修改的全球疾病负担的准确性 疾病国际分类 识别败血症的编码方法:一个前性的多中心队列研究
Ashwani Kumar1, Bala Venkatesh2,3, Simon Finfer2,4
1The George Institute for Global Health, University of New South Wales, Sydney, Australia. akumar@georgeinstitute.org.au.
Critical care (London, England)
|June 2, 2025
概括
经过修改的全球疾病负担 (GBD) 方法显示,使用国际疾病分类 (ICD) 代码识别败血症的准确性很低. 隐式加法是最准确的,但错误往往源于未指定的感染和器官功能障碍编码.
科学领域:
- 医疗信息学 医疗信息学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 败血症的鉴定依赖于流行病学研究的准确编码.
- 像安格斯方法这样的现有方法也有局限性.
- 全球疾病负担 (GBD) 研究开发了修改的国际疾病分类 (ICD) 代码方法来识别败血症.
研究的目的:
- 评估三种修改的GBD ICD编码方法用于识别败血症的准确性.
- 将这些方法的准确性与安格斯方法进行比较.
- 为了确定ICD对败血症的编码中的错误来源.
主要方法:
- 一项前性,多中心的观察性研究,涉及患有败血症高风险的急诊室患者.
- 使用败血症3标准确认了败血症的诊断.
- 三种修改的GBD方法 (明确的,隐含的,隐含的加) 和安格斯方法用于ICD编码.
- 使用克伦巴赫的alpha (α) 评估了协议.
主要成果:
- 在450名符合条件的患者中,215名 (47.8%) 患有临床败血症.
- 隐式加法在修改后的GBD方法中显示出最高的灵敏度 (67.4%) 和精度 (49.3%).
- 所有ICD编码方法都显示出与临床诊断的一致性很低 (α = 0.52-0.56).
- 常见的错误包括编码未指定的尿路感染和相关器官功能障碍,以及缺乏记录的病原体.
结论:
- 经过修改的GBD方法对通过ICD代码识别败血症的准确性较低.
- 隐式加法是修改后的GBD方法中最准确的.
- 编码的不准确性经常与未指定的感染和器官功能障碍有关.
相关概念视频
Healthcare Associated Infections II: Preventive Measures
2.8K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
2.8K
Principles of Disease Surveillance
190
Disease surveillance is the systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. This process integrates data dissemination to entities responsible for preventing and controlling disease, injury, and disability. Surveillance systems provide crucial information for action, helping public health authorities make informed decisions to manage and prevent outbreaks, ensure public safety, optimize...
190
Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
4.4K
Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
4.4K
Classification of Illness
8.0K
The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
8.0K
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
184
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
184
Methods of Classification and Identification
241
Bacterial identification relies on a diverse array of techniques to classify and understand microorganisms, each tailored to uncover specific characteristics. Traditional morphological approaches, while still valuable, are limited for closely related or structurally simple organisms. Modern methods integrate biochemical, serological, genetic, and advanced molecular tools to achieve greater accuracy.Morphological and Biochemical TechniquesMorphological characteristics, such as cell shape and...
241


