Comparison of Validity of Mapping between Drug Indications and ICD-10

2014 ◽  
Vol 53 (03) ◽  
pp. 195-201 ◽  
Author(s):  
Y. Choi ◽  
C. Jung ◽  
Y. Chae ◽  
M. Kang ◽  
J. Kim ◽  
...  
Keyword(s):  
Gold Standard ◽  
Kappa Statistic ◽  
Direct Approach ◽  
Free Text ◽  
Good Opportunity ◽  
Mapping Approach ◽  
Icd 10 ◽  
Standard Terminology ◽  
The Mean ◽  
Experienced Nurse

SummaryBackground: Mapping of drug indications to ICD-10 was undertaken in Korea by a public and a private institution for their own purposes. A different mapping approach was used by each institution, which presented a good opportunity to compare the validity of the two approaches.Objectives: This study was undertaken to compare the validity of a direct mapping approach and an indirect terminology based mapping approach of drug indications against the gold standard drawn from the results of the two mapping processes.Methods: Three hundred and seventy-five cardiovascular reference drugs were selected from all listed cardiovascular drugs for the study. In the direct approach, two experienced nurse coders mapped the free text indications directly to ICD-10. In the indirect terminology based approach, the indications were extracted and coded in the Korean Standard Terminology of Medicine. These terminology coded indications were then manually mapped to ICD-10. The results of the two approaches were compared to the gold standard. A kappa statistic was calculated to see the compatibility of both mapping approaches. Recall, precision and F1 score of each mapping approach were calculated and analyzed using a paired t-test.Results: The mean number of indications for the study drugs was 5.42. The mean number of ICD-10 codes that matched in direct approach was 46.32 and that of indirect terminology based approach was 56.94. The agreement of the mapping results between the two approaches were poor (kappa = 0.19). The indirect terminology based approach showed higher recall (86.78%) than direct approach (p < 0.001). However, there was no difference in precision and F1 score between the two approaches.Conclusions: Considering no differences in the F1 scores, both approaches may be used in practice for mapping drug indications to ICD-10. However, in terms of consistency, time and manpower, better results are expected from the indirect terminology based approach.

ICD10Net: An Artificial Intelligence Algorithm with Medical Background Conducts ICD-10-CM Coding Task with Outstanding Performance (Preprint)

2019 ◽  
Author(s):  
Chin Lin ◽  
Yu-Sheng Lou ◽  
Chia-Cheng Lee ◽  
Chia-Jung Hsu ◽  
Ding-Chung Wu ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
General Hospital ◽  
Pearson Correlation ◽  
Model Performance ◽  
International Classification Of Diseases ◽  
Free Text ◽  
Daily Work ◽  
Medical Background ◽  
Icd 10 ◽  
F Measure

BACKGROUND An artificial intelligence-based algorithm has shown a powerful ability for coding the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) in discharge notes. However, its performance still requires improvement compared with human experts. The major disadvantage of the previous algorithm is its lack of understanding medical terminologies. OBJECTIVE We propose some methods based on human-learning process and conduct a series of experiments to validate their improvements. METHODS We compared two data sources for training the word-embedding model: English Wikipedia and PubMed journal abstracts. Moreover, the fixed, changeable, and double-channel embedding tables were used to test their performance. Some additional tricks were also applied to improve accuracy. We used these methods to identify the three-chapter-level ICD-10-CM diagnosis codes in a set of discharge notes. Subsequently, 94,483-labeled discharge notes from June 1, 2015 to June 30, 2017 were used from the Tri-Service General Hospital in Taipei, Taiwan. To evaluate performance, 24,762 discharge notes from July 1, 2017 to December 31, 2017, from the same hospital were used. Moreover, 74,324 additional discharge notes collected from other seven hospitals were also tested. The F-measure is the major global measure of effectiveness. RESULTS In understanding medical terminologies, the PubMed-embedding model (Pearson correlation = 0.60/0.57) shows a better performance compared with the Wikipedia-embedding model (Pearson correlation = 0.35/0.31). In the accuracy of ICD-10-CM coding, the changeable model both used the PubMed- and Wikipedia-embedding model has the highest testing mean F-measure (0.7311 and 0.6639 in Tri-Service General Hospital and other seven hospitals, respectively). Moreover, a proposed method called a hybrid sampling method, an augmentation trick to avoid algorithms identifying negative terms, was found to additionally improve the model performance. CONCLUSIONS The proposed model architecture and training method is named as ICD10Net, which is the first expert level model practically applied to daily work. This model can also be applied in unstructured information extraction from free-text medical writing. We have developed a web app to demonstrate our work (https://linchin.ndmctsgh.edu.tw/app/ICD10/).

scholarly journals Development and validation of the Sorting non-trauMatIc adoLescent knEe pain (SMILE) tool – a development and initial validation study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Clara Guldhammer ◽  
Sinead Holden ◽  
Marina Elmelund Sørensen ◽  
Jens Lykkegaard Olesen ◽  
Martin Bach Jensen ◽  
...  
Keyword(s):  
Knee Pain ◽  
Gold Standard ◽  
Sports Medicine ◽  
Kappa Statistic ◽  
Medical Doctors ◽  
Clinical Tests ◽  
Support Tool ◽  
Expert Clinician ◽  
Diagnostic Flowchart ◽  
Development And Validation

Abstract Background Despite the commonality of adolescent knee pain, there are no tools to support medical doctors to correctly diagnose knee pain. This study aimed to develop and evaluate a support tool for diagnosing the most common types of non-traumatic adolescent knee pain. Method A systematic search on Medline identified the literature on clinical tests and diagnoses of adolescent knee pain. The search was supplemented by textbooks and transformed into a diagnostic flowchart based on onset, symptoms, and pain localisation. This tool was revised based on feedback from general practitioners and experts in sports medicine. The tool was evaluated on two separate days with blinded assessors. Overall, 27 participants (aged 10–17 years) with non-traumatic knee pain were included. All participants were diagnosed by medical doctors or medical students, without and with the use of the tool. Diagnoses were compared to a gold standard (expert clinician). An interview to inform optimisations of the tool was performed with the assessors. Percentage agreement with the gold standard, and Kappa statistic for interrater reliability were calculated. Results The final tool improved diagnostic agreement with the gold standard from 22.7% (95% CI 10.3–35.1) to 77.3% (95% CI 64.9–89.7). Inter-rater reliability increased from poor agreement k = − 0.04 (95% CI, − 0.12-0.04) to moderate agreement k = 0.56 (95% CI, 0.40–0.72). Conclusion This simple diagnostic tool is quick to use and may assist doctors in diagnosing non-traumatic knee pain in adolescents.

scholarly journals Dementia epidemiology in Hungary based on data from neurological and psychiatric specialty services

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nóra Balázs ◽  
András Ajtay ◽  
Ferenc Oberfrank ◽  
Dániel Bereczki ◽  
Tibor Kovács
Keyword(s):  
Psychiatric Services ◽  
Psychiatric Diagnoses ◽  
Prevalence Rates ◽  
Health Insurance System ◽  
Crude Incidence ◽  
Specialist Services ◽  
Single Payer ◽  
Icd 10 ◽  
Medical Reports ◽  
The Mean

AbstractHungary has a single-payer health insurance system covering 10 million inhabitants. All medical reports of the in- and outpatient specialist services were collected in the NEUROHUN database. We used ICD-10 codes of Alzheimer’s disease (AD), vascular dementia (VaD), miscellaneous dementia group and mild cognitive impairment (MCI) for the inclusion of the patients. Incidence, prevalence and survival of different dementias and MCI were calculated and analyzed depending on the diagnoses given by neurological or psychiatric services or both. Between 2011 and 2016, the mean crude incidence of all dementias was 242/100,000/year, whereas the age standardized incidence was 287/100,000/year. Crude and age standardized mean prevalence rates were 570/100,000 and 649/100,000, respectively. There were significantly more VaD diagnoses than AD, the VaD:AD ratio was 2.54:1, being the highest in patients with psychiatric diagnoses only (4.85:1) and the lowest in patients with only neurological diagnoses (1.32:1). The median survival after the first diagnosis was 3.01 years regarding all dementia cases. Compared to international estimates, the prevalence of dementia and MCI is considerably lower in Hungary and the VaD:AD ratio is reversed.

scholarly journals Development of an Electronic Algorithm to Target Outpatient Antimicrobial Stewardship Efforts for Acute Bronchitis

2020 ◽  
Vol 41 (S1) ◽  
pp. s32-s32
Author(s):  
Ebbing Lautenbach ◽  
Keith Hamilton ◽  
Robert Grundmeier ◽  
Melinda Neuhauser ◽  
Lauri Hicks ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Predictive Value ◽  
Gold Standard ◽  
Chart Review ◽  
Acute Bronchitis ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Diagnostic Codes ◽  
Icd 10 ◽  
The Impact

Background: Antibiotic resistance has increased at alarming rates, driven predominantly by antibiotic overuse. Although most antibiotic use occurs in outpatients, antimicrobial stewardship programs have primarily focused on inpatient settings. A major challenge for outpatient stewardship is the lack of accurate and accessible electronic data to target interventions. We sought to develop and validate an electronic algorithm to identify inappropriate antibiotic use for outpatients with acute bronchitis. Methods: This study was conducted within the University of Pennsylvania Health System (UPHS). We used ICD-10 diagnostic codes to identify encounters for acute bronchitis at any outpatient UPHS practice between March 15, 2017, and March 14, 2018. Exclusion criteria included underlying immunocompromising condition, other comorbidity influencing the need for antibiotics (eg, emphysema), or ICD-10 code at the same visit for a concurrent infection (eg, sinusitis). We randomly selected 300 (150 from academic practices and 150 from nonacademic practices) eligible subjects for detailed chart abstraction that assessed patient demographics and practice and prescriber characteristics. Appropriateness of antibiotic use based on chart review served as the gold standard for assessment of the electronic algorithm. Because antibiotic use is not indicated for this study population, appropriateness was assessed based upon whether an antibiotic was prescribed or not. Results: Of 300 subjects, median age was 61 years (interquartile range, 50–68), 62% were women, 74% were seen in internal medicine (vs family medicine) practices, and 75% were seen by a physician (vs an advanced practice provider). On chart review, 167 (56%) subjects received an antibiotic. Of these subjects, 1 had documented concern for pertussis and 4 had excluding conditions for which there were no ICD-10 codes. One received an antibiotic prescription for a planned dental procedure. Thus, based on chart review, 161 (54%) subjects received antibiotics inappropriately. Using the electronic algorithm based on diagnostic codes, underlying and concurrent conditions, and prescribing data, the number of subjects with inappropriate prescribing was 170 (56%) because 3 subjects had antibiotic prescribing not noted based on chart review. The test characteristics of the electronic algorithm (compared to gold standard chart review) for identification of inappropriate antibiotic prescribing were the following: sensitivity, 100% (161 of 161); specificity, 94% (130 of 139); positive predictive value, 95% (161 of 170); and negative predictive value, 100% (130 of 130). Conclusions: For outpatients with acute bronchitis, an electronic algorithm for identification of inappropriate antibiotic prescribing is highly accurate. This algorithm could be used to efficiently assess prescribing among practices and individual clinicians. The impact of interventions based on this algorithm should be tested in future studies.Funding: NoneDisclosures: None

Disability in Schizophrenic Disorders

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. Wancata ◽  
M. Freidl ◽  
F. Friedrich ◽  
T. Matschnig ◽  
A. Unger ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Social Consequences ◽  
Subjective Burden ◽  
Social Contacts ◽  
Mothers And Fathers ◽  
Duration Of Illness ◽  
The Family ◽  
Different Types ◽  
Icd 10 ◽  
The Mean

Aims:The purpose of this study was to investigate disability among patients suffering from schizophrenia and to identify predictors of disability.Methods:101 patients from different types of psychiatric services in Vienna and diagnosed with schizophrenia according to ICD-10 were included. They were investigates by means of 36-Item self-administered version of the WHO Disability Assessment Schedule II (WHO-DAS-II) and the PANSS-scale. Patients’ mothers and fathers were asked to fill in the Family Problem Questionnaire.Results:The mean total score of the WHO-DAS-II was 74.1 (SD 21.9). When using weighted sub-scores the highest disability scores were found for social contacts, participation in society and household (means 2.58, 2.57 and 2.51 respectively). Using logistic regression, overall disability was positively associated with patient's age, overall severity of symptoms (PANSS) and number of previous hospital admissions. Overall disability was not associated with duration of illness and or patient's gender. The subjective burden experienced by patients’ fathers and mothers were increased by reduced social contacts and impaired participation in society, while we could not find an association with other domains of patient's disability (understanding, mobility, self-care, household).Conclusions:This study shows that schizophrenia results in disability in several domains. Family caregivers’ burden was predominantly increased by social consequences of schizophrenia.

scholarly journals Non-Invasive Scale Measurement of Cardiac Output Compared with the Gold-Standard Direct Fick Method: A Feasibility Study

2021 ◽  
Author(s):  
Daniel Yazdi ◽  
Sarin Patel ◽  
Suriya Sridaran ◽  
Evan Wilson ◽  
Sarah Smith ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Cardiac Function ◽  
Exercise Test ◽  
Gold Standard ◽  
Cardiopulmonary Exercise Test ◽  
Cardiac Monitoring ◽  
Non Invasive ◽  
Cardiopulmonary Exercise ◽  
The Mean

AbstractBackgroundObjective markers of cardiac function are limited in the outpatient setting and may be beneficial for monitoring patients with chronic cardiac conditions.ObjectiveWe assess the accuracy of a scale, with the ability to capture ballistocardiography, electrocardiography, and impedance plethysmography signals from a patient’s feet while standing on the scale, in measuring stroke volume and cardiac output compared to the gold-standard direct Fick method.MethodsThirty-two patients with unexplained dyspnea undergoing level 3 invasive cardiopulmonary exercise test at a tertiary medical center were included in the final analysis. We obtained scale and direct Fick measurements of stroke volume and cardiac output before and immediately after invasive cardiopulmonary exercise test.ResultsStroke volume and cardiac output from a cardiac scale and the direct Fick method correlated with r = 0.81 and r = 0.85, respectively (P < 0.001 each). The mean absolute error of the scale estimated stroke volume was -1.58 mL, with a 95% limits of agreement (LOA) of -21.97 mL to 18.81 mL. The mean error for the scale estimated cardiac output was -0.31 L/min, with a 95% LOA of -2.62 L/min to 2.00 L/min. The change in stroke volume and cardiac output before and after exercise were 78.9% and 96.7% concordant, respectively between the two measuring methods.ConclusionsThis novel scale with cardiac monitoring abilities may allow for non-invasive, longitudinal measures of cardiac function. Using the widely accepted form factor of a bathroom scale, this method of monitoring can be easily integrated into a patient’s lifestyle.

scholarly journals Therapeutic difficulties in vesicorectal fistula treatment using several techniques in one center

2021 ◽  
Author(s):  
Maciej Przudzik ◽  
Maria Derkaczew ◽  
Robert Hofman ◽  
Marek Roslan
Keyword(s):  
Radical Cystectomy ◽  
Gold Standard ◽  
Ileal Conduit ◽  
Surgical Techniques ◽  
Anterior Rectal Resection ◽  
Surgical Methods ◽  
The Mean ◽  
Fistula Treatment ◽  
No Gold Standard ◽  
Radiotherapy Treatment

Introduction: Vesicorectal fistula (VRF) is a rare but devastating condition that may develop after surgery or radiotherapy. Many surgical methods to treat VRF have been described, but there is still no gold standard of VRF treatment. Aim: The aim of the study is to present our experience in the treatment of VRFs and analyze different surgical techniques applied in our center retrospectively. Material and methods: From June 2016 to June 2020, 7 patients (5 males and 2 females) aged 59–73 years (average 67.3 years) were treated for VRF in our center. The primary causes of VRFs were complications after laparoscopic radical prostatectomy (LRP), sigmoidectomy, laparotomy with removal of the tumour of the vaginal stump and anterior rectal resection and colostomy, Hartmann’s operation due to rectosigmoid carcinoma, radiotherapy, treatment of cervical cancer and transurethral resection of bladder tumor (TURBT). The patients were treated with one of the following methods: transvesical laparoscopic single-site surgery (T-LESS), transanal minimally invasive surgery (TAMIS), transurethral fulguration and radical cystectomy with the Bricker’s ileal conduit. Results and discussion: Five patients underwent T-LESS, 2 TAMIS, 1 transurethral fulguration and 1 radical cystectomy with the Bricker’s ileal conduit. The mean postoperative hospital stay was 4 days (range 2–8 days). The mean operative time was 139 minutes (range 100–285 minutes). Only 1 patient had a recurrence of a fistula. Conclusions: Surgical management of VRFs is obligatory to prevent possible complications. Currently, there is no gold standard for treatment of VRFs. Therefore, this condition requires further investigation.

scholarly journals Standardized patient program: Student feedback

2016 ◽  
Vol 7 (5) ◽  
pp. 102-107 ◽  
Author(s):  
PR Shankar ◽  
NR Dwivedi ◽  
A Nandy ◽  
AK Dubey
Keyword(s):  
Response Rate ◽  
Clinical Skills ◽  
Student Perception ◽  
Student Feedback ◽  
Standardized Patient ◽  
Free Text ◽  
Medical Sciences ◽  
First Semester ◽  
The Mean ◽  
Teaching Learning

Objective: Standardized patients (SPs) are widely used in medical and other health professions education. At xxxx SPs have been used for teaching-learning and assessment of basic science medical students since January 2013. The opinion of SPs about their involvement in teaching-learning and assessment of students has been recently studied. The present study had the objective of studying student perception about various aspects of the program.Materials and Methods: The study was conducted towards end of March and beginning of April 2016. Student perception regarding the program was studied by noting their degree of agreement with a set of 25 statements. Free text comments were also obtained. Gender, nationality and semester of study of the respondents was noted. The total score was compared among different subgroups of respondents.Results: Ninety-eight of the 107 students (91.6%) participated. The mean ± SD total score was 92.33 ± 13.68 (maximum possible score being 125). The scores were significantly higher among first semester students compared to other semesters. Students agreed that interacting with SPs will prepare them for interacting with patients, for their licensing exams and improve their clinical skills. Students learn how to interact with persons from a different cultural background. Suggestions for further improvement were also obtained.    Conclusions: The response rate was high and students’ perception of the SP program was positive. Our experiences would be of special interest to educators in other medical schools with small and/or new SP programs. Similar feedback could be obtained from other xxx schools with SP programs.Asian Journal of Medical Sciences Vol.7(5) 2016 102-107

Diagnostic Accuracy of Rapid Diagnostic Kits Test for Diagnosis of Malaria

2021 ◽  
Vol 15 (10) ◽  
pp. 2826-2828
Author(s):  
Muhammad Ahsan Zafar ◽  
Sidra Khalid ◽  
Talha Munir
Keyword(s):  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Female Ratio ◽  
Diagnostic Kits ◽  
Negative Results ◽  
Malaria Antigen ◽  
The Mean ◽  
Sensitivity Specificity ◽  
Age Range ◽  
Male To Female

Objective: To assess the diagnostic accuracy of rapid diagnostic kits test for diagnosis of malaria taking microscopy as gold standard Methodology: A total of 375 cases with age range 18-65 years of either gender as suspected for malaria were included in the study. We excluded all those cases already taking anti-malarial drugs. The study was conducted at Chughtais Lahore Lab, Lahore. Required blood sample were obtained following aseptic measures. Malaria RDT SD Bioline Malaria Antigen Pf/Pan (Catalogue No. 05FK60, Standard Diagnostics Inc, Hagal-Dong, Korea, from now on referred as “SD RDT”) was used. Patients were labeled as positive or negative on the basis of reports from hematology department assessed by microscopy and patients were labeled as positive or negative Results: The mean age of the patients was 41.84±13.44 years, male to female ratio of the patients was 1.01:1. The sensitivity, specificity, and diagnostic accuracy of the RDT for diagnosing malaria was 96.79%, 96.28% and 96.53% respectively taking microscopy as gold standard Conclusion: Rapid diagnostic kits is very useful reliable test with high diagnostic accuracy for diagnosis of malaria taking microscopy as gold standard Keywords: Microscopy, Rapid Diagnostic kits, Malaria,

scholarly journals M151. DIFFERENCES IN PATTERN OF OBESITY BETWEEN PEOPLE WITH SCHIZOPHRENIA LIVING IN CHINA AND IN AUSTRALIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S192-S193
Author(s):  
Cherrie Galletly ◽  
Xiaoli Wu ◽  
Zili Han ◽  
Dennis Liu
Keyword(s):  
Central Obesity ◽  
Psychotic Disorders ◽  
Chinese Han ◽  
Chinese Sample ◽  
Han Ethnicity ◽  
Cardiovascular Morbidity And Mortality ◽  
Cardiometabolic Disorders ◽  
Icd 10 ◽  
Australian Sample ◽  
The Mean

Abstract Background People with psychotic disorders, including schizophrenia, suffer premature cardiovascular morbidity and mortality. Obesity is a major factor in cardiometabolic disorders in this population. There has been very little research investigating differences in patterns of obesity in diverse ethnic populations. Guidelines for treatment of complex comorbidities in people with schizophrenia and related psychoses may need to provide specific recomendations for different ethnic groups. Methods The Chinese sample consisted 192 subjects were recruited from the outpatients and inpatients department of the psychiatry department of the third affiliated hospital of Sun Yat-sen. All enrolled subjects were Chinese Han ethnicity, aged 16–45 years, with a diagnosis of schizophrenia according to ICD-10 criteria for schizophrenia, excluding other acute psychiatric disorders. The Australian sample (N=1825) were drawn from the Survey of High Impact Psychosis. BMI and central obesity were measured in all subjects. Results 10.3% of men and 4.7% of women in the China sample were obese (BMI&gt;30). In the Australian sample, 41.6% of men and 50.3% of women were obese. Overall, 7.8% of Chinese sample and 45.1% of the Australian sample were obese. However, amongst the non-obese China sample, 41.7% of men and 53.1% of women had central obesity; the mean for all non-obese Chinese people was 46.7%. 73% of non-obese Australian men and 81.5% of non-obese Australian women had central obesity; the mean for all non-obese Australians was 76%. Discussion Chinese Han people with schizophrenia have much lower rates of obesity than the Australian sample. In both groups, rates of abdominal obesity were higher than rates of obesity as defined by BMI. These ethnic differences may help in understanding the high rates of cardiometabolic disorder in people with psychotic disorders in Western countries. They may also inform interventions to assist Western people with psychoses to maintain better physical health.

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