Validation of the diagnosis of eosinophilic esophagitis based on histopathology reports in Sweden

Background: Eosinophilic esophagitis (EoE) is a relatively new diagnosis, where until recently a specific international classification of disease code was missing. One way to identify patients with EoE is to use histopathology codes. We validated the clinicopathological EoE diagnosis based on histopathology reports and patient charts to establish these data sources as the basis for a nationwide EoE patient cohort. Methods: Through the Epidemiology Strengthened by histoPathology Reports in Sweden (ESPRESSO) study, we randomly selected 165 patients from five Swedish health care regions with a histopathologic diagnosis of EoE. Patients were assigned a histopathology diagnosis of EoE if they had ≥15 eosinophils per high-power field or, in the absence of eosinophil quantification, the pathologist interpreted the biopsy as consistent with EoE. Patient charts were scrutinized to see if the other diagnostic criteria were fulfilled. Of the 131 received patient charts, 111 (85%) had sufficient information to be included in the study. Results: Of the 111 validated patients, 99 had EoE, corresponding to a positive predictive value of 89% (95% confidence interval = 82–94%). Dysphagia was the most common symptom (n = 78, 70%), followed by food impaction (n = 64, 58%) and feeding difficulties (n = 37, 33%). Twelve patients had coexisting asthma (11%) and 16 allergic rhinitis (14%). Seventeen patients underwent esophageal dilatation (15%), of which seven had more than one dilatation. Ninety-seven (87%) patients had a proton-pump inhibitor treatment ≤2 years before or after the diagnosis. Forty-two patients (38%) had been prescribed inhalation steroids and 64 (58%) had undergone esophageal radiology. Conclusion: Histopathology reports from the ESPRESSO cohort with esophageal eosinophilic inflammation are suggestive of EoE.

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A Description of the Prehospital Phase of Aortic Dissection in Terms of Early Suspicion and Treatment

Prehospital and Disaster Medicine ◽

10.1017/s1049023x15000060 ◽

2015 ◽

Vol 30 (2) ◽

pp. 155-162 ◽

Cited By ~ 2

Author(s):

Christer Axelsson ◽

Thomas Karlsson ◽

Katarina Pande ◽

Kristin Wigertz ◽

Per Örtenwall ◽

...

Keyword(s):

Aortic Dissection ◽

Common Symptom ◽

Publication Type ◽

Narcotic Analgesics ◽

Exclusion Criteria ◽

Exact Test ◽

International Classification Of Disease ◽

Prehospital Phase ◽

Significant Difference

AbstractPurposeAortic dissection is difficult to detect in the early phase due to a variety of symptoms. This report describes the prehospital setting of aortic dissection in terms of symptoms, treatment, and suspicion by the Emergency Medical Service (EMS) staff.Basic ProceduresAll patients in the Municipality of Gothenburg, Sweden, who, in 2010 and 2011, had a hospital discharge diagnosis of aortic dissection (international classification of disease (ICD) I 71,0) were included. The exclusion criteria were: age < 18 years of age and having a planned operation. This was a retrospective, descriptive study based on patient records. In the statistical analyses, Fisher's exact test and the Mann-Whitney U test were used for analyses of dichotomous and continuous/ordered variables.Main findingsOf 92 patients, 78% were transported to the hospital by the EMS. The most common symptom was pain (94%). Pain was intensive or very intensive in 89% of patients, with no significant difference in relation to the use of the EMS. Only 47% of those using the EMS were given pain relief with narcotic analgesics. Only 12% were free from pain on admission to the hospital. A suspicion of aortic dissection was reported by the EMS staff in only 17% of cases. The most common preliminary diagnosis at the dispatch center (31%) and by EMS clinicians (52%) was chest pain or angina pectoris. In all, 79% of patients were discharged alive from the hospital (75% of those that used the EMS and 95% of those that did not).ConclusionAmong patients who were hospitalized due to aortic dissection in Gothenburg, 78% used the EMS. Despite severe pain in the majority of patients, fewer than half received narcotic analgesics, and only 12% were free from pain on admission to the hospital. In fewer than one-in-five patients was a suspicion of aortic dissection reported by the EMS staff.AxelssonC, KarlssonT, PandeK, WigertzK, ÖrtenwallP, NordanstigJ, HerlitzJ. A description of the prehospital phase of aortic dissection in terms of early suspicion and treatment. Prehosp Disaster Med. 2015;30(2):1-8.

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Prevalence of Depression in Patients with CKD 5 on Hemodialysis at A Tertiary Care Center in Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.4408 ◽

2019 ◽

Vol 57 (217) ◽

Cited By ~ 1

Author(s):

Krishna Kumar Agrawaal ◽

Pramod Kumar Chhetri ◽

Pradip Man Singh ◽

Dhiraj Narayan Manandhar ◽

Prakash Poudel ◽

...

Keyword(s):

Rating Scales ◽

International Classification ◽

Patient Health Questionnaire ◽

Ethical Review ◽

Common Symptom ◽

Health Questionnaire ◽

International Classification Of Disease ◽

Prevalence Of Depression ◽

Patient Health

Introduction: Co-morbid depression impacts negatively on quality of life in Chronic Kidney Diseasepatients. It is unclear if self-reported depression rating scales can be used accurately for screening.The aim of this study was to estimate prevalence of depression in patients on hemodialysis usingPatient Health Questionnaire-9 and compare Patient Health Questionnaire-9, Max Hamilton Ratingscale and International Classification of Disease-10 for diagnosis of depression. Methods: It was descriptive cross-sectional study conducted from November 2017 till June 2018.Ethical approval was taken from Ethical Review Board, Nepal Health Research Council. Informedand written consent was taken. Patients undergoing hemodialysis at Nepal Medical College for >3 months duration were included in study. Patients on hemodialysis were asked to fill validatedNepali translated version of Patient Health Questionnaire -9. Psychiatrist administered MaxHamilton Rating scale for diagnosis and categorization of depression and confirmed depressionbased on International Classification of Disease -10. Statistical Package for Social Sciences version 20was used for statistical analysis. Results: Total of 100 patients completed study. Median age was 47.5 years. Prevalence of depressionwas 78 (78%) using Patient Health Questionnaire-9 and 65 (65%) using Max Hamilton Rating scaleand 51 (51%) using International Classification of Disease -10. Mean depression in males using PatientHealth Questionnaire -9 was 7±4.33 and in females was 11.04±5.90. The most common symptom wasfatigue among 82 (82%). Conclusions: There is a high prevalence of depression in patients with Chronic Kidney Disease onhemodialysis compared to general population.

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Future Directions

The Oxford Handbook of Digital Technologies and Mental Health ◽

10.1093/oxfordhb/9780190218058.013.40 ◽

2020 ◽

pp. 476-479

Author(s):

Marc N. Potenza ◽

Kyle A. Faust ◽

David Faust

Keyword(s):

Technology Development ◽

Digital Technologies ◽

World Health ◽

International Classification Of Disease ◽

Levels Of Use ◽

Pornography Use ◽

Negative Impacts ◽

Mental Health Treatments ◽

The Many

As digital technology development continues to expand, both its positive and negative applications have also grown. As such, it is essential to continue gathering data on the many types of digital technologies, their overall effects, and their impact on public health. The World Health Organization’s inclusion of Gaming Disorder in the eleventh edition of the International Classification of Disease (ICD-11) indicates that some of the problematic effects of gaming are similar to those of substance-use disorders and gambling. Certain behaviors easily engaged in via the internet may also lead to compulsive levels of use in certain users, such as shopping or pornography use. In contrast, digital technologies can also lead to improvements in and wider accessibility to mental health treatments. Furthermore, various types of digital technologies can also lead to benefits such as increased productivity or social functioning. By more effectively understanding the impacts of all types of digital technologies, we can aim to maximize their benefits while minimizing or preventing their negative impacts.

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Neue Terminologie für Sprachentwicklungsstörungen?

Monatsschrift Kinderheilkunde ◽

10.1007/s00112-021-01148-2 ◽

2021 ◽

Author(s):

K. Neumann ◽

B. Arnold ◽

A. Baumann ◽

C. Bohr ◽

H. A. Euler ◽

...

Keyword(s):

International Classification Of Diseases ◽

International Classification ◽

International Classification Of Disease ◽

Diagnostik Und Therapie ◽

Classification Of Diseases ◽

Icd 10

Zusammenfassung Hintergrund Sprachtherapeutisch-linguistische Fachkreise empfehlen die Anpassung einer von einem internationalen Konsortium empfohlenen Änderung der Nomenklatur für Sprachstörungen im Kindesalter, insbesondere für Sprachentwicklungsstörungen (SES), auch für den deutschsprachigen Raum. Fragestellung Ist eine solche Änderung in der Terminologie aus ärztlicher und psychologischer Sicht sinnvoll? Material und Methode Kritische Abwägung der Argumente für und gegen eine Nomenklaturänderung aus medizinischer und psychologischer Sicht eines Fachgesellschaften- und Leitliniengremiums. Ergebnisse Die ICD-10-GM (Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification) und eine S2k-Leitlinie unterteilen SES in umschriebene SES (USES) und SES assoziiert mit anderen Erkrankungen (Komorbiditäten). Die USES- wie auch die künftige SES-Definition der ICD-11 (International Classification of Diseases 11th Revision) fordern den Ausschluss von Sinnesbehinderungen, neurologischen Erkrankungen und einer bedeutsamen intellektuellen Einschränkung. Diese Definition erscheint weit genug, um leichtere nonverbale Einschränkungen einzuschließen, birgt nicht die Gefahr, Kindern Sprach- und weitere Therapien vorzuenthalten und erkennt das ICD(International Classification of Disease)-Kriterium, nach dem der Sprachentwicklungsstand eines Kindes bedeutsam unter der Altersnorm und unterhalb des seinem Intelligenzalter angemessenen Niveaus liegen soll, an. Die intendierte Ersetzung des Komorbiditäten-Begriffs durch verursachende Faktoren, Risikofaktoren und Begleiterscheinungen könnte die Unterlassung einer dezidierten medizinischen Differenzialdiagnostik bedeuten. Schlussfolgerungen Die vorgeschlagene Terminologie birgt die Gefahr, ätiologisch bedeutsame Klassifikationen und differenzialdiagnostische Grenzen zu verwischen und auf wertvolles ärztliches und psychologisches Fachwissen in Diagnostik und Therapie sprachlicher Störungen im Kindesalter zu verzichten.

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Lack of accuracy of the international classification of disease, ninth (ICD-9) codes in identifying patients with encephalitis

Journal of Neurology ◽

10.1007/s00415-019-09229-9 ◽

2019 ◽

Vol 266 (4) ◽

pp. 1034-1035 ◽

Cited By ~ 2

Author(s):

Mohammed Samannodi ◽

Michael Hansen ◽

Rodrigo Hasbun

Keyword(s):

International Classification ◽

International Classification Of Disease

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The International Classification of Disease Critical Care Severity Score Demonstrates that Pediatric Burden of Injury is Similar to that of Adults: Validation Using the National Trauma Databank

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2021.05.013 ◽

2021 ◽

Author(s):

Christopher W. Snyder ◽

Tara M. Barry ◽

David J. Ciesla ◽

Keith Thatch ◽

Nicholas Poulos ◽

...

Keyword(s):

Critical Care ◽

Severity Score ◽

International Classification ◽

International Classification Of Disease ◽

National Trauma

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Is Cauda Equina Syndrome Being Treated Within the Recommended Time Frame?

Neurosurgery ◽

10.1227/neu.0b013e31820cd426 ◽

2011 ◽

Vol 68 (6) ◽

pp. 1520-1526 ◽

Cited By ~ 19

Author(s):

Robert T. Arrigo ◽

Paul Kalanithi ◽

Maxwell Boakye

Keyword(s):

Cauda Equina Syndrome ◽

Medical Condition ◽

Cauda Equina ◽

Time Frame ◽

Current Guideline ◽

International Classification Of Disease ◽

Lumbar Disk ◽

Urgent Surgery ◽

Spine Surgeon

Abstract BACKGROUND: Cauda equina syndrome (CES) is a rare but devastating medical condition requiring urgent surgery to halt or reverse neurological compromise. Controversy exists as to how soon surgery must be performed after diagnosis, and clinical and medicolegal factors make this question highly relevant to the spine surgeon. It is unclear from the literature how often CES patients are treated within the recommended time frame. OBJECTIVE: To determine whether CES patients are being treated in compliance with the current guideline of surgery within 48 hours and to assess incidence, demography, comorbidities, and outcome measures of CES patients. METHODS: We searched the 2003 to 2006 California State Inpatient Databases to identify degenerative lumbar disk disorder patients surgically treated for CES. An International Classification of Disease, ninth revision, clinical modification, diagnosis code was used to identify CES patients with advanced disease. RESULTS: The majority (88.74%) of California's CES patients received surgery within the recommended 48-hour window after diagnosis. The incidence of CES in surgically treated degenerative lumbar disk patients was 1.51% with an average of 397 cases per year in California. CES patients had worse outcomes and used more healthcare resources than other surgically treated degenerative lumbar disk patients; this disparity was more pronounced for patients with advanced CES. CES patients treated after 48 hours had 3 times the odds of a nonroutine discharge as patients treated within 48 hours (odds ratio = 3.082; P < .001). CONCLUSION: In California, patients are being treated within the recommended 48-hour time frame.

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Risk Adjustment in Outcome Assessment: the Charlson Comorbidity Index

Methods of Information in Medicine ◽

10.1055/s-0038-1634956 ◽

1993 ◽

Vol 32 (05) ◽

pp. 382-387 ◽

Cited By ~ 324

Author(s):

C. Sicotte ◽

C. Tilquin ◽

W. D’Hoore

Keyword(s):

Risk Adjustment ◽

Predictive Accuracy ◽

Charlson Index ◽

Administrative Databases ◽

Receiver Operating Curve ◽

Multiple Logistic Regression ◽

Principal Diagnosis ◽

International Classification Of Disease ◽

Comorbidity Index

AbstractTo measure the burden of comorbid diseases using the MED-ECHO database (Quebec), the so-called Charlson index was adapted to International Classification of Disease (ICD-9) codes. The resulting comorbidity index was applied to the study of inpatient death in a group of 62,456 patients having one of the following conditions: ischemic heart disease, congestive heart failure, stroke, or bacterial pneumonia. Multiple logistic regression was used to relate inpatient death to its predictors, including gender, principal diagnosis, age, and the comorbidity index. Various transformations of the comorbidity score were performed, and their effect on predictive accuracy was assessed. The comorbidity index was constantly and strongly associated with death. When gender, age, comorbidity and the principal diagnoses were taken into account, the area under the receiver-operating curve was 0.83. Therefore, the Charlson Index is a useful approach to risk adjustment in outcomes research from administrative databases.

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System for Cross-Classification of Small Group Studies

Psychological Reports ◽

10.2466/pr0.1968.23.3f.1295 ◽

1968 ◽

Vol 23 (3_suppl) ◽

pp. 1295-1304

Author(s):

Richard Heslin ◽

Dexter Dunphy

Keyword(s):

Small Group ◽

Classification System ◽

Sufficient Information ◽

Coding System ◽

Similar System ◽

Cross Classification

The article describes a method for placing information into a classification system that maximizes the flexibility in retrieval at a later time. It uses (1) a stack of edge-punched cards containing information of interest that has been punched according to (2) a coding system developed by the users. The authors have developed a classification system for the small-group field which is depicted and described in detail. It allows for coding a study on about 50 dimensions to (1) locate an article, (2) give an over-all description of the article, and (3) indicate the variables measured or discussed. Examples of uses and discussion of special features are provided to give the reader sufficient information to establish and use the system or a similar system for his own purposes.

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