使用国际疾病分类 (ICD) 代码识别阿片类药物使用障碍患者:挑战和机遇
Katie P Osterhage1, Yih-Ing Hser2, Larissa J Mooney2,3
1Department of Family Medicine, University of Washington, Seattle, Washington, USA.
Addiction (Abingdon, England)
|September 16, 2023
概括
国际疾病分类 (ICD) 对阿片类药物使用障碍 (OUD) 的诊断代码在各诊所中应用不一致. 这种不一致性挑战了OUD研究的电子健康记录的使用.
科学领域:
- 医疗信息学 医疗信息学
- 公共卫生 公共卫生
- 临床研究 临床研究
背景情况:
- 国际疾病分类 (ICD) 诊断代码经常在研究中用于识别患有阿片类药物使用障碍 (OUD) 的患者.
- 这些ICD代码在研究环境中用于OUD识别的准确性需要彻底评估.
- 这项研究专门研究了ICD-10诊断代码与阿片类药物使用,依赖和滥用有关的电子健康记录 (EHR) 数据中的应用.
研究的目的:
- 为了评估国际疾病分类第十次修订 (ICD-10) 的准确性和一致性,在电子健康记录 (EHR) 中使用的诊断代码用于识别患有阿片类药物使用障碍 (OUD) 的患者.
- 描述ICD-10特定代码 (F11.10,F11.20,F11.21,F11.23,F11.90,F11.99) 在初级保健环境中对阿片类药物使用,依赖和滥用的应用.
- 通过将它们与临床诊断和患者登记册进行比较,评估使用这些代码用于研究目的的可靠性.
主要方法:
- 在美国华盛顿和爱达荷州的四个农村初级保健诊所进行了一项横截面观察研究.
- 数据从电子健康记录 (EHR) 中提取,包括ICD-10代码的有限数据集,基于诊所的OUD患者登记册以及临床医生/工作人员的EHR条目 (进展说明,问题列表).
- 护理协调员根据确认的OUD,可能的OUD,没有OUD的慢性疼痛或没有OUD/慢性疼痛的证据对307名患者进行了分类,将这些类别与应用的ICD-10代码进行比较.
主要成果:
- 特定的ICD-10代码 (F11.10,F11.21,F11.99) 经常应用于已确认OUD诊断的患者 (64-89%准确率).
- 其他代码 (F11.20,F11.23,F11.90) 适用于OUD和没有OUD的慢性疼痛混合的患者,表明潜在的错误分类.
- 在四个参与诊所应用ICD-10诊断代码时,观察到显著的不一致性.
结论:
- 不同诊所对国际疾病分类 (ICD) 诊断代码的不一致应用构成了重大挑战.
- 仅依靠电子健康记录 (EHR) 中的诊断代码数据,可能无法准确识别患有阿片类药物使用障碍 (OUD) 个人的研究群体.
- 需要进一步的标准化和验证工作,以提高ICD代码对使用EHR数据进行OUD研究的实用性.
关键词:
在ICD中,代码是ICD代码.疾病的国际分类.这是一个OUD.滥用阿片类药物滥用阿片类药物滥用对阿片类药物依赖的成使用阿片类药物使用."阿片类药物使用障碍"主要护理是一级医疗保健.农村农村农村农村农村农村农村更多相关视频
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