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后COVID-19定义和临床编码实践的表征:纵向研究

Monika Maripuri¹, Andrew Dey¹, Jacqueline Honerlaw¹

¹Veterans Affairs Boston Healthcare System, Boston, MA, United States.

Online journal of public health informatics

|May 3, 2024

概括

国际疾病分类,第十次修订 (ICD-10) 后COVID-19条件的代码U09.9显示电子健康记录的精度可变. 这项研究评估了其在三个卫生系统中的效用,发现长期COVID-19的流行率范围为23.2%至62.4%.

科学领域:

医疗信息学医疗信息学
公共卫生公共卫生
传染性疾病传染性疾病

背景情况:

后COVID-19状态,或长COVID-19,缺乏一个普遍的临床定义.
电子健康记录 (EHR) 数据对于了解长期COVID-19至关重要.
在EHR中使用了COVID-19后状态的ICD-10代码U09.9,但其准确性不确定.

研究的目的:

评估ICD-10代码U09.9的准确性和实用性,用于识别长期COVID-19.
将U09.9代码的性能与三个主要医疗保健系统的临床病例定义进行比较.
通过世界卫生组织 (WHO) 和疾病控制和预防中心 (CDC) 的定义来评估代码的有效性.

主要方法:

审查了退伍军人卫生管理局,伯特以色列牧师女医疗中心和匹兹堡大学医疗中心的900份患者病历.
使用ICD-10代码U07.1或阳性PCR测试识别了COVID-19的患者.
采样了带有和没有U09.9代码的患者,根据症状持续时间,发病和核心症状集群,应用了长时间的COVID-19定义.

主要成果:

在患有U09.9代码的患者中,长期COVID-19的患病率在医疗保健系统中从23.2%到62.4%不等.
使用不那么严格的世卫组织和疾病预防控制中心的定义,在所有地点都增加了长期COVID-19的流行率.
该研究提供了对U09.9代码在现实世界EHR数据中的表现的初步见解.

结论:

这项研究是第一个与长期COVID-19临床病例定义对U09.9代码进行验证的研究之一.
图表审查方法在全国范围内在多个卫生系统中应用,证明了评估EHR代码准确性的可行性.
调查结果表明,U09.9代码的实用性有所不同,突出了在不同的电子健康记录系统中需要进一步评估的需要.

关键词:

在 COVID-19 疫情中,疾病的国际分类.帕斯克 (Pasc) 是一个过去.U09.9 ICD-10 代码中的 U09.9 算法验证算法的验证查看图表查看图表查看图表电子健康记录是电子健康记录.长时间的COVID-19 在SARS-CoV-2的后急性后果.退伍军人的退伍军人

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