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

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manifested by loss of normal vasculature, blunting of the haustral pattern and granularity. A yellow mucosal exudate and inflammatory pseudopolyps might be present. Inflamed mucosa is friable, meaning that the intestinal wall bleeds easily following minor trauma [10]. 2.1.5 Epidemiology of IBD The literature surrounding the epidemiology of IBD is very rich [11]. Table 1. summarizes some of the incidence and prevalence rates reported in population-based studies for CD and UC. Table1. Incidence and prevalence rates per 100,000 persons of IBD in different geographic regions Region Year North America Northern Alberta[12] UC incidence UC prevalence CD incidence CD prevalence 1981 6 37.5 10 44.4 Manitoba[2] 1994 14.3 169.7 14.6 198.5 Olmsted, MN[13] Europe 1993 8.3 229 6.9 144.1 Denmark[14] 1987 9.2 161.2 4.2 54 Denmark[15] 1999 20.3 - 3.6 - UK[16] 1995 13.9 243 8.3 144 Italy[17] 1992 9.6 121 3.4 40 Croatia[18, 19] 1989 1.5 21.4 0.7 8.3 East Asia Japan[20] 1991 1.9 18.1 0.5 5.8 6
Incidence and prevalence rates of IBD are dynamic and differ enormously based on geographic region. The highest reported rates for CD are from Manitoba [2]. For UC the highest rates have been reported from Manitoba [2], US [13] and Denmark [14]. In general the incidence and prevalence of IBD seems to be higher in northern regions [11] and also western locales (North to South, West to East gradient). In addition to the incidence and prevalence of IBD being different all around the world, it seems that the rates are not constant in a given region. In the mid 1980s and 1990s, explosive increases were reported from Europe, Africa and Latin America [21]. Although some reports have mentioned a plateau in developed countries, this increase still continues in developing countries [13]. Three population-based epidemiologic studies have been performed on IBD patients in Canada: 1-Northern Alberta: (Population=1,295,360) Pinchbeck et al. [12] identified all the patients discharged from northern Alberta hospitals with the diagnosis of IBD from 1977 to 1981, along with the records of IBD patients being managed by Edmonton gastroenterologists in case they were not hospitalized within that period. All of eligible 2,419 charts were reviewed and only those with clinical plus radiological and/or pathological criteria were included (n=1716). Results of this study are shown in Table 1. 7
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 and 12: List of Abbreviations Symbol Defini
Page 13 and 14: Chapter One: INTRODUCTION Crohn‘s
Page 15 and 16: 2.1 Inflammatory Bowel disease Chap
Page 17: are usually apparent. Potentially l
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
Page 63 and 64: • Incomplete documentation of lin
Page 65 and 66: 94.5% of our subjects were regarded
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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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