关于儿童急诊室遇到自杀想法和行动的ICD-10代码的准确性
Pediatric emergency care
|December 27, 2024
概括
国际疾病分类,第10修订,临床修改 (ICD-10-CM) 代码准确地识别了自杀念头,但不是紧急部门的自杀行为. 需要改进数据来源,以捕捉人口研究的所有自杀倾向病例.
科学领域:
- 公共卫生 公共卫生
- 临床信息学 临床信息学
- 心理健康研究 心理健康研究
背景情况:
- 自杀倾向是通过不同的思想和行动轨迹来理解的.
- 准确识别自杀想法和行为对于研究至关重要.
- 国际疾病分类,第10修订,临床修改 (ICD-10-CM) 代码用于医疗保健中诊断的分类.
研究的目的:
- 评估ICD-10-CM代码的准确性,以识别自杀想法和行为.
- 评估ICD-10-CM代码在急诊室遇到的自杀性研究中的有用性.
- 帮助开发更好的数据来源,用于人口层面的自杀倾向研究.
主要方法:
- 从205次急诊室遇到的6-18岁患者的临床笔记的图表回顾.
- 包括103个随机选择的"案例"与ICD-10-CM自杀性代码和102个倾向匹配的"非案例".
- 使用灵敏度,特异性,正预测值和负预测值对黄金标准图表审查进行ICD-10-CM代码准确性的评估.
主要成果:
- 对ICD-10-CM自杀性代码的积极预测值为86.9%,负预测值为76.2%.
- 捕捉自杀倾向的总体灵敏度为53.4%,表明近一半的病例错过了.
- 相比于行动-当前 (33.7%) 或行动-过去 (20.4%),对于构想-当前 (82.4%) 的敏感性显著更高.
结论:
- 仅依靠ICD-10-CM代码可能导致自杀倾向病例的数量不足.
- ICD-10-CM代码对自杀想法具有很高的准确性,但对自杀行为具有较低的准确性.
- 加强数据收集方法是必要的,以准确地识别大规模人口研究的自杀行为.
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