在加拿大开发疾病国际分类的代码定义,用于研究肠道感染后果
Eleni Galanis1, Azita Goshtasebi2, Yuen Wai Hung3
1Faculty of Medicine, University of British Columbia, Vancouver, BC.
概括
已验证的国际疾病分类 (ICD) 对肠道感染的慢性后果的代码定义是为加拿大环境而开发的. 这项研究提高了用于测量疾病负担的行政卫生数据的准确性.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗信息学 医疗信息学
背景情况:
- 肠道感染导致严重的残疾和死亡,慢性后果构成重大公共卫生挑战.
- 行政卫生数据越来越多地用于追踪慢性疾病负担,但在加拿大缺乏国际疾病分类 (ICD) 对肠道感染后续的验证代码定义.
- 准确的ICD代码定义对于可靠的人口级疾病监测和疾病负担估计至关重要.
研究的目的:
- 验证现有的并开发新的ICD代码为基础的病例定义,用于加拿大医疗保健系统中肠道感染的慢性后果.
- 评估这些拟议定义的敏感性和积极预测值 (PPV).
- 调整定义以反映加拿大编码实践和后勤约束.
主要方法:
- 一种多步骤的方法,结合文献审查,临床医生评估和行政卫生数据的图表审查.
- 在文献中搜索以确定肠道感染后续现有验证的定义.
- 对六个特定的后续病例的181个病例进行临床审查和图表审查,以验证和完善拟议的ICD代码定义.
主要成果:
- 针对15种不同的肠道感染后果,确定或开发了经过验证的ICD代码定义.
- 对于拟议的ICD代码定义,敏感度在42.8%至100%之间,PPV在63.6%至100%之间.
- 临床医生修改了六个定义 (急性损伤,血栓性血栓性缺血性紫外线,吉兰-巴雷综合征/米勒-菲舍综合征,慢性炎症性脱髓化多神经病,结性脊髓炎,反应性关节炎) 以提高准确性和适用性.
结论:
- 多步骤的衍生过程成功地产生了针对加拿大环境量身定制的肠道感染后果的验证ICD代码定义.
- 开发的定义增强了行政卫生数据在加拿大流行病学研究和公共卫生监测方面的实用性.
- 这项工作为更准确地测量由肠道感染引起的慢性疾病负担提供了基础.
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