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The late professor Henk Lamberts directed the department of general practice at the University of Amsterdam during the 1980’s. The teachers and the assistants of the department had the arduous task of reading and indexing medical journals specific to general practice. Articles relevant to symptoms, processes and diagnoses (i.e., clinical concepts) were indexed with ICPC (the International Classification of Primary Care). Non-clinical concepts were indexed with “Q-Codes.”
Using the letter Q, not available in ICPC, Professor Henk Lamberts had, therefore, created new categories to represent these non-clinical concepts. The original Q-Codes were developed before the Internet age and before Medline became available on CD-ROM. Thus, to the best of our knowledge, the original Q-Codes list has never been published (Table 1).
Beginning The Q-Codes
Beginning with the original idea of Henk Lamberts, we have tried to identify the main themes in the congress abstracts of family doctors. The Q-Codes have been identified through content analysis of 1700 congress abstracts. The non-clinical items discussed in these abstracts have been gathered into a set of 182 items organized in a taxonomy called Q-Codes.
The Q-Codes taxonomy is divided into 8 domains and a rag bag/catchall category. Each domain has categories, subcategories, and sub-subcategories. The Q-Codes are available in an online portal at www.hetop.eu through a free subscription process.
Each of the 182 concepts identified in the online portal have been carefully studied and mapped to Medical Subject Headings, if any. MeSH mappings are available for all but ten concepts (Table 2). In addition, definitions have been selected from online terminologies or dictionaries.
Naturally, we are not pretending to cover the whole field of general practice. More themes will certainly have to be identified in the near future. GP/FM is a very large discipline which working fields probably follow the long tail distribution rules. We hope to cover, by the use of ICPC-2 and Q-Codes, the most frequent themes discussed by general practitioners in the congress abstracts.
The author and the team of translators are aware that this terminology only partially represents the complex reality of the GP/FM job. Further analysis of congress abstracts will show the need for additional themes and demonstrate the vitality of our profession. Thus, we will move from version 2.4.1 to version 2.5, as these new themes are discovered.
Organizational content of General practice / Family Medicine
Q-Codes are represented here as a matrix in the shape of a Q letter.
- On the left; the people related domains, Doctors and Patients.
- On the right; Structure, Knowledge management including teaching, Research and development.
- On the center; joining all, Medical Ethics.
Hazards are the underlying environmental conditions represented by the downward oblique tail stylized as a triangle but which is in reality the background of the GPs work. Note that QH locks the wheel.