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Intervention

What is an intervention?

General definition

Interventions are:

• Some technical act, such as an operation
• Some administrative act, such as an admission
• Some patient self-treatment, such as exercise

Interventions are usually intended to treat a condition, as opposed to investigations, which are usually aimed at diagnosing a condition.

• Note that this distinction is blurred and imprecise
  • For example, a diagnosis may be made as a result of some failed or succesful treatment. Or a procedure may both investigate and treat some condition (as in endoscopy).
  • For example, staging may involve both an intervention and an investigation.
• The distinction is, however, still felt useful for the purposes of annotation.
• Where the distinction is unclear, annotators should err on the side of annotating mentions as an "investigation"

Patient administration and movement

Patient administration and management events are interventions. Stock phrases include:

• admission
• discharge
• referral

Therapeutic acts

Therapeutic acts that do not involve drugs are considered to be interventions.

• For example, radiotherapy

Interventions as verbs

Interventions may often be expressed in verbal form. For example,

• "it was excised with clear margins"
• implies an excision intervention

Patient self-treatment

Some interventions are patient self-treatments, such as exercise.

• For example,
  • "I have given him advice with regard to exercises to help with this"
  • "exercises" should be annotated as an intervention.

Advice given to patients

Advice given to a patient may also be considered an intervention.

• See the above example, where "advice" should be annotated as an intervention.

Operations and sub-procedures

Complex descriptions of interventions, such as operation notes, may mention sub-parts of a procedure. These will be annotated.

• For example, a single note may mention:
  • Bladder opened and a cuff of bladder removed. Rectum divided just above the peritoneal resection.
  • Three interventions will be annotated: "opened", "removed", and "divided"
• Such sub-processes include:
  • resection
  • division
  • closure
  • suture
  • and so on...

What is not an intervention?

Seeing a patient

The verb "see" can sometimes stand in for some unspecified intervention on patient and clinician. The verb "see" will not be annotated as an intervention.

• For example,
  • "I have asked by a consultant psychologist colleague to see this patient"
  • "see" will not be annotated as an intervention.

Care and treatment

General statements about care and treatment, as opposed to specific acts and events, will not be annotated as interventions

• For example,
  • "Thank you for involving us with her care"
  • "care" will not be annotated
• Examples:
  • "treated with atenolol", "his hypercalcaemia was treated"
  • "treated" will not be annotated
• Example:
  • "He presented in September"
  • "presented" will not be annotated

Section and paragraph headings

General statements of intervention in section and paragraph headings will not be annotated.

• Example:
  • "operation note and discharge summary:"
  • Neither operation nor discharge will be annotated

Changes to drugs

Starting and stopping of drug treatments will not be annotated as interventions.

• For example, the italicised words in the following will not be annotated as interventions:
  • "In 1987, she was c_commenced_ on Tamoxifen"
  • "Tamoxifen was _discontinued_"

Interventions modified by other words

Don't forget to use the dictionary test when considering interventions. Some interventions may be referred to by complex phrases, with additional words being added to the actual intervention to describe it further.

• For example,
  • "partial nephrectomy" would not appear in a dictionary, though "nephrectomy" would.
  • Just "nephrectomy" should be annotated.