We note that some authors have referred to either the DoD-GEIS or the CDC/DoD code sets as "standard'' ICD code sets (Heffernan et al., 2004a, Mandl et al., 2004). However it would be extremely premature to standardize on these code sets other than for research reporting purposes. Given the variability in diseases, ICD assignment by clinicians and coders, and diagnostic precision, it is unlikely that a one-size-fits-all ICD code set will be optimal for all settings and purposes. Moreover, it is trivial for computer systems to aggregate raw ICD-coded data using any desired code set in real time and as needed.10
We note that identifying an optimal code set is not trivial. A computer scientist would, in fact, call it an intractable problem, which means that it cannot be done. The reason: there are
10 A single microchip cannibalized from a discarded DVD player likely has sufficient processing power to keep up with all the ICD-to-code set translations required for biosurveillance by the entire world.
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