Identifying pediatric emergency department visits for aggression using administrative claims data

Area of Science:

• Public Health
• Pediatric Emergency Medicine
• Mental Health Research

Background:

• Youth violence and aggression are significant drivers of Emergency Department (ED) mental health (MH) encounters.
• A consistent method is crucial for public health research to identify ED encounters linked to aggression.
• Developing such a screening procedure is essential for accurate data collection and analysis.

Purpose of the Study:

• To develop and validate a screening procedure for identifying youth aggression within ED mental health encounters.
• To establish a reliable method for public health research using administrative and electronic health data.
• To improve the identification of aggressive behaviors in pediatric patients presenting to the ED.

Main Methods:

• Utilized a combination of ICD-10 codes to screen mental health ED encounters for aggression.
• Conducted chart reviews to compare characteristics of screen-positive and screen-negative groups.
• Compared confirmed aggression cases with non-aggression cases to assess screening accuracy.

Main Results:

• The developed screening method demonstrated high accuracy, with sensitivity of 0.901 and specificity of 0.817.
• Positive and negative predictive values were 0.818 and 0.864, respectively, indicating reliable identification of aggression.
• Chart review confirmed aggression in a significant proportion of screen-positive encounters.

Conclusions:

• A novel screening method for identifying ED encounters related to youth aggression has been presented.
• Replication studies are necessary to validate the method before large-scale application to claims data.
• If validated, this method will significantly support future research on youth aggression in emergency settings.