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a means for describing causes of death; a trace of its heritage is its continued difficulty with describing chronic as opposed to acute forms of disease. This is one basis for the temporal fault lines that emerge in its usage. The UMLS originated as a means of information retrieval (the MeSH scheme) and is not as sensitive to clinical conditions as it might be (Musen 1992, 440). |
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The two basic problems for any overarching classification scheme in a rapidly changing and complex field can be described as follows. First, any classificatory decision made now might by its nature block off valuable future developments. If we decide that all instances of sudden infant death syndrome (SIDS) are to be placed into a single box (R95 in ICD-10), then we are not recording information that might be used by future researchers to distinguish possible multiple social or environmental causes of SIDS. We are not making it impossible to carry out such studies; but we are making it difficult to retrieve information. Inversely, if every possibly relevant piece of information were stored in the scheme, it would be entirely unwieldy. |
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For these reasons, the decision not to collect is the most difficult to take for people maintaining any sort of collection based on a classification system, whether it be the acquisition department of a library, the curator of an art museum, or the collector of information for vital statistics. There are always practical budget and storage issues. These are balanced against two other factors, the need for a well-ordered and in some sense parsimonious repository that can be used, and the side bets that are made about what material will be useful in the future. This latter is particularly difficult. Collectors and curators of all sorts must become future forecasters and decide the boundaries of what will be useful for the future. There is no perfect answer, only a set of practical tradeoffs. This is a problem that has plagued museums of natural history. Fossils found in the nineteenth century might come along with general information about the depth at which they were discovered and the surrounding geological features (though they often did not). Even if this information was included, it was never as precisely noted as would be useful for geologists and paleontologists today: since there was no conception at that stage of the kinds of dating techniques that are used nowadays. The museum is then faced with the choice between recording as much as possible now (which is very expensive and possibly not useful anyway) and having the collection perhaps last longer into the future, or recording a judicious amount now (which will keep the administrative costs down) and having the |
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