Development of an ICD Coding Definition for Inflammatory Bowel ...

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Epigraph —No knowledge is acquired prudent through the study of its causes and beginnings, if it has had causes and beginnings, nor completed except by knowledge of its effects and associated essentials“ Ibn Sina (Avicenna) Iranian Physician and philosopher (980œ1037 AD): Iranian Culture xii Journal
Chapter One: INTRODUCTION Crohn‘s disease (CD) and ulcerative colitis (UC), known as inflammatory bowel diseases (IBD), are chronic inflammatory conditions of the gastrointestinal tract. Although several hypotheses suggest a combination of environmental factors, genetic predisposition and dysfunctional immunoregulation for the etiology of IBD, the exact etiology of IBD remains uncertain. The highest incidence and prevalence of IBD is reported in Canada and about 0.5% of Canadians are estimated to have IBD [1]. Quality of life is negatively affected with loss of productivity in school or at work, and patients require continuous treatment and long-term follow-up. One approach to achieve valuable clues to the etiology, or the social or economic burden of IBD is through meticulous population-based epidemiologic studies. Epidemiologic studies describe, understand, interpret and predict the impact of a disease on public health to a wide variety of audiences including caregivers, patients, decision makers, government agencies, and service providers. However, establishing a universal registry for IBD patients in a health region is not an easy task. More and more IBD cases are being diagnosed and managed in outpatient clinics [2], so that hospital based data would not be adequate to identify IBD patients. In Canada there is a unique ability to access health care contacts through comprehensive administrative databases, which can be utilized to identify IBD patients. Although Alberta benefits from a rich and sophisticated health care data collection system, there are no indigenous administrative criteria to extract IBD cases from the administrative databases. This study was conducted to develop an administrative 1
Page 1 and 2: UNIVERSITY OF CALGARY DEVELOPMENT O
Page 3 and 4: Abstract INTRODUCTION: To facilitat
Page 5 and 6: Dedication To my parents and my sis
Page 7 and 8: 4.3.1 Computerized search..........
Page 9 and 10: List of Tables Table1. Incidence an
Page 11: List of Abbreviations Symbol Defini
Page 15 and 16: 2.1 Inflammatory Bowel disease Chap
Page 17 and 18: are usually apparent. Potentially l
Page 19 and 20: Incidence and prevalence rates of I
Page 21 and 22: contact in 1989 or later, to allow
Page 23 and 24: significant condition of the patien
Page 25 and 26: Young et al.[36] found that agreeme
Page 27 and 28: 3.1 Significance Chapter Three: Sig
Page 29 and 30: 4.1 Summarized design Chapter Four:
Page 31 and 32: 4.2.4 Ambulatory Care Classificatio
Page 33 and 34: 4.4 Retrieving the personal health
Page 35 and 36: 4.7 Preliminary development of the
Page 37 and 38: Each time frame 1 (i.e. ”t‘ in
Page 39 and 40: 4.7.1 Sensitivity Sensitivity (true
Page 41 and 42: hospitals were reviewed for each pa
Page 43 and 44: final two definitions was founded o
Page 45 and 46: Figure 1. Distribution of the proce
Page 47 and 48: 5.4.1 IP database (FY 1994 œ FY 20
Page 49 and 50: 5.4.2 PC database (FY 1995 œ FY 20
Page 51 and 52: Diagram 4. Frequency of ACCS contac
Page 53 and 54: Table 3. 2×2 contingency table and
Page 55 and 56: within 5 years“. Of 137 false pos
Page 57 and 58: —IP≥1 or PC≥5 or ACCS≥2 wit
Page 59 and 60: 5.6.2 False negative patients Defin
Page 61 and 62: definitions were selected as our fi
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• Incomplete documentation of lin
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94.5% of our subjects were regarded
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prevalence of IBD in the Calgary He
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with no flare in the last 10 years
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• At least two independent and se
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FP rate (i.e. 1-specificity or ). T
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CD, IC patients who become CD or UC
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6.5 Limitations When extrapolating
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egions that do not have access to t
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17. Trallori, G., et al., A populat
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APPENDIX 1. INTERNATIONAL CLASSIFIC
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556.8 Other ulcerative colitis 556.
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• ICD-10-CA Enteritis, NOS, diete
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APPENDIX 2. SEARCH TERMS IN ENDOPRO
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INVOLVEMENT Shade the corresponding
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APPENDIX 4. ETHICAL APPROVAL 81
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IP = 1 PC =3 ACCS =2 IP = 1 PC = 3
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IP = 1 PC = 5 ACCS = 2 IP = 1 PC =
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IP = 2 PC = 2 ACCS = 2 IP = 2 PC =
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IP = 2 PC = 4 ACCS = 2 IP = 2 PC =
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IP = 2 PC = 6 ACCS = 2 IP = 2 PC =
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IP = 1 PC =4 IP = 1 PC = 5 Criteria
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IP = 2 PC = 3 IP = 2 PC = 4 Criteri
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APPENDIX 7. 2×2 TABLES AND TEST CH
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• Definition —IP≥1 or PC≥4
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IBD patients had a median number of
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Diagram 8. Frequency of ACCS contac
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IP = 1 PC =3 ACCS =2 IP = 1 PC = 3
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IP = 1 PC = 5 ACCS = 2 IP = 1 PC =
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IP = 2 PC = 2 ACCS = 2 IP = 2 PC =
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IP = 2 PC = 4 ACCS = 2 IP = 2 PC =
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IP = 2 PC = 6 ACCS = 2 IP = 2 PC =
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IP = 1 PC =4 IP = 1 PC = 5 Criteria
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IP = 2 PC = 3 IP = 2 PC = 4 Criteri
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APPENDIX 11. 2×2 TABLES AND TEST C
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