Extending ICPC-2 PLUS terminology to develop a classification system specific for the study of chiropractic...

Area of Science:

• Chiropractic Research
• Health Informatics
• Clinical Terminology Development

Background:

• Healthcare research generates vast data requiring organization for manageable reporting.
• The Chiropractic Observation and Analysis Study (COAST) described clinical practices in Victoria, Australia.
• Existing coding systems like ICPC-2 PLUS needed expansion for chiropractic-specific encounters.

Purpose of the Study:

• To describe the development of a chiropractic-specific terminology.
• To expand the ICPC-2 PLUS system for coding chiropractic encounters in research.
• To facilitate organized and clear reporting of chiropractic clinical practices.

Main Methods:

• A coder utilized the ICPC-2 PLUS system for encounter details (reasons, diagnoses, processes).
• Rules and conventions from the PLUS system developers were applied.
• New chiropractic-specific terms and codes were created when absent in ICPC-2 PLUS.

Main Results:

• 169 new chiropractic-specific terms were added to the ICPC-2 PLUS list from 4,464 encounters.
• New terms were primarily for diagnoses/problems (47% of diagnoses) and processes of care (17%).
• Existing ICPC-2 PLUS adequately covered only 4% of reasons for encounter.

Conclusions:

• Expanding ICPC-2 PLUS with chiropractic terms improved coding accuracy for encounters.
• The new system captured chiropractic diversity while allowing for generalized reporting.
• Further research is needed on chiropractor diagnosis/problem descriptions; COAST is ongoing for terminology refinement.