scholarly journals Towards a national perioperative clinical quality registry: The diagnostic accuracy of administrative data in identifying major postoperative complications

2020 ◽  
Vol 48 (3) ◽  
pp. 203-212 ◽  
Author(s):  
Jennifer R Reilly ◽  
Mark A Shulman ◽  
Annie M Gilbert ◽  
Bismi Jomon ◽  
Robin J Thompson ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Administrative Data ◽  
Clinical Audit ◽  
Hospital Performance ◽  
Clinical Quality ◽  
Quality Registry ◽  
Alfred Hospital ◽  
Classification Of Diseases ◽  
International Statistical Classification

Accurately measuring the incidence of major postoperative complications is essential for funding and reimbursement of healthcare providers, for internal and external benchmarking of hospital performance and for valid and reliable public reporting of outcomes. Actual or surrogate outcomes data are typically obtained by one of three methods: clinical quality registries, clinical audit, or administrative data. In 2017 a perioperative registry was developed at the Alfred Hospital and mapped to administrative and clinical data. This study investigated the statistical agreement between administrative data (International Statistical Classification of Diseases and Related Health Problems (10th edition) Australian Modification codes) and clinical audit by anaesthetists in identifying major postoperative complications. The study population included 482 high-risk surgical patients referred to the Alfred Hospital anaesthesia postoperative service over two years. Clinical audit was conducted to determine the presence of major complications and these data were compared to administrative data. The main outcome was statistical agreement between the two methods, as defined by Cohen’s kappa statistic. Substantial agreement was observed for five major complications, moderate agreement for three, fair agreement for six and poor agreement for two. Sensitivity and positive predictive value ranged from 0 to 100%. Specificity was above 90% for all complications. There was important variation in inter-rater agreement. For four of the five complications with substantial agreement between administrative data and clinical audit, sensitivity was only moderate (61.5%–75%). Using International Statistical Classification of Diseases and Related Health Problems (10th edition) Australian Modification codes to identify postoperative complications at our hospital has high specificity but is likely to underestimate the incidence compared to clinical audit. Further, retrospective clinical audit itself is not a highly reliable method of identifying complications. We believe a perioperative clinical quality registry is necessary to validly and reliably measure major postoperative complications in Australia for benchmarking of hospital performance and before public reporting of outcomes should be considered.

Die Wirksamkeit eines Frühinterventionsprogramms für Jugendliche mit Computerspiel- und Internetabhängigkeit: Mittelfristige Effekte der PROTECT+ Studie

2020 ◽  
Vol 48 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Carolin Szász-Janocha ◽  
Eva Vonderlin ◽  
Katajun Lindenberg
Keyword(s):  
Internet Use ◽  
Health Problems ◽  
Reliable Change Index ◽  
Gaming Disorder ◽  
Statistical Classification ◽  
Reliable Change ◽  
Classification Of Diseases ◽  
International Statistical Classification

Zusammenfassung. Fragestellung: Das junge Störungsbild der Computerspiel- und Internetabhängigkeit hat in den vergangenen Jahren in der Forschung zunehmend an Aufmerksamkeit gewonnen. Durch die Aufnahme der „Gaming Disorder“ in die ICD-11 (International Statistical Classification of Diseases and Related Health Problems) wurde die Notwendigkeit von evidenzbasierten und wirksamen Interventionen avanciert. PROTECT+ ist ein kognitiv-verhaltenstherapeutisches Gruppentherapieprogramm für Jugendliche mit Symptomen der Computerspiel- und Internetabhängigkeit. Die vorliegende Studie zielt auf die Evaluation der mittelfristigen Effekte nach 4 Monaten ab. Methodik: N = 54 Patientinnen und Patienten im Alter von 9 bis 19 Jahren (M = 13.48; SD = 1.72) nahmen an der Frühinterventionsstudie zwischen April 2016 und Dezember 2017 in Heidelberg teil. Die Symptomschwere wurde zu Beginn, zum Abschluss der Gruppentherapie sowie nach 4 Monaten anhand von standardisierten Diagnostikinstrumenten erfasst. Ergebnisse: Mehrebenenanalysen zeigten eine signifikante Reduktion der Symptomschwere anhand der Computerspielabhängigkeitsskala (CSAS) nach 4 Monaten. Im Selbstbeurteilungsbogen zeigte sich ein kleiner Effekt (d = 0.35), im Elternurteil ein mittlerer Effekt (d = 0.77). Der Reliable Change Index, der anhand der Compulsive Internet Use Scale (CIUS) berechnet wurde, deutete auf eine starke Heterogenität im individuellen Symptomverlauf hin. Die Patientinnen und Patienten bewerteten das Programm zu beiden Follow-Up-Messzeitpunkten mit einer hohen Zufriedenheit. Schlussfolgerungen: Die vorliegende Arbeit stellt international eine der wenigen Studien dar, die eine Reduktion der Symptome von Computerspiel- und Internetabhängigkeit im Jugendalter über 4 Monate belegen konnte.

scholarly journals Application of MRI for the Diagnosis of Neoplasms

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ewa Bejer-Oleńska ◽  
Michael Thoene ◽  
Andrzej Włodarczyk ◽  
Joanna Wojtkiewicz
Keyword(s):  
Benign Neoplasms ◽  
Young Males ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Mri Scans ◽  
International Statistical Classification ◽  
The Central Nervous System ◽  
Spss Software ◽  
The Brain

Aim. The aim of the study was to determine the most commonly diagnosed neoplasms in the MRI scanned patient population and indicate correlations based on the descriptive variables. Methods. The SPSS software was used to determine the incidence of neoplasms within the specific diagnoses based on the descriptive variables of the studied population. Over a five year period, 791 patients and 839 MRI scans were identified in neoplasm category (C00-D48 according to the International Statistical Classification of Diseases and Related Health Problems ICD-10). Results. More women (56%) than men (44%) represented C00-D48. Three categories of neoplasms were recorded. Furthermore, benign neoplasms were the most numerous, diagnosed mainly in patients in the fifth decade of life, and included benign neoplasms of the brain and other parts of the central nervous system. Conclusions. Males ≤ 30 years of age with neoplasms had three times higher MRI scans rate than females of the same age group; even though females had much higher scans rate in every other category. The young males are more often selected for these scans if a neoplasm is suspected. Finally, the number of MRI-diagnosed neoplasms showed a linear annual increase.

scholarly journals Zmiany kryteriów w diagnozowaniu zaburzeń związanych z hazardem oraz uzależnień chemicznych i czynnościowych

2017 ◽  
Vol 12 ◽  
pp. 91
Author(s):  
Iwona Niewiadomska ◽  
Agnieszka Palacz-Chrisidis
Keyword(s):  
Mental Disorders ◽  
Health Problems ◽  
Statistical Classification ◽  
Addictive Disorders ◽  
Statistical Manual ◽  
Dsm V ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
International Statistical Classification

Autorki poruszają kwestię zmian w kryteriach diagnostycznych dotyczących zaburzeń związanych z hazardem oraz uzależnień chemicznych i czynnościowych w literaturze przedmiotu. Prezentują też krótki przegląd kolejnych edycji podręczników międzynarodowych klasyfikacji, zarówno Diagnostics and Statistical Manual of Mental Disorders – DSM, jak i The International Statistical Classification of Diseases and Related Health Problems – ICD. W artykule przedstawiona jest również dyskusja badaczy na temat umiejscowienia zaburzeń związanych z hazardem w klasyfikacjach diagnostycznych. DSM-V umiejscawia zaburzenie hazardowe w kategorii „zaburzenia używania substancji i nałogów” (ang. Substance-Related and Addictive Disorders, DSM-V), w podkategorii „zaburzenia niezwiązane z substancjami” (ang. Non-Substace Related Disorders, DSM-V). Natomiast według nadal obowiązującego ICD-10, zaburzenie hazardowe pozostaje w obszarze zaburzeń kontroli i impulsów, pod nazwą „hazard patologiczny”.

PUBLIC HEALTH, NURSING, AND MEDICAL SOCIAL WORK

PEDIATRICS ◽  
1959 ◽  
Vol 23 (4) ◽  
pp. 761-765
Author(s):  
Myron E. Wegman
Keyword(s):  
Causes Of Death ◽  
Geographic Area ◽  
Final Diagnosis ◽  
International Classification Of Diseases ◽  
Limiting Factor ◽  
Standard Nomenclature ◽  
Classification Of Diseases ◽  
International Statistical Classification ◽  
Health Nursing

Every physician who has been through an internship is familiar with the Standard Nomenclature of Diseases and Operations. Far fewer know the International Statistical Classification of Diseases, Injuries and Causes of Death or appreciate the relationship between the two. Official inauguration of the use of the Seventh Revision of the International Classification of Diseases on January 1, 1958 offers occasion for reviewing some of the considerations affecting the proper naming and classification of diseases and causes of death. It is necessary to clarify the distinction between a "nomenclature" and a "classification." A nomenclature is a list of all terms considered satisfactory in medical usage at the time the nomenclature was prepared. Its primary purpose is to promote use of the same name for the same disease, a necessity for comparability of reports and effective study of a disease. To achieve such uniformity there must be some background of usage and custom, as well as a systematic reference work to help the physician arrive at and use the standard term as a final diagnosis for his case. The Standard Nomenclature of Diseases and Operations of the American Medical Association is in practically universal use in the major institutions of the U. S. A. The Nomenclature itself, while detailed and inevitably complicated by extent of coverage and inclusiveness, follows such a logical pattern that under the pressure of institutional rules and routines it is not difficult to use the system efficiently. Individual physicians, however, are not so disposed to spend the time necessary to follow the Nomenclature and tend rather to use the terminology popular in the geographic area where they are working. Development of local terminologies and usages is perhaps the greatest limiting factor militating against a really general nomenclature.

scholarly journals Fall-related deaths among older adults in British Columbia: cause and effect of policy change

2019 ◽  
Vol 26 (5) ◽  
pp. 412-416 ◽  
Author(s):  
Aayushi Joshi ◽  
Fahra Rajabali ◽  
Kate Turcotte ◽  
M Denise Beaton ◽  
Ian Pike
Keyword(s):  
British Columbia ◽  
Policy Change ◽  
Mortality Data ◽  
Reporting Practices ◽  
Change In Practice ◽  
Classification Of Diseases ◽  
International Statistical Classification ◽  
Underlying Causes ◽  
Causes Of Deaths

BackgroundThe British Columbia Coroners Service implemented a policy in 2010 advising the reclassification of underlying causes of deaths due to falls from ‘natural’ to ‘accidental’. This study investigates whether observed data trends reflect this change in practice, are artefacts of inconsistent reporting, or indicate a true increase in fall-related deaths.MethodsMortality data were analysed from 2004 to 2017 for cases with International Statistical Classification of Diseases and Related Health Problems, 10th Revision fall codes W00–W19, occurring among adults aged 60 years and older.ResultsFrom 2010 to 2012, accidental fall-related deaths increased among those aged 80 years and older, followed by an increase in natural deaths with fall as the contributing cause.ConclusionsChanges in reporting resulting from the 2010 policy change were observed; however, post-2012 data indicate a reversion to previous reporting practices.

scholarly journals Discretionary Surgery: A Comparison of Workers’ Compensation and Commercial Insurance

Hand ◽  
2018 ◽  
Vol 14 (1) ◽  
pp. 95-101 ◽  
Author(s):  
Bonheur A. T. D. van der Gronde ◽  
Tom J. Crijns ◽  
David Ring ◽  
Nina Leung
Keyword(s):  
Null Hypothesis ◽  
Claims Data ◽  
Anatomical Site ◽  
Workers Compensation ◽  
Statistical Classification ◽  
Commercial Insurance ◽  
Classification Of Diseases ◽  
International Statistical Classification ◽  
Procedure Codes

Background: Workers’ compensation is intended for injuries that occur at work and is expected to be mostly for trauma and mostly nondiscretionary conditions. We tested the null hypothesis that there is no difference in the ratio of likely discretionary to likely nondiscretionary surgery between patients treated under workers’ compensation compared with commercial insurance controlling for age, sex, and anatomical site for either traumatic or nontraumatic diagnoses. Methods: Using claims data from the Texas workers’ compensation database and Truven Health commercial claims we classified International Statistical Classification of Diseases and Related Health Problems, Ninth Revision, Clinical Modification (ICD-9-CM) diagnoses and procedure codes as likely discretionary or likely nondiscretionary, and as traumatic or nontraumatic. Ratios of likely discretionary to likely nondiscretionary surgery were calculated and compared. Results: Among patients treated under workers’ compensation, the ratio of likely discretionary to likely nondiscretionary surgery was significantly higher for traumatic diagnoses (0.57 [95% confidence interval, CI, = 0.56-0.61] vs 0.38 [95% CI = 0.37-0.40], P < .05) and significantly lower for nontraumatic diagnoses (9.4 [95% CI = 9.20-9.42] vs 13.2 [95% CI = 12.9-13.3], P < .05) compared with commercial insurance. Conclusions: Workers’ compensation often covers likely discretionary musculoskeletal surgery, and insurance type may influence treatment.

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