Coded Chief Complaints-Automated Analysis of Free-text Complaints

David A. Thompson*, David Eitel, Christopher M.B. Fernandes, Jesse M. Pines, James Amsterdam, Steven J. Davidson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Objectives: To describe a new chief-complaint categorization schema, the development of a computer text-parsing algorithm to automatically classify free-text chief complaints into this schema, and use of these coded chief complaints to describe the case mix of a community emergency department (ED). Methods: Coded Chief Complaints for Emergency Department Systems (CCC-EDS) is a new and untested schema of 228 chief complaints, grouped within dimensions of type and system. A computerized text-parsing algorithm for automatically reading and classifying free-text chief complaints into 1 of these 228 coded chief complaints was developed by using a consecutive derivation sample of 46,602 patients who presented to a community teaching-hospital ED in 2004. Descriptive statistics included frequency of patients presenting with the 228 coded chief complaints; percentage of free-text complaints not categorizable by the CCC-EDS; and admission rate, age, and gender differences by chief complaint. Results: In the derivation sample, the text-parsing algorithm classified 87.5% of 45,329 ED visits with non-null free-text chief complaints into 1 of 194 coded chief complaints. The text-parsing algorithm successfully classified 87.3% of the free-text chief complaints in a validation sample. The five most common coded chief complaints were Abdominal Pain (3,734 visits), Fever (2,234), Chest Pain (2,183), Breathing Difficulty (2,030), and Cuts-Lacerations (2,028). Conclusions: The CCC-EDS is a new comprehensive, granular, and useful classification schema for categorizing chief complaints in an ED. A CCC-EDS text-parsing algorithm successfully classified the majority of free-text chief complaints from an ED computer log. These coded chief complaints were used to describe the case mix of a community teaching-hospital ED.

Original languageEnglish (US)
Pages (from-to)774-782
Number of pages9
JournalAcademic Emergency Medicine
Issue number7
StatePublished - Jul 2006
Externally publishedYes


  • algorithm
  • chief complaint
  • emergency department
  • emergency medicine
  • free-text
  • triage

ASJC Scopus subject areas

  • Emergency Medicine


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