谁会得到肥胖症的代码? 结合国际疾病分类基于肥胖的代码的可靠性,使用和影响,2014-2021年
Lyudmyla Kompaniyets1, Samantha Pierce1, Brook Belay1
1Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
Childhood obesity (Print)
|November 4, 2024
概括
电子健康记录中的肥胖编码不是随机的,经常错过病例,特别是在患有严重肥胖或慢性疾病的儿童中. 为了准确的研究和护理,需要改进文档.
科学领域:
- 儿科健康 儿科健康
- 医疗信息学 医疗信息学
- 流行病学 流行病学
背景情况:
- 国际疾病分类 (ICD) 代码被广泛用于在电子健康记录 (EHR) 中识别儿科肥胖症.
- 以前的研究表明,这些代码对儿科肥胖症的错误分类和低敏感性显著.
- 错误分类的随机性和组合不同代码类型的影响仍然不清楚.
研究的目的:
- 评估大量儿科人口中肥胖代码的患病率,敏感性和特异性.
- 调查与接受肥胖代码相关的患者特征.
- 评估使用不同肥胖代码类型的影响.
主要方法:
- 从2014年到2021年,分析了740万2-19岁儿童的情况.
- 随着时间的推移,估计肥胖代码的流行率和敏感性.
- 后勤回归用于根据患者特征和代码类型确定影响代码分配的因素.
主要成果:
- 肥胖代码的患病率从3.9%增加到9.8% (2014-2021),而BMI定义的肥胖患病率从17.4%增加到20.5%.
- 代码灵敏度从19.8%提高到40.8%,但仍然很低.
- 患有严重肥胖或慢性疾病的儿童更有可能获得代码,特别是诊断代码而不是状态代码.
结论:
- 肥胖代码错误分类是非随机的,受患者因素的影响,如疾病严重程度.
- 肥胖代码类型之间存在显著差异,警告不要将它们结合用于纵向分析.
- 增强和标准化的肥胖文档对于改善儿科护理质量和研究数据实用性至关重要.
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