Construction of the Computerized Accident Registration System in a Casualty Department

1980 ◽  
Vol 8 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Risto Honkanen ◽  
Jarl-Erik Michelsson

The main benefit of computerized accident registration systems is that they assist, with the help of multi-dimensional cross-tabulation of variables, in the identification of high injury risk areas in the community. The E code of the International Classification of Diseases has been the traditional means for the causal classification of injuries. The applicability of its abridged version in ambulatory care settings was tested by the development of a classification with 50 accident type categories in the framework of the computerized statistics in a large casualty department treating more than 30000 new injuries annually. With maximally effective coding, the proportion of the ‘Other accidents’ category of the E code (E929) of all injuries can be reduced to 10%, but not less than that without its division into subcategories. Obviously, the E code should be further developed, better to meet the needs of ambulatory care. The registration system of this casualty department includes also a 15-category accident place classification, a 3-digit ICD diagnosis as well as demographic and time variables. In order to improve its problem identification power, accident object (agent) should still be added into its variable arsenal.

2021 ◽  
Vol 27 (S1) ◽  
pp. i19-i26
Author(s):  
Eduard A Poltavskiy ◽  
Susan H Fenton ◽  
Oluseun Atolagbe ◽  
Banafsheh Sadeghi ◽  
Heejung Bang ◽  
...  

IntroductionExternal cause of injury matrices is used to classify mechanisms/causes of injuries for surveillance and research. Little is known about the performance of the Centers for Disease Control and Prevention’s new external cause of injury matrix for Clinical Modification of the 10th Revision of the International Classification of Diseases (ICD-10-CM), compared with the ICD-9-CM version.MethodsDually coded (ICD-9-CM and ICD-10-CM) administrative data were obtained from two major academic trauma centres. Injury-related cases were identified and categorised by mechanism/cause and manner/intent. Comparability ratios (CR) were used to estimate the net impact of changing from ICD-9-CM to ICD-10-CM on the number of cases classified to each mechanism/cause category. Chamberlain’s percent positive agreements (PPA) were calculated and McNemar’s test was used to assess the significance of observed classification differences.ResultsOf 4832 and 5211 dual-coded records from the two centres, 632 and 520 with injury-related principal diagnoses and external cause codes in both ICD-9-CM and ICD-10-CM were identified. CRs for the mechanisms/causes with at least 20 records ranged from 0.85 to 1.9 at one centre and from 0.97 to 1.07 at the other. Among these mechanisms/causes, PPAs ranged from 33% for ‘other transport’ to 94% for poisoning at one centre, and from 75% for ‘other transport’ to 100% for fires/burns at the other centre. Case assignment differed significantly for falls, motor vehicle traffic, other transport, and ‘struck by/against’ injuries at one centre, and for ‘other pedal cyclist’ at the other centre.ConclusionSwitching to ICD-10-CM and the new external cause of injury matrix may affect injury surveillance and research, especially for certain mechanisms/causes.


Author(s):  
Jessica W. M. Wong ◽  
Friedrich M. Wurst ◽  
Ulrich W. Preuss

Abstract. Introduction: With advances in medicine, our understanding of diseases has deepened and diagnostic criteria have evolved. Currently, the most frequently used diagnostic systems are the ICD (International Classification of Diseases) and the DSM (Diagnostic and Statistical Manual of Mental Disorders) to diagnose alcohol-related disorders. Results: In this narrative review, we follow the historical developments in ICD and DSM with their corresponding milestones reflecting the scientific research and medical considerations of their time. The current diagnostic concepts of DSM-5 and ICD-11 and their development are presented. Lastly, we compare these two diagnostic systems and evaluate their practicability in clinical use.


Author(s):  
Timo D. Vloet ◽  
Marcel Romanos

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.


Author(s):  
Nicolas Arnaud ◽  
Rainer Thomasius

Zusammenfassung. Der Beitrag informiert über die Eingliederung der Suchtstörungen in die 11. Auflage der International Classification of Diseases (ICD-11) der Weltgesundheitsorganisation (WHO). Die Revision der ICD soll einem gewandelten Verständnis der Suchtstörungen und deren Diagnostik Rechnung tragen und die klinische Anwendbarkeit vereinfachen. Im Bereich der substanzbezogenen und nicht substanzbezogenen Störungen sind gegenüber der Vorgängerversion erhebliche Neuerungen eingeführt worden. Die wichtigsten Änderungen betreffen ein erweitertes Angebot an Stoffklassen, deutliche (vereinfachende) Anpassungen in den konzeptuellen und diagnostischen Leitlinien der substanzbezogenen Störungsbilder und insbesondere der „Abhängigkeit“, sowie die Einführung der Kategorie der „abhängigen Verhaltensweisen“ und damit verbunden die Zuordnung der „Glücksspielstörung“ zu den Suchtstörungen sowie die Aufnahme der neuen (bildschirmbezogenen) „Spielstörung“. Zudem findet eine Erweiterung der diagnostischen Optionen für frühe, präklinische Phänotypen der Suchtstörungen („Episodisch Schädlicher Gebrauch“) erstmals Eingang in den ICD-Katalog. Im vorliegenden Beitrag werden die Änderungen Episodisch schädlicher Gebrauch für den Bereich der Suchtstörungen aus kinder- und jugendpsychiatrischer Sicht zusammenfassend dargestellt und diskutiert.


1968 ◽  
Vol 07 (03) ◽  
pp. 141-151 ◽  
Author(s):  
H. Fassl

In Krankenprotokollen finden sieb, nicht selten Angaben über den Patienten, die nicht mehr als Diagnosen anzusprechen sind. Dennoch sollten diese Feststellungen nicht verworfen werden, da sie wichtige Informationen darstellen. In der vorliegenden Arbeit wird (dem Vorschlag der Weltgesundheitsorganisation folgend) eine sog. Y-Klassifikation vorgestellt, mittels derer Feststellungen bei Personen ohne akute Klagen oder. Erkrankungen verschlüsselt werden können (z. B. Zustand nach einer Krankheit oder Verletzung, Verdacht auf eine Krankheit, Nachsorgemaßnahmen, prophylaktische Maßnahmen usw.). Der Entwurf folgt der Systematik der ICD (International Classification of Diseases) und kann dazu benutzt werden, gewisse Lücken darin zu überbrücken.


Author(s):  
Neill Y. Li ◽  
Alexander S. Kuczmarski ◽  
Andrew M. Hresko ◽  
Avi D. Goodman ◽  
Joseph A. Gil ◽  
...  

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.


2020 ◽  
Author(s):  
Thomas Gaisl ◽  
Naser Musli ◽  
Patrick Baumgartner ◽  
Marc Meier ◽  
Silvana K Rampini ◽  
...  

BACKGROUND The health aspects, disease frequencies, and specific health interests of prisoners and refugees are poorly understood. Importantly, access to the health care system is limited for this vulnerable population. There has been no systematic investigation to understand the health issues of inmates in Switzerland. Furthermore, little is known on how recent migration flows in Europe may have affected the health conditions of inmates. OBJECTIVE The Swiss Prison Study (SWIPS) is a large-scale observational study with the aim of establishing a public health registry in northern-central Switzerland. The primary objective is to establish a central database to assess disease prevalence (ie, International Classification of Diseases-10 codes [German modification]) among prisoners. The secondary objectives include the following: (1) to compare the 2015 versus 2020 disease prevalence among inmates against a representative sample from the local resident population, (2) to assess longitudinal changes in disease prevalence from 2015 to 2020 by using cross-sectional medical records from all inmates at the Police Prison Zurich, Switzerland, and (3) to identify unrecognized health problems to prepare successful public health strategies. METHODS Demographic and health-related data such as age, sex, country of origin, duration of imprisonment, medication (including the drug name, brand, dosage, and release), and medical history (including the International Classification of Diseases-10 codes [German modification] for all diagnoses and external results that are part of the medical history in the prison) have been deposited in a central register over a span of 5 years (January 2015 to August 2020). The final cohort is expected to comprise approximately 50,000 to 60,000 prisoners from the Police Prison Zurich, Switzerland. RESULTS This study was approved on August 5, 2019 by the ethical committee of the Canton of Zurich with the registration code KEK-ZH No. 2019-01055 and funded in August 2020 by the “Walter and Gertrud Siegenthaler” foundation and the “Theodor and Ida Herzog-Egli” foundation. This study is registered with the International Standard Randomized Controlled Trial Number registry. Data collection started in August 2019 and results are expected to be published in 2021. Findings will be disseminated through scientific papers as well as presentations and public events. CONCLUSIONS This study will construct a valuable database of information regarding the health of inmates and refugees in Swiss prisons and will act as groundwork for future interventions in this vulnerable population. CLINICALTRIAL ISRCTN registry ISRCTN11714665; http://www.isrctn.com/ISRCTN11714665 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/23973


Author(s):  
Philip Cowen

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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