201
|
Fogelberg M, Baranov A, Herbst A, Vikhareva O. Underreporting of complete uterine rupture and uterine dehiscence in women with previous cesarean section. J Matern Fetal Neonatal Med 2016; 30:2058-2061. [PMID: 27899049 DOI: 10.1080/14767058.2016.1236249] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine the true incidence of complete uterine rupture and uterine dehiscence among women delivered by cesarean section after a previous cesarean section. METHODS Medical records of all women who delivered at University Hospital in Malmö, Sweden, during 2005-2009 (n = 21 420) were retrieved from the electronic patient record system (EPRS). After adjustment for inaccuracies, 716 women who had undergone repeat cesarean section were identified and their operation reports were reviewed. Descriptions of complete uterine rupture or uterine dehiscence in operation reports were compared with diagnoses registered in EPRS with International Classification of Diseases codes version 10 (ICD-10). Sensitivity and specificity of complete uterine rupture registration were calculated. RESULTS There were 13 women with a registered diagnosis of uterine rupture. After reviewing medical records of women with repeat cesarean section, seven additional cases of complete uterine rupture, 33 cases of uterine dehiscence and 39 cases of extremely thin myometrium were identified. The incidence of complete uterine rupture and uterine dehiscence for women who delivered by repeat cesarean section was 2.8% and 10.1%, respectively. CONCLUSIONS Diagnosis of complete uterine rupture was underreported in the EPRS by 35% and diagnosis of uterine dehiscence was missing in 100% of cases.
Collapse
Affiliation(s)
- Maria Fogelberg
- a Department of Obstetrics and Gynecology , Skåne University Hospital Malmö, Lund University , Sweden
| | - Anton Baranov
- a Department of Obstetrics and Gynecology , Skåne University Hospital Malmö, Lund University , Sweden
| | - Andreas Herbst
- a Department of Obstetrics and Gynecology , Skåne University Hospital Malmö, Lund University , Sweden
| | - Olga Vikhareva
- a Department of Obstetrics and Gynecology , Skåne University Hospital Malmö, Lund University , Sweden
| |
Collapse
|
202
|
Derogatis LR, Sand M, Balon R, Rosen R, Parish SJ. Toward a More Evidence-Based Nosology and Nomenclature for Female Sexual Dysfunctions-Part I. J Sex Med 2016; 13:1881-1887. [PMID: 27743749 DOI: 10.1016/j.jsxm.2016.09.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 09/09/2016] [Accepted: 09/10/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION A nomenclature is defined as a classification system for assigning names or terms in a scientific discipline. A nosology more specifically provides a scientific classification system for diseases or disorders. Historically, the nosologic system informing female sexual dysfunction (FSD) has been the system developed by the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders (DSM-III through DSM-5). Experts have recognized limitations of its use in clinical practice, including concerns that the DSM-5 system does not adequately reflect the spectrum and presentation of FSD. AIM To review the central considerations and issues that underlie the development of a new evidence-based nomenclature that reliably and validly defines the categories of FSD and will effectively function in clinical and research settings, serve as a basis for International Classification of Diseases (ICD) codes, and provide regulatory guidance for interventions designed as FSD treatments. METHODS The International Society for the Study of Women's Sexual Health conducted a 2-day conference on nomenclature for FSD in December 2013. Key opinion leaders representing diverse areas of expertise discussed ideal characteristics, existing DSM definitions, and current and future ICD coding to develop consensus for this new nomenclature. MAIN OUTCOME MEASURE A comprehensive appreciation of the parameters and characteristics essential to a new FSD nomenclature and terminology that will serve as the principal nosology for the description and diagnosis of FSD. RESULTS A critical appraisal of the essential elements of a classification system for diagnosing FSD was accomplished. The applicability of DSM-5 FSD definitions was challenged; and the considerations for developing a new nomenclature were discussed, including comorbidities, clinical thresholds, alternative etiologies, and validity. CONCLUSION The essential elements for developing a valid, reliable, credible, and clinically applicable nosology for FSD were enumerated as a preamble to constructing the actual nosologic system (Part II).
Collapse
Affiliation(s)
- Leonard R Derogatis
- Maryland Center for Sexual Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Sand
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA
| | - Richard Balon
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Raymond Rosen
- New England Research Institutes, Inc., Watertown, MA, USA
| | - Sharon J Parish
- Departments of Psychiatry and Medicine, Weill Cornell Medical College, New York, NY, USA.
| |
Collapse
|
203
|
Reed GM, Drescher J, Krueger RB, Atalla E, Cochran SD, First MB, Cohen‐Kettenis PT, Arango‐de Montis I, Parish SJ, Cottler S, Briken P, Saxena S. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations. World Psychiatry 2016; 15:205-221. [PMID: 27717275 PMCID: PMC5032510 DOI: 10.1002/wps.20354] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In the World Health Organization's forthcoming eleventh revision of the International Classification of Diseases and Related Health Problems (ICD-11), substantial changes have been proposed to the ICD-10 classification of mental and behavioural disorders related to sexuality and gender identity. These concern the following ICD-10 disorder groupings: F52 Sexual dysfunctions, not caused by organic disorder or disease; F64 Gender identity disorders; F65 Disorders of sexual preference; and F66 Psychological and behavioural disorders associated with sexual development and orientation. Changes have been proposed based on advances in research and clinical practice, and major shifts in social attitudes and in relevant policies, laws, and human rights standards. This paper describes the main recommended changes, the rationale and evidence considered, and important differences from the DSM-5. An integrated classification of sexual dysfunctions has been proposed for a new chapter on Conditions Related to Sexual Health, overcoming the mind/body separation that is inherent in ICD-10. Gender identity disorders in ICD-10 have been reconceptualized as Gender incongruence, and also proposed to be moved to the new chapter on sexual health. The proposed classification of Paraphilic disorders distinguishes between conditions that are relevant to public health and clinical psychopathology and those that merely reflect private behaviour. ICD-10 categories related to sexual orientation have been recommended for deletion from the ICD-11.
Collapse
Affiliation(s)
- Geoffrey M. Reed
- Department of Mental Health and Substance AbuseWorld Health OrganizationGenevaSwitzerland,School of PsychologyUniversidad Nacional Autónoma de MéxicoMexico CityMexico
| | - Jack Drescher
- Department of PsychiatryNew York Medical CollegeNew YorkNYUSA
| | - Richard B. Krueger
- Department of PsychiatryColumbia University, College of Physicians and Surgeons, New York State Psychiatric Institute and New York Presbyterian HospitalNew YorkNYUSA
| | - Elham Atalla
- Primary Care and Public Health Directorate, Ministry of HealthManamaBahrain
| | - Susan D. Cochran
- Fielding School of Public HealthUniversity of CaliforniaLos AngelesCAUSA
| | - Michael B. First
- Department of PsychiatryColumbia University, College of Physicians and Surgeons, New York State Psychiatric Institute and New York Presbyterian HospitalNew YorkNYUSA
| | - Peggy T. Cohen‐Kettenis
- Department of Medical PsychologyVU University Medical Centre, and Center of Expertise on Gender DysphoriaAmsterdamThe Netherlands
| | | | - Sharon J. Parish
- Departments of Medicine and PsychiatryWeill Cornell Medical College and New York Presbyterian Hospital/Westchester DivisionWhite PlainsNYUSA
| | - Sara Cottler
- Department of Reproductive Health and ResearchWorld Health OrganizationGenevaSwitzerland
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg‐EppendorfHamburgGermany
| | - Shekhar Saxena
- Department of Mental Health and Substance AbuseWorld Health OrganizationGenevaSwitzerland
| |
Collapse
|
204
|
Benchimol EI, Smeeth L, Guttmann A, Harron K, Hemkens LG, Moher D, Petersen I, Sørensen HT, von Elm E, Langan SM. [The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement]. Z Evid Fortbild Qual Gesundhwes 2016; 115-116:33-48. [PMID: 27837958 PMCID: PMC5330542 DOI: 10.1016/j.zefq.2016.07.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/18/2016] [Indexed: 12/17/2022]
Abstract
Zunehmend werden routinemäßig gesammelte Gesundheitsdaten, die zu administrativen und klinischen Zwecken und ohne spezifische, a priori festgelegte Forschungsziele erhoben wurden, auch für die Forschung eingesetzt. Die rasche Entwicklung und Verfügbarkeit dieser Daten machten Probleme deutlich, die in den bestehenden Berichts-Leitlinien, wie dem STROBE-Statement (Strengthening the Reporting of Observational Studies in Epidemiology) nicht behandelt werden. Das RECORD-Statement (REporting of studies Conducted using Observational Routinely-collected health Data) wurde entwickelt, um diese Lücken zu schließen. RECORD ist als Erweiterung des STROBE-Statements gedacht, um Punkte abzudecken, die spezifisch sind beim Berichten von Beobachtungsstudien, die routinemäßig gesammelte Gesundheitsdaten verwenden. RECORD besteht aus einer Checkliste von 13 Punkten mit Bezug zu Titel, Abstract, Einleitung, Methoden-, Ergebnis- und Diskussionsteil von Artikeln sowie zu anderen Informationen, die in Forschungsberichten dieser Art enthalten sein sollten. Dieses Dokument enthält die Checkliste sowie Erläuterungen und weitere Erklärungen, um die Verwendung der Checkliste zu verbessern. Beispiele für ein gutes Berichten der einzelnen Punkte der RECORD-Checkliste sind ebenfalls in diesem Dokument enthalten. Dieses Dokument sowie die zugehörige Website und ein Forum (http://www.record-statement.org) werden die Umsetzung und das Verständnis von RECORD verbessern. Autoren, Redakteure von Fachzeitschriften und Peer-Reviewer können die Transparenz beim Berichten von Forschungsergebnissen erhöhen, indem sie RECORD anwenden.
Collapse
Affiliation(s)
- Eric I Benchimol
- Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada; Institute for Clinical Evaluative Sciences, Toronto, Canada.
| | - Liam Smeeth
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Astrid Guttmann
- Institute for Clinical Evaluative Sciences, Toronto, Canada; Hospital for Sick Children, Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Katie Harron
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Lars G Hemkens
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Switzerland
| | - David Moher
- Ottawa Hospital Research Institute, Ottawa, Canada, and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa, Ottawa, Canada
| | - Irene Petersen
- Department of Primary Care and Population Health, University College London (UCL), London, United Kingdom
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Erik von Elm
- Cochrane Switzerland, Institute of Social and Preventive Medicine, University Medical Centre Lausanne, Lausanne, Switzerland
| | - Sinéad M Langan
- London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | | |
Collapse
|
205
|
Cedars AM, Burns S, Novak EL, Amin AP. Predictors of Rehospitalization Among Adults With Congenital Heart Disease Are Lesion Specific. Circ Cardiovasc Qual Outcomes 2016; 9:566-75. [PMID: 27625407 DOI: 10.1161/circoutcomes.116.002733] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/27/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Readmission is responsible for a large proportion of inpatient care costs in adult congenital heart disease. There are, however, few data available to identify at-risk patients or to suggest strategies for intervention to prevent rehospitalization. METHODS AND RESULTS We conducted an analysis of admissions in patients over the age of 18 years with a 3-digit International Classification of Diseases-Ninth Revision code of 745 to 747 from the State Inpatient Databases of Arkansas (2008-2010), California (2003-2012), Florida (2005-2012), Hawaii (2006-2010), Nebraska (2003-2011), and New York (2005-2012). We investigated index admission diagnoses most commonly associated with 1-year readmission and the most common reasons for readmission. We then selected variables we thought would be associated with increased rates of 1-year readmission and constructed multivariable regression models grouping patients by congenital lesion, to examine the relative contribution of the specified variables to readmission risk for each lesion. A total of 64 420 patients were included in the final analysis. Thirty-nine percent of patients experienced a readmission within 12 months of an index admission. Compared with those who did not experience a readmission, those who did were more likely to have had a primary diagnosis of congestive heart failure at the time of index admission, and the most common diagnoses at the time of readmission were congestive heart failure and arrhythmia. There is lesion-specific heterogeneity in risk factors for readmission. CONCLUSIONS Patients with adult congenital heart disease have high rates of readmission, predominantly for congestive heart failure and arrhythmia. Predictors of readmission are lesion specific, and future strategies aimed at decreasing readmission rate will likely need to be individualized.
Collapse
Affiliation(s)
- Ari M Cedars
- From the Department of Cardiology, Baylor University Hospital, Dallas, TX (A.M.C.); and the Department of Cardiology, Washington University School of Medicine, St. Louis, MO (S.B., E.L.N., A.P.A.).
| | - Sara Burns
- From the Department of Cardiology, Baylor University Hospital, Dallas, TX (A.M.C.); and the Department of Cardiology, Washington University School of Medicine, St. Louis, MO (S.B., E.L.N., A.P.A.)
| | - Eric L Novak
- From the Department of Cardiology, Baylor University Hospital, Dallas, TX (A.M.C.); and the Department of Cardiology, Washington University School of Medicine, St. Louis, MO (S.B., E.L.N., A.P.A.)
| | - Amit P Amin
- From the Department of Cardiology, Baylor University Hospital, Dallas, TX (A.M.C.); and the Department of Cardiology, Washington University School of Medicine, St. Louis, MO (S.B., E.L.N., A.P.A.)
| |
Collapse
|
206
|
Dorjbal D, Cieza A, Gmünder HP, Scheel-Sailer A, Stucki G, Üstün TB, Prodinger B. Strengthening quality of care through standardized reporting based on the World Health Organization's reference classifications. Int J Qual Health Care 2016; 28:626-633. [PMID: 27566981 DOI: 10.1093/intqhc/mzw078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 05/06/2016] [Accepted: 06/07/2016] [Indexed: 01/18/2023] Open
Abstract
QUALITY ISSUE Responding to person's health and related needs requires the availability of health information that reflects relevant aspects of a health condition and how this health condition impacts on a person's daily life. INITIAL ASSESSMENT Health information is routinely collected at different time points by diverse professionals, in different settings for various purposes with varying methods. Consequently, health information is not always comparable, posing a challenge to the regular monitoring of quality. CHOICE OF SOLUTION The World Health Organization's (WHO) International Classification of Diseases (ICD), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI; under development) are complementary and serve as meaningful reference classifications for comparing data on persons' health and related interventions across health systems. IMPLEMENTATION We developed a systematic approach of translating routinely collected information into a standardized report based on the three WHO reference classifications and the Rehab-Cycle®. Subsequently, we have demonstrated its application using five random case records of individuals attending a rehabilitation program. EVALUATION All identified concepts were able to be linked to WHO's reference classifications. The ICF served as a tool to standardize information on rehabilitation goals and their achievement. The ICHI served as the basis for reporting the interventions that were documented in the case records, including the intervention targets that were derived from the ICF codes. LESSONS LEARNED Our experience shows that, it is possible to translate routinely collected information into standardized reports by linking existing narrative records with WHO's reference classifications.
Collapse
Affiliation(s)
- Delgerjargal Dorjbal
- Swiss Paraplegic Research , Nottwil, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Alarcos Cieza
- Swiss Paraplegic Research , Nottwil, Switzerland.,Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Highfield Campus, Southampton, UK.,Department of Medical Informatics, Biometry and Epidemiology - IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | | | | | - Gerold Stucki
- Swiss Paraplegic Research , Nottwil, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.,ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI) , Nottwil, Switzerland
| | - T Bedirhan Üstün
- Big data for Health, Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Birgit Prodinger
- Swiss Paraplegic Research , Nottwil, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.,ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI) , Nottwil, Switzerland
| |
Collapse
|
207
|
Allanson ER, Tunçalp Ö, Gardosi J, Pattinson RC, Francis A, Vogel JP, Erwich J, Flenady VJ, Frøen JF, Neilson J, Quach A, Chou D, Mathai M, Say L, Gülmezoglu AM. The WHO application of ICD-10 to deaths during the perinatal period (ICD-PM): results from pilot database testing in South Africa and United Kingdom. BJOG 2016; 123:2019-2028. [PMID: 27527122 DOI: 10.1111/1471-0528.14244] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To apply the World Health Organization (WHO) Application of the International Classification of Diseases, tenth revision (ICD-10) to deaths during the perinatal period: ICD-Perinatal Mortality (ICD-PM) to existing perinatal death databases. DESIGN Retrospective application of ICD-PM. SETTING South Africa, UK. POPULATION Perinatal death databases. METHODS Deaths were grouped according to timing of death and then by the ICD-PM cause of death. The main maternal condition at the time of perinatal death was assigned to each case. MAIN OUTCOME MEASURES Causes of perinatal mortality, associated maternal conditions. RESULTS In South Africa 344/689 (50%) deaths occurred antepartum, 11% (n = 74) intrapartum and 39% (n = 271) in the early neonatal period. In the UK 4377/9067 (48.3%) deaths occurred antepartum, with 457 (5%) intrapartum and 4233 (46.7%) in the neonatal period. Antepartum deaths were due to unspecified causes (59%), chromosomal abnormalities (21%) or problems related to fetal growth (14%). Intrapartum deaths followed acute intrapartum events (69%); neonatal deaths followed consequences of low birthweight/ prematurity (31%), chromosomal abnormalities (26%), or unspecified causes in healthy mothers (25%). Mothers were often healthy; 53%, 38% and 45% in the antepartum, intrapartum and neonatal death groups, respectively. Where there was a maternal condition, it was most often maternal medical conditions, and complications of placenta, cord and membranes. CONCLUSIONS The ICD-PM can be a globally applicable perinatal death classification system that emphasises the need for a focus on the mother-baby dyad as we move beyond 2015. TWEETABLE ABSTRACT ICD-PM is a global system that classifies perinatal deaths and links them to maternal conditions.
Collapse
Affiliation(s)
- E R Allanson
- Faculty of Medicine, Dentistry and Health Sciences, School of Women's and Infants' Health, University of Western Australia, Crawley, Western Australia, Australia. , .,Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland. ,
| | - Ö Tunçalp
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | | | - R C Pattinson
- SAMRC Maternal and Infant Health Care Strategies Unit, Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | | | - J P Vogel
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Jjhm Erwich
- Department of Obstetrics, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - V J Flenady
- Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, Queensland, Australia.,International Stillbirth Alliance, Bristol, UK
| | - J F Frøen
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
| | - J Neilson
- Centre for Intervention Science for Maternal and Child Health, University of Bergen, Bergen, Norway.,Centre for Women's Health Research, University of Liverpool, Liverpool, UK
| | - A Quach
- Pacific Northwest University of Health Sciences, Yakima, Washington, USA
| | - D Chou
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - M Mathai
- Maternal & Perinatal Health, Department of Maternal, Newborn, Child & Adolescent Health, World Health Organization, Geneva, Switzerland
| | - L Say
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - A M Gülmezoglu
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| |
Collapse
|
208
|
Abstract
Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity rather than anxiety and, therefore, was removed from the anxiety disorders chapter and given its own in both the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Beta Draft Version of the 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11). This revised clustering is based on increasing evidence of common affected neurocircuits between disorders, differently from previous classification systems based on interrater agreement. In this article, we focus on the classification of obsessive-compulsive and related disorders (OCRDs), examining the differences in approach adopted by these 2 nosological systems, with particular attention to the proposed changes in the forthcoming ICD-11. At this stage, notable differences in the ICD classification are emerging from the previous revision, apparently converging toward a reformulation of OCRDs that is closer to the DSM-5.
Collapse
|
209
|
Tanno LK, Calderon M, Demoly P. Supporting the validation of the new allergic and hypersensitivity conditions section of the World Health Organization International Classification of Diseases-11. Asia Pac Allergy 2016; 6:149-56. [PMID: 27489786 PMCID: PMC4967614 DOI: 10.5415/apallergy.2016.6.3.149] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 07/20/2016] [Indexed: 01/28/2023] Open
Abstract
Background The new International Classification of Diseases (ICD)-11 "Allergic and hypersensitivity conditions" section has been constructed as a result of a detailed and careful action plan based on scientific evidences for the necessity of changes and collaboration with the World Health Organization (WHO) ICD-11 revision governance. All the efforts are being acknowledged by the Joint Allergy Academies. Objective Considering the new classification model addressed to the allergic and hypersensitivity conditions and following the ICD WHO agenda, we believe it is the appropriate time to start supporting the validation process in collaboration with the WHO ICD governance. Methods We conducted a mapping of ICD-10 allergic and hypersensitivity conditions in the ICD-11 beta phase structure and categorized the conditions as fitting by "precoordination," "postcoordination," "indexed to the ICD-11 Foundation," "no code fit properly" or "no correspondence" in the ICD-11. Results From overall 125 ICD-10 entities spread in 6 chapters, 57.6% were able to be precoordinated, 4% postcoordinated, 12% indexed to the Foundation, 9.6% had no code fitting properly and 18.6% had no correspondence in the ICD-11 framework. Conclusion We have been able to demonstrate that 83.2% of the ICD-10 allergic and hypersensitivity conditions could be captured by the current ICD-11 beta draft framework. We strongly believe that our findings constitute a key step forward for a softer transition of the ICD-10 allergic and hypersensitivity conditions to the ICD-11, supporting the WHO in this process as well as strengthening the visibility of the Allergy specialty and ensuring quality management of allergic patients.
Collapse
Affiliation(s)
- Luciana Kase Tanno
- Hospital Sírio Libanês, São Paulo 01308-050, Brazil.; Division of Allergy, Department of Pulmonology, University Hospital of Montpellier, Montpellier, and Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, Paris, France
| | - Moises Calderon
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom
| | - Pascal Demoly
- Division of Allergy, Department of Pulmonology, University Hospital of Montpellier, Montpellier, and Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, Paris, France
| | | |
Collapse
|
210
|
Chan V, Pole JD, Keightley M, Mann RE, Colantonio A. Children and youth with non-traumatic brain injury: a population based perspective. BMC Neurol 2016; 16:110. [PMID: 27439699 PMCID: PMC4955214 DOI: 10.1186/s12883-016-0631-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 07/01/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Children and youth with non-traumatic brain injury (nTBI) are often overlooked in regard to the need for post-injury health services. This study provided population-based data on their burden on healthcare services, including data by subtypes of nTBI, to provide the foundation for future research to inform resource allocation and healthcare planning for this population. METHODS A retrospective cohort study design was used. Children and youth with nTBI in population-based healthcare data were identified using International Classification of Diseases Version 10 codes. The rate of nTBI episodes of care, demographic and clinical characteristics, and discharge destinations from acute care and by type of nTBI were identified. RESULTS The rate of pediatric nTBI episodes of care was 82.3 per 100,000 (N = 17,977); the average stay in acute care was 13.4 days (SD = 25.6 days) and 35% were in intensive care units. Approximately 15% were transferred to another inpatient setting and 6% died in acute care. By subtypes of nTBI, the highest rates were among those with a diagnosis of toxic effect of substances (22.7 per 100,000), brain tumours (18.4 per 100,000), and meningitis (15.4 per 100,000). Clinical characteristics and discharge destinations from the acute care setting varied by subtype of nTBI; the proportion of patients that spent at least one day in intensive care units and the proportion discharged home ranged from 25.9% to 58.2% and from 50.6% to 76.4%, respectively. CONCLUSIONS Children and youth with nTBI currently put an increased demand on the healthcare system. Active surveillance of and in-depth research on nTBI, including subtypes of nTBI, is needed to ensure that timely, appropriate, and targeted care is available for this pediatric population.
Collapse
Affiliation(s)
- Vincy Chan
- />Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON M5G 2A2 Canada
- />Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON M5G 1 V7 Canada
- />Pediatric Oncology Group of Ontario, 480 University Avenue, Toronto, ON M5G 1 V2 Canada
| | - Jason D. Pole
- />Pediatric Oncology Group of Ontario, 480 University Avenue, Toronto, ON M5G 1 V2 Canada
- />Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3 M7 Canada
| | - Michelle Keightley
- />Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON M5G 1 V7 Canada
- />Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON M5G 1R8 Canada
| | - Robert E. Mann
- />Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3 M7 Canada
- />Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 3M1 Canada
| | - Angela Colantonio
- />Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON M5G 2A2 Canada
- />Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON M5G 1 V7 Canada
- />Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3 M7 Canada
| |
Collapse
|
211
|
Motola JA. Special Article: ICD-10: The Time is Now. Urol Pract 2016; 3:270-275. [PMID: 37592495 DOI: 10.1016/j.urpr.2015.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The mandated conversion to ICD-10 is immediately on the horizon. METHODS The history, rationale, costs and benefits of, and opposition to the new coding system are presented. RESULTS Successful implementation requires a teamwork approach. Billing and coding systems that are in place must be thoroughly assessed. Conversion is expensive and a budget must be created. Training is a crucial part of moving forward and a test period is needed after training is complete. CONCLUSIONS ICD-10 has arrived and adopting it is the only option.
Collapse
Affiliation(s)
- Jay A Motola
- Department of Urology, Icahn School of Medicine at Mt. Sinai, New York, New York
| |
Collapse
|
212
|
Yu AYX, Holodinsky JK, Zerna C, Svenson LW, Jetté N, Quan H, Hill MD. Use and Utility of Administrative Health Data for Stroke Research and Surveillance. Stroke 2016; 47:1946-52. [PMID: 27174527 DOI: 10.1161/strokeaha.116.012390] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 04/13/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Amy Y X Yu
- From the Department of Clinical Neurosciences (A.Y.X.Y., C.Z., N.J., M.D.H.), Department of Community Health Sciences (A.Y.X.Y., J.K.H., L.W.S., N.J., H.Q., M.D.H.), O'Brien Institute for Public Health (N.J., H.Q., M.D.H.), and Hotchkiss Brain Institute (N.J., M.D.H.), University of Calgary, Calgary, Alberta, Canada; Surveillance and Assessment Branch, Alberta Health, Edmonton, Alberta, Canada (L.W.S.); and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (L.W.S.)
| | - Jessalyn K Holodinsky
- From the Department of Clinical Neurosciences (A.Y.X.Y., C.Z., N.J., M.D.H.), Department of Community Health Sciences (A.Y.X.Y., J.K.H., L.W.S., N.J., H.Q., M.D.H.), O'Brien Institute for Public Health (N.J., H.Q., M.D.H.), and Hotchkiss Brain Institute (N.J., M.D.H.), University of Calgary, Calgary, Alberta, Canada; Surveillance and Assessment Branch, Alberta Health, Edmonton, Alberta, Canada (L.W.S.); and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (L.W.S.)
| | - Charlotte Zerna
- From the Department of Clinical Neurosciences (A.Y.X.Y., C.Z., N.J., M.D.H.), Department of Community Health Sciences (A.Y.X.Y., J.K.H., L.W.S., N.J., H.Q., M.D.H.), O'Brien Institute for Public Health (N.J., H.Q., M.D.H.), and Hotchkiss Brain Institute (N.J., M.D.H.), University of Calgary, Calgary, Alberta, Canada; Surveillance and Assessment Branch, Alberta Health, Edmonton, Alberta, Canada (L.W.S.); and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (L.W.S.)
| | - Lawrence W Svenson
- From the Department of Clinical Neurosciences (A.Y.X.Y., C.Z., N.J., M.D.H.), Department of Community Health Sciences (A.Y.X.Y., J.K.H., L.W.S., N.J., H.Q., M.D.H.), O'Brien Institute for Public Health (N.J., H.Q., M.D.H.), and Hotchkiss Brain Institute (N.J., M.D.H.), University of Calgary, Calgary, Alberta, Canada; Surveillance and Assessment Branch, Alberta Health, Edmonton, Alberta, Canada (L.W.S.); and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (L.W.S.).
| | - Nathalie Jetté
- From the Department of Clinical Neurosciences (A.Y.X.Y., C.Z., N.J., M.D.H.), Department of Community Health Sciences (A.Y.X.Y., J.K.H., L.W.S., N.J., H.Q., M.D.H.), O'Brien Institute for Public Health (N.J., H.Q., M.D.H.), and Hotchkiss Brain Institute (N.J., M.D.H.), University of Calgary, Calgary, Alberta, Canada; Surveillance and Assessment Branch, Alberta Health, Edmonton, Alberta, Canada (L.W.S.); and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (L.W.S.)
| | - Hude Quan
- From the Department of Clinical Neurosciences (A.Y.X.Y., C.Z., N.J., M.D.H.), Department of Community Health Sciences (A.Y.X.Y., J.K.H., L.W.S., N.J., H.Q., M.D.H.), O'Brien Institute for Public Health (N.J., H.Q., M.D.H.), and Hotchkiss Brain Institute (N.J., M.D.H.), University of Calgary, Calgary, Alberta, Canada; Surveillance and Assessment Branch, Alberta Health, Edmonton, Alberta, Canada (L.W.S.); and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (L.W.S.)
| | - Michael D Hill
- From the Department of Clinical Neurosciences (A.Y.X.Y., C.Z., N.J., M.D.H.), Department of Community Health Sciences (A.Y.X.Y., J.K.H., L.W.S., N.J., H.Q., M.D.H.), O'Brien Institute for Public Health (N.J., H.Q., M.D.H.), and Hotchkiss Brain Institute (N.J., M.D.H.), University of Calgary, Calgary, Alberta, Canada; Surveillance and Assessment Branch, Alberta Health, Edmonton, Alberta, Canada (L.W.S.); and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (L.W.S.)
| |
Collapse
|
213
|
Tanno LK, Calderon MA, Demoly P. Optimization and simplification of the Allergic and Hypersensitivity conditions classification for the ICD-11. Allergy 2016; 71:671-6. [PMID: 26728868 DOI: 10.1111/all.12834] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Since 2013, an international collaboration of Allergy Academies, including first the World Allergy Organization (WAO), the American Academy of Allergy Asthma and Immunology (AAAAI), and the European Academy of Allergy and Clinical Immunology (EAACI), and then the American College of Allergy, Asthma and Immunology (ACAAI), the Latin American Society of Allergy, Asthma and Immunology (SLAAI), and the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI), has spent tremendous efforts to have a better and updated classification of allergic and hypersensitivity conditions in the forthcoming International Classification of Diseases (ICD)-11 version by providing evidences and promoting actions for the need for changes. The latest action was the implementation of a classification proposal of hypersensitivity/allergic diseases built by crowdsourcing the Allergy Academy leaderships. METHODS Following bilateral discussions with the representatives of the ICD-11 revision, a face-to-face meeting was held at the United Nations Office in Geneva and a simplification process of the hypersensitivity/allergic disorders classification was carried out to better fit the ICD structure. RESULTS We are here presenting the end result of what we consider to be a model of good collaboration between the World Health Organization and a specialty. CONCLUSION We strongly believe that the outcomes of all past and future actions will impact positively the recognition of the allergy specialty as well as the quality improvement of healthcare system for allergic and hypersensitivity conditions worldwide.
Collapse
Affiliation(s)
- L. K. Tanno
- Hospital Sírio Libanês; São Paulo Brazil
- University Hospital of Montpellier; Montpellier France
- UPMC Paris 06; UMR-S 1136; IPLESP; Equipe EPAR; Sorbonne Universités; Paris France
| | - M. A. Calderon
- Section of Allergy and Clinical Immunology; Imperial College London; National Heart and Lung Institute; Royal Brompton Hospital; London UK
| | - P. Demoly
- University Hospital of Montpellier; Montpellier France
- UPMC Paris 06; UMR-S 1136; IPLESP; Equipe EPAR; Sorbonne Universités; Paris France
| | | |
Collapse
|
214
|
Trzepacz PT, Meagher DJ, Franco JG. Comparison of diagnostic classification systems for delirium with new research criteria that incorporate the three core domains. J Psychosom Res 2016; 84:60-8. [PMID: 27095161 DOI: 10.1016/j.jpsychores.2016.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/08/2016] [Accepted: 03/10/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Diagnostic classification systems do not incorporate phenomenological research findings about the three core symptom domains of delirium (Attentional/Cognitive, Circadian, Higher Level Thinking). We evaluated classification performances of novel Trzepacz, Meagher, and Franco research diagnostic criteria (TMF) that incorporate those domains and ICD-10, DSM-III-R, DSM-IV, and DSM-5. METHODS Primary data analysis of 641 patients with mixed neuropsychiatric profiles. Delirium (n=429) and nondelirium (n=212) reference standard groups were identified using cluster analysis of symptoms assessed using the Delirium Rating Scale-Revised-98. Accuracy, sensitivity, specificity, positive and negative predictive values (PPV, NPV), and likelihood ratios (LR+, LR-) are reported. RESULTS TMF criteria had high sensitivity and specificity (87.4% and 89.2%), more balanced than DSM-III-R (100% and 31.6%), DSM-IV (97.7% and 74.1%), DSM-5 (97.7% and 72.6%), and ICD-10 (66.2% and 100%). PPV of DSM-III-R, DSM-IV, and DSM-5 were <90.0%, while PPV for ICD-10 and TMF were >90%. ICD-10 had the lowest NPV (59.4%). TMF had the highest LR+ (8.06) and DSM-III-R the lowest LR- (0.0). Overall, values for DSM-IV and DSM-5 were similar, whereas for ICD-10 and DSM-III-R were inverse of each other. In the pre-existing cognitive impairment/dementia subsample (n=128), TMF retained its highest LR+ though specificity (58.3%) became less well balanced with sensitivity (87.9%), which still exceeded that of DSM. CONCLUSIONS TMF research diagnostic criteria performed well, with more balanced sensitivity and specificity and the highest likelihood ratio for delirium identification. Reflecting the three core domains of delirium, TMF criteria may have advantages in biological research where delineation of this syndrome is important.
Collapse
|
215
|
Abstract
INTRODUCTION Breast, lung and colorectal cancers constitute the most common cancers worldwide and their epidemiology, related health outcomes and quality indicators can be studied using administrative healthcare databases. To constitute a reliable source for research, administrative healthcare databases need to be validated. The aim of this protocol is to perform the first systematic review of studies reporting the validation of International Classification of Diseases 9th and 10th revision codes to identify breast, lung and colorectal cancer diagnoses in administrative healthcare databases. METHODS AND ANALYSIS This review protocol has been developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) 2015 statement. We will search the following databases: MEDLINE, EMBASE, Web of Science and the Cochrane Library, using appropriate search strategies. We will include validation studies that used administrative data to identify breast, lung and colorectal cancer diagnoses or studies that evaluated the validity of breast, lung and colorectal cancer codes in administrative data. The following inclusion criteria will be used: (1) the presence of a reference standard case definition for the disease of interest; (2) the presence of at least one test measure (eg, sensitivity, positive predictive values, etc) and (3) the use of data source from an administrative database. Pairs of reviewers will independently abstract data using standardised forms and will assess quality using a checklist based on the Standards for Reporting of Diagnostic accuracy (STARD) criteria. ETHICS AND DISSEMINATION Ethics approval is not required. We will submit results of this study to a peer-reviewed journal for publication. The results will serve as a guide to identify appropriate case definitions and algorithms of breast, lung and colorectal cancers for researchers involved in validating administrative healthcare databases as well as for outcome research on these conditions that used administrative healthcare databases. TRIAL REGISTRATION NUMBER CRD42015026881.
Collapse
Affiliation(s)
- Iosief Abraha
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Gianni Giovannini
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Diego Serraino
- Epidemiology and Biostatistic Unit, IRCCS Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Mario Fusco
- Registro Tumori Regione Campania, ASL NA3 Sud, Brusciano (Na), Italy
| | | |
Collapse
|
216
|
Chan V, Mollayeva T, Ottenbacher KJ, Colantonio A. Sex-Specific Predictors of Inpatient Rehabilitation Outcomes After Traumatic Brain Injury. Arch Phys Med Rehabil 2016; 97:772-80. [PMID: 26836952 DOI: 10.1016/j.apmr.2016.01.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/06/2016] [Accepted: 01/08/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify sex-specific predictors of inpatient rehabilitation outcomes among patients with a traumatic brain injury (TBI) from a population-based perspective. DESIGN Retrospective cohort study. SETTING Inpatient rehabilitation. PARTICIPANTS Patients in inpatient rehabilitation for a TBI within 1 year of acute care discharge between 2008/2009 and 2011/2012 (N=1730, 70% men, 30% women). INTERVENTIONS None. MAIN OUTCOME MEASURES Inpatient rehabilitation length of stay, total FIM score, and motor and cognitive FIM ratings at discharge. RESULTS Sex, as a covariate in multivariable linear regression models, was not a significant predictor of rehabilitation outcomes. Although many of the predictors examined were similar across men and women, sex-specific multivariable models identified some predictors of rehabilitation outcome that are specific for men and women; mechanism of injury (P<.0001) was a significant predictor of functional outcome only among women, whereas comorbidities (P<.0001) was a significant predictor for men only. CONCLUSIONS Predictors of outcomes after inpatient rehabilitation differed by sex, providing evidence for a sex-specific approach in planning and resource allocation for inpatient rehabilitation services for patients with TBI.
Collapse
Affiliation(s)
- Vincy Chan
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
| | - Tatyana Mollayeva
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | | | - Angela Colantonio
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
217
|
Southern DA, Pincus HA, Romano PS, Burnand B, Harrison J, Forster AJ, Moskal L, Quan H, Droesler SE, Sundararajan V, Colin C, Gurevich Y, Brien SE, Kostanjsek N, Üstün B, Ghali WA. Enhanced capture of healthcare-related harms and injuries in the 11th revision of the International Classification of Diseases (ICD-11). Int J Qual Health Care 2016; 28:136-42. [PMID: 26660444 PMCID: PMC4767048 DOI: 10.1093/intqhc/mzv099] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 12/15/2022] Open
Abstract
The World Health Organization (WHO) plans to submit the 11th revision of the International Classification of Diseases (ICD) to the World Health Assembly in 2018. The WHO is working toward a revised classification system that has an enhanced ability to capture health concepts in a manner that reflects current scientific evidence and that is compatible with contemporary information systems. In this paper, we present recommendations made to the WHO by the ICD revision's Quality and Safety Topic Advisory Group (Q&S TAG) for a new conceptual approach to capturing healthcare-related harms and injuries in ICD-coded data. The Q&S TAG has grouped causes of healthcare-related harm and injuries into four categories that relate to the source of the event: (a) medications and substances, (b) procedures, (c) devices and (d) other aspects of care. Under the proposed multiple coding approach, one of these sources of harm must be coded as part of a cluster of three codes to depict, respectively, a healthcare activity as a 'source' of harm, a 'mode or mechanism' of harm and a consequence of the event summarized by these codes (i.e. injury or harm). Use of this framework depends on the implementation of a new and potentially powerful code-clustering mechanism in ICD-11. This new framework for coding healthcare-related harm has great potential to improve the clinical detail of adverse event descriptions, and the overall quality of coded health data.
Collapse
Affiliation(s)
- Danielle A Southern
- Department of Community Health Sciences and the O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Harold A Pincus
- Department of Psychiatry, Columbia University and the New York StatePsychiatric Institute, New York, NY, USA Irving Institute for Clinical and Translational Research at Columbia University and New York-Presbyterian Hospital, New York, NY, USA RAND Corporation, Pittsburgh, PA, USA
| | - Patrick S Romano
- Division of General Medicine, University of California-Davis School of Medicine, Sacramento, CA, USA
| | - Bernard Burnand
- Institute of Social and PreventiveMedicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | | | - Alan J Forster
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lori Moskal
- Canadian Institute of Health Information, Ontario, Canada
| | - Hude Quan
- Department of Community Health Sciences and the O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Saskia E Droesler
- Faculty of Health Care, Niederrhein University of Applied Sciences, Reinarzstrasse 49, 47805, Krefeld, Germany
| | - Vijaya Sundararajan
- Department of Medicine, St. Vincent's Hospital, University ofMelbourne, Australia Department of Medicine, Southern Clinical School, Monash University, Australia
| | - Cyrille Colin
- Department of Medical Information, Health Evaluation and ClinicalResearch, University Lyon I, Hospices Civils de Lyon, France
| | - Yana Gurevich
- Canadian Institute of Health Information, Ontario, Canada
| | | | - Nenad Kostanjsek
- World Health Organization, Classifications, Terminology and Standards, Geneva, Switzerland
| | - Bedirhan Üstün
- World Health Organization, Classifications, Terminology and Standards, Geneva, Switzerland
| | - William A Ghali
- Department of Community Health Sciences and the O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
218
|
Chaitanya NC, Garlapati K, Priyanka DR, Soma S, Suskandla U, Boinepally NH. Assessment of Anxiety and Depression in Oral Mucositis Patients Undergoing Cancer Chemoradiotherapy: A Randomized Cross-sectional Study. Indian J Palliat Care 2016; 22:446-454. [PMID: 27803567 PMCID: PMC5072237 DOI: 10.4103/0973-1075.191797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Introduction: Oral mucositis is an unavoidable complication occurring during the treatment of cancer by radiotherapy, concurrent chemoradiotherapy (CCRT), or chemotherapy. This is a painful sequelae, significantly affecting the nutritional intake and quality of life. Materials and Methods: A multicentric cross-sectional study was done at four cancer centers in Hyderabad. About 455 subjects of both genders between 20 and 80 years undergoing cancer treatment such as chemotherapy (Group I), CCRT (Group II), radiotherapy within 14 days of initiation (Group III), and radiotherapy after 14 days of initiation of therapy (Group IV) who had oral mucositis were included in the study. A self-addressed Hospital Anxiety and Depression Scale questionnaire was used to assess the anxiety/depression in cancer therapy-induced oral mucositis patients. Results: Group III had established anxiety (58.82%) followed by Group IV (47.5%) of patients showing severe oral mucositis. In Group I, 47.17% and in Group II, 40% patients with borderline anxiety had mild mucositis, which was statistically significant (P = 0.01). Group III had established depression in 56.36%, followed by Group IV with 39.62% patients showed severe oral mucositis. Group I and II had mild to moderate mucositis, which was associated with established depression at statistically significant result (P = 0.02). Conclusion: Group IV had maximum participants with anxiety and depression, closely followed by Group II, Group III, and least in Group I. Thus appropriate intervention in the form of nonpharmacological and pharmacological treatment is warranted.
Collapse
Affiliation(s)
- Nallan Csk Chaitanya
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Komali Garlapati
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Danam Reshma Priyanka
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Sravani Soma
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Ujwala Suskandla
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Niharika Harsha Boinepally
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| |
Collapse
|
219
|
Southern DA, Hall M, White DE, Romano PS, Sundararajan V, Droesler SE, Pincus HA, Ghali WA. Opportunities and challenges for quality and safety applications in ICD-11: an international survey of users of coded health data. Int J Qual Health Care 2015; 28:129-35. [PMID: 26660153 DOI: 10.1093/intqhc/mzv096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2015] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE In 2018, the World Health Organization (WHO) plans to release the 11th revision of the International Classification of Diseases (ICD). The overall goal of the WHO is to produce a new disease classification that has an enhanced ability to capture health concepts in a manner that is compatible with contemporary information systems. Accordingly, our objective was to identify opportunities and challenges in improving the utility of ICD-11 for quality and safety applications. DESIGN A survey study of international stakeholders with expertise in either the production or use of coded health data. SETTING International producers or users of ICD-coded health care data. STUDY PARTICIPANTS We used a snowball sampling approach to identify individuals with relevant expertise in 12 countries, mostly from North America, Europe, and Australasia. An 8-item online survey included questions on demographic characteristics, familiarity with ICD, experience using ICD-coded data on healthcare quality and safety, opinions regarding the use of ICD classification systems for quality and safety measurement, and current limitations and potential future improvements that would permit better coding of quality and safety concepts in ICD-11. RESULTS Two-hundred fifty-eight unique individuals accessed the online survey; 246 provided complete responses. The respondents identified specific desires for the ICD revision: more code content for adverse events/complications; a desire for code clustering mechanisms; the need for diagnosis timing information; and the addition of better code definitions to reference materials. CONCLUSION These findings reinforce the vision and existing work plan of the WHO's ICD revision process, because each of these desires is being addressed.
Collapse
Affiliation(s)
- Danielle A Southern
- Department of Community Health Sciences and the O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Marc Hall
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Deborah E White
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Patrick S Romano
- Division of General Medicine, University of California-Davis School of Medicine, Sacramento, CA, USA
| | - Vijaya Sundararajan
- Department of Medicine, St Vincent's Hospital, University of Melbourne, Parkville, Australia Department of Medicine, Southern Clinical School, Monash University, Melbourne, Australia
| | - Saskia E Droesler
- Faculty of Health Care, Niederrhein University of Applied Sciences, Reinarzstrasse 49, 48705, Krefeld, Germany
| | - Harold A Pincus
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY, USA Irving Institute for Clinical and Translational Research at Columbia University and New York-Presbyterian Hospital, New York, NY, USA RAND Corporation, Pittsburgh, PA, USA
| | - William A Ghali
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
220
|
Noor SK, Elmadhoun WM, Bushara SO, Ahmed MH. The Changing Pattern of Hospital Admission to Medical Wards: Burden of non-communicable diseases at a hospital in a developing country. Sultan Qaboos Univ Med J 2015; 15:e517-22. [PMID: 26629380 DOI: 10.18295/squmj.2015.15.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/27/2015] [Accepted: 07/30/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to determine the pattern of hospital admissions and patient outcomes in medical wards at Atbara Teaching Hospital in River Nile State, Sudan. METHODS This retrospective cross-sectional study was conducted from August 2013 to July 2014 and included all patients admitted to medical wards at the Atbara Teaching Hospital during the study period. Morbidity and mortality data was obtained from medical records. Diseases were categorised using the World Health Organization's International Classification of Diseases (ICD) coding system. RESULTS A total of 2,614 patient records were analysed. The age group with the highest admissions was the 56-65-year-old age group (19.4%) and the majority of patients were admitted for one week or less (86.4%). Non-communicable diseases constituted 71.8% of all cases. According to ICD classifications, patients were admitted most frequently due to infectious or parasitic diseases (19.7%), followed by diseases of the circulatory (16.4%), digestive (16.4%) and genito-urinary (13.8%) systems. The most common diseases were cardiovascular disease (16.4%), malaria (11.3%), gastritis/peptic ulcer disease (9.8%), urinary tract infections (7.2%) and diabetes mellitus (6.9%). The mortality rate was 4.7%. CONCLUSION The burden of non-communicable diseases was found to exceed that of communicable diseases among patients admitted to medical wards at the Atbara Teaching Hospital.
Collapse
Affiliation(s)
- Sufian K Noor
- Departments of Medicine, Nile Valley University, Atbara, Sudan
| | | | - Sarra O Bushara
- Departments of Medicine, Nile Valley University, Atbara, Sudan
| | - Mohamed H Ahmed
- Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Buckinghamshire, UK
| |
Collapse
|
221
|
Abstract
INTRODUCTION On October 1, 2015 the ICD (International Classification of Diseases)-10-CM (10th Revision, Clinical Modification) code set replaced ICD-9 (9th Revision) for coding medical encounters in the United States. The introduction of this unique, expanded code set will change the way medical encounters are coded, and may affect specialties and subspecialists to different degrees. METHODS A retrospective review was performed evaluating ICD-9 codes used at a large urology group. The most commonly used codes were evaluated in the office and hospital settings, and also from 3 individual subspecialists including a men's health/infertility subspecialist, a pelvic floor/reconstruction subspecialist and a pediatric subspecialist. RESULTS The top 30 ICD-9 codes comprised 82.5% and 80.7% of the codes chosen in the office and hospital settings, with a 1:1 conversion from ICD-10 in 60% (18 of 30) and 36.7% (11 of 30), respectively. The top 25 codes from the 3 subspecialists (men's health/infertility, pelvic floor/reconstruction and pediatric) comprised 86.8%, 88.7% and 88.1% of the ICD-9 codes chosen, with a 1:1 correlation in 48% (12 of the top 25), 56% (14 of 25) and 40% (10 of 25), respectively. A significant number of unspecified codes was used across all of the aspects of practice. CONCLUSIONS Urologists need to be aware of their practice patterns when converting from ICD-9 to ICD-10. The high percentage of codes concentrated in the top 25 of a practice may allow urologists to focus on their individual needs. Improved documentation and coding education may decrease the number of unspecified codes chosen, leading to improved coding accuracy.
Collapse
|
222
|
Tanno LK, Calderon MA, Demoly P. Making allergic and hypersensitivity conditions visible in the International Classification of Diseases-11. Asia Pac Allergy 2015; 5:193-6. [PMID: 26539400 PMCID: PMC4630456 DOI: 10.5415/apallergy.2015.5.4.193] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/01/2015] [Indexed: 11/23/2022] Open
Abstract
Understanding that the International Classification of Diseases (ICD)-11 revision would be an opportunity to standardize the code definitions for all allergic and hypersensitivity conditions, an international collaboration of Allergy Academies, including first the World Allergy Organization, the American Academy of Allergy Asthma and Immunology and the European Academy of Allergy and Clinical Immunology, has been coordinating tremendous efforts since 2013 to provide a better classification of these disorders in the new ICD-11. During this process, a strategic action plan has been constructed to keep bilateral dialog with representatives of the ICD revision by providing them scientific and technical evidences for the need of changes in the ICD framework. As a major achievement of this process, was the construction of the "allergic and hypersensitivity conditions" parented subchapter guided by the World Health Organization ICD representatives and further supported by three more regional allergy societies: the Latin American Society of Allergy, Asthma and Immunology, the American College of Allergy Asthma and Immunology, and the Asia Pacific Association of Allergy, Asthma and Clinical Immunology. Believing that the outcomes of all past and future actions will impact positively to the Allergy specialty, we expect for the full approval by the United Nations in 2017.
Collapse
Affiliation(s)
- Luciana Kase Tanno
- Hospital Sírio Libanês, São Paulo 01308-050, Brazil. ; University Hospital of Montpellier, Montpellier 34090, Paris, France. ; Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, 75013, Paris, France
| | - Moises A Calderon
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London SW3 6NP, United Kingdom
| | - Pascal Demoly
- University Hospital of Montpellier, Montpellier 34090, Paris, France. ; Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, 75013, Paris, France
| |
Collapse
|
223
|
Wei WQ, Teixeira PL, Mo H, Cronin RM, Warner JL, Denny JC. Combining billing codes, clinical notes, and medications from electronic health records provides superior phenotyping performance. J Am Med Inform Assoc 2015; 23:e20-7. [PMID: 26338219 DOI: 10.1093/jamia/ocv130] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 07/15/2015] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To evaluate the phenotyping performance of three major electronic health record (EHR) components: International Classification of Disease (ICD) diagnosis codes, primary notes, and specific medications. MATERIALS AND METHODS We conducted the evaluation using de-identified Vanderbilt EHR data. We preselected ten diseases: atrial fibrillation, Alzheimer's disease, breast cancer, gout, human immunodeficiency virus infection, multiple sclerosis, Parkinson's disease, rheumatoid arthritis, and types 1 and 2 diabetes mellitus. For each disease, patients were classified into seven categories based on the presence of evidence in diagnosis codes, primary notes, and specific medications. Twenty-five patients per disease category (a total number of 175 patients for each disease, 1750 patients for all ten diseases) were randomly selected for manual chart review. Review results were used to estimate the positive predictive value (PPV), sensitivity, andF-score for each EHR component alone and in combination. RESULTS The PPVs of single components were inconsistent and inadequate for accurately phenotyping (0.06-0.71). Using two or more ICD codes improved the average PPV to 0.84. We observed a more stable and higher accuracy when using at least two components (mean ± standard deviation: 0.91 ± 0.08). Primary notes offered the best sensitivity (0.77). The sensitivity of ICD codes was 0.67. Again, two or more components provided a reasonably high and stable sensitivity (0.59 ± 0.16). Overall, the best performance (Fscore: 0.70 ± 0.12) was achieved by using two or more components. Although the overall performance of using ICD codes (0.67 ± 0.14) was only slightly lower than using two or more components, its PPV (0.71 ± 0.13) is substantially worse (0.91 ± 0.08). CONCLUSION Multiple EHR components provide a more consistent and higher performance than a single one for the selected phenotypes. We suggest considering multiple EHR components for future phenotyping design in order to obtain an ideal result.
Collapse
Affiliation(s)
- Wei-Qi Wei
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
| | - Pedro L Teixeira
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
| | - Huan Mo
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
| | - Robert M Cronin
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Jeremy L Warner
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Joshua C Denny
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA Department of Medicine, Vanderbilt University, Nashville, TN, USA
| |
Collapse
|
224
|
Ampt AJ, Patterson JA, Roberts CL, Ford JB. Obstetric anal sphincter injury rates among primiparous women with different modes of vaginal delivery. Int J Gynaecol Obstet 2015; 131:260-4. [PMID: 26489488 DOI: 10.1016/j.ijgo.2015.06.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 05/27/2015] [Accepted: 08/18/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine whether rates of obstetric anal sphincter injuries (OASIS) are continuing to increase and whether risk of OASIS according to mode of delivery is constant over time. METHODS In a retrospective population-based study, data were obtained for vaginal singleton vertex deliveries at 37-41 weeks of pregnancy among primiparous women in New South Wales, Australia, between January 2001 and December 2011. Annual OASIS rates were determined among non-instrumental, forceps, and vacuum deliveries with and without episiotomy. Multivariable logistic regression was used to determine adjusted odds ratios for each delivery mode category by year. Trends in adjusted odds ratios over time for each delivery category were compared. RESULTS OASIS occurred in 955 (4.1%) of 23 081 deliveries in 2001 and 1487 (5.9%) of 25 081 deliveries in 2011. After adjustment for known risk factors, the only delivery categories to show statistically significant increases in OASIS over the study period were non-instrumental deliveries without episiotomy (linear trend P<0.001) and forceps deliveries with episiotomy (linear trend P=0.004). CONCLUSION Overall, OASIS rates have continued to increase. Known risk factors do not fully explain the increase in OASIS rates in non-instrumental deliveries without an episiotomy and in forceps deliveries with an episiotomy.
Collapse
Affiliation(s)
- Amanda J Ampt
- Clinical and Population Perinatal Health Research, The Kolling Institute, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia.
| | - Jillian A Patterson
- Clinical and Population Perinatal Health Research, The Kolling Institute, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| | - Christine L Roberts
- Clinical and Population Perinatal Health Research, The Kolling Institute, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| | - Jane B Ford
- Clinical and Population Perinatal Health Research, The Kolling Institute, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| |
Collapse
|
225
|
Prescott HC, Sjoding MW, Iwashyna TJ. Diagnoses of early and late readmissions after hospitalization for pneumonia. A systematic review. Ann Am Thorac Soc 2014; 11:1091-100. [PMID: 25079245 DOI: 10.1513/AnnalsATS.201404-142OC] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Pneumonia is a frequent cause of hospitalization, yet drivers of post-pneumonia morbidity remain poorly characterized. Causes of hospital readmissions may elucidate important sources of morbidity and are of particular interest given the U.S. Hospital Readmission Reductions Program. OBJECTIVES To review the primary diagnoses of early (≤30 d) and late (≥31 d) readmissions after pneumonia hospitalization. METHODS Systematic review of MEDLINE, Embase, and CINAHL databases. We identified original research studies of adults aged 18 years or older, hospitalized for pneumonia, and for whom cause-specific readmission rates were reported. Two authors abstracted study results and assessed study quality. MEASUREMENTS AND MAIN RESULTS Of the 1,243 citations identified, 12 met eligibility criteria. Included studies were conducted in the United States, Spain, Canada, Croatia, and Sweden. All-cause 30-day readmission rates ranged from 16.8 to 20.1% across administrative studies; the weighted average for the studies using chart review was 11.6% (15.6% in United States-based studies). Pneumonia, heart failure/cardiovascular causes, and chronic obstructive pulmonary disease/pulmonary causes are the most common reasons for early readmission after pneumonia hospitalization. Although it was the single most common cause for readmission, pneumonia accounted for only 17.9 to 29.4% of all 30-day readmissions in administrative studies and a weighted average of 23.0% in chart review studies. After accounting for study population, there was no clear difference in findings between claims-based versus chart-review studies. Few studies assessed readmissions beyond 30 days, although the limited available data suggest similar primary diagnoses for early and late readmissions. No studies assessed whether reasons for readmission were similar to patients' reasons for healthcare use before hospitalization. CONCLUSIONS Pneumonia, heart failure/cardiovascular disease, and chronic obstructive pulmonary disease/pulmonary disease are the most common readmission diagnoses after pneumonia hospitalization. Although pneumonia was the most common readmission diagnosis, it accounted for only a minority of all readmissions. Late readmission diagnoses are less thoroughly described, and further research is needed to understand how hospitalization for pneumonia fits within the broader context of patients' health trajectory.
Collapse
|
226
|
Tanno LK, Calderon MA, Goldberg BJ, Gayraud J, Bircher AJ, Casale T, Li J, Sanchez-Borges M, Rosenwasser LJ, Pawankar R, Papadopoulos NG, Demoly P. Constructing a classification of hypersensitivity/allergic diseases for ICD-11 by crowdsourcing the allergist community. Allergy 2015; 70:609-15. [PMID: 25736171 DOI: 10.1111/all.12604] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2015] [Indexed: 11/29/2022]
Abstract
The global allergy community strongly believes that the 11th revision of the International Classification of Diseases (ICD-11) offers a unique opportunity to improve the classification and coding of hypersensitivity/allergic diseases via inclusion of a specific chapter dedicated to this disease area to facilitate epidemiological studies, as well as to evaluate the true size of the allergy epidemic. In this context, an international collaboration has decided to revise the classification of hypersensitivity/allergic diseases and to validate it for ICD-11 by crowdsourcing the allergist community. After careful comparison between ICD-10 and 11 beta phase linearization codes, we identified gaps and trade-offs allowing us to construct a classification proposal, which was sent to the European Academy of Allergy and Clinical Immunology (EAACI) sections, interest groups, executive committee as well as the World Allergy Organization (WAO), and American Academy of Allergy Asthma and Immunology (AAAAI) leaderships. The crowdsourcing process produced comments from 50 of 171 members contacted by e-mail. The classification proposal has also been discussed at face-to-face meetings with experts of EAACI sections and interest groups and presented in a number of business meetings during the 2014 EAACI annual congress in Copenhagen. As a result, a high-level complex structure of classification for hypersensitivity/allergic diseases has been constructed. The model proposed has been presented to the WHO groups in charge of the ICD revision. The international collaboration of allergy experts appreciates bilateral discussion and aims to get endorsement of their proposals for the final ICD-11.
Collapse
Affiliation(s)
| | - M. A. Calderon
- Section of Allergy and Clinical Immunology; Imperial College London; National Heart and Lung Institute; Royal Brompton Hospital; London UK
| | - B. J. Goldberg
- Kaiser-Permanente Southern California Regional Allergy-Immunology Laboratory; Los Angeles, CA USA
- International Health Terminology Standards Development Organization; Los Angeles, CA USA
| | | | - A. J. Bircher
- Allergy Unit; Department of Dermatology; University Hospital Basel; Basel Switzerland
| | - T. Casale
- Internal Medicine; Morsani College of Medicine; University of South Florida; Tampa FL USA
| | - J. Li
- Division of Allergic Diseases; Mayo Clinic; Rochester MN USA
| | - M. Sanchez-Borges
- Allergy and Clinical Immunology Department; Centro Medico Docente La Trinidad; Caracas Venezuela
| | - L. J. Rosenwasser
- Division of Immunology Research; Department of Pediatrics; Children's Mercy Hospitals & Clinics; Kansas City MO USA
| | - R. Pawankar
- Division of Allergy; Department of Pediatrics; Nippon Medical School; Tokyo Japan
| | - N. G. Papadopoulos
- Centre for Paediatrics and Child Health; Institute of Human Development; University of Manchester; Manchester UK
- Department of Allergy; 2nd Pediatric Clinic; University of Athens; Athens Greece
| | - P. Demoly
- University Hospital of Montpellier; Montpellier France
- Sorbonne Universités; UPMC Paris 06; UMR-S 1136; IPLESP; Equipe EPAR; Paris France
| |
Collapse
|
227
|
Ehrenstein V, Gammelager H, Schiødt M, Nørholt SE, Neumann-Jensen B, Folkmar TB, Pedersen L, Svaerke C, Sørensen HT, Ma H, Acquavella J. Evaluation of an ICD-10 algorithm to detect osteonecrosis of the jaw among cancer patients in the Danish National Registry of Patients. Pharmacoepidemiol Drug Saf 2015; 24:693-700. [PMID: 25974710 DOI: 10.1002/pds.3786] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 03/05/2015] [Accepted: 03/17/2015] [Indexed: 11/08/2022]
Abstract
PURPOSE This study aimed to validate a predefined algorithm for osteonecrosis of the jaw (ONJ) among cancer patients in the Danish National Registry of Patients and to assess the nature of clinical information recorded in medical charts of ONJ patients. METHODS We identified potential ONJ cases recorded in 2005-2010 among cancer patients at the hospital Departments of Oral and Maxillofacial Surgery (DOMS) in three Danish regions, using a set of codes from the International Classification of Diseases, 10th revision (ICD-10). We abstracted DOMS charts of the potential cases, had the ONJ status adjudicated by an expert ONJ adjudication committee (ONJAC), and computed positive predictive values. For patients with ONJAC-confirmed ONJ, we abstracted the charts for information on ONJ clinical course. Sensitivity of the algorithm was computed using a separate sample of 101 known ONJ cases accrued in 2005-2011. RESULTS We identified 212 potential ONJ cases, of which 197 (93%) had charts available for abstraction. Eighty-three potential cases were confirmed by ONJAC, with a positive predictive value of 42% (95% confidence interval [CI] 35%-49%). DOMS charts of these 83 cases contained complete information on ONJ clinical course. Information about antiresorptive treatment was recorded for 84% of the patients. Among the 101 known ONJ cases, 74 had at least one prespecified ICD-10 code recorded in the Danish National Registry of Patients within ±90 days of the ONJ diagnosis (sensitivity 73%; 95%CI [64%-81%]). CONCLUSIONS The predefined algorithm is not adequate for monitoring ONJ in pharmacovigilance studies. Additional case-finding approaches, coupled with adjudication, are necessary to estimate ONJ incidence accurately.
Collapse
Affiliation(s)
- Vera Ehrenstein
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Gammelager
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Schiødt
- Department of Oral and Maxillofacial Surgery, Rigshospitalet, Copenhagen Ø, Denmark
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Bjarne Neumann-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Troels Bille Folkmar
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Pedersen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Claus Svaerke
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Haijun Ma
- Global Biostatistical Science, Amgen Inc., Thousand Oaks, CA, USA
| | - John Acquavella
- Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA
| |
Collapse
|
228
|
Álvaro-Meca A, Rodríguez-Gijón L, Díaz A, Gil Á, Resino S. Trends in nontuberculous mycobacterial disease in hospitalized subjects in Spain (1997-2010) according to HIV infection. HIV Med 2015; 16:485-93. [PMID: 25854195 DOI: 10.1111/hiv.12251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2014] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The aim of the study was to estimate the incidence of nontuberculous mycobacterial (NTM) disease and the rate of NTM disease-related mortality and to analyse trends in these variables according to HIV infection. METHODS We performed a retrospective study for the period 1997-2010 using data from the Minimum Basic Data Set (MBDS) provided by the Spanish Ministry of Health. The exposure variables were: (i) HIV infection (HIV positive versus HIV negative); (ii) calendar period in relation to widespread use of combination antiretroviral therapy (cART) [1997-1999 (early cART period), 2000-2003 (middle cART period) and 2004-2010 (late cART period)]. The outcome variables were (i) new NTM disease diagnosis and (ii) mortality. RESULTS A total of 3729 cases of incident NTM disease were collected in MBDS, 1795 in the HIV-negative group and 1934 in the HIV-positive group, among whom 602 deaths occurred, 223 in the HIV-negative group and 379 in the HIV-positive group. The incidence of NTM disease and the rate of NTM disease-related mortality were 1000-fold higher in the HIV-positive group than in the HIV-negative group. Regarding the incidence of NTM disease, in the HIV-negative group the incidence increased from 2.91 to 3.97 events per 1,000,000 patient-years from 1997-1999 to 2004-2010 (P < 0.001), while in the HIV-positive group the incidence decreased from 2.29 to 0.71 events per 1000 patient-years from 1997-1999 to 2004-2010 (P < 0.001). Regarding mortality, in the HIV-negative group mortality increased from 2.63 to 4.26 events per 10,000,000 patient-years from 1997-1999 to 2000-2003 (P = 0.059), and then the rate stabilized at around 3.87 events per 10,000,000 patient-years in 2004-2010 (P = 0.128), while in the HIV-positive group mortality decreased from 4.28 to 1.39 events per 10,000 patient-years from 1997-1999 to 2004-2010 (P < 0.001). CONCLUSIONS HIV infection was associated with a higher NTM disease incidence and higher NTM disease-related mortality than in the general population, but these rates decreased in the HIV-positive group from 1997-1999 to 2004-2010, whereas the NTM disease incidence increased in the HIV-negative group.
Collapse
Affiliation(s)
- A Álvaro-Meca
- Department of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - L Rodríguez-Gijón
- Department of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - A Díaz
- Unit of HIV Surveillance and Behavioural Monitoring, National Center of Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Á Gil
- Department of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - S Resino
- Unit of Viral Infection and Immunity, National Center for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain
| |
Collapse
|
229
|
de Schipper E, Lundequist A, Coghill D, de Vries PJ, Granlund M, Holtmann M, Jonsson U, Karande S, Robison JE, Shulman C, Singhal N, Tonge B, Wong VCN, Zwaigenbaum L, Bölte S. Ability and Disability in Autism Spectrum Disorder: A Systematic Literature Review Employing the International Classification of Functioning, Disability and Health-Children and Youth Version. Autism Res 2015; 8:782-94. [PMID: 25820780 PMCID: PMC6680328 DOI: 10.1002/aur.1485] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 02/24/2015] [Indexed: 11/17/2022]
Abstract
Objective: This study is the first in a series of four empirical investigations to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The objective was to use a systematic review approach to identify, number, and link functional ability and disability concepts used in the scientific ASD literature to the nomenclature of the ICF‐CY (Children and Youth version of the ICF, covering the life span). Methods: Systematic searches on outcome studies of ASD were carried out in Medline/PubMed, PsycINFO, ERIC and Cinahl, and relevant functional ability and disability concepts extracted from the included studies. These concepts were then linked to the ICF‐CY by two independent researchers using a standardized linking procedure. New concepts were extracted from the studies until saturation of identified ICF‐CY categories was reached. Results: Seventy‐one studies were included in the final analysis and 2475 meaningful concepts contained in these studies were linked to 146 ICF‐CY categories. Of these, 99 categories were considered most relevant to ASD (i.e., identified in at least 5% of the studies), of which 63 were related to Activities and Participation, 28 were related to Body functions, and 8 were related to Environmental factors. The five most frequently identified categories were basic interpersonal interactions (51%), emotional functions (49%), complex interpersonal interactions (48%), attention functions (44%), and mental functions of language (44%). Conclusion: The broad variety of ICF‐CY categories identified in this study reflects the heterogeneity of functional differences found in ASD—both with respect to disability and exceptionality—and underlines the potential value of the ICF‐CY as a framework to capture an individual's functioning in all dimensions of life. The current results in combination with three additional preparatory studies (expert survey, focus groups, and clinical study) will provide the scientific basis for defining the ICF Core Sets for ASD for multipurpose use in basic and applied research and every day clinical practice of ASD. Autism Res2015, 8: 782–794. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research
Collapse
Affiliation(s)
- Elles de Schipper
- From the Pediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden
| | - Aiko Lundequist
- From the Pediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden
| | - David Coghill
- Division of Neuroscience, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Petrus J de Vries
- Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | | | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics of the Ruhr University Bochum, Hamm, Germany
| | - Ulf Jonsson
- From the Pediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden
| | - Sunil Karande
- Learning Disability Clinic, Department of Pediatrics, Seth G.S. Medical College & K.E.M. Hospital, Mumbai, India
| | - John E Robison
- Interagency Autism Coordinating Committee, US Department of Health and Human Services, Washington, DC
| | - Cory Shulman
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Bruce Tonge
- Centre for Developmental Psychiatry and Psychology, Monash University, Victoria, Australia
| | - Virginia C N Wong
- Division of Pediatric Neurology, Developmental Behavioral Paediatrics and NeuroHabilitation, Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Sven Bölte
- From the Pediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Division of Child and Adolescent Psychiatry, Stockholm County Council, Stockholm, Sweden
| |
Collapse
|
230
|
Sohn JH, Cho MY, Park Y, Kim H, Kim WH, Kim JM, Jung ES, Kim KM, Lee JH, Chan HK, Park DY, Joo M, Kim S, Moon WS, Kang MS, Jin SY, Kang YK, Yoon SO, Han H, Choi E. Prognostic Significance of Defining L-Cell Type on the Biologic Behavior of Rectal Neuroendocrine Tumors in Relation with Pathological Parameters. Cancer Res Treat 2015; 47:813-22. [PMID: 25715764 PMCID: PMC4614207 DOI: 10.4143/crt.2014.238] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 11/04/2014] [Indexed: 02/08/2023] Open
Abstract
Purpose In 2010, the World Health Organization categorized L-cell type neuroendocrine tumors (NETs) as tumors of uncertain malignancy, while all others were classified as malignant. However, the diagnostic necessity of L-cell immunophenotyping is unclear, as are tumor stage and grade that may guide diagnosis and management. To clarify the predictive markers of rectal neuroendocrine neoplasms (NENs), 5- and 10-year overall survival (OS) was analyzed by pathological parameters including L-cell phenotype. Materials and Methods A total of 2,385 rectal NENs were analyzed from our previous multicenter study and a subset of 170 rectal NENs was immunophenotyped. Results In univariate survival analysis, tumor grade (p < 0.0001), extent (p < 0.0001), size (p < 0.0001), lymph node metastasis (p=0.0063), and L-cell phenotype (p < 0.0001) showed significant correlation with the prognosis of rectal NENs; however, none of these markers achieved independent significance in multivariate analysis. The 10-year OS of tumors of NET grade 1, < 10 mm, the mucosa/submucosa was 97.58%, 99.47%, and 99.03%, respectively. L-Cell marker, glucagon II (GLP-1&2), with a cut off score of > 10, is useful in defining L-Cell type. In this study, an L-cell immunophenotype was found in 83.5% of all rectal NENs and most, but not all L-cell type tumors were NET G1, small (< 10 mm) and confined to the mucosa/submucosa. Conclusion From these results, the biological behavior of rectal NENs does not appear to be determined by L-cell type alone but instead by a combination of pathological parameters.
Collapse
Affiliation(s)
| | - Jin Hee Sohn
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mee-Yon Cho
- Department of Pathology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yangsoon Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyunki Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Ho Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Joon Mee Kim
- Department of Pathology, Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Eun Sun Jung
- Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyoung-Mee Kim
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyuk Lee
- Department of Pathology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Kyung Chan
- Department of Pathology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Do Youn Park
- Department of Pathology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Mee Joo
- Department of Pathology, Inje University Ilsan Paik Hospital, Inje Univeristy College of Medicine, Goyang, Korea
| | - Sujin Kim
- Department of Pathology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
| | - Woo Sung Moon
- Department of Pathology, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Mi Seon Kang
- Department of Pathology, Inje University Busan Paik Hospital,Inje University College of Medicine, Busan, Korea
| | - So-Young Jin
- Department of Pathology, Soon Chun Hyang University Hospital, Soon Chun Hyang University College of Medicine, Seoul, Korea
| | - Yun Kyung Kang
- Department of Pathology, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Sun Och Yoon
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - HyeSeung Han
- Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - EunHee Choi
- Division of Statistics in Institute of ifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| |
Collapse
|
231
|
Jette N, Beghi E, Hesdorffer D, Moshé SL, Zuberi SM, Medina MT, Bergen D. ICD coding for epilepsy: past, present, and future--a report by the International League Against Epilepsy Task Force on ICD codes in epilepsy. Epilepsia 2015; 56:348-55. [PMID: 25684068 DOI: 10.1111/epi.12895] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2014] [Indexed: 11/28/2022]
Abstract
The World Health Organization (WHO) International Classification of Diseases (ICD) has been used to classify causes of morbidity and mortality such as epilepsy for more than 50 years. The aims of this critical commentary are to do the following: (1) Introduce the ICD classification, summarize the ICD-9 and ICD-10 codes for epilepsy and seizures, and discuss the challenges of mapping epilepsy codes between these two versions; (2) discuss how the ICD-9 and ICD-10 relate to the revised International League Against Epilepsy (ILAE) terminology and concepts for classification of seizures and epilepsies; (3) discuss how ICD-coded data have been used for epilepsy care and research and briefly examine the potential impact of the international ICD-10 clinical modifications on research; (4) discuss the upcoming ICD-11 codes and the role of the epilepsy community in their development; and (5) discuss how the ICD-11 will conform more closely to the current ILAE terminology and classification of the epilepsies and seizures and its potential impact on clinical care, surveillance, and public health and research.
Collapse
Affiliation(s)
- Nathalie Jette
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | | | | | | | | | | | | |
Collapse
|
232
|
Turer RW, Zuckowsky TD, Causey HJ, Rosenbloom ST. ICD-10-CM Crosswalks in the primary care setting: assessing reliability of the GEMs and reimbursement mappings. J Am Med Inform Assoc 2015; 22:417-25. [PMID: 25665703 DOI: 10.1093/jamia/ocu028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The general equivalence mappings (GEMs) and reimbursement mappings (RMs) facilitate translation between ICD-9-CM and ICD-10-CM. This study compared prospectively dual-encoded diagnoses assigned by professional coders with the GEMs/RMs in a clinical setting. MATERIALS AND METHODS Professional coders manually encoded diagnoses from 100 primary care notes into both ICD-9-CM and ICD-10-CM. The investigators evaluated whether manual mappings were reproducible using the GEMs/RMs. Reproducible mappings with one ICD-9-CM and one ICD-10-CM code ("one-to-one") were classified as exact or approximate using GEMs flags. Mismatches were characterized manually. RESULTS Manual encodings were reproducible from the forward GEMs, backward GEMs, and RMs in 85.2%, 90.4%, and 88.1% of diagnoses, respectively. For one-to-one, reproducible mappings, 61% (forward) and 63% (backward) were approximate mappings compared to 85% and 95% in the GEMs as a whole. Mismatches between manual and GEMs encodings were due to differences in coder interpretation (11%-13%), subtle hierarchical differences (52%-55%), or unknown reasons (32%-35%). DISCUSSION This study highlights inconsistencies between manual encoding and using the GEMs/RMs. The number of approximate mappings in our population compared to all one-to-one GEMs entries supports the notion that statistics describing the GEMs as a whole might not represent the most important mappings for each organization. The mismatch characteristics highlight the subtle differences between manual encoding and using the GEMs/RMs. CONCLUSION These results support the need for organizations to assess the GEMs and RMs in their own environment to avoid changes in reimbursement and longitudinal statistics.
Collapse
Affiliation(s)
- Robert W Turer
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Theresa D Zuckowsky
- Health Informatics Technologies and Services, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - S Trent Rosenbloom
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
233
|
Jain S, Himali J, Beiser A, Ton TGN, Kelly-Hayes M, Biggs ML, Delaney JAC, Rosano C, Seshadri S, Frank SA. Validation of secondary data sources to identify Parkinson disease against clinical diagnostic criteria. Am J Epidemiol 2015; 181:185-90. [PMID: 25550359 DOI: 10.1093/aje/kwu326] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Parkinson disease (PD) is the second most common neurodegenerative disorder. Its diagnosis relies solely on a clinical examination and is not straightforward because no diagnostic test exists. Large, population-based, prospective cohort studies designed to examine other outcomes that are more common than PD might provide cost-efficient alternatives for studying the disease. However, most cohort studies have not implemented rigorous systematic screening for PD. A majority of epidemiologic studies that utilize population-based prospective designs rely on secondary data sources to identify PD cases. Direct validation of these secondary sources against clinical diagnostic criteria is lacking. The Framingham Heart Study has prospectively screened and evaluated participants for PD based on clinical diagnostic criteria. We assessed the predictive value of secondary sources for PD identification relative to clinical diagnostic criteria in the Framingham Heart Study (2001-2012). We found positive predictive values of 1.0 (95% confidence interval: 0.868, 1.0), 1.0 (95% confidence interval: 0.839, 1.0), and 0.50 (95% confidence interval: 0.307, 0.694) for PD identified from self-report, use of antiparkinsonian medications, and Medicare claims, respectively. The negative predictive values were all higher than 0.99. Our results highlight the limitations of using only Medicare claims data and suggest that population-based cohorts may be utilized for the study of PD determined via self-report or medication inventories while preserving a high degree of confidence in the validity of PD case identification.
Collapse
|
234
|
Metcalfe A, Lix LM, Johnson JA, Currie G, Lyon AW, Bernier F, Tough SC. Validation of an obstetric comorbidity index in an external population. BJOG 2015; 122:1748-55. [PMID: 25559311 PMCID: PMC5006847 DOI: 10.1111/1471-0528.13254] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2014] [Indexed: 12/03/2022]
Abstract
Objectives An obstetric comorbidity index has been developed recently with superior performance characteristics relative to general comorbidity measures in an obstetric population. This study aimed to externally validate this index and to examine the impact of including hospitalisation/delivery records only when estimating comorbidity prevalence and discriminative performance of the obstetric comorbidity index. Design Validation study. Setting Alberta, Canada. Population Pregnant women who delivered a live or stillborn infant in hospital (n = 5995). Methods Administrative databases were linked to create a population‐based cohort. Comorbid conditions were identified from diagnoses for the delivery hospitalisation, all hospitalisations and all healthcare contacts (i.e. hospitalisations, emergency room visits and physician visits) that occurred during pregnancy and 3 months pre‐conception. Logistic regression was used to test the discriminative performance of the comorbidity index. Main outcome measures Maternal end‐organ damage and extended length of stay for delivery. Results Although prevalence estimates for comorbid conditions were consistently lower in delivery records and hospitalisation data than in data for all healthcare contacts, the discriminative performance of the comorbidity index was constant for maternal end‐organ damage [all healthcare contacts area under the receiver operating characteristic curve (AUC) = 0.70; hospitalisation data AUC = 0.67; delivery data AUC = 0.65] and extended length of stay for delivery (all healthcare contacts AUC = 0.60; hospitalisation data AUC = 0.58; delivery data AUC = 0.58). Conclusions The obstetric comorbidity index shows similar performance characteristics in an external population and is a valid measure of comorbidity in an obstetric population. Furthermore, the discriminative performance of the comorbidity index was similar for comorbidities ascertained at the time of delivery, in hospitalisation data or through all healthcare contacts.
Collapse
Affiliation(s)
- A Metcalfe
- Department of Obstetrics and Gynaecology, University of Calgary, Calgary, AB, Canada
| | - L M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - J-A Johnson
- Department of Obstetrics and Gynaecology, University of Calgary, Calgary, AB, Canada
| | - G Currie
- Department of Paediatrics, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - A W Lyon
- Department of Pathology and Laboratory Medicine, Saskatoon Health Region and College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - F Bernier
- Department of Clinical Genetics, University of Calgary, Calgary, AB, Canada
| | - S C Tough
- Department of Paediatrics, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
235
|
Saverskiĭ AV. [On orphan uniqueness to standard technology]. TERAPEVT ARKH 2014; 86:52-61. [PMID: 36471619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Indexed: 06/17/2023]
Abstract
The paper discusses the problem of free drug provision as an integral part of medical care in the amount of state guarantees and lists legislative contradictions that cause the above violation. It clarifies the concept of the drug legal status, by using examples, and on this basis considers whether the patients needing therapy with orphan drugs may have access to drug provision. The author analyzes normative legal acts regulating the drug provision in patients with rare (orphan) diseases and on this basis formulates a number of proposals to enhance both the availability of drug therapy to these patients and the efficiency of medical care to them, including suggestions to be considered by the State Duma, the Government of the Russian Federation and its subjects.
Collapse
|
236
|
Hanauer DA, Saeed M, Zheng K, Mei Q, Shedden K, Aronson AR, Ramakrishnan N. Applying MetaMap to Medline for identifying novel associations in a large clinical dataset: a feasibility analysis. J Am Med Inform Assoc 2014; 21:925-37. [PMID: 24928177 PMCID: PMC4147617 DOI: 10.1136/amiajnl-2014-002767] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 05/23/2014] [Accepted: 05/27/2014] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE We describe experiments designed to determine the feasibility of distinguishing known from novel associations based on a clinical dataset comprised of International Classification of Disease, V.9 (ICD-9) codes from 1.6 million patients by comparing them to associations of ICD-9 codes derived from 20.5 million Medline citations processed using MetaMap. Associations appearing only in the clinical dataset, but not in Medline citations, are potentially novel. METHODS Pairwise associations of ICD-9 codes were independently identified in both the clinical and Medline datasets, which were then compared to quantify their degree of overlap. We also performed a manual review of a subset of the associations to validate how well MetaMap performed in identifying diagnoses mentioned in Medline citations that formed the basis of the Medline associations. RESULTS The overlap of associations based on ICD-9 codes in the clinical and Medline datasets was low: only 6.6% of the 3.1 million associations found in the clinical dataset were also present in the Medline dataset. Further, a manual review of a subset of the associations that appeared in both datasets revealed that co-occurring diagnoses from Medline citations do not always represent clinically meaningful associations. DISCUSSION Identifying novel associations derived from large clinical datasets remains challenging. Medline as a sole data source for existing knowledge may not be adequate to filter out widely known associations. CONCLUSIONS In this study, novel associations were not readily identified. Further improvements in accuracy and relevance for tools such as MetaMap are needed to realize their expected utility.
Collapse
Affiliation(s)
- David A Hanauer
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Mohammed Saeed
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Kai Zheng
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
| | - Qiaozhu Mei
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
- Department of Electronic Engineering and Computer Science, University of Michigan, Ann Arbor, Michigan, USA
| | - Kerby Shedden
- Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Alan R Aronson
- Lister Hill Center, National Library of Medicine, Bethesda, Maryland, USA
| | - Naren Ramakrishnan
- Department of Computer Science, Discovery Analytics Center, Virginia Tech, Arlington, Virginia, USA
| |
Collapse
|
237
|
Chung CP, Rohan P, Krishnaswami S, McPheeters ML. A systematic review of validated methods for identifying patients with rheumatoid arthritis using administrative or claims data. Vaccine 2014; 31 Suppl 10:K41-61. [PMID: 24331074 DOI: 10.1016/j.vaccine.2013.03.075] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 02/15/2013] [Accepted: 03/26/2013] [Indexed: 11/15/2022]
Abstract
PURPOSE To review the evidence supporting the validity of billing, procedural, or diagnosis code, or pharmacy claim-based algorithms used to identify patients with rheumatoid arthritis (RA) in administrative and claim databases. METHODS We searched the MEDLINE database from 1991 to September 2012 using controlled vocabulary and key terms related to RA and reference lists of included studies were searched. Two investigators independently assessed the full text of studies against pre-determined inclusion criteria and extracted the data. Data collected included participant and algorithm characteristics. RESULTS Nine studies reported validation of computer algorithms based on International Classification of Diseases (ICD) codes with or without free-text, medication use, laboratory data and the need for a diagnosis by a rheumatologist. These studies yielded positive predictive values (PPV) ranging from 34 to 97% to identify patients with RA. Higher PPVs were obtained with the use of at least two ICD and/or procedure codes (ICD-9 code 714 and others), the requirement of a prescription of a medication used to treat RA, or requirement of participation of a rheumatologist in patient care. For example, the PPV increased from 66 to 97% when the use of disease-modifying antirheumatic drugs and the presence of a positive rheumatoid factor were required. CONCLUSIONS There have been substantial efforts to propose and validate algorithms to identify patients with RA in automated databases. Algorithms that include more than one code and incorporate medications or laboratory data and/or required a diagnosis by a rheumatologist may increase the PPV.
Collapse
Affiliation(s)
- Cecilia P Chung
- Division of Rheumatology, Vanderbilt University School of Medicine, 1161 21st Avenue South, D-3100, Medical Center North, Nashville, TN 37232-2358, USA.
| | - Patricia Rohan
- Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, Food and Drug Administration, WOC1 Building, Room 454S, 1401 Rockville Pike, Rockville, MD 20852-1428, USA
| | - Shanthi Krishnaswami
- Vanderbilt Evidence-based Practice Center, Vanderbilt University Medical Center, Suite 600, 2525 West End Avenue, Nashville, TN 37203-1738, USA.
| | - Melissa L McPheeters
- Vanderbilt Evidence-based Practice Center and Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Suite 600, 2525 West End Avenue, Nashville, TN 37203-1738, USA.
| |
Collapse
|
238
|
Lee CD, Williams SE, Sathe NA, McPheeters ML. A systematic review of validated methods to capture several rare conditions using administrative or claims data. Vaccine 2014; 31 Suppl 10:K21-7. [PMID: 24331071 DOI: 10.1016/j.vaccine.2013.03.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 03/22/2013] [Accepted: 03/25/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE To identify and assess billing, procedural, or diagnosis code, or pharmacy claim-based algorithms used to identify the following health outcomes in administrative and claims databases: acute disseminated encephalomyelitis (ADEM), optic neuritis, tics, and Henoch Schönlein purpura (HSP). METHODS We searched the MEDLINE database from 1991 to September 2012 using controlled vocabulary and key terms related to the conditions. We also searched the reference lists of included studies. Two investigators independently assessed the full text of studies against pre-determined inclusion criteria and extracted case validation data from those studies meeting inclusion criteria. RESULTS Two eligible studies addressed ADEM, two addressed optic neuritis, and four studies addressed tics. Only one study addressed HSP. Among these, one study of ADEM reported a positive predictive value of 66%, however the identification algorithm contained a combination of International Classification of Diseases (ICD) codes and other identification methods and the performance of the ICD-9 codes alone was not reported. No other studies reported validation data. CONCLUSIONS The lack of data on the validity of algorithms to identify these conditions may hamper our ability to determine incidence patterns with respect to infection and vaccination exposures. Further epidemiologic research to define validated methods of identifying cases could improve surveillance using large linked healthcare databases.
Collapse
Affiliation(s)
- Christopher D Lee
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave S, MCN A0118, Nashville, TN 37232, USA.
| | - S Elizabeth Williams
- Vanderbilt Vaccine Research Program, Vanderbilt University Medical Center, 1161 21st Avenue, CCC 5326 Medical Center North, Nashville, TN 37232, USA.
| | - Nila A Sathe
- Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Suite 600, 2525 West End Avenue, Nashville, TN 37203-1738, USA.
| | - Melissa L McPheeters
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Suite 600, 2525 West End Avenue, Nashville, TN 37203-1738, USA.
| |
Collapse
|
239
|
McPheeters ML, Sathe NA, Jerome RN, Carnahan RM. Methods for systematic reviews of administrative database studies capturing health outcomes of interest. Vaccine 2014; 31 Suppl 10:K2-6. [PMID: 24331070 DOI: 10.1016/j.vaccine.2013.06.048] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 06/08/2013] [Accepted: 06/17/2013] [Indexed: 11/15/2022]
Abstract
This report provides an overview of methods used to conduct systematic reviews for the US Food and Drug Administration (FDA) Mini-Sentinel project, which is designed to inform the development of safety monitoring tools for FDA-regulated products including vaccines. The objective of these reviews was to summarize the literature describing algorithms (e.g., diagnosis or procedure codes) to identify health outcomes in administrative and claims data. A particular focus was the validity of the algorithms when compared to reference standards such as diagnoses in medical records. The overarching goal was to identify algorithms that can accurately identify the health outcomes for safety surveillance. We searched the MEDLINE database via PubMed and required dual review of full text articles and of data extracted from studies. We also extracted data on each study's methods for case validation. We reviewed over 5600 abstracts/full text studies across 15 health outcomes of interest. Nearly 260 studies met our initial criteria (conducted in the US or Canada, used an administrative database, reported case-finding algorithm). Few studies (N=45), however, reported validation of case-finding algorithms (sensitivity, specificity, positive or negative predictive value). Among these, the most common approach to validation was to calculate positive predictive values, based on a review of medical records as the reference standard. Of the studies reporting validation, the ease with which a given clinical condition could be identified in administrative records varied substantially, both by the clinical condition and by other factors such as the clinical setting, which relates to the disease prevalence.
Collapse
Affiliation(s)
- Melissa L McPheeters
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Suite 600, 2525 West End Avenue, Nashville, TN 37203-1738, USA; Vanderbilt Evidence-Based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Suite 600, 2525 West End Avenue, Nashville, TN 37203-1738, USA.
| | - Nila A Sathe
- Vanderbilt Evidence-Based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Suite 600, 2525 West End Avenue, Nashville, TN 37203-1738, USA.
| | - Rebecca N Jerome
- Eskind Biomedical Library and Department of Biomedical Informatics, Vanderbilt University Medical Center, 2209 Garland Avenue, Nashville, TN 37232, USA.
| | - Ryan M Carnahan
- Department of Epidemiology, University of Iowa College of Public Health, S437 CPHB University of Iowa, 105 River Street, Iowa City, IA 52242, USA.
| |
Collapse
|
240
|
Moores KG, Sathe NA. A systematic review of validated methods for identifying systemic lupus erythematosus (SLE) using administrative or claims data. Vaccine 2013; 31 Suppl 10:K62-73. [PMID: 24331075 DOI: 10.1016/j.vaccine.2013.06.104] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 04/30/2013] [Accepted: 06/25/2013] [Indexed: 02/04/2023]
Abstract
PURPOSE To examine the validity of billing, procedural, or diagnosis code, or pharmacy claim-based algorithms used to identify patients with systemic lupus erythematosus (SLE) in administrative and claims databases. METHODS We searched the MEDLINE database from 1991 to September 2012 using controlled vocabulary and key terms related to SLE. We also searched the reference lists of included studies. Two investigators independently assessed the full text of studies against pre-determined inclusion criteria. The two reviewers independently extracted data regarding participant and algorithm characteristics and assessed a study's methodologic rigor using a pre-defined approach. RESULTS Twelve studies included validation statistics for the identification of SLE in administrative and claims databases. Seven of these studies used the ICD-9 code of 710.0 in selected populations of patients seen by a rheumatologist or patients who had experienced the complication of SLE-associated nephritis, other kidney disease, or pregnancy. The other studies looked at limited data in general populations. The algorithm in the selected populations had a positive predictive value (PPV) in the range of 70-90% and of the limited data in general populations it was in the range of 50-60%. CONCLUSIONS Few studies use rigorous methods to validate an algorithm for the identification of SLE in general populations. Algorithms including ICD-9 code of 710.0 in physician billing and hospitalization records have a PPV of approximately 60%. A requirement that the code is obtained from a record based on treatment by a rheumatologist increases the PPV of the algorithm but limits the generalizability in the general population.
Collapse
|
241
|
Baker MA, Nguyen M, Cole DV, Lee GM, Lieu TA. Post-licensure rapid immunization safety monitoring program (PRISM) data characterization. Vaccine 2014; 31 Suppl 10:K98-112. [PMID: 24331080 DOI: 10.1016/j.vaccine.2013.04.088] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 03/18/2013] [Accepted: 04/30/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Post-Licensure Rapid Immunization Safety Monitoring (PRISM) program is the immunization safety monitoring component of FDA's Mini-Sentinel project, a program to actively monitor the safety of medical products using electronic health information. FDA sought to assess the surveillance capabilities of this large claims-based distributed database for vaccine safety surveillance by characterizing the underlying data. METHODS We characterized data available on vaccine exposures in PRISM, estimated how much additional data was gained by matching with select state and local immunization registries, and compared vaccination coverage estimates based on PRISM data with other available data sources. We generated rates of computerized codes representing potential health outcomes relevant to vaccine safety monitoring. Standardized algorithms including ICD-9 codes, number of codes required, exclusion criteria and location of the encounter were used to obtain the background rates. RESULTS The majority of the vaccines routinely administered to infants, children, adolescents and adults were well captured by claims data. Immunization registry data in up to seven states comprised between 5% and 9% of data for all vaccine categories with the exception of 10% for hepatitis B and 3% and 4% for rotavirus and zoster respectively. Vaccination coverage estimates based on PRISM's computerized data were similar to but lower than coverage estimates from the National Immunization Survey and Healthcare Effectiveness Data and Information Set. For the 25 health outcomes of interest studied, the rates of potential outcomes based on ICD-9 codes were generally higher than rates described in the literature, which are typically clinically confirmed cases. CONCLUSION PRISM program's data on vaccine exposures and health outcomes appear complete enough to support robust safety monitoring.
Collapse
Affiliation(s)
- Meghan A Baker
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, United States; Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States.
| | - Michael Nguyen
- US Food and Drug Administration Center for Biologics Evaluation and Research, Rockville, MD, United States.
| | - David V Cole
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, United States.
| | - Grace M Lee
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, United States; Division of Infectious Diseases, Department of Medicine, Boston Children's Hospital, Boston, MA, United States.
| | - Tracy A Lieu
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, United States.
| |
Collapse
|
242
|
Motie MR, Ansari M, Nasrollahi HR. Assessment of surgical site infection risk factors at Imam Reza hospital, Mashhad, Iran between 2006 and 2011. Med J Islam Repub Iran 2014; 28:52. [PMID: 25405118 PMCID: PMC4219881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 11/24/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The present study was conducted to establish the patterns and risk factors of surgical site infections in our institution between 2006 and 2011. METHODS This was a retrospective cross-sectional study. The surgical site infection (SSI) was identified based on the presence of ICD-10-CM diagnostic code in hospital discharge records. By using a standardized data collection form predictor variables including patient characteristics, preoperative, intra-operative and postoperative data were obtained. RESULTS Ninety five patients fulfilled the inclusion criteria. The patients were admitted for various procedures including both elective (62.1%) and emergency (37.9%) operations. Colectomy (13.7%) was the leading procedure followed by umbilical herniation (12.6) and appendix perforation (12.6%). The mean age was 47.13 years with standard deviation of 19.60 years. Twenty percent were addicted to opium. Midline incision above and below the umbilicus (40%) had the highest prevalence of infection. Most patients (46.3%) had cleancontaminated wounds and 30.5% had contaminated one. The quantitative variables which were also measured include duration of surgery, pre-operative and post-operative hospital stay with the mean of 2.9±1.45 hours, 1.02±1.42 and 7.75±6.75 days respectively. The most antibiotics prescribed post-operatively were the combination of ceftriaxone and metronidazole (51.6%). CONCLUSION The contaminated and clean-contaminated wounds are associated with higher rate of SSIs. Also, there was a converse relation between length of surgical incision and rate of SSIs. In overall, we found type of surgery as the main risk factor in developing the SSIs.
Collapse
Affiliation(s)
- Mohammad Reza Motie
- 1. MD, Associate Professor of Surgery, Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ansari
- 2. MD, Resident of General Surgery, Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hamid Reza Nasrollahi
- 3. MD, Medical Student, Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
243
|
Park LS, Tate JP, Rodriguez-Barradas MC, Rimland D, Goetz MB, Gibert C, Brown ST, Kelley MJ, Justice AC, Dubrow R. Cancer Incidence in HIV-Infected Versus Uninfected Veterans: Comparison of Cancer Registry and ICD-9 Code Diagnoses. J AIDS Clin Res 2014; 5:1000318. [PMID: 25580366 PMCID: PMC4285627 DOI: 10.4172/2155-6113.1000318] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Given the growing interest in the cancer burden in persons living with HIV/AIDS, we examined the validity of data sources for cancer diagnoses (cancer registry versus International Classification of Diseases, Ninth Revision [ICD-9 codes]) and compared the association between HIV status and cancer risk using each data source in the Veterans Aging Cohort Study (VACS), a prospective cohort of HIV-infected and uninfected veterans from 1996 to 2008. METHODS We reviewed charts to confirm potential incident cancers at four VACS sites. In the entire cohort, we calculated cancer-type-specific age-, sex-, race/ethnicity-, and calendar-period-standardized incidence rates and incidence rate ratios (IRR) (HIV-infected versus uninfected). We calculated standardized incidence ratios (SIR) to compare VACS and Surveillance, Epidemiology, and End Results rates. RESULTS Compared to chart review, both Veterans Affairs Central Cancer Registry (VACCR) and ICD-9 diagnoses had approximately 90% sensitivity; however, VACCR had higher positive predictive value (96% versus 63%). There were 6,010 VACCR and 13,386 ICD-9 incident cancers among 116,072 veterans. Although ICD-9 rates tended to be double VACCR rates, most IRRs were in the same direction and of similar magnitude, regardless of data source. Using either source, all cancers combined, most viral-infection-related cancers, lung cancer, melanoma, and leukemia had significantly elevated IRRs. Using ICD-9, eight additional IRRs were significantly elevated, most likely due to false positive diagnoses. Most ICD-9 SIRs were significantly elevated and all were higher than the corresponding VACCR SIR. CONCLUSIONS ICD-9 may be used with caution for estimating IRRs, but should be avoided when estimating incidence or SIRs. Elevated cancer risk based on VACCR diagnoses among HIV-infected veterans was consistent with other studies.
Collapse
Affiliation(s)
- Lesley S Park
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
- Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, CT, USA
| | - Janet P Tate
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of General Internal Medicine, Veterans Affairs Healthcare System, West Haven, CT, USA
| | - Maria C Rodriguez-Barradas
- Infectious Diseases Section, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - David Rimland
- Medical Specialty Care Service Line, Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Matthew Bidwell Goetz
- Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Cynthia Gibert
- Section of Infectious Diseases, Washington DC Veterans Affairs Medical Center, Washington, DC, USA
- Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Sheldon T Brown
- Department of Medicine, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
- Department of Medicine, Icahn School of Medicine, Mt. Sinai, New York, NY, USA
| | - Michael J Kelley
- Office of Patient Care Services, Department of Veterans Affairs, Washington, DC, USA
- Hematology-Oncology Service, Durham Veterans Affairs Medical Center, Durham, NC, USA
- Division of Medical Oncology, Duke University Medical Center, Durham, NC, USA
| | - Amy C Justice
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of General Internal Medicine, Veterans Affairs Healthcare System, West Haven, CT, USA
| | - Robert Dubrow
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
- Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, CT, USA
| |
Collapse
|
244
|
Robert E, Hajizadeh M, El-Bialy R, Bidisha SH. Globalization and the diffusion of ideas: why we should acknowledge the roots of mainstream ideas in global health. Int J Health Policy Manag 2014; 3:7-9. [PMID: 24987715 DOI: 10.15171/ijhpm.2014.55] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 06/02/2014] [Indexed: 11/09/2022] Open
Abstract
Although globalization has created ample opportunities and spaces to share experiences and information, the diffusion of ideas, especially in global health, is primarily influenced by the unequal distribution of economic, political and scientific powers around the world. These ideas in global health are generally rooted in High-Income Countries (HICs), and then reach Low- and Middle-Income Countries (LMICs). We argue that acknowledging and addressing this invisible trend would contribute to a greater degree of open discussions in global health. This is expected to favor innovative, alternative, and culturally sound solutions for persistent health problems and reducing inequities.
Collapse
Affiliation(s)
- Emilie Robert
- University of Montreal Hospital Centre-Research Centre (CR-CHUM), University of Montréal, Montreal, Quebec, Canada
| | - Mohammad Hajizadeh
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
| | - Rowan El-Bialy
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | | |
Collapse
|
245
|
Kilgo PD, Weaver AA, Barnard RT, Love TP, Stitzel JD. Comparison of injury mortality risk in motor vehicle crash versus other etiologies. Accid Anal Prev 2014; 67:137-147. [PMID: 24646525 DOI: 10.1016/j.aap.2014.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 12/05/2013] [Accepted: 03/02/2014] [Indexed: 06/03/2023]
Abstract
The mortality risk ratio (MRR), a measure of the proportion of people who died that sustained a given injury, is reported to be among the most powerful discriminators of mortality following trauma. The primary aim was to determine whether mechanistic differences exist and are quantifiable when comparing MRR-based injury severity across two broadly defined etiologies (motor vehicle crash (MVC) versus non-MVC) for the clarification of important injury types that have some room for improvement by emergency treatment and vehicle design. All International Classification of Diseases, 9th revision (ICD-9) coded injuries in the National Trauma Data Bank (NTDB) database were stratified into MVC and non-MVC groups and the MRR for each injury was computed within each group. Injuries were classified as 11 different types for MRR comparison between etiologies. Overall, MRRs for specific injuries were 10-18% lower for MVC compared to non-MVC etiologies. MVCs however produced much higher mean MRRs for crushing injuries (0.184 versus 0.072) and internal injuries to the thorax, abdomen, and pelvis (0.200 versus 0.169). Non-MVCs produced much higher MRRs for intracranial injuries (0.199 versus 0.250). Analysis of the top 95% most frequent MVC injuries revealed higher MVC MRR values for 78% of the injuries with MRR ratios indicating an average 50% increase in a given injury's MRR when MVC was the etiology. Addressing the large differences in MRR in between etiologies for identical injuries could provide a reduction in fatalities and may be important to patient triage and vehicle safety design.
Collapse
Affiliation(s)
| | - Ashley A Weaver
- Virginia Tech-Wake Forest University, Center for Injury Biomechanics, Winston-Salem, NC, USA; Wake Forest University, School of Medicine, Winston-Salem, NC, USA.
| | - Ryan T Barnard
- Wake Forest University, Public Health Sciences, Winston-Salem, NC, USA.
| | - Timothy P Love
- Emory University Department of General Surgery, Atlanta, GA, USA.
| | - Joel D Stitzel
- Virginia Tech-Wake Forest University, Center for Injury Biomechanics, Winston-Salem, NC, USA; Wake Forest University, School of Medicine, Winston-Salem, NC, USA.
| |
Collapse
|
246
|
Hohl CM, Karpov A, Reddekopp L, Stausberg J. ICD-10 codes used to identify adverse drug events in administrative data: a systematic review. J Am Med Inform Assoc 2014; 21:547-57. [PMID: 24222671 PMCID: PMC3994866 DOI: 10.1136/amiajnl-2013-002116] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 10/23/2013] [Accepted: 10/27/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Adverse drug events, the unintended and harmful effects of medications, are important outcome measures in health services research. Yet no universally accepted set of International Classification of Diseases (ICD) revision 10 codes or coding algorithms exists to ensure their consistent identification in administrative data. Our objective was to synthesize a comprehensive set of ICD-10 codes used to identify adverse drug events. METHODS We developed a systematic search strategy and applied it to five electronic reference databases. We searched relevant medical journals, conference proceedings, electronic grey literature and bibliographies of relevant studies, and contacted content experts for unpublished studies. One author reviewed the titles and abstracts for inclusion and exclusion criteria. Two authors reviewed eligible full-text articles and abstracted data in duplicate. Data were synthesized in a qualitative manner. RESULTS Of 4241 titles identified, 41 were included. We found a total of 827 ICD-10 codes that have been used in the medical literature to identify adverse drug events. The median number of codes used to search for adverse drug events was 190 (IQR 156-289) with a large degree of variability between studies in the numbers and types of codes used. Authors commonly used external injury (Y40.0-59.9) and disease manifestation codes. Only two papers reported on the sensitivity of their code set. CONCLUSIONS Substantial variability exists in the methods used to identify adverse drug events in administrative data. Our work may serve as a point of reference for future research and consensus building in this area.
Collapse
Affiliation(s)
- Corinne M Hohl
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Emergency Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Andrei Karpov
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lisa Reddekopp
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jürgen Stausberg
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, München, Germany
| |
Collapse
|
247
|
Abstract
Death certificate data are often used to study the epidemiology of poisoning deaths, but the International Classification of Diseases (ICD) codes used to tabulate death data do not convey all of the available information about the drugs and other substances named on death certificates. In the United States and some other countries, the SuperMICAR computer system is used to assign ICD codes to deaths. The SuperMICAR system also stores a verbatim record of the text entered for the cause of death. We used the SuperMICAR text entries to study the 7,817 poisoning deaths that occurred among Washington State residents between 2003 and 2010. We tabulated the drugs named on death certificates and computed age-adjusted and age-specific death rates for the top-named drugs and for prescription and illicit drugs. Methadone was named on 2,149 death certificates and was the most frequently named substance, followed by alcohol, opiate, cocaine, oxycodone, and methamphetamine. For both men and women and at all ages, prescription drugs were involved in more deaths than were illicit drugs. Among the 25 drugs named most frequently, only 4 have unique ICD codes; the other 21 can be identified only by using the SuperMICAR data.
Collapse
|
248
|
Ruiz E, Ramalle-Gómara E, Quiñones C. Record linkage between hospital discharges and mortality registries for motor neuron disease case ascertainment for the Spanish National Rare Diseases Registry. Amyotroph Lateral Scler Frontotemporal Degener 2014; 15:275-8. [PMID: 24641576 DOI: 10.3109/21678421.2014.890226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Our objective was to analyse the coverage of hospital discharge data and the mortality registry (MR) of La Rioja to ascertain motor neuron disease (MND) cases to be included in the Spanish National Rare Diseases Registry. MND cases that occurred in La Rioja during the period 1996-2011 were selected from hospital discharge data and the MR by means of the International Classification of Diseases. Review of the medical histories was carried out to confirm the causes of death reported. Characteristics of the population with MND were analysed. A total of 133 patients with MND were detected in La Rioja during the period 1996-2011; 30.1% were only recorded in the hospital discharges data, 12.0% only in the MR, and 57.9% were recorded by both databases. Medical records revealed a miscoding of patients who had been diagnosed with progressive supranuclear palsy but were recorded in the MR with an MND code. In conclusion, the hospital discharges data and the MR appear to be complementary and are valuable databases for the Spanish National Rare Diseases Registry when MNDs are properly codified. Nevertheless, it would be advisable to corroborate the validity of the MR as data source since the miscoding of progressive supranuclear palsy has been corrected.
Collapse
Affiliation(s)
- Elena Ruiz
- Department of Epidemiology, La Rioja Regional Authority , Logroño , Spain
| | | | | | | |
Collapse
|
249
|
Berentzen TL, Gamborg M, Holst C, Sørensen TIA, Baker JL. Body mass index in childhood and adult risk of primary liver cancer. J Hepatol 2014; 60:325-30. [PMID: 24076363 DOI: 10.1016/j.jhep.2013.09.015] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 08/14/2013] [Accepted: 09/10/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Childhood overweight increases the risk of early development of non-alcoholic fatty liver disease, which may predispose to carcinogenesis. We investigated if childhood body size during school ages was associated with the risk of primary liver cancer in adults. METHODS A cohort of 285,884 boys and girls, born 1930 through 1980, who attended school in Copenhagen, were followed from 1977 to 31 December 2010. Their heights and weights were measured by school doctors or nurses at ages 7 through 13 years. Body mass index (BMI) z-scores were calculated from an internal age- and sex-specific reference. Information on liver cancer was obtained from the National Cancer Registry. Hazard ratios and 95% confidence intervals (95% CI) of liver cancer were estimated by Cox regression. RESULTS During 6,963,105 person-years of follow-up, 438 cases of primary liver cancer were recorded. The hazard ratio (95% CI) of adult liver cancer was 1.20 (1.07-1.33) and 1.30 (1.16-1.46) per 1-unit BMI z-score at 7 years and 13 years of age, respectively. Similar associations were found in boys and girls, for hepatocellular carcinoma only, across years of birth, and after accounting for diagnoses of viral hepatitis, alcohol-related disorders, and biliary cirrhosis. CONCLUSIONS Higher BMI in childhood increases the risk of primary liver cancer in adults. In view of the high case fatality of primary liver cancer, this result adds to the future negative health outcomes of the epidemic of childhood overweight, reinforcing the need for its prevention.
Collapse
Affiliation(s)
- Tina Landsvig Berentzen
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Copenhagen, Denmark
| | - Michael Gamborg
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Copenhagen, Denmark
| | - Claus Holst
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Copenhagen, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Jennifer L Baker
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Copenhagen, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health Sciences, University of Copenhagen, Denmark.
| |
Collapse
|
250
|
Kappelman MD, Farkas DK, Long MD, Erichsen R, Sandler RS, Sørensen HT, Baron JA. Risk of cancer in patients with inflammatory bowel diseases: a nationwide population-based cohort study with 30 years of follow-up evaluation. Clin Gastroenterol Hepatol 2014; 12:265-73.e1. [PMID: 23602821 PMCID: PMC4361949 DOI: 10.1016/j.cgh.2013.03.034] [Citation(s) in RCA: 167] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 02/12/2013] [Accepted: 03/15/2013] [Indexed: 01/18/2023]
Abstract
BACKGROUND & AIMS Data regarding the risk of gastrointestinal and extraintestinal cancers in Crohn's disease (CD) and ulcerative colitis (UC) are needed to understand the clinical course of inflammatory bowel diseases (IBDs) and their treatments. METHODS We performed a nationwide historical cohort study using Danish health care databases. We identified patients with a diagnosis of CD or UC, recorded from 1978 through 2010, and followed them up until the first occurrence of cancer, death, or emigration. We used standardized incidence ratios (SIRs) to compare cancer incidence in CD and UC patients with that expected in the general population. RESULTS Excluding cancers diagnosed within 1 year of IBD diagnosis, 772 cases of invasive cancer occurred among 13,756 patients with CD (SIR, 1.3; 95% confidence interval [CI], 1.2-1.4) and 2331 occurred among 35,152 patients with UC (SIR, 1.1; 95% CI, 1.0-1.1). CD was associated weakly with gastrointestinal cancers (SIR, 1.2; 95% CI, 1.0-1.4) and extraintestinal cancers (SIR, 1.3; 95% CI, 1.2-1.4), with the strongest associations for hematologic malignancies (SIR, 1.9; 95% CI, 1.5-2.3), smoking-related cancers (SIR, 1.5; 95% CI, 1.3-1.8), and melanoma (SIR, 1.4; 95% CI, 1.0-1.9). Associations between UC and gastrointestinal and extraintestinal cancers were weaker (SIR, 1.1; 95% CI, 1.0-1.2; and SIR, 1.1; 95% CI, 1.0-1.1, respectively). The relative risk of extraintestinal cancers among patients with IBD was relatively stable over time, although the risk of gastrointestinal cancers decreased. CONCLUSIONS Patients with IBD, particularly CD, are at increased risk for gastrointestinal and extraintestinal malignancies. The relative risk of gastrointestinal malignancy has decreased since 1978, without a concomitant increase in the risk of nongastrointestinal malignancy.
Collapse
Affiliation(s)
| | | | - Millie D. Long
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Robert S. Sandler
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - John A. Baron
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| |
Collapse
|