Isolated subsegmental pulmonary embolism identification based on international classification of diseases (ICD)-10 codes and imaging reports.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Rashedi Sina, Bejjani Antoine, Hunsaker Andetta R, Aghayev Ayaz, Khairani Candrika D, McGonagle Bridget, Lo Ying-Chih, Mahajan Shiwani, Caraballo César, Jimenez Jose Victor, Krishnathasan Darsiya, Zarghami Mehrdad, Monreal Manuel, Barco Stefano, Secemsky Eric A, Klok Frederikus A, Muriel Alfonso, Hussain Mohamad A, Appah-Sampong Abena, Rahaghi Farbod N, Sadeghipour Parham, Lin Zhenqiu, Mojibian Hamid, Aneja Sanjay, Konstantinides Stavros, Goldhaber Samuel Z, Wang Liqin, Zhou Li, Jimenez David, Krumholz Harlan M, Piazza Gregory, Bikdeli Behnood, PE-EHR+ Investigators
Аннотация
METHODS: Based on prespecified criteria, 1734 medical records of adult patients hospitalized within the Mass General Brigham health system (2016-2021) were selected in three equal groups: (1) patients with principal discharge diagnosis codes for PE, (2) patients with secondary discharge diagnosis codes for PE, and (3) patients with no PE codes. The accuracy of ICD-10 codes for issPE was verified by two independent physicians and weighted by total hospitalizations. In a randomly selected sample of 70 patients, the accuracy of initial radiology reports was determined through a blinded re-evaluation by two expert radiologists.
RESULTS: In weighted estimates, ICD-10 codes in primary or secondary discharge positions, compared with chart reviews, showed a low sensitivity (7.0 %) and positive predictive value (25.2 %). Evaluation by two expert radiologists noted that initial radiology reports were sensitive (97.1 %) for issPE but had a low specificity (40.0 %). Two (3.6 %) out of 55 patients with initial issPE reports did not have PE, while 19 (34.5 %) had more proximal PE.
CONCLUSIONS: ICD-10 codes for issPE have poor sensitivity and positive predictive value and should not be used for research or quality improvement. Radiology reports for issPE may be inaccurate regarding the location or, less often, the presence of PE.