在医疗接触数据中验证胆肌炎的诊断代码,2013-2018年
Clinton Hall1,2, Sandra M Magallon1,2, Katherine J Snell1,2
1Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.
国际疾病分类 (ICD) 对胆肌炎的代码在确定临床病例方面显示出中等准确性. 这突出了通过医疗记录区分实验室确认的感染与临床诊断的子宫内感染的挑战.
科学领域:
- 产科和妇科 产科和妇科
- 传染性疾病 传染性疾病
- 医疗信息学 医疗信息学
背景情况:
- 胆子膜炎是一种子宫内感染或炎症,可以通过临床或实验室检测来诊断.
- 准确识别胆膜炎对于适当的患者管理和研究至关重要.
- 诊断码的验证对于研究中可靠使用电子健康记录至关重要.
研究的目的:
- 根据已建立的参考标准,验证国际疾病分类 (ICD) 对胆 ?? 膜炎的代码.
- 评估ICD代码在确定临床和组织学诊断的胆膜炎病例中的准确性.
- 评估ICD代码在军事医院大量分娩的表现.
主要方法:
- 分析了两家美国军事医院2013-2018年间的一组活产.
- 使用ICD代码,分娩被选为胆 ?? 膜炎,样本正在进行图表审查.
- 验证使用了临床和/或组织学肌炎的参考标准,计算了灵敏度,特异性和预测值.
主要成果:
- 临床胆肌炎的积极预测值 (PPV) 为0.68,灵敏度为0.76.
- 当包括组织病例时,整体PPV增加到0.75,在2018年达到0.91.
- 负预测值和特异性仍然很高,在所有参考标准中超过0.97.
结论:
- 胆肌炎的ICD代码显示与临床诊断的疾病有中等的相关性.
- 使用医疗经验数据来区分临床膜炎和仅通过实验室检测发现的病例存在挑战.
- 为了在研究和临床环境中精确识别胆膜炎,可能需要进一步完善编码实践.
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