Pterygia are indicators of an increased risk of developing cutaneous melanomas

AimTo investigate whether pterygium is an indicator of an increased risk of cutaneous melanoma (CM).MethodsA matched-cohort study, using linked health administrative data sets to identify all hospital-treated pterygium in Western Australia (WA) between 1979 and 2014. We identified pterygium cases from hospital diagnosis and/or procedure International Classification of Diseases 9th revision (ICD-9) and 10th revision (ICD-10) codes and matched cases by age, sex and residential postcode to WA Electoral Roll controls with no known history of pterygium. Both cohorts were linked to the WA Cancer Registry and the WA Deaths Registry.Results23 625 people had pterygium treatment (64% male) in WA hospitals. The median age for pterygium diagnosis and/or treatment was 49 years (range 14–96). There were significantly more CM cases in the pterygium cohort compared with the control cohort (1083 vs 874; p<0.001). In a logistic regression analysis, there was a 24% increase in the odds of developing a CM in the pterygium cohort, compared with controls, after controlling for other predictors (OR 1.24, 95% CI 1.1 to 1.4). The incident rate ratio (IRR) of a malignant CM diagnosis was 20% greater in people who had treatment for a pterygium compared with controls (IRR 1.2, 95% CI 1.0 to 1.4).ConclusionThe presence of a pterygium indicates a significantly increased risk of developing a CM. Eye care providers who see patients with developing pterygia should advise these patients of this increased risk and recommend regular skin surveillance.

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ICD-11 extension codes support detailed clinical abstraction and comprehensive classification

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01635-2 ◽

2021 ◽

Vol 21 (S6) ◽

Author(s):

Saskia E. Drösler ◽

Stefanie Weber ◽

Christopher G. Chute

Keyword(s):

Clinical History ◽

International Classification Of Diseases ◽

Disease Stage ◽

Clinical State ◽

Classification Of Diseases ◽

Icd 10 ◽

Clinical Detail ◽

History Of ◽

Comprehensive Classification

Abstract Background The new International Classification of Diseases—11th revision (ICD-11) succeeds ICD-10. In the three decades since ICD-10 was released, demands for detailed information on the clinical history of a morbid patient have increased. Methods ICD-11 has now implemented an addendum chapter X called “Extension Codes”. This chapter contains numerous codes containing information on concepts including disease stage, severity, histopathology, medicaments, and anatomical details. When linked to a stem code representing a clinical state, the extension codes add significant detail and allow for multidimensional coding. Results This paper discusses the purposes and uses of extension codes and presents three examples of how extension codes can be used in coding clinical detail. Conclusion ICD-11 with its extension codes implemented has the potential to improve precision and evidence based health care worldwide.

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A Missed Opportunity to Prevent Subsequent Fractures Confirmed through Trends in the Treatment of Osteoporosis in Patients with Distal Radius and Hip Fractures

10.21203/rs.2.21943/v1 ◽

2020 ◽

Author(s):

Dae-Geun Kim ◽

Hae-Dong Jang ◽

Gi-Won Seo ◽

Hyun-Uk Lee ◽

Hye-Won Nam

Keyword(s):

Distal Radius ◽

Osteoporosis Treatment ◽

International Classification Of Diseases ◽

Trend Test ◽

Classification Of Diseases ◽

Icd 10 ◽

History Of ◽

Armitage Trend Test ◽

Missed Opportunity

Abstract Background A history of osteoporotic fracture (OF) is strongly associated with subsequent OFs. It is important to treat osteoporosis following OFs to prevent subsequent fractures. A distal radius fracture (DRF) is the most common type of OF in people in their 50s and could be a hallmark of future OFs. We compared the rate of osteoporosis treatment within 6 months post-DRF with hip fracture (HF). Methods We used data from the Korean Health Insurance Review and Assessment Service nationwide claims database from 2010 to 2016. International Classification of Diseases 10th revision (ICD-10) codes and procedures codes were used to identify patients older than 50 years with newly diagnosed DRFs and HFs. Then the rate of prescription and kinds of osteoporosis medications in these patients were analysed. We also compared the trends in both groups using the Cochran–Armitage trend test. Results A database search identified 77,209 DRFs and 72,044 HFs in patient aged 50 years or older from 2011 to 2016. Insufficient DRF and HF patients had osteoporosis medications (17.2% and 34.5%) and the numbers of osteoporosis medication for both DRFs and HFs decreased significantly annually ( P <0.0001). Bisphosphonates were used most often, although the use of selective oestrogen receptor modifiers (SERMs) increased gradually in both groups.Conclusions Clinicians who treat OFs should treat osteoporosis to prevent subsequent fractures and pay more attention to DRF patients who fail to get proper osteoporosis treatment.

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Presentation and management of community-onset vs hospital-onset first seizures

Neurology Clinical Practice ◽

10.1212/cpj.0000000000000524 ◽

2018 ◽

Vol 8 (5) ◽

pp. 421-428

Author(s):

Emma Foster ◽

Sarah Holper ◽

Zhibin Chen ◽

Patrick Kwan

Keyword(s):

International Classification Of Diseases ◽

Economic Effects ◽

Hospitalized Elderly ◽

Increased Risk ◽

Classification Of Diseases ◽

Icd 10 ◽

Community Onset ◽

International League ◽

New Onset

BackgroundNew-onset seizures are frequently encountered in community and hospital settings. It is likely that seizures presenting in these distinct settings have different etiologies and prognoses, requiring different investigation and treatment approaches. We directly compare the presentation and management of patients with community- and hospital-onset first seizures attending the same hospital.MethodsWe reviewed the medical records of patients aged 18 years or older with discharge International Classification of Diseases, Australian Classification (ICD-10-AM) codes of G40 (epilepsy), G41 (status epilepticus), and R56.8 (unspecified convulsions), who attended a general hospital in Melbourne, Australia, from January 1, 2008, through November 30, 2016. Patients with new-onset seizures were included for analysis.ResultsA total of 367 patients were discharged with a relevant ICD-10-AM code. Among them, 151 patients met the inclusion criteria: 97 presented to the emergency department with community-onset seizure (median age 70 years), and 54 experienced seizures during hospitalization for other indications (median age 80.5 years). Provoked seizures were more common in the latter group (26.8% vs 63.0%, p < 0.001), with exposure to proconvulsant drugs a major risk factor. Despite not fulfilling the International League Against Epilepsy (ILAE) diagnostic criteria, 72.5% (58/80) who survived to discharge were prescribed antiepileptic drug (AED) therapy, whereas 19.0% (12/63) of those who met the ILAE criteria were not.ConclusionsHospitalized elderly patients are at an increased risk of provoked seizures, and caution should be exercised when prescribing potential proconvulsant medications and procedures. A more standardized approach to AED prescribing is needed. Further studies should consider morbidity, mortality, and health economic effects of first seizures and assess optimal management to improve outcomes in this cohort.

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Pregnancy outcomes in women with a history of immunoglobulin A vasculitis

Rheumatology ◽

10.1093/rheumatology/key408 ◽

2018 ◽

Vol 58 (5) ◽

pp. 884-888

Author(s):

Johannes Nossent ◽

Warren Raymond ◽

Helen Keen ◽

Charles Inderjeeth ◽

David Preen

Keyword(s):

Preterm Delivery ◽

Gestational Hypertension ◽

Immunoglobulin A ◽

Case Series ◽

International Classification Of Diseases ◽

International Classification ◽

Increased Risk ◽

Classification Of Diseases ◽

History Of

Abstract Objectives Case series suggest an increased risk of pregnancy complications in women with a history of IgA vasculitis (IgAV); however, no large quantitative studies have examined this possible association to date. We compared pregnancy rates and outcomes between female IgAV patients and controls and assessed flare risk of IgAV during pregnancy. Methods Using state-wide hospital morbidity data we compared rates for live birth, preterm birth, abortive outcome and gestational complications between female IgAV patients (International Classification of Diseases-9-Clinical Modification 287.0; International Classification of Diseases-10-Australian Modification D69.0) (n = 121) and non-exposed age-matched controls (n = 284) in Western Australia. Results presented are means compared by Kruskal–Wallis test and proportions with odds ratios (ORs) (95% CI) compared by χ2 testing. Results There were 247 pregnancies in IgAV patients during which no disease flares were recorded and 556 pregnancies in controls. IgAV patients were younger at first pregnancy (24.7 vs 27.0 years, P < 0.01) and had 43 unsuccessful pregnancies (17.4%) and 204 live births with 17 preterm deliveries (8.3%). Women with IgAV had increased odds of spontaneous abortion (OR 1.9, 95% CI 1.1, 3.1, P = 0.04), preterm delivery (OR 2.0, 95% CI 1.1, 3.9, P = 0.02) and gestational hypertension (OR 4.7, 95% CI 2.3, 9.8). While gravidity did not differ (mean pregnancy number 2.4 vs 2.3, P = 0.36), IgAV patients had over a two-fold greater number of obstetric visits than controls (5.1 vs 2.5, P < 0.01). Conclusions Hospitalization for IgAV has little impact on fertility and IgAV rarely flares during pregnancy. However, a history of IgAV associates with increased odds of spontaneous abortions, gestational hypertension and preterm delivery.

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Classification

Shorter Oxford Textbook of Psychiatry ◽

10.1093/med/9780198747437.003.0002 ◽

2017 ◽

pp. 21-34

Author(s):

Paul Harrison ◽

Philip Cowen ◽

Tom Burns ◽

Mina Fazel

Keyword(s):

International Classification Of Diseases ◽

Classification Systems ◽

World Health ◽

Psychiatric Classification ◽

Dsm 5 ◽

Classification Of Diseases ◽

Icd 10 ◽

History Of ◽

Key Issues

‘Classification’ introduces concepts of mental illness before briefly reviewing the reasons for, and criticisms of, psychiatric classification. Key issues of reliability, validity, and stigma associated with classification are covered. After an overview of the history of classifications, the organizing principles of the two current major classification systems used in psychiatry (ICD-10 and DSM-5) are then outlined: the World Health Organization’s International Classification of Diseases (‘ICD-10’), and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (‘DSM-5’). Additional schemes, used in particular countries, are also briefly mentioned. Finally, the chapter summarizes how psychiatric classification may develop in the future, with particular reference to ICD-11, which is due in 2018 or 2019.

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Angststörungen – von der ICD-10 zur ICD-11

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000768 ◽

2020 ◽

pp. 1-5

Author(s):

Timo D. Vloet ◽

Marcel Romanos

Keyword(s):

Mental Disorders ◽

International Classification Of Diseases ◽

International Classification ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Dsm 5 ◽

Classification Of Diseases ◽

Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

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Four-Corner Arthrodesis versus Proximal Row Carpectomy: Risk Factors and Complications Associated with Prolonged Postoperative Opioid Use

Journal of Hand and Microsurgery ◽

10.1055/s-0040-1715426 ◽

2020 ◽

Author(s):

Neill Y. Li ◽

Alexander S. Kuczmarski ◽

Andrew M. Hresko ◽

Avi D. Goodman ◽

Joseph A. Gil ◽

...

Keyword(s):

Risk Factors ◽

International Classification Of Diseases ◽

Opioid Use ◽

Proximal Row Carpectomy ◽

Use Patterns ◽

Patient Demographics ◽

Implant Complications ◽

Increased Risk ◽

Classification Of Diseases

Abstract Introduction This article compares opioid use patterns following four-corner arthrodesis (FCA) and proximal row carpectomy (PRC) and identifies risk factors and complications associated with prolonged opioid consumption. Materials and Methods The PearlDiver Research Program was used to identify patients undergoing primary FCA (Current Procedural Terminology [CPT] codes 25820, 25825) or PRC (CPT 25215) from 2007 to 2017. Patient demographics, comorbidities, perioperative opioid use, and postoperative complications were assessed. Opioids were identified through generic drug codes while complications were defined by International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification codes. Multivariable logistic regressions were performed with p < 0.05 considered statistically significant. Results A total of 888 patients underwent FCA and 835 underwent PRC. Three months postoperatively, more FCA patients (18.0%) continued to use opioids than PRC patients (14.7%) (p = 0.033). Preoperative opioid use was the strongest risk factor for prolonged opioid use for both FCA (odds ratio [OR]: 4.91; p < 0.001) and PRC (OR: 6.33; p < 0.001). Prolonged opioid use was associated with an increased risk of implant complications (OR: 4.96; p < 0.001) and conversion to total wrist arthrodesis (OR: 3.55; p < 0.001) following FCA. Conclusion Prolonged postoperative opioid use is more frequent in patients undergoing FCA than PRC. Understanding the prevalence, risk factors, and complications associated with prolonged postoperative opioid use after these procedures may help physicians counsel patients and implement opioid minimization strategies preoperatively.

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Depression

10.1093/oso/9780198801900.003.0004 ◽

2017 ◽

Author(s):

Philip Cowen

Keyword(s):

International Classification Of Diseases ◽

Behavioural Therapy ◽

Historical Background ◽

Cognitive Behavioural ◽

Classification Of Diseases ◽

Icd 10 ◽

Diagnosis And Classification ◽

Modern Experience ◽

Symptoms And Signs

This chapter discusses the symptomatology, diagnosis, and classification of depression. It begins with a brief historical background on depression, tracing its origins to the classical term ‘melancholia’ that describes symptoms and signs now associated with modern concepts of the condition. It then considers the phenomenology of the modern experience of depression, its diagnosis in the operational scheme of ICD-10 (International Classification of Diseases, tenth edition), and current classificatory schemes. It looks at the symptoms needed to meet the criteria for ‘depressive episode’ in ICD-10, as well as clinical features of depression with ‘melancholic’ features or ‘somatic depression’ in ICD-10. It also presents an outline of the clinical assessment of an episode of depression before concluding with an overview of issues that need to be taken into account when addressing approaches to treatment, including cognitive behavioural therapy and the administration of antidepressants.

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Neue Terminologie für Sprachentwicklungsstörungen?

Monatsschrift Kinderheilkunde ◽

10.1007/s00112-021-01148-2 ◽

2021 ◽

Author(s):

K. Neumann ◽

B. Arnold ◽

A. Baumann ◽

C. Bohr ◽

H. A. Euler ◽

...

Keyword(s):

International Classification Of Diseases ◽

International Classification ◽

International Classification Of Disease ◽

Diagnostik Und Therapie ◽

Classification Of Diseases ◽

Icd 10

Zusammenfassung Hintergrund Sprachtherapeutisch-linguistische Fachkreise empfehlen die Anpassung einer von einem internationalen Konsortium empfohlenen Änderung der Nomenklatur für Sprachstörungen im Kindesalter, insbesondere für Sprachentwicklungsstörungen (SES), auch für den deutschsprachigen Raum. Fragestellung Ist eine solche Änderung in der Terminologie aus ärztlicher und psychologischer Sicht sinnvoll? Material und Methode Kritische Abwägung der Argumente für und gegen eine Nomenklaturänderung aus medizinischer und psychologischer Sicht eines Fachgesellschaften- und Leitliniengremiums. Ergebnisse Die ICD-10-GM (Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification) und eine S2k-Leitlinie unterteilen SES in umschriebene SES (USES) und SES assoziiert mit anderen Erkrankungen (Komorbiditäten). Die USES- wie auch die künftige SES-Definition der ICD-11 (International Classification of Diseases 11th Revision) fordern den Ausschluss von Sinnesbehinderungen, neurologischen Erkrankungen und einer bedeutsamen intellektuellen Einschränkung. Diese Definition erscheint weit genug, um leichtere nonverbale Einschränkungen einzuschließen, birgt nicht die Gefahr, Kindern Sprach- und weitere Therapien vorzuenthalten und erkennt das ICD(International Classification of Disease)-Kriterium, nach dem der Sprachentwicklungsstand eines Kindes bedeutsam unter der Altersnorm und unterhalb des seinem Intelligenzalter angemessenen Niveaus liegen soll, an. Die intendierte Ersetzung des Komorbiditäten-Begriffs durch verursachende Faktoren, Risikofaktoren und Begleiterscheinungen könnte die Unterlassung einer dezidierten medizinischen Differenzialdiagnostik bedeuten. Schlussfolgerungen Die vorgeschlagene Terminologie birgt die Gefahr, ätiologisch bedeutsame Klassifikationen und differenzialdiagnostische Grenzen zu verwischen und auf wertvolles ärztliches und psychologisches Fachwissen in Diagnostik und Therapie sprachlicher Störungen im Kindesalter zu verzichten.

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Validation of ICD-10-CM codes for injuries complicating pregnancy, childbirth and the puerperium: a medical record review

Injury Prevention ◽

10.1136/injuryprev-2019-043512 ◽

2021 ◽

Vol 27 (Suppl 1) ◽

pp. i9-i12

Author(s):

Anna Hansen ◽

Dana Quesinberry ◽

Peter Akpunonu ◽

Julia Martin ◽

Svetla Slavova

Keyword(s):

Emergency Department ◽

Medical Record ◽

International Classification Of Diseases ◽

Medical Record Review ◽

Full Sample ◽

Emergency Department Data ◽

Classification Of Diseases ◽

Icd 10 ◽

Record Review

IntroductionThe purpose of this study was to estimate the positive predictive value (PPV) of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for injury, poisoning, physical or sexual assault complicating pregnancy, childbirth and the puerperium (PCP) to capture injury encounters within both hospital and emergency department claims data.MethodsA medical record review was conducted on a sample (n=157) of inpatient and emergency department claims from one Kentucky healthcare system from 2015 to 2017, with any diagnosis in the ICD-10-CM range O9A.2-O9A.4. Study clinicians reviewed medical records for the sampled cases and used an abstraction form to collect information on documented presence of injury and PCP complications. The study estimated the PPVs and the 95% CIs of O9A.2-O9A.4 codes for (1) capturing injuries and (2) capturing injuries complicating PCP.ResultsThe estimated PPV for the codes O9A.2-O9A.4 to identify injury in the full sample was 79.6% (95% CI 73.3% to 85.9%) and the PPV for capturing injuries complicating PCP was 72.0% (95% CI 65.0% to 79.0%). The estimated PPV for an inpatient principal diagnosis O9A.2-O9A.4 to capture injuries was 90.7% (95% CI 82.0% to 99.4%) and the PPV for capturing injuries complicating PCP was 88.4% (95% CI 78.4% to 98.4%). The estimated PPV for any mention of O9A.2-O9A.4 in emergency department data to capture injuries was 95.2% (95% CI 90.6% to 99.9%) and the PPV for capturing injuries complicating PCP was 81.0% (95% CI 72.4% to 89.5%).DiscussionThe O9A.2-O9A.4 codes captured high percentage true injury cases among pregnant and puerperal women.

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