scholarly journals Holomorphic symplectic geometry: a problem list

Author(s):  
Arnaud Beauville
2017 ◽  
Vol 210 (3) ◽  
pp. 759-814 ◽  
Author(s):  
Marco Bertola ◽  
Dmitry Korotkin ◽  
Chaya Norton

Author(s):  
Michael D McCulloch ◽  
Tim Sobol ◽  
Joy Yuhas ◽  
Bill Ahern ◽  
Eric D Hixson ◽  
...  

Background: Administrative claims data are commonly used for measurement of mortality and readmissions in Acute Myocardial Infarction (AMI). With advent of the Electronic Medical Record (EMR), the electronic problem list offers new ways to capture diagnosis data. However, no data comparing the accuracy of administrative claims data and the EMR problem list exists. Methods: Two years of admissions at a single, quaternary medical center were analyzed to compare the presence of AMI diagnosis in administrative claims and EMR problem list data using a 2x2 matrix. To gain insights into this novel method, 25 patient admissions were randomly selected from each group to undergo physician chart review to adjudicate a clinical diagnosis of myocardial infarction based on the universal definition. Results: A total of 105,929 admissions from January 1, 2010 to December 31, 2011 were included. Where EMR problem list and administrative claims data were in agreement for or against AMI diagnosis they were highly accurate. Where administrative claims data, but not EMR problem list, reported AMI the most common explanation was true AMI with missing EMR problem list diagnoses (60%). Less common reasons for discordance in this category include: (1) administrative coding error (20%), (2) computer algorithm error (8%), (3) patient death before EMR problem list created (4%), (4) EMR problem list not used (4%) and (5) AMI diagnosis was removed from EMR problem list (4%). Where EMR problem list, but not administrative claims data, reported AMI the most common explanation was no AMI with historical diagnosis of AMI from a previous admission (60%). Less common reasons for discordance in this category include: (1) AMI present but not the principal diagnosis (32%), (2) administrative coding error (4%) and (3) erroneous EMR problem list entry (4%). Conclusion: Compared to administrative and chart review diagnoses, we found that using the EMR problem list to identify patient admissions with a principal diagnosis of AMI will overlook a subset of patients primarily due to inadequate clinical documentation. Additionally, the EMR problem list does not discriminate the admission principal diagnosis from the secondary diagnoses.


1993 ◽  
Vol 14 (8) ◽  
pp. 300-301

Name: Roger Horton1 Date of Birth: June 1, 19842 Drug Allergies: None known3 Immunizations: Complete4 Wednesday, June 9, 1993 1 PM CHIEF COMPLAINT: Fell and hit side and head. PRESENT ILLNESS: At 12:15 PM was swinging high on swing at schoolyard. Fell off at top of arc and landed on hard ground, striking right side of body and right side of head. Remembers landing and "seeing stars," then being surrounded by others. Does not think he lost consciousness. Walked into school, with help. PAST MEDICAL HISTORY (as recorded on problem list): Occasional wheezing, relieved by albuterol inhaler. Fracture, left radius, age 6. PHYSICAL EXAMINATION: Slim, pale boy, sitting quietly on table. Complains of headache; feels "sick to my stomach" and cold. Right shoulder and hip hurt; neck does not. Weight: 58 lb Temperature: 98.2°F, orally Pulse rate: 92 beats/min Respiratory rate: 20 breaths/min Blood pressure: 120/70 Head: Tender and mildly swollen over right parietal area. Eyes: Sclerae clear. Pupils equal in size and reactive. Extraocular movements full without nystagmus. Media clear. Optic discs sharp. Venous pulsations noted. No retinal hemorrhages. Acuity 20/26 in each eye. Ears: Clear tympanic membranes without blood. Nose: Clear; no discharge. Mouth/throat: Clear; no injury noted. Neck: Full movement without pain. Mild tenderness on right side. Chest: Breathing easily. Clear sounds. No tenderness of ribs. Heart: Good sounds in regular rhythm without murmurs.


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