Discordance Between Self-report of Physician Diagnosis and Administrative Database Diagnosis of Arthritis and Its Predictors

2009 ◽  
Vol 36 (9) ◽  
pp. 2000-2008 ◽  
Author(s):  
JASVINDER A. SINGH
Keyword(s):  
Short Form ◽  
Functional Limitation ◽  
International Classification Of Diseases ◽  
Epidemiological Studies ◽  
Kappa Coefficient ◽  
Self Report ◽  
Administrative Database ◽  
Lower Education Level ◽  
Classification Of Diseases ◽  
Physician Diagnosis

Objective.To study predictors of discordance between self-reported physician diagnosis and administrative database diagnosis of arthritis.Methods.A cohort of all veterans who utilized Veterans Integrated Service Network (VISN)-13 medical facilities were mailed a questionnaire that included patient self-report of physician diagnosis of arthritis and questions regarding demographics, functional limitation, and SF-36V (a validated version of the Medical Outcomes Study Short-Form 36). Kappa coefficient was used to assess the extent of agreement between self-report of physician diagnosis and administrative database definitions that incorporated International Classification of Diseases (ICD) codes and use of medications for arthritis. We identified predictors of overall discordance between self-report and administrative database diagnosis using multivariable logistic regression analyses.Results.Among 70,334 eligible veterans surveyed, 19,749 subjects had an ICD diagnosis of arthritis in the administrative database in the year prior to the survey; 34,440 answered the arthritis question and 18,464 self-reported a physician diagnosis of arthritis. Kappa coefficient showed slight to fair agreement of 0.19–0.32 between self-report and administrative database definitions of arthritis. We found significantly higher overall discordance among veterans with more comorbidities, greater age, worse functional status, lower use of outpatient and inpatient services, lower education level, and among single medical-site users.Conclusion.Low level of agreement between self-report and database diagnosis of arthritis and its significant association with patient demographic, clinical, and functional characteristics highlights the limitation of use of these strategies for identification of patients with arthritis in epidemiological studies.

scholarly journals Acute Kidney Injury and In-Hospital Mortality: A Retrospective Analysis of a Nationwide Administrative Database of Elderly Subjects in Italy

2019 ◽  
Vol 8 (9) ◽  
pp. 1371 ◽  
Author(s):  
Fabbian ◽  
Savriè ◽  
De Giorgi ◽  
Cappadona ◽  
Di Simone ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
International Classification Of Diseases ◽  
Administrative Database ◽  
Elderly Subjects ◽  
Dialysis Treatment ◽  
The Third ◽  
Classification Of Diseases

Background: The aim of this study was to investigate the association between acute kidney injury (AKI) and in-hospital mortality (IHM) in a large nationwide cohort of elderly subjects in Italy. Methods: We analyzed the hospitalization data of all patients aged ≥65 years, who were discharged with a diagnosis of AKI, which was identified by the presence of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), and extracted from the Italian Health Ministry database (January 2000 to December 2015). Data regarding age, gender, dialysis treatment, and comorbidity, including the development of sepsis, were also collected. Results: We evaluated 760,664 hospitalizations, the mean age was 80.5 ± 7.8 years, males represented 52.2% of the population, and 9% underwent dialysis treatment. IHM was 27.7% (210,661 admissions): Deceased patients were more likely to be older, undergoing dialysis treatment, and to be sicker than the survivors. The population was classified on the basis of tertiles of comorbidity score (the first group 7.48 ± 1.99, the second 13.67 ± 2,04, and third 22.12 ± 4.13). IHM was higher in the third tertile, whilst dialysis-dependent AKI was highest in the first. Dialysis-dependent AKI was associated with an odds ratios (OR) of 2.721; 95% confidence interval (CI) 2.676–2.766; p < 0.001, development of sepsis was associated with an OR of 1.990; 95% CI 1.948–2.033; p < 0.001, the second tertile of comorbidity was associated with an OR of 1.750; 95% CI 1.726–1.774; p < 0.001, and the third tertile of comorbidity was associated with an OR of 2.522; 95% CI 2.486–2.559; p < 0.001. Conclusions: In elderly subjects with AKI discharge codes, IHM is a frequent complication affecting more than a quarter of the investigated population. The increasing burden of comorbidity, dialysis-dependent AKI, and sepsis are the major risk factors.

Impact of Surgeon Volume on Incidence of Neck Hematoma after Thyroid and Parathyroid Surgery: Ten Years’ Analysis of Nationwide In-patient Sample Database

2014 ◽  
Vol 80 (10) ◽  
pp. 948-952 ◽  
Author(s):  
Ahmed Dehal ◽  
Ali Abbas ◽  
Mohammed Al-Tememi ◽  
Farabi Hussain ◽  
Samir Johna
Keyword(s):  
High Volume ◽  
International Classification Of Diseases ◽  
Surgeon Volume ◽  
Administrative Database ◽  
Parathyroid Surgery ◽  
Patient Sample ◽  
Surgeon Experience ◽  
Classification Of Diseases ◽  
Low Volume ◽  
The Impact

The study's objective is to examine the impact of surgeon experience on the incidence and the severity of neck hematoma after thyroid and parathyroid surgery using a nationwide database. The Nationwide In-patient Sample is a nationwide clinical and administrative database. We used the International Classification of Diseases, 9th Revision diagnosis and procedures codes to identify adult patients who underwent thyroid and parathyroid surgery and subsequently developed neck hematoma. Patient and hospital characteristics were collected along with surgeon volume to predict patient outcomes. Surgical procedures were stratified into three groups according to surgeon volume: low (less than 10 operations), intermediate (10 to 99), and high (100 or more). We identified 147,344 thyroid and parathyroid surgery performed between 2000 and 2009 nationwide. Overall incidence of postoperative neck hematoma was 1.5 per cent (n = 2210). This was 2.1, 1.4, and 0.9 per cent among procedures performed by low-volume, intermediate-volume, and high-volume surgeons, respectively. After adjusting for other confounders, compared with procedures performed by low-volume surgeons, those performed by intermediate- (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6 to 0.8; P < 0.01) and high-volume surgeons (OR, 0.5; 95% CI, 0.4 to 0.6; P < 0.01) were less to likely to develop neck hematoma. Surgeon experience is significantly associated with the development of neck hematoma after thyroid and parathyroid surgery.

scholarly journals Dementia and Diabetes Mellitus: Association with Apolipoprotein E4 Polymorphism from a Hospital in Southern India

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Lakshmi Narayanan Kota ◽  
Bhagyalakshmi Mallapura Shankarappa ◽  
Prafulla Shivakumar ◽  
Shilpa Sadanand ◽  
Bhavani Shankara Bagepally ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
International Classification Of Diseases ◽  
Alzheimer’S Dementia ◽  
Self Report ◽  
Parental History ◽  
Alzheimer's Dementia ◽  
Apolipoprotein E4 ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
History Of

Objective. To evaluate the association of Apolipoprotein E4 (ApoE4) in Alzheimer's dementia (AD) with comorbid diabetes mellitus (DM).Methods. The study included subjects with Alzheimer's dementia (AD) (n=209), individuals with non-Alzheimer's dementia (nAD) (n=122), individuals with parental history of AD (f/hAD) (n=70), and control individuals who had normal cognitive functions and no parental history of dementia (NC) (n=193). Dementia was diagnosed using International Classification of Diseases-10 revision (ICD-10) criteria. DM was assessed on the basis of self-report and/or use of antidiabetic medications. ApoE genotyping was done using sequence-specific primer polymerase chain reaction.Results. ApoE4 allele frequencies were highest among AD with comorbid DM (0.35) followed by AD without DM (0.25), nAD with DM (0.13), nAD without comorbid DM (0.12), and NC (0.08). Frequency of ApoE4 in persons with f/hAD was 0.13. The association of AD with co-morbid DM in ApoE4 carriers was more in comparison to NC with DM (OR=5.68,P=0.04).Conclusion. There is a significant association between AD with co-morbid DM and ApoE4 genotype.

scholarly journals Personality Disorder in a Nigerian Prison Community

2020 ◽  
pp. 61-65
Author(s):  
Enyidah Nonyenim Solomon
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Strong Association ◽  
International Classification Of Diseases ◽  
Epidemiological Studies ◽  
Chi Square ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Prison Community ◽  
The 19Th Century

Background: Personality disorders have since the 19th century been known and established as psychiatric diagnosis, yet very few epidemiological studies have been done. Absence of information about this disorder in the prisons led to the assessment of its prevalence in Agodi prisons in Nigeria. Objective: To determine the prevalence of personality disorder in a prison community. Methods: A total of 213 inmates who met the study criteria were interviewed, using (IPDE) International Personality Disorder Examination, a semi structured questionnaire modified to conform to DSM 111-R (Diagnostic and Statistical Manual) and ICD-10 (International Classification of Diseases) classifications. Using the Statistical Package for Social Sciences (SPSS/PC+), cross tabulation of the variables was obtained using chi-square and t- test. Results: The results showed that at least 31% of prison inmates have personality disorders with antisocial personality disorder being most prevalent. A strong association between criminality and personality disorder was established.

scholarly journals Predicting ICD-9 Codes Using Self-Report of Patients

2021 ◽  
Vol 11 (21) ◽  
pp. 10046
Author(s):  
Anandakumar Singaravelan ◽  
Chung-Ho Hsieh ◽  
Yi-Kai Liao ◽  
Jia-Lien Hsu
Keyword(s):  
Language Processing ◽  
Short Term Memory ◽  
International Classification Of Diseases ◽  
Discharge Summary ◽  
Self Report ◽  
Health Trends ◽  
Clinical Notes ◽  
Classification Of Diseases ◽  
Medical Classification ◽  
Remote Assistance

The International Classification of Diseases (ICD) is a globally recognized medical classification system that aids in the identification of diseases and the regulation of health trends. The ICD framework makes it easy to keep track of records and evaluate medical data for evidence-based decision-making. Several methods have predicted ICD-9 codes based on the discharge summary, clinical notes, and nursing notes. In our study, our approach only utilizes the subjective component to predict ICD-9 codes. Data cleaning and segmentation, and Natural Language Processing (NLP) techniques are applied on the subjective component during the pre-processing. Our study builds the Long Short-Term Memory (LSTM) and the Gated Recurrent Unit (GRU) to develop a model for predicting ICD-9 codes. The ICD-9 codes contain different ICD levels such as chapter, block, three-digit code, and full code. The GRU model scores the highest recall of 57.91% in the chapter level and the top-10 experiment has a recall of 67.37%. Based on the subjective component, the model can help patients in the form of a remote assistance tool.

scholarly journals A kórházi adatlapok jelentéseinek alkalmazhatósága epidemiológiai elemzésekre az ischaemiás cerebrovascularis betegségek példája alapján

2015 ◽  
Vol 156 (38) ◽  
pp. 1540-1546 ◽  
Author(s):  
András Ajtay ◽  
Ferenc Oberfrank ◽  
Dániel Bereczki
Keyword(s):  
Health Care Financing ◽  
International Classification Of Diseases ◽  
Epidemiological Studies ◽  
Insurance Fund ◽  
Cerebral Infarcts ◽  
Hospital Report ◽  
Single Payer ◽  
Classification Of Diseases ◽  
Icd 10

Introduction: In single-payer health care financing systems data extracted from hospital report forms submitted for reimbursement purposes may be used for epidemiological investigations. Aim: Based on data submitted by 14 neurological wards in Central Hungary the authors examined the reliability of these reports. Method: Analyses were performed for the 3-digit codes of the 10th version of the International Classification of Diseases for cerebral infarcts (ICD-10 I63+I64) reported for the National Health Insurance Fund. Results: The number of cases in individual hospitals changed between a decrease by 35% and an increase by 73% from the first to the second half of the year 2012, reflecting changes in the size of the catchment area of the hospitals in July 2012. Of those with an ICD-10 I63 or I64 discharge diagnosis 54–84% had acute stroke. Neurological wards cared for 34–98% of all stroke patients. The diagnoses submitted for reimbursement purposes corresponded in over 99% to the diagnoses in the hospital discharge reports. Inaccuracies occurred in a larger proportion (about 20%) in coding the DRG financing categories. Conclusions: Databases created from hospital reports submitted for reimbursement purposes can be used reliably in Hungary for stroke epidemiological studies. Orv. Hetil., 2015, 156(38), 1540–1546.

Outcomes of Right and Left Colectomy at Academic Centers

2007 ◽  
Vol 73 (10) ◽  
pp. 945-948 ◽  
Author(s):  
Marcelo W. Hinojosa ◽  
Viken R. Konyalian ◽  
Zuri A. Murrell ◽  
J. Esteban Varela ◽  
Michael J. Stamos ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Malignant Disease ◽  
Lower Cost ◽  
Length Of Hospital Stay ◽  
International Classification Of Diseases ◽  
Administrative Database ◽  
Wound Infections ◽  
Left Colectomy ◽  
Classification Of Diseases ◽  
Mean Cost

Few studies have compared outcomes of right colectomy (RC) and left colectomy (LC) with respect to both benign and malignant disease. The objective of this study was to compare outcomes of RC versus LC for benign and malignant disease using a national administrative database of academic medical centers. Using International Classification of Diseases, 9th Revision diagnosis and procedure codes, data was obtained from the University HealthSystem Consortium Clinical Data Base for patients that underwent RC and LC for benign and malignant disease between 2002 and 2006. The main outcomes compared were demographics, length of hospital stay, observed to expected in-hospital mortality, complications, 30-day readmission, and mean cost. There were a total of 27,483 patients; 12,971 patients (47.2%) underwent RC. Compared with LC for benign disease, RC was associated with a shorter length of stay, lower overall complications, lower wound infections, lower 30-day readmissions, and lower cost. Compared with LC for malignant disease, RC was associated with lower overall complications, lower wound infections, and lower cost. In this analysis of academic centers, RC was associated with a lower length of stay, lower morbidity, and lower cost when compared with LC for benign and malignant disease.

scholarly journals Reproducibility of an extensive self-report questionnaire used in secondary coronary prevention

2017 ◽  
Vol 45 (3) ◽  
pp. 269-276 ◽  
Author(s):  
Kari Peersen ◽  
John Munkhaugen ◽  
Lars Gullestad ◽  
Toril Dammen ◽  
Torbjorn Moum ◽  
...  
Keyword(s):  
De Novo ◽  
Short Form ◽  
Intraclass Correlation ◽  
Epidemiological Studies ◽  
Sleep Apnoea ◽  
Self Report ◽  
Cross Sectional ◽  
Coronary Patients ◽  
Prevention Studies ◽  
Test Retest Reliability

Aims: Self-reported information from questionnaires is frequently used in clinical epidemiological studies, but few provide information on the reproducibility of instruments applied in secondary coronary prevention studies. This study aims to assess the test–retest reproducibility of the questionnaire applied in the cross-sectional NORwegian CORonary (NOR-COR) Prevention Study. Methods: In the NOR-COR study 1127 coronary heart disease (CHD) patients completed a self-report questionnaire consisting of 249 questions, of which there are both validated instruments and de novo questions. Test–retest reliability of the instrument was estimated after four weeks in 99 consecutive coronary patients. Intraclass Correlation Coefficient (ICC) and Kappa (κ) were calculated. Results: The mean interval between test and retest was 33 (±6.4) days. Reproducibility values for questions in the first part of the questionnaire did not differ from those in the latter. A good to very good reproducibility was found for lifestyle factors (smoking: κ = 1.0; exercise: ICC = 0.90), medical factors (drug adherence: ICC = 0.74; sleep apnoea: ICC = 0.87), and psychosocial factors (anxiety and depression: ICC = 0.95; quality of life 12-Item Short-Form Health Survey (SF12): ICC = 0.89), as well as for the majority of de-novo-created variables covering the patient’s perceptions, motivation, needs, and preferences. Conclusions: The present questionnaire demonstrates a highly acceptable reproducibility for all key items and instruments. It thus emerges as a valuable tool for evaluating patient factors associated with coronary risk factor control in CHD patients.

scholarly journals Diagnostic Accuracy of Health Care Administrative Diagnosis Codes to Identify Nontuberculous Mycobacteria Disease: A Systematic Review

2021 ◽  
Vol 8 (5) ◽  
Author(s):  
Carlos Mejia-Chew ◽  
Lauren Yaeger ◽  
Kevin Montes ◽  
Thomas C Bailey ◽  
Margaret A Olsen
Keyword(s):  
Health Care ◽  
Diagnostic Accuracy ◽  
Administrative Data ◽  
International Classification Of Diseases ◽  
Administrative Database ◽  
Cochrane Central Register ◽  
Predictive Values ◽  
Diagnosis Codes ◽  
Database Research ◽  
Classification Of Diseases

Abstract Background Health care administrative database research frequently uses standard medical codes to identify diagnoses or procedures. The aim of this review was to establish the diagnostic accuracy of codes used in administrative data research to identify nontuberculous mycobacterial (NTM) disease, including lung disease (NTMLD). Methods We searched Ovid Medline, Embase, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from inception to April 2019. We included studies assessing the diagnostic accuracy of International Classification of Diseases, 9th edition, Clinical Modification (ICD-9-CM) diagnosis codes to identify NTM disease and NTMLD. Studies were independently assessed by 2 researchers, and the Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess bias and quality. Results We identified 5549 unique citations. Of the 96 full-text articles reviewed, 7 eligible studies of moderate quality (3730 participants) were included in our review. The diagnostic accuracy of ICD-9-CM diagnosis codes to identify NTM disease varied widely across studies, with positive predictive values ranging from 38.2% to 100% and sensitivity ranging from 21% to 93%. For NTMLD, 4 studies reported diagnostic accuracy, with positive predictive values ranging from 57% to 64.6% and sensitivity ranging from 21% to 26.9%. Conclusions Diagnostic accuracy measures of codes used in health care administrative data to identify patients with NTM varied across studies. Overall the positive predictive value of ICD-9-CM diagnosis codes alone is good, but the sensitivity is low; this method is likely to underestimate case numbers, reflecting the current limitations of coding systems to capture NTM diagnoses.

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