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基于规则的ICD-10-CM算法的验证,以检测Medicare数据中的摔伤
David A Ganz1,2, Denise Esserman3, Nancy K Latham4
1Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
概括
使用诊断代码的算法准确地识别了Medicare数据中的摔伤,包括Medicare Advantage. 这种验证对于研究使用Medicare索赔来研究摔倒伤害结果的研究至关重要.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 基于诊断代码的算法对于识别Medicare数据中的摔倒伤害对于研究至关重要.
- 以前的算法缺乏与外部标准的验证,特别是在ICD-10-CM和医疗保险优势 (MA) 数据中.
研究的目的:
- 根据参考标准验证一种基于诊断代码的算法,用于识别摔倒伤害.
- 为了评估Medicare服务费用 (FFS) 和MA数据中的算法性能.
主要方法:
- 从STRIDE试验与Medicare FFS和MA数据 (2015-19年) 相关的自我报告的摔倒伤害 (参考标准).
- 计算了接收器运行特征曲线 (AUC) 下的面积,以测量算法的灵敏度和特异性.
- 根据数据源,试验组和医疗保健系统,不同的日期窗口大小和分层结果.
主要成果:
- 该算法在同一日历月内识别跌伤时显示了45%的灵敏度和99%的特异性.
- 总体AUC为0.79,在FFS和MA数据源和试验臂中表现相似.
- 性能因参与医疗保健系统而异,AUC从0.71到0.84.8不等.
结论:
- 一个ICD-10-CM算法显示在Medicare FFS和MA数据中识别跌伤的可接受性能.
- 这种经过验证的算法可以在使用Medicare索赔数据的观察和干预研究中可靠地确定跌倒伤害的结果.
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