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关于儿童急诊室遇到的自杀想法和行动的ICD-10代码的准确性

Rena Xu, Louisa Bode, Alon Geva

medRxiv : the preprint server for health sciences

|August 30, 2024

概括

ICD-10代码准确地识别了自杀念头,但错过了许多紧急部门的自杀行为案例. 需要更好的数据源来捕捉自杀行为,以实现思想转化为行动模型.

科学领域:

公共卫生公共卫生
精神病学是一个精神病学.
医疗信息学医疗信息学

背景情况:

自杀性研究经常使用思想到行动的框架,需要准确识别自杀思想和行动.
紧急部门 (ED) 遭遇是识别和干预自杀倾向的关键点.

研究的目的:

为了评估国际疾病分类的准确性,第10版 (ICD-10) 代码用于识别儿科ED遇到的自杀想法和行动.

主要方法:

对205例6-18岁患者的ED遭遇进行了临床笔记的图表审查.
遭遇被分类为"案例" (具有ICD-10自杀性代码) 或"非案例" (没有代码).
准确度指标包括灵敏度,特异性,正预测值 (PPV) 和负预测值 (NPV) 根据黄金标准图表审查计算.

主要成果:

在ICD-10代码中,自杀的PPV为86.9%,NPV为76.2%.
总体敏感度为53.4%,表明近一半的自杀倾向病例被错过了.
与行动相比,对于构想 (82.4%) 的敏感性显著更高 (33.7%过去,20.4%现在).

结论:

仅依赖ICD-10代码可能会导致自杀性病例的低估,特别是自杀行为.
虽然ICD-10代码对自杀想法相对准确,但对自杀行为的准确性较低.
改进的数据源对于准确捕捉自杀行为至关重要,以推进人口层面的研究,使用思想转化为行动模型.

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