Development of a case-based system for grouping diagnoses in general practice

Introduction: This article describes the development of EPICON; an application to group ICPC-coded diagnoses from electronic medical records in general practice into episodes of care. These episodes can be used to estimate prevalence and incidence rates. Methods: We used data from 89 practices that participated in the Dutch National Survey of General Practice. Additionally, we held interviews with seven experts, and studied documentation to establish the requirements of the application and to develop the design. We then performed a formative evaluation by assessing incorrectly grouped diagnoses. Results: EPICON is based on a combination of logical expressions, a decision table, and information extracted from individual cases by case-based reasoning. EPICON is able to group all diagnoses in the selected 89 practices, and groups 95% correctly. Conclusion: The results cautiously indicate that EPICONs performance will probably be adequate for the purpose of estimating morbidity rates in general practice. (C) 2007 Elsevier Ireland Ltd. All rights reserved.