagnosis of AIDS defining illnesses (ADIs) can compromise data quality and decisions made on clinical care. Methods: We used a structured framework to derive a reference set of concepts and terms used to describe ADIs. The four sources used were: (i) CDC/Accenture list of opportunistic infections, (ii) SNOMED Clinical Terms (SNOMED CT), (iii) Focus Group Discussion (FGD) among clinicians and nurses attending to patients at a referral provincial hospital in western Kenya, and (iv) chart abstraction from the Maternal Child Health (MCH) and HIV clinics at the same hospital. Using the January 2014 release of SNOMED CT, concepts were retrieved that matched terms abstracted from approach iii and iv, and the content coverage assessed. Post-coordination matching was applied when needed. Results: The final reference set had 1054 unique ADI concepts which were described by 1860 unique terms. Content coverage of SNOMED CT was high (99.9% with pre-coordinated concepts; 100% with post-coordination). The resulting reference set for ADIs was implemented as the interface terminology on OpenMRS data entry forms. Conclusion: Different sources demonstrate complementarity in the collection of concepts and terms for an interface terminology. SNOMED CT provides a high coverage in the domain of ADIs. Further work is needed to evaluate the effect of the interface terminology on data quality and quality of care.
Place, publisher, year, edition, pages
Elsevier , 2015. Vol. 56, 387-394 p.
AIDS; SNOMED CT; AIDS-related opportunistic infections; Developing countries; Quality of healthcare
IdentifiersURN: urn:nbn:se:liu:diva-121320DOI: 10.1016/j.jbi.2015.07.009ISI: 000359752100035PubMedID: 26184057OAI: oai:DiVA.org:liu-121320DiVA: diva2:854128
Funding Agencies|U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS (DGHA), under KEMRI/CDC Cooperative Agreement [GH000048-04]2015-09-162015-09-142015-09-16