scholarly journals Using a retrospective cross-sectional study to analyse unintentional fatal drowning in Australia: ICD-10 coding-based methodologies verses actual deaths

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e019407 ◽  
Author(s):  
Amy E Peden ◽  
Richard C Franklin ◽  
Alison J Mahony ◽  
Justin Scarr ◽  
Paul D Barnsley
Keyword(s):  
Causes Of Death ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Life Saving ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Underlying Causes ◽  
Icd Codes ◽  
Underlying Cause Of Death

ObjectivesFatal drowning estimates using a single underlying cause of death (UCoD) may under-represent the number of drowning deaths. This study explores how data vary by International Classification of Diseases (ICD)-10 coding combinations and the use of multiple underlying causes of death using a national register of drowning deaths.DesignAn analysis of ICD-10 external cause codes of unintentional drowning deaths for the period 2007–2011 as extracted from an Australian total population unintentional drowning database developed by Royal Life Saving Society—Australia (the Database). The study analysed results against three reporting methodologies: primary drowning codes (W65-74), drowning-related codes, plus cases where drowning was identified but not the UCoD.SettingAustralia, 2007–2011.ParticipantsUnintentional fatal drowning cases.ResultsThe Database recorded 1428 drowning deaths. 866 (60.6%) had an UCoD of W65-74 (accidental drowning), 249 (17.2%) cases had an UCoD of either T75.1 (0.2%), V90 (5.5%), V92 (3.5%), X38 (2.4%) or Y21 (5.9%) and 53 (3.7%) lacked ICD coding. Children (aged 0–17 years) were closely aligned (73.9%); however, watercraft (29.2%) and non-aquatic transport (13.0%) were not. When the UCoD and all subsequent causes are used, 67.2% of cases include W65-74 codes. 91.6% of all cases had a drowning code (T75.1, V90, V92, W65-74, X38 and Y21) at any level.ConclusionDefining drowning with the codes W65-74 and using only the UCoD captures 61% of all drowning deaths in Australia. This is unevenly distributed with adults, watercraft and non-aquatic transport-related drowning deaths under-represented. Using a wider inclusion of ICD codes, which are drowning-related and multiple causes of death minimises this under-representation. A narrow approach to counting drowning deaths will negatively impact the design of policy, advocacy and programme planning for prevention.

scholarly journals Understanding the full burden of drowning: a retrospective, cross-sectional analysis of fatal and non-fatal drowning in Australia

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e024868 ◽  
Author(s):  
Amy E Peden ◽  
Alison J Mahony ◽  
Paul D Barnsley ◽  
Justin Scarr
Keyword(s):  
Best Practice ◽  
Case Fatality ◽  
Population Level ◽  
International Classification Of Diseases ◽  
Cross Sectional ◽  
Life Saving ◽  
Classification Of Diseases ◽  
Icd Codes ◽  
Hospital Morbidity ◽  
Sectional Analysis

ObjectivesThe epidemiology of fatal drowning is increasingly understood. By contrast, there is relatively little population-level research on non-fatal drowning. This study compares data on fatal and non-fatal drowning in Australia, identifying differences in outcomes to guide identification of the best practice in minimising the lethality of exposure to drowning.DesignA subset of data on fatal unintentional drowning from the Royal Life Saving National Fatal Drowning Database was compared on a like-for-like basis to data on hospital separations sourced from the Australian Institute of Health and Welfare’s National Hospital Morbidity Database for the 13-year period 1 July 2002 to 30 June 2015. A restrictive definition was applied to the fatal drowning data to estimate the effect of the more narrow inclusion criteria for the non-fatal data (International Classification of Diseases (ICD) codes W65-74 and first reported cause only). Incidence and ratios of fatal to non-fatal drowning with univariate and Χ2 analysis are reported and used to calculate case-fatality rates.SettingAustralia, 1 July 2002 to 30 June 2015.ParticipantsUnintentional fatal drowning cases and cases of non-fatal drowning resulting in hospital separation.Results2272 fatalities and 6158 hospital separations occurred during the study period, a ratio of 1:2.71. Children 0–4 years (1:7.63) and swimming pools (1:4.35) recorded high fatal to non-fatal ratios, whereas drownings among people aged 65–74 years (1:0.92), 75+ years (1:0.87) and incidents in natural waterways (1:0.94) were more likely to be fatal.ConclusionsThis study highlights the extent of the drowning burden when non-fatal incidents are considered, although coding limitations remain. Documenting the full burden of drowning is vital to ensuring that the issue is fully understood and its prevention adequately resourced. Further research examining the severity of non-fatal drowning cases requiring hospitalisation and tracking outcomes of those discharged will provide a more complete picture.

scholarly journals Validating Coding for the Identification of Pediatric Treatment Resistant Epilepsy Patients

2021 ◽  
Vol 8 ◽  
pp. 2329048X2110378
Author(s):  
Daniel A. Freedman ◽  
Zachary Grinspan ◽  
Peter Glynn ◽  
Jackson Mittlesteadt ◽  
Alex Dawes ◽  
...  
Keyword(s):  
Refractory Epilepsy ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
Absence Epilepsy ◽  
Treatment Resistant ◽  
Cross Sectional ◽  
Classification Of Diseases ◽  
Icd Codes ◽  
Pediatric Treatment

The International Classification of Diseases (ICD) system includes sub codes to indicate that an individual with epilepsy is treatment resistant. These codes would be a valuable tool to identify individuals for quality improvement and population health, as well as for recruitment into clinical trials. However, the accuracy of these codes is unclear. We performed a single center cross sectional study to understand the accuracy of ICD codes for treatment resistant epilepsy. We identified 344 individuals, roughly half with treatment resistant epilepsy The ICD code had a sensitivity of 90% (147 of 164) and specificity of 86% (155 of 180). The miscoding of children with refractory epilepsy was attributed to the following reasons: 5 patients had epilepsy surgery, 4 had absence epilepsy, 4 patients were seen by different providers, and 1 patient was most recently seen in movement disorders clinic. ICD codes accurately identify children with treatment resistant epilepsy.

scholarly journals Comparative evaluation of underlying causes of death processed by the Automated Classification of Medical Entities and the Underlying Cause of Death Selection Systems

1998 ◽  
Vol 32 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Augusto H. Santo ◽  
Celso E. Pinheiro ◽  
Eliana M. Rodrigues
Keyword(s):  
Cause Of Death ◽  
Comparative Evaluation ◽  
Causes Of Death ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Automated Classification ◽  
Classification Of Diseases ◽  
Underlying Causes ◽  
Underlying Cause Of Death

INTRODUCTION: The correct identification of the underlying cause of death and its precise assignment to a code from the International Classification of Diseases are important issues to achieve accurate and universally comparable mortality statistics These factors, among other ones, led to the development of computer software programs in order to automatically identify the underlying cause of death. OBJECTIVE: This work was conceived to compare the underlying causes of death processed respectively by the Automated Classification of Medical Entities (ACME) and the "Sistema de Seleção de Causa Básica de Morte" (SCB) programs. MATERIAL AND METHOD: The comparative evaluation of the underlying causes of death processed respectively by ACME and SCB systems was performed using the input data file for the ACME system that included deaths which occurred in the State of S. Paulo from June to December 1993, totalling 129,104 records of the corresponding death certificates. The differences between underlying causes selected by ACME and SCB systems verified in the month of June, when considered as SCB errors, were used to correct and improve SCB processing logic and its decision tables. RESULTS: The processing of the underlying causes of death by the ACME and SCB systems resulted in 3,278 differences, that were analysed and ascribed to lack of answer to dialogue boxes during processing, to deaths due to human immunodeficiency virus [HIV] disease for which there was no specific provision in any of the systems, to coding and/or keying errors and to actual problems. The detailed analysis of these latter disclosed that the majority of the underlying causes of death processed by the SCB system were correct and that different interpretations were given to the mortality coding rules by each system, that some particular problems could not be explained with the available documentation and that a smaller proportion of problems were identified as SCB errors. CONCLUSION: These results, disclosing a very low and insignificant number of actual problems, guarantees the use of the version of the SCB system for the Ninth Revision of the International Classification of Diseases and assures the continuity of the work which is being undertaken for the Tenth Revision version.

scholarly journals Garbage codes as causes of death and quality of mortality statistics in Belo Horizonte, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Ishitani ◽  
R Teixeira ◽  
D Abreu ◽  
L Paixão ◽  
E França
Keyword(s):  
Causes Of Death ◽  
Health Planning ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Mortality Statistics ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Hospital Deaths ◽  
Belo Horizonte

Abstract Background Quality of cause-of-death information is fundamental for health planning. Traditionally, this quality has been assessed by the analysis of ill-defined causes from chapter XVIII of the International Classification of Diseases - 10th revision (ICD-10). However, studies have considered other useless diagnoses for public health purposes, defined, in conjunction with ill-defined causes, as garbage codes (GC). In Brazil, despite the high completeness of the Mortality Information System, approximately 30% of deaths are attributable to GCs. This study aims to analyze the frequency of GCs in Belo Horizonte municipality, the capital of Minas Gerais state, Brazil. Methods Data of deaths from 2011 to 2013 in Belo Horizonte were analyzed. GCs were classified according to the GBD 2015 study list. These codes were classified in: a) GCs from chapter XVIII of ICD-10 (GC-R), and b) GC from other chapters of ICD-10 (GC-nonR). Proportions of GC were calculated by sex, age, and place of occurrence. Results In Belo Horizonte, from the total of 44,123 deaths, 5.5% were classified as GC-R. The majority of GCs were GC-nonR (25% of total deaths). We observed a higher proportion of GC in children (1 to 4 years) and in people aged over 60 years. GC proportion was also higher in females, except in the age-groups under 1 year and 30-59 years. Home deaths (n = 7,760) had higher proportions of GCs compared with hospital deaths (n = 30,182), 36.9% and 28.7%, respectively. The leading GCs were the GC-R other ill-defined and unspecified causes of death (ICD-10 code R99)), and the GCs-nonR unspecified pneumonia (J18.9), unspecified stroke (I64), and unspecified septicemia (A41.9). Conclusions Analysis of GCs is essential to evaluate the quality of mortality information. Key messages Analysis of ill-defined causes (GC-R) is not sufficient to evaluate the quality of information on causes of death. Causes of death analysis should consider the total GC, in order to advance the discussion and promote adequate intervention on the quality of mortality statistics.

scholarly journals ELEVATED UNCONJUGATED BILIRUBIN IN SCHIZOPHRENIC PATIENTS

2018 ◽  
Vol 3 (1) ◽  
pp. 20
Author(s):  
Ilhamuddin Aziz ◽  
Yuyun Widaningsih ◽  
Rosdiana Natzir ◽  
A. Jayalangkara Tanra
Keyword(s):  
Total Bilirubin ◽  
International Classification Of Diseases ◽  
Cross Sectional ◽  
Elevated Liver Enzymes ◽  
Two Samples ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Schizophrenic Patients ◽  
Schizophrenic Group ◽  
Cross Sectional Design

Strategies for schizophrenic treatment still have been developed in order to increase their effectively, based on latest findings in the etio-pathology. Coincidence of hyperbilirubinemia, especially related to Gilbert’s Syndrome (GS), and schizophrenia/other psychiatric disorders, was reported in several studies although the pattern of this alteration is still controversial.  Bilirubin could induce microglia to release pro-inflammatory cytokine that cause neuroinflammation, one of hypothetic etio-pathogenesis has been the most extensively studied recently. However, no data have been presented about this phenomenon in Indonesia. Therefore, this study aims to investigate plasma bilirubin concentration in psychotic spectrum.This study is cross sectional design that we examined both the total bilirubin and direct bilirubin of every psychotic patient admitted for the first time to Rumah Sakit Khusus Daerah (RSKD) Provinsi Sulawesi Selatan over a period of July—December 2012, by using health people as control. Diagnostic determination was set based on International Classification of Diseases (ICD) 10. Patients suffering from any disease such as anemia (decreased hemoglobin), liver diseases (elevated liver enzymes), or substance abuse were excluded.            From 73 samples, we found that plasma UCB level was significantly elevated, higher in psychotic patients, especially schizophrenic group, than in the control. Total bilirubin rate was slightly increased in schizophrenic group compare to the others and two samples in this group showed hyperbilirubinemia. Further investigations are needed to ensure that whether the elevated UCB was related to GS and whether this condition has inflammatory effect.

scholarly journals Comparative analysis of methods for identifying multimorbidity patterns: a study of ‘real-world’ data

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018986 ◽  
Author(s):  
Albert Roso-Llorach ◽  
Concepción Violán ◽  
Quintí Foguet-Boreu ◽  
Teresa Rodriguez-Blanco ◽  
Mariona Pons-Vigués ◽  
...  
Keyword(s):  
Real World ◽  
Hierarchical Cluster ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
Real World Data ◽  
Cross Sectional ◽  
World Data ◽  
Data Usage ◽  
Classification Of Diseases ◽  
Depth Study

ObjectiveThe aim was to compare multimorbidity patterns identified with the two most commonly used methods: hierarchical cluster analysis (HCA) and exploratory factor analysis (EFA) in a large primary care database. Specific objectives were: (1) to determine whether choice of method affects the composition of these patterns and (2) to consider the potential application of each method in the clinical setting.DesignCross-sectional study. Diagnoses were based on the 263 corresponding blocks of the International Classification of Diseases version 10. Multimorbidity patterns were identified using HCA and EFA. Analysis was stratified by sex, and results compared for each method.Setting and participantsElectronic health records for 408 994 patients with multimorbidity aged 45–64 years in 274 primary health care teams from 2010 in Catalonia, Spain.ResultsHCA identified 53 clusters for women, with just 12 clusters including at least 2 diagnoses, and 15 clusters for men, all of them including at least two diagnoses. EFA showed 9 factors for women and 10 factors for men. We observed differences by sex and method of analysis, although some patterns were consistent. Three combinations of diseases were observed consistently across sex groups and across both methods: hypertension and obesity, spondylopathies and deforming dorsopathies, and dermatitis eczema and mycosis.ConclusionsThis study showed that multimorbidity patterns vary depending on the method of analysis used (HCA vs EFA) and provided new evidence about the known limitations of attempts to compare multimorbidity patterns in real-world data studies. We found that EFA was useful in describing comorbidity relationships and HCA could be useful for in-depth study of multimorbidity. Our results suggest possible applications for each of these methods in clinical and research settings, and add information about some aspects that must be considered in standardisation of future studies: spectrum of diseases, data usage and methods of analysis.

scholarly journals La reconstrucción de las causas de muerte por el método MODICOD en el  análisis demográfico-sanitario. De la CIE-9 a la CIE-10 a un nivel de cuarto dígito

2018 ◽  
pp. 167
Author(s):  
Aina Faus-Bertomeu ◽  
Rosa Gómez-Redondo
Keyword(s):  
Causes Of Death ◽  
International Classification Of Diseases ◽  
Epidemiological Transition ◽  
Health Transition ◽  
Fourth Digit ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
La Red ◽  
First Time

A pesar del conocimiento acumulado sobre mortalidad y longevidad se hace imprescindible conocer con mayor profundidad la cuarta fase de la Transición Epidemiológica en la que se encuentra España, como otros países de su entorno, para anticipar la emergencia de un nuevo escalón en la Transición Sanitaria así como su impacto social en los años venideros. Para ello, se precisa del análisis de datos de mortalidad por  causas de muerte con el objeto de seguir su evolución y cambios. No obstante la codificación de las causas de muerte se interrumpe con las sucesivas revisiones a la Clasificación Internacional de Enfermedades (CIE). Por ello, se utiliza la metodología de la reconstrucción de causas de muerte propuesta por France Meslé y Jacques Vallin (1988, 1996), de aplicación en la comunidad científica de los países que forman parte de la red internacional Mortality, Divergence and Causes of Death (MODICOD) y en la que las autoras participan en representación de España. El presente trabajo describe las fases de dicho protocolo y lo ejemplifica con los datos de causas de muerte españolas para el periodo 1980- 2012, reconstruyendo las series entre la CIE-9 y la CIE-10. Los resultados obtenidos garantizan el seguimiento de 6.902 rúbricas de causas de muerte continuas y homogeneizadas que por primera vez se establece a nivel de desagregación del cuarto dígito de la CIE-10 configurándose como un instrumento metodológico en el análisis demográfico-epidemiológico.Despite the accumulated knowledge about mortality and longevity, it is essential to know in the depth of the fourth phase of the Epidemiological Transition in which Spain, like other neighboring countries, is in to anticipate a new step in the Health Transition as well as its impact in the coming years. In this context, the analysis of the data of the causes of death is necessary in order to follow its evolution and changes. However, the codification of causes of death is interrupted by the successive revisions to the International Classification of Diseases and Related Health Problems (ICD). For this reason, the methodology of the reconstruction of causes of death proposed by France Meslé and Jacques Vallin (1988, 1996) is used and applied in the countries that are part of the international network Mortality, Divergence and Causes of Death (MODICOD) and in which the authors participate in representation of Spain. The present work describes the phases of this protocol and exemplifies it with the date of Spanish causes of death for the period 1980 to 2015, reconstructing series between ICD-9 and ICD-10. The results obtained ensuring the monitoring of 6,902 rubrics of continuous and homogenized causes of death at a fourth digit level of the ICD-10, which for the first time is established at a level of the fourth digit of the ICD-10, that are configured as a demographic-epidemiological methodological instrument.

scholarly journals Colchicine Use Is Associated with Decreased Prevalence of Myocardial Infarction in Patients with Gout

2012 ◽  
Vol 39 (7) ◽  
pp. 1458-1464 ◽  
Author(s):  
DARIA B. CRITTENDEN ◽  
R. AARON LEHMANN ◽  
LAURA SCHNECK ◽  
ROBERT T. KEENAN ◽  
BINITA SHAH ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
New York ◽  
Statistical Significance ◽  
International Classification Of Diseases ◽  
Serum Urate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
All Cause Mortality ◽  
Classification Of Diseases ◽  
Level Versus

Objective.The ability of antiinflammatory strategies to alter cardiovascular risk has not been rigorously examined. Colchicine is an antiinflammatory agent that affects macrophages, neutrophils, and endothelial cells, all of which are implicated in the pathogenesis of cardiovascular disease. We examined whether colchicine use was associated with a reduced risk of myocardial infarction (MI) in patients with gout.Methods.We conducted a retrospective, cross-sectional study of all patients with an International Classification of Diseases, 9th ed, code for gout in the electronic medical record (EMR) of the New York Harbor Healthcare System Veterans Affairs network and ≥ 1 hospital visit between August 2007 and August 2008. Hospital pharmacy data were used to identify patients who had filled at least 1 colchicine prescription versus those who had not. Demographics and CV comorbidities were collected by EMR review. The primary outcome was diagnosis of MI. Secondary outcomes included all-cause mortality and C-reactive protein (CRP) level.Results.In total, 1288 gout patients were identified. Colchicine (n = 576) and no colchicine (n = 712) groups had similar baseline demographics and serum urate levels. Prevalence of MI was 1.2% in the colchicine versus 2.6% in the no-colchicine group (p = 0.03). Colchicine users also had fewer deaths and lower CRP levels, although these did not achieve statistical significance. Colchicine effects persisted when allopurinol users were excluded from the analysis.Conclusion.In this hypothesis-generating study, gout patients who took colchicine had a significantly lower prevalence of MI and exhibited trends toward reduced all-cause mortality and lower CRP level versus those who did not take colchicine.

scholarly journals DEPRESSION AND ANXIETY IN CORRELATION TO BODY AREAS INVOLVED IN PATIENTS OF BURNS

2021 ◽  
Vol 71 (3) ◽  
pp. 734-38
Author(s):  
Ghazanfar Ali ◽  
Sikander Ali Khan ◽  
Muzzafar Ahmed ◽  
Muhammad Sheraz Afzal Malik ◽  
Danish Almas ◽  
...  
Keyword(s):  
Severe Depression ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Military Hospital ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
High Prevalence ◽  
Classification Of Diseases ◽  
Burns Unit

Objective: To evaluate the severity of depression and anxiety among patients of burns and correlate depression and anxiety with areas of body involved in burns. Study Design: A cross-sectional study. Place and Duration of Study: The departments of Psychiatry and department of Plastic Surgery, Combined Military Hospital Multan, from Oct 2019 to Mar 2020. Methodology: Through consecutive sampling, 56 patients of burns reporting to burns unit were assessed for anxiety and/ or depression based on the diagnostic criteria of International Classification of Diseases version 10. Symptom severity was assessed using Beck Depressive Inventory for depression and Beck Anxiety Inventory for anxiety. Descriptive statistics like mean with standard deviation was calculated for age. Frequency along with percentages was calculated for sociodemographic variables, Anxiety and depression. Results: Depression was present among 30 (53%) of participants out of which 16 (53.5%) had mild, 11 (37.9%) had moderate while only 3 (12.5%) had severe depression. Anxiety was seen among 50 (89%) of participants out of which sixteen (32.1%) had mild, 26 (51.7%) had moderate while 8 (16%) had severe anxiety. Significant correlation existed among the major area involved in burn with both anxiety and depression (p<0.01). Conclusion: There is a very high prevalence of anxiety and depression among patients of burn. Significant positive correlation existed between the level of anxiety and the areas involved in burns.

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