ICD-10诊断代码对于胎盘增生谱系障碍的有效性
Anjali R Jotwani1, Deirdre J Lyell1, Alexander J Butwick2
1Department of Obstetrics and Gynecology, Stanford University, Stanford, California, USA.
Paediatric and perinatal epidemiology
|March 22, 2024
概括
新的国际疾病分类,第10修订 (ICD-10) 代码的胎盘增殖谱显示研究的潜力,但有局限性. 研究人员在使用这些代码进行监控时,必须考虑潜在的假阳性.
科学领域:
- 产科和妇科 产科和妇科
- 医疗信息学 医疗信息学
- 公共卫生监督 公共卫生监督
背景情况:
- 国际疾病分类,临床修改 (ICD-10) 的第十次修订引入了胎盘积谱 (PAS) 的诊断代码.
- 帕斯是一种危及生命的产科并发症,发病率越来越高.
- 准确的编码对于研究和监测PAS至关重要.
研究的目的:
- 评估新引入的ICD-10诊断代码对胎盘增殖谱的有效性.
- 识别导致错误代码分配的因素.
主要方法:
- 在四级产科中心从2015年10月到2020年3月的医疗记录的回顾性审查.
- 对ICD-10 PAS代码的灵敏度,特异性,正预测值和负预测值的计算.
- 组织病理学诊断作为比较的黄金标准.
主要成果:
- 在22,345名患者中,104人有ICD-10 PAS代码,51人有组织病理学确认.
- ICD-10代码显示高特异性 (0.98) 和负预测值 (1.00),但中度敏感性 (0.71) 和正预测值 (0.61).
- 亚型的敏感性各不相同,错误的代码分配与较低的孕产妇发病率有关.
结论:
- 胎盘增殖谱的ICD-10代码对流行病学研究和监测有希望.
- 研究人员应该意识到存在大量的假阳性代码赋值率.
- 编码实践可能需要进一步改进,以提高PAS诊断的准确性.
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