scholarly journals Part II: Accuracy of Teledermatology in Skin Neoplasms

2020 ◽  
Vol 7 ◽  
Author(s):  
Mara Giavina-Bianchi ◽  
Maria Fernanda Dias Azevedo ◽  
Raquel Machado Sousa ◽  
Eduardo Cordioli
Keyword(s):  
Skin Neoplasms ◽  
Complete Agreement ◽  
Benign Lesions ◽  
Agreement Rate ◽  
General Physician ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
International Statistical Classification ◽  
Store And Forward ◽  
Histopathological Report

Teledermatology has been proving to be of great help for delivering healthcare, especially now, during the SARS-CoV-2 pandemic. It is crucial to assess how accurate this method can be for evaluating different dermatoses. Such knowledge can contribute to the dermatologists' decision of whether to adhere to teledermatology or not. Our objective was to determine the accuracy of teledermatology in the 10 most frequent skin neoplasms in our population, comparing telediagnosis to histopathological report and in-person dermatologists' diagnosis. A retrospective cohort study was conducted in São Paulo, Brazil, where a store-and-forward teledermatology project was implemented under primary-care attention to triage surgical, more complex, or severe dermatoses. A total of 30,976 patients presenting 55,012 lesions took part in the project. Thirteen teledermatologists who participated in the project had three options to refer the patients: send them directly to biopsy, to the in-person dermatologist, or back to the general physician with the most probable diagnosis and management. In the groups referred to the in-person dermatologist and biopsy, we looked for the 10 most frequent International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) of skin neoplasms, which resulted in 289 histopathologic reports and 803 in-person dermatologists' diagnosis. We were able to compare the ICD-10 codes filled by teledermatologists, in-person dermatologists, and from histopathological reports. The proportion of complete, partial, and no agreement rates between the in-person dermatologist's, histopathologic report, and the teledermatologist's diagnosis was assessed. We also calculated Cohen's kappa, for complete and complete plus partial agreement. The mean complete agreement rate comparing telediagnosis to histopathological report was 54% (157/289; kappa = 0.087), being the highest for malign lesions; to in-person dermatologists was 61% (487/803; kappa = 0.213), highest for benign lesions. When accuracy of telediagnosis for either malign or benign lesions was evaluated, the agreement rate with histopathology was 70% (kappa = 0.529) and with in-person dermatologist, 81% (kappa = 0.582). This study supports that teledermatology for skin neoplasms has moderate accuracy. This result reassures that it can be a proper option for patient care, especially when the goal is to differentiate benign from malign lesions.

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”.

Varying impact of co-morbid conditions on self-harm resulting in mortality in Australia

2016 ◽  
Vol 47 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Kate Churruca ◽  
Brian Draper ◽  
Rebecca Mitchell
Keyword(s):  
Chronic Conditions ◽  
Mortality Data ◽  
Free Text ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
International Statistical Classification ◽  
Self Harm ◽  
Australian Bureau Of Statistics ◽  
The Impact ◽  
Morbid Conditions

Background: Research has associated some chronic conditions with self-harm and suicide. Quantifying such a relationship in mortality data relies on accurate death records and adequate techniques for identifying these conditions. Objective: This study aimed to quantify the impact of identification methods for co-morbid conditions on suicides in individuals aged 30 years and older in Australia and examined differences by gender. Method: A retrospective examination of mortality records in the National Coronial Information System (NCIS) was conducted. Two different methods for identifying co-morbidities were compared: International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) coded data, which are provided to the NCIS by the Australian Bureau of Statistics, and free-text searches of Medical Cause of Death fields. Descriptive statistics and χ2 tests were used to compare the methods for identifying co-morbidities and look at differences by gender. Results: Results showed inconsistencies between ICD-10 coded and coronial reports in the identification of suicide and chronic conditions, particularly by type (physical or mental). There were also significant differences in the proportion of co-morbid conditions by gender. Conclusion: While ICD-10 coded mortality data more comprehensively identified co-morbidities, discrepancies in the identification of suicide and co-morbid conditions in both systems require further investigation to determine their nature (linkage errors, human subjectivity) and address them. Furthermore, due to the prescriptive coding procedures, the extent to which medico-legal databases may be used to explore potential and previously unrecognised associations between chronic conditions and self-harm deaths remains limited.

Development of the ICD-10 simplified version and field test

2017 ◽  
Vol 47 (2) ◽  
pp. 77-84 ◽  
Author(s):  
Wansa Paoin ◽  
Maliwan Yuenyongsuwan ◽  
Yukiko Yokobori ◽  
Hiroyoshi Endo ◽  
Sukil Kim
Keyword(s):  
Developing Countries ◽  
Field Testing ◽  
World Health ◽  
Asia Pacific ◽  
Clinical Coding ◽  
Average Accuracy ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
International Statistical Classification ◽  
Health Organization

Background: The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) has been used in various Asia-Pacific countries for more than 20 years. Although ICD-10 is a powerful tool, clinical coding processes are complex; therefore, many developing countries have not been able to implement ICD-10-based health statistics (WHO-FIC APN, 2007). Objective: This study aimed to simplify ICD-10 clinical coding processes, to modify index terms to facilitate computer searching and to provide a simplified version of ICD-10 for use in developing countries. Method: The World Health Organization Family of International Classifications Asia-Pacific Network (APN) developed a simplified version of the ICD-10 and conducted field testing in Cambodia during February and March 2016. Ten hospitals were selected to participate. Each hospital sent a team to join a training workshop before using the ICD-10 simplified version to code 100 cases. All hospitals subsequently sent their coded records to the researchers. Results: Overall, there were 1038 coded records with a total of 1099 ICD clinical codes assigned. The average accuracy rate was calculated as 80.71% (66.67–93.41%). Three types of clinical coding errors were found. These related to errors relating to the coder (14.56%), those resulting from the physician documentation (1.27%) and those considered system errors (3.46%). Discussion: The field trial results demonstrated that the APN ICD-10 simplified version is feasible for implementation as an effective tool to implement ICD-10 clinical coding for hospitals. Conclusion: Developing countries may consider adopting the APN ICD-10 simplified version for ICD-10 code assignment in hospitals and health care centres. The simplified version can be viewed as an introductory tool which leads to the implementation of the full ICD-10 and may support subsequent ICD-11 adoption.

Fall-related mortality in southern Sweden: a multiple cause of death analysis, 1998–2014

2017 ◽  
Vol 25 (2) ◽  
pp. 129-135 ◽  
Author(s):  
Aliasghar A Kiadaliri ◽  
Björn E Rosengren ◽  
Martin Englund
Keyword(s):  
Cause Of Death ◽  
Temporal Trends ◽  
Circulatory System ◽  
Southern Sweden ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
International Statistical Classification ◽  
The Mean ◽  
Related Mortality

ObjectivesTo investigate temporal trend in fall mortality among adults (aged ≥20 years) in southern Sweden using multiple cause of death data.MethodsWe examined all death certificates (DCs, n=2 01 488) in adults recorded in the Skåne region during 1998–2014. We identified all fall deaths using International Statistical Classification of Diseases (ICD)-10 codes (W00-W19) and calculated the mortality rates by age and sex. Temporal trends were evaluated using joinpoint regression and associated causes were identified by age-adjusted and sex-adjusted observed/expected ratios.ResultsFalls were mentioned on 1.0% and selected as underlying cause in 0.7% of all DCs, with the highest frequency among those aged ≥70 years. The majority (75.6%) of fall deaths were coded as unspecified fall (ICD-10 code: W19) followed by falling on or from stairs/steps (7.7%, ICD-10 code: W10) and other falls on the same level (6.3%, ICD-10 code: W18). The mean age at fall deaths increased from 77.5 years in 1998–2002 to 82.9 years in 2010–2014 while for other deaths it increased from 78.5 to 79.8 years over the same period. The overall mean age-standardised rate of fall mortality was 8.3 and 4.0 per 1 00 000 person-years in men and women, respectively, and increased by 1.7% per year in men and 0.8% per year in women during 1998–2014. Head injury and diseases of the circulatory system were recorded as contributing cause on 48.7% of fall deaths.ConclusionsThere is an increasing trend of deaths due to falls in southern Sweden. Further investigations are required to explain this observation particularly among elderly men.

Bipolar and related disorders in DSM-5 and ICD-10

CNS Spectrums ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 318-323 ◽  
Author(s):  
Alexander Kaltenboeck ◽  
Dietmar Winkler ◽  
Siegfried Kasper
Keyword(s):  
Negative Impact ◽  
Bipolar Disorders ◽  
Diagnostic Categories ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Previous Edition ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
International Statistical Classification

Bipolar disorders are a group of psychiatric disorders with profound negative impact on affected patients. Even if their symptomatology has long been recognized, diagnostic criteria have changed over time and diagnosis often remains difficult. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), issued in May 2013, comprises several changes regarding the diagnosis of bipolar disorders compared to the previous edition. Diagnostic categories and criteria for bipolar disorders show some concordance with the internationally also widely used Tenth Edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). However, there are also major differences that are worth highlighting. The aim of the following text is to depict and discuss those.

scholarly journals Eight-year outcome after invasive treatment of infrainguinal intermittent claudication: A population-based analysis from the Swedish vascular register (Swedvasc)

2020 ◽  
Vol 8 ◽  
pp. 205031212092678
Author(s):  
Thordur Gunnarsson ◽  
Anders Gottsäter ◽  
Stefan Bergman ◽  
Thomas Troëng ◽  
Hans Lindgren
Keyword(s):  
Intermittent Claudication ◽  
Circulatory System ◽  
Population Based ◽  
High Morbidity ◽  
Invasive Treatment ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Positive Treatment ◽  
International Statistical Classification

Objectives: Invasive treatment of infrainguinal intermittent claudication is controversial, and long-term outcomes are scarce. The study aim was to evaluate 8 years results regarding new vascular interventions on index and contralateral limb, hospitalization, mortality, and amputation in 775 patients revascularized for infrainguinal intermittent claudication in 2009. Methods: Data on new vascular interventions retrieved from the Swedish vascular register (Swedvasc) were linked to the Inpatient Register and Cause of Death Register with information on hospitalizations, primary discharge diagnoses according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), deaths, causes of death, and amputations. Results: During 8 years of follow-up, 486 new vascular interventions were performed. Patients were admitted for a total of 4662 hospitalizations and spent 25,970 days in hospital. Between 79% and 99% of surviving subjects were hospitalized each year. During follow-up, 311 (40.1%) patients died. The most common causes of hospitalization and death were cerebrovascular disease, ischemic heart disease, or other diseases of the circulatory system, causing 47.5% of hospitalizations and 42.4% of deaths. Seventy-seven major lower limb amputations were performed in 52 patients. Conclusion: As patients undergoing invasive treatment of infrainguinal intermittent claudication have high morbidity and mortality, during 8 years of follow-up, the indication for invasive treatment should be carefully weighed against concomitant comorbidities and the timing of this treatment optimized with regard to the patient’s possibilities to enjoy positive treatment effects on quality of life.

Abstract 17375: The Potential Role of Stress-Associated Neurobiological Metabolism in the Cardiovascular Sequelae of Sleep Apnea

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ahmed Ghoneem ◽  
Michael Osborne ◽  
Shady Abohashem ◽  
Hadil Zureigat ◽  
Tawseef Dar ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Sleep Fragmentation ◽  
Novel Treatments ◽  
Positron Emission ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
International Statistical Classification

Introduction: Obstructive and central sleep apnea (SA) induce sleep fragmentation and associates with HTN and cardiovascular diseases (CVDs). Sleep fragmentation is known to increase stress. Further, heightened stress-associated neurobiological metabolism (particularly amygdalar activity - AmygA), potentiates atherosclerosis. However, it is unknown: 1) whether SA increases AmygA in humans, or 2) whether AmygA mediates the link between SA and its CV consequences (HTN and CVD). Hypothesis: SA associates with higher AmygA which in turn associates with hypertension (HTN) and myocardial infarction (MI). Methods: We studied a cohort of 36424 participants within the Partners Biobank. Diagnoses of MI and sleep apnea and relevant clinical data were obtained from International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes. A subset of 1520 patients provided clinically indicated 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging. AmygA was measured using validated measures. Results: Of 36424 participants, 6596 (18.1%) had SA, 20881(57.3%) had HTN and 4033 (11.1%) had MI. OSA significantly associated with HTN (OR [95%CI]: 3.2 [2.95, 4.48], p<0.0001) and MI (1.30 [1.21, 1.41], p<0.001) in multivariable models. SA associated with AmygA (β [95%CI]: 0.183 [0.058, 0.337], p=0.006). AmygA associated with HTN (1.18 [1.02, 1.38], p= 0.028). Further, AmygA associated with MI (1.28 [1.11, 1.46], p=0.0005). Moreover, AmygA mediated the association between SA and HTN and between SA and MI (p<0.05 for both, figs 1a and 1b). Conclusion: Our findings suggest that SA increases the risk of HTN & MI via a mechanism that involves heightened amygdalar activity. This potential mechanism may inform novel treatments.

The Health of Workers with the Intake of Radionuclides in Case of Skin Damage

2020 ◽  
Vol 65 (3) ◽  
pp. 40-44
Author(s):  
A. Gurev ◽  
A. Tukov ◽  
A. Bushmanov ◽  
M. Kalinina ◽  
A. Zubov
Keyword(s):  
Musculoskeletal System ◽  
Occupational Diseases ◽  
Circulatory System ◽  
Health Indicators ◽  
Skin Damage ◽  
Statistical Validity ◽  
Circulatory System Diseases ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
International Statistical Classification

Purpose: Analysis of the prevalence of diseases of non-professional genesis in individuals with intake of radionuclides through damaged skin and served by health care institutions of the Federal Medical and Biological Agency of Russia. Material and methods: The database of the “Industry register of persons with occupational diseases” includes the health indicators of individuals with intake of radionuclides through damaged skin and a population of 185 patients aged 68.9 ± 1.0 years for 2014 (166 men aged 68.3 ± 1.0 years and 19 women aged 74.0 ± 3.4 years). The coding of diseases of non-professional genesis was carried out according to the International Statistical Classification of Diseases and Problems Related to Health (ICD-10). Student’s criterion was used as a criterion of statistical validity (p < 0.05). To assess the health of persons counted in the register, the prevalence rate of diseases of non-professional genesis, calculated for 1000 patients with occupational diseases, was used. An intensive indicator error was calculated ( ± m 95 %). Results: The prevalence of non-occupational diseases is 1637.8 ± 94.1 (men 1614.5 ± 98.6, women 1842.1 ± 311.4; p > 0.05). Disorders of the musculoskeletal system occupy the first place – 340.5 ± 34.8; 20.8 % (men 313.3 ± 36.0; 19.4 %, women 578.9 ± 174.6; 31.4 %; p > 0.05). Of these, dorsopathies accounted for 286.5 ± 33.1; 84.1 % (men 265.1 ± 34.3; 84.6 %, women 473.7 ± 114.6; 81.8 %; p > 0.05). Diseases of the digestive organs are 270.3 ± 32.7; 16.5 %. The highest rates in persons with diseases of the esophagus, stomach and duodenum 205.4 ± 29.7; 76.0 % (men 210.8 ± 31.7; 76.1 %, women 157.9 ± 83.7; 75.0 %; p > 0.05). The third ranking place is divided by diseases of the eye and its adnexa 200.0 ± 29.4; 12.2 % (men 192.8 ± 30.6; 11.9 %, women, 263.2 ± 101.0; 14.3 %; p > 0.05) and circulatory system diseases 200.0 ± 29,4; 12.2 % (men 174.7 ± 29.5; 10.8 %, women 421.1 ± 113.3; 22.9 %; p > 0.05). In the structure of diseases of non-professional genesis, the diseases of the first four ranking places, including respiratory diseases, make up 73.6 % (men 72.4 %, women 82.9 %). Conclusion: Among the diseases in persons with the intake of radionuclides through damaged skin are the most common disorders of the musculoskeletal system, diseases of the digestive system, diseases of the eye and its appendage apparatus. In terms of frequency, they are inferior to diseases of the circulatory system and respiratory organs. As one of the solutions to the problem of registration in persons with signs of contamination of radionuclides of damaged skin in the framework of ICD-10, it is proposed to introduce code S61.2 as “Open wounds of wrist and hand with intake of radionuclides”.

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