The classification-nomenclature issues in medicine: a return to natural language

The subject is examined in accordance with recommendations made at two recent international conferences. The historical backgrounds of the International Classification of Diseases (ICD) and the Systematized Nomenclature of Medicine (SNOMED) are related to explain the current status and objectives of both as well as their structural differences. A Canadian alternative to the ICD is presented along with the reason for its non-acceptance. Finally, it is proposed that SNOMED and ICD be integrated in a practical way to obtain the benefits of a multiaxial nomenclature while retaining the equivalent ICD classes necessary for maintaining the continuity of statistical information. This approach would prepare the groundwork necessary for completely automated encoding in natural medical language for health care data banks, while providing ICD-based national and international statistics.