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Variation of SNOMED CT Coding of Clinical Research Concepts among Coding Experts

^a School of Library and Information Science, University of South Florida, Tampa, FL
^b Pediatrics Epidemiology Center, University of South Florida, Tampa, FL.

^_* Correspondence and reprint requests to: James E. Andrews, PhD, School of Library and Information Science, University of South Florida, 4202 E. Fowler Ave., CIS 1040 , Tampa FL 33620 (Email: jandrews{at}cas.usf.edu).

Received for publication: 01/10/07; accepted for publication: 04/09/07.

Objective: To compare consistency of coding among professional SNOMED CT coders representing three commercial providers of coding services when coding clinical research concepts with SNOMED CT.

Design: A sample of clinical research questions from case report forms (CRFs) generated by the NIH-funded Rare Disease Clinical Research Network (RDCRN) were sent to three coding companies with instructions to code the core concepts using SNOMED CT. The sample consisted of 319 question/answer pairs from 15 separate studies. The companies were asked to select SNOMED CT concepts (in any form, including post-coordinated) that capture the core concept(s) reflected in the question. Also, they were asked to state their level of certainty, as well as how precise they felt their coding was.

Measurements: Basic frequencies were calculated to determine raw level agreement among the companies and other descriptive information. Krippendorff’s alpha was used to determine a statistical measure of agreement among the coding companies for several measures (semantic, certainty, and precision).

Results: No significant level of agreement among the experts was found.

Conclusion: There is little semantic agreement in coding of clinical research data items across coders from 3 professional coding services, even using a very liberal definition of agreement.