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

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4.8.2 False negatives Considering the sensitivity and specificity of our different sets of administrative definitions, the definition with the lowest acceptable sensitivity was chosen. A random number of 35 PHNs were selected from the total number of FNs. Corresponding hospital chart numbers were extracted from EndoPro database and charts were reviewed. The advantage of this approach was that the definition with the lowest acceptable sensitivity includes the FNs of the more sensitive definition as well. 4.8.3 True positives To assess the reliability of EndoPro search in capturing IBD patients, we performed a random number of chart reviews (i.e. 33 patients) in the true positive group. 4.9 Integration of charts reviews with EndoPro search In case there was a discrepancy in IBD status between EndoPro search and chart reviews, we considered the results of the chart reviews as the final decisive diagnostic tool. EndoPro IBD status was kept for patients whose charts were unavailable. Number of discrepant cases in each cluster and the reason for the discrepancy were reported. A final data file containing the IBD status of our subjects was developed based on the final gold standard diagnostic tool (i.e. EndoPro search + Chart review). 4.10 Selection of the final administrative definition for IBD Using the data file developed in section 4.9, all the analysis in section 4.7 was repeated and definition characteristics were calculated through the same methods. Selection of our 30
final two definitions was founded on a balance among specificity, sensitivity, results of chart reviews, and periodicity of the administrative definition (one definition does not integrate the ACSS database). 4.11 Ethical considerations Ethical approval was received from the Office of Medical Bioethics at the University of Calgary (Appendix 4). This research was carried out according to Tri-council policy statement: the ethical conduct for research involving humans [43]. Data were presented in aggregate form and individual patients were not identified. Individual patients were never contacted and their care was not influenced by any means by this research. 31
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 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: hospitals were reviewed for each pa
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
Page 67 and 68: prevalence of IBD in the Calgary He
Page 69 and 70: with no flare in the last 10 years
Page 71 and 72: • At least two independent and se
Page 73 and 74: FP rate (i.e. 1-specificity or ). T
Page 75 and 76: CD, IC patients who become CD or UC
Page 77 and 78: 6.5 Limitations When extrapolating
Page 79 and 80: egions that do not have access to t
Page 81 and 82: 17. Trallori, G., et al., A populat
Page 83 and 84: APPENDIX 1. INTERNATIONAL CLASSIFIC
Page 85 and 86: 556.8 Other ulcerative colitis 556.
Page 87 and 88: • ICD-10-CA Enteritis, NOS, diete
Page 89 and 90: APPENDIX 2. SEARCH TERMS IN ENDOPRO
Page 91 and 92: INVOLVEMENT Shade the corresponding
Page 93:
APPENDIX 4. ETHICAL APPROVAL 81
Page 96 and 97:
IP = 1 PC =3 ACCS =2 IP = 1 PC = 3
Page 98 and 99:
IP = 1 PC = 5 ACCS = 2 IP = 1 PC =
Page 100 and 101:
IP = 2 PC = 2 ACCS = 2 IP = 2 PC =
Page 102 and 103:
IP = 2 PC = 4 ACCS = 2 IP = 2 PC =
Page 104 and 105:
IP = 2 PC = 6 ACCS = 2 IP = 2 PC =
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IP = 1 PC =4 IP = 1 PC = 5 Criteria
Page 108 and 109:
IP = 2 PC = 3 IP = 2 PC = 4 Criteri
Page 110 and 111:
APPENDIX 7. 2×2 TABLES AND TEST CH
Page 112 and 113:
• Definition —IP≥1 or PC≥4
Page 114 and 115:
Page 116 and 117:
Page 118 and 119:
Page 120 and 121:
IBD patients had a median number of
Page 122 and 123:
Diagram 8. Frequency of ACCS contac
Page 124 and 125:
IP = 1 PC =3 ACCS =2 IP = 1 PC = 3
Page 126 and 127:
IP = 1 PC = 5 ACCS = 2 IP = 1 PC =
Page 128 and 129:
IP = 2 PC = 2 ACCS = 2 IP = 2 PC =
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IP = 2 PC = 4 ACCS = 2 IP = 2 PC =
Page 132 and 133:
IP = 2 PC = 6 ACCS = 2 IP = 2 PC =
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IP = 1 PC =4 IP = 1 PC = 5 Criteria
Page 136 and 137:
IP = 2 PC = 3 IP = 2 PC = 4 Criteri
Page 138 and 139:
APPENDIX 11. 2×2 TABLES AND TEST C
Page 140 and 141:
Page 142 and 143:
Page 144 and 145:
Page 146:
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