Why Real-World Evidence Fails Without Terminology
Most RWE problems are diagnosed as data problems. They are usually semantic problems wearing a data problem's clothes.
CAD CARE INSIGHTS · REAL-WORLD EVIDENCE
Most RWE problems are diagnosed as data problems. They are usually semantic problems wearing a data problem's clothes.
A dataset can be complete, well-governed and still unusable for evidence if two sites code the same diagnosis three different ways. Analysis code cannot fix that; only terminology mapping upstream can.
SNOMED CT and ICD solve different problems and are often confused. SNOMED captures clinical meaning at the point of care; ICD serves classification and billing. RWE usually needs both, mapped to each other deliberately.
The fix that actually works is boring: code at the point of capture, against a governed ValueSet, with a named owner for terminology decisions. Retrospective cleanup is always more expensive than this would have been.
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