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医院诊断代码的有效性,以识别SARS-CoV-2感染,参考聚合酶连锁反应结果:一个描述性研究

Cristiano S Moura¹, Autumn Neville¹, Fangming Liao¹

¹Faculty of Medicine (Moura, Bernatsky), McGill University; Research Institute of the McGill University Health Centre (Neville, Bernatsky), Montréal, Que.; Li Ka Shing Knowledge Institute, St. Michael's Hospital (Liao, Wen, Razak, Roberts, Verma), Unity Health Toronto; Department of Medicine (Razak, Verma) and Institute of Health Policy, Management and Evaluation (Razak, Roberts, Verma), University of Toronto, Toronto, Ont.

|October 24, 2023

概括

疾病和相关健康问题的国际统计分类,第10版 (ICD-10) 代码U07.1准确地识别了住院患者的SARS-CoV-2感染. 这个诊断代码显示了COVID-19病例确诊的高灵敏度和特异性.

科学领域:

传染性疾病传染性疾病
医疗信息学医疗信息学
流行病学流行病学

背景情况:

疾病和相关健康问题的国际统计分类第10版 (ICD-10) 引入了2020年实验室确认的SARS-CoV-2感染的U07.1代码.
在住院数据中准确识别COVID-19病例对于流行病学监测和资源分配至关重要.

研究的目的:

评估ICD-10排放诊断码U07.1的操作特性,用于识别SARS-CoV-2感染.
使用聚合酶链反应 (PCR) 作为参考标准,评估U07.1代码的灵敏度,特异性,正预测值 (PPV) 和负预测值 (NPV).

主要方法:

利用加拿大安大略省通用医学住院患者倡议 (GEMINI) 的住院数据,用于2020年入院的成年人.
包括在住院期间或住院后48小时内通过PCR测试SARS-CoV-2的患者.
针对ICD-10代码U07.1的计算诊断准确度指标 (灵敏度,特异性,PPV,NPV) 与PCR结果相比,具有分层分析.

主要成果:

在11852例接受SARS-CoV-2 PCR检测的住院患者中,444例 (3.7%) 呈阳性.
ICD-10编码U07.1显示了高的操作特征:灵敏度为97.8%,特异性为99.5%,PPV为88.2%,NPV为99.9%.
当初始SARS-CoV-2 PCR测试在入院后48小时以上进行时,特异性和PPV降低了.

结论:

ICD-10代码U07.1在住院患者的环境中对识别SARS-CoV-2感染具有很高的准确性.
这些发现支持在住院数据集中可靠使用U07.1代码来确定SARS-CoV-2病例.
及时进行PCR测试对于最大限度地提高COVID-19诊断编码的准确性至关重要.

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