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Condition
What is a condition?
Problems
Conditions are typically the sorts of things that some clinicians record in the "problem list" at the start of a patient document. Conditions include:
- symptoms
- diagnoses
- complications
- pathological functions
- processes
- injuries
Normal function
Conditions are not neccesarily pathological. For example, a piece of text may be commenting on some normal function.
- For example,
- "bowel sounds were normal"
- "sound" should be annotated as a condition.
Social and general life issues
Conditions may also include social and general life issues, that the writer has considered it important to mention
- For example,
- Smoking
- Drinking
- Frail
- Ederley
Psychological problems
Conditions may include psychological problems.
- For example,
- "devastated by the results of surgery"
- "devastated" should be annotated as a condition.
- For example,
- "distressed by the bulge"
- "distressed" should be annotated as a condition.
Physical and physiological processes
Conditions may also include processes. This is often associated with a locus.
- For example, here are several process conditions, each with an associated locus:
- distended abdomen
- swollen feet
- painful joints
- For example,
- "the mass is causing compression "
- "the mass is compressing her trachea"
- "his trachea is compressed"
- In each of these, compression / compressing / compressed should be annotated as a condition.
- Cellular Processes such as "transformation" and "proliferation" should also be annotated as Conditions. See: Histopathology reports
General terms for problems and diseases
Sometimes, a patient's disease will be referred to as "the disease", or in phrases such as "no disease found". This will be annotated as a mention of the relevant condition entity
- For example,
- "Mr. X has five to six in-transit deposits of melanoma around his groin. I have explained the nature of the disease to him."
- "disease" will be annotated as a mention of the melanoma entity.
Similarly, a condition may be referred to using a general term such as "symptoms", "difficulties", "problems", "abnormality" etc. This will also be annotated.
- For example,
- "No chest symptoms found"
- "symptoms" will be marked as a condition, with locus "chest" and negation of "absent".
- For example,
- "difficulty with breathing"
- "difficulty" is a condition
- For example,
- "The problem persists"
- "problem" is a condition - probably coreferring with some other problem.
- For example,
- "Sections show large bowel mucosa with no significant histological abnormality"
- "abnormality" is a Condition, modified by the negation signal "no signficant"
Other people's conditions (e.g. a relative)
Even if a condition belongs to a person other than the patient, it should still be annotated. It is still a condition. Deciding who it belongs to is a separate process.
- For example,
- "She attended outpatients today accompanied by her husband, who has CLL".
- "CLL" should be annotated as a condition, even though it is not directly related to the patient.
Conditions as the findings of examinations
Examinations, as investigations (see below), often have lists of conditions that are related to the examination (by has_finding relationships: see below).
- For example
- "On abdominal examination she had a scar consistent with the surgery, bruising over the abdominal wall. She had pitting oedema of both limbs."
- There are three conditions, all related to the "examination" investigation.
What is not a condition?
Doubts and wonderings
General doubts and wonderings of the clinician will not be annotated as conditions.
- For example,
- "My main concern was her femoral nerve neuropraxia"
- "concern" will not be annotated as a condition
Progress, recurrence, change
Statements of the progress of a condition will not be annotated as standing for the condition.
- For example,
- "She has noticed a change in her voice"
- "change" will not be anotated as a condition.
- For example,
- "I discussed the potential for recurrence"
- "recurrence" will not be anotated as a condition.
- For example,
- "He is free of tumour recurrence"
- "recurrence" will not be anotated as a condition.
The loss or change of functional conditions should not be annotated.
- For example,
- "She has lost strength in her adductors"
- The loss of strength will not be annotated.
Results of an investigation
An investigation may find the absence of any condition. This will be marked as a result: see section on Result entity below.
- For example,
- "Plain X-rays of these areas were all normal"
- "normal" is a result, not a condition.
Conditions modified by other words: complex condition terms.
Conditions modified with loci
Conditions are often combined with a locus as a modifier
- For example,
- Bony metastases
- Cerebral atrophy
- An important questions in these examples is: should the whole phrase be annotated as a condition, or should it be split and annotated as a condition and a locus?
- The decision whether to split the phrase, or to leave as one, will follow the general guidelines on breaking down terms.
- Usually, one part of the phrase will be annotated as a locus, and one part as a condition. A relationship will be created between the locus and condition (see the has_location relationship)
- For example,
- "joint pain"
- "pain" will be annotated as a condition, and "joint" as a locus
- However, where a condition is commonly modified by a locus, and the combined term is accepted as the name of a condition, it will be annotated in its entirety as a condition. The locus will not be annotated separately.
- For example,
- "myocardial infarction"
- the entire term is valid as a condition entity
- "myocardial" will not be annotated as a locus
Loci modified with conditions
As well as loci qualifying conditons, conditions may appear qualifying loci.
- For example,
- "broken bone"
- "fractured" will be annotated as a condition (a fracture), and "bone" as a locus
Other modifiers: detail of the condition
In additon to loci being added to condition words, many other words are combined to give more detail. These cannot and should not all be annotated, Where the modifier is commonly accepted as part of the condition name, it will retained and annotated with the condition. See the general discussion of entity annotation above, for further explanation of this guideline.
- For example,
- "malignant melanoma"
- the entire term is valid as a condition entity and might be found in a dictionary
- "malignant" will be included in the annotation
- For example,
- "multinodal goitre"
- You would not find the entire term in a dictionary, and so only goitre will be annotated as a condition. "multinodal" will not be annotated.
- For example,
- "moderately differentiated adenocarcinoma"
- "adenocarcinoma" will be annotated as a condition, and the additional qualifying words ignored.
Multiple conditions appearing together
Some phrases give complex combinations of conditions that are associated with, or sub-parts of, each other. Each separate condition should be annotated. There is no need to combine them in any way.
- For example,
- "a moderately differentiated adenocarcinoma with lymphatic invasion"
- Two problems should be annotated: "adenocarsinoma" and "lymphatic invasion".