Coded Chief Complaints--automated analysis of free-text complaints.
OBJECTIVE
To describe a new chief-complaint categorization schema, the development of a computer text-parsing algorithm to automatically classify free-text chief complaints into this schema, and use of these coded chief complaints to describe the case mix of a community emergency department (ED).


METHODS
Coded Chief Complaints for Emergency Department Systems (CCC-EDS) is a new and untested schema of 228 chief complaints, grouped within dimensions of type and system. A computerized text-parsing algorithm for automatically reading and classifying free-text chief complaints into 1 of these 228 coded chief complaints was developed by using a consecutive derivation sample of 46,602 patients who presented to a community teaching-hospital ED in 2004. Descriptive statistics included frequency of patients presenting with the 228 coded chief complaints; percentage of free-text complaints not categorizable by the CCC-EDS; and admission rate, age, and gender differences by chief complaint.


RESULTS
In the derivation sample, the text-parsing algorithm classified 87.5% of 45,329 ED visits with non-null free-text chief complaints into 1 of 194 coded chief complaints. The text-parsing algorithm successfully classified 87.3% of the free-text chief complaints in a validation sample. The five most common coded chief complaints were Abdominal Pain (3,734 visits), Fever (2,234), Chest Pain (2,183), Breathing Difficulty (2,030), and Cuts-Lacerations (2,028).


CONCLUSIONS
The CCC-EDS is a new comprehensive, granular, and useful classification schema for categorizing chief complaints in an ED. A CCC-EDS text-parsing algorithm successfully classified the majority of free-text chief complaints from an ED computer log. These coded chief complaints were used to describe the case mix of a community teaching-hospital ED.
Thompson
David A
DA
Department of Emergency Medicine, MacNeal Hospital, Berwyn, IL 60402, USA. dthompsonmd@ameritech.net
Eitel
David
D
Fernandes
Christopher M B
CM
Pines
Jesse M
JM
Amsterdam
James
J
Davidson
Steven J
SJ
D000465:Algorithms; D001331:Automation / Q000379:methods*; D004636:Emergency Service, Hospital; D005568:Forms and Records Control / Q000379:methods; D006801:Humans; D007087:Illinois; D015203:Reproducibility of Results; D018875:Vocabulary, Controlled