STEVEN J. ROSANSKY, M.D.
To the editor: In the October issue, two articles, by Payne (1) and Stern (2), bring attention to the written medical record as a means of evaluating physician performance and as a tool for epidemiologic research. This potential usefulness of the medical record can be reduced by a major shortcoming I recently encountered.
When a patient is discharged from the hospital, the physician summarizes his course and lists the final diagnoses. Medical record librarians code these diagnoses for morbidity and mortality statistics. Unfortunately, the list of diagnostic categories used for this task may have little relevance to contemporary clinical medicine.
ROSANSKY SJ. Updating The International Classification of Diseases. Ann Intern Med. ;92:437. doi: 10.7326/0003-4819-92-3-437_2
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Published: Ann Intern Med. 1980;92(3):437.
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