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Use of COSREEL clinical codes in large animal veterinary practice.

COSREEL, a computerised animal health recording system with a versatile coding system for recording diagnoses, symptoms and medical and surgical treatments, has been tested by veterinary surgeons in practice. The codes were found to be logical and generally easy to use. The application of these codes, with particular reference to their use in infertility investigations, is illustrated.

Animals↗

Patient radiation doses during invasive cardiac procedures categorised by clinical code.

Patient radiation doses delivered during invasive fluoroscopic cardiology procedures at the University Hospital of North Staffordshire during a 3 year period from November 1999 to August 2002, and comprising 6189 patient records, have been analysed. Cases have been stratified using classification codes from the Office of Population Census and Surveys (OPCS-4 codes), allowing representative doses to be assessed for 34 distinct types of cardiac radiological procedure. In addition, local guidance levels have been derived for the eight most common procedures. This work represents one of the largest and most detailed published studies of patient radiation dose during cardiac procedures, and should assist in meeting the IR(ME)R regulations requirement for establishment of diagnostic reference levels, and in enabling dose optimization of individual exposures.

Cardiac Surgical Procedures↗

[Rupture of the interventricular septum in acute myocardial infarct: diagnosis by Doppler color code. Clinical case].

Doppler Color Flow Mapping represents the most recent step in the evolution of Doppler techniques that display blood flow signals superimposed on real time, two dimensional echocardiographic images. The following case illustrates the utility of this technique in the diagnosis of a ventricular septal rupture complicating the course of an inferior wall acute myocardial re-infarction. An abnormal blood flow pattern from the left to right ventricle through the ventricular septum was promptly visualized. Early operative intervention may improve the prognosis of acute infarct-related ventricular septal rupture; Doppler Color Flow Mapping and Pulsed Doppler Echocardiography are at present the most rapid and reliable noninvasive techniques in the detection of post-infarct ventricular septal rupture and may greatly expedite medical and surgical management.

Coronary Circulation↗

Factors influencing the costs of emergency medical admissions to an Irish teaching hospital.

This study examined whether there is a relationship between coded diseases at the time of hospital discharge and costs of hospital re-admission. We carried out a systematic review of data relating to emergency medical patients admitted to St. James' Hospital in Dublin between 1 January 2002 and 31 October 2004. Data on discharges from hospital were analyzed as recorded in the hospital in-patient enquiry (HIPE) system. Of 15,876 episodes recorded among 11,201 patients admitted the number of re-admissions numbered up to 43. Age, year of admission, and frequency of admission were factors associated with increased hospital costs. HIPE coding at first discharge predicted increased costs: codes related to heart failure, pneumonia, stroke, diabetes, malignancy, psychiatric, and anaemia-related codes. Clinical coding using the HIPE database thus strongly predicted hospital costs.

Adolescent↗

GALEN Based Formal Representation of ICD10.

The authors present a formal representation of ICD10 based on GALEN CRM. The goal of the work is to create a coding support tool for coding clinical diagnoses to ICD10. The formal representation of the first two chapters of ICD10 has been almost completed. The paper presents the main aspects of the modelling, and the experienced problems. The constructed ontology has been converted to OWL, and a test system has been implemented in Prolog to verify the feasibility of the approach. The system successfully identified diseases in medical records from gastrointestinal oncology. The classifier module is still under development.

Clinical Coding↗

[Coding for clinical laboratory information].

The field of clinical laboratory tests is facing an increase in the number of test items as well as a corresponding diversification due to the demands of medical institutions as well as improvements in analytical techniques. To respond to this situation, medical institutions have been promoting systematization of their testing procedures; information exchange among the institutions has likewise expanded with the use of media such as on-line systems and internet. Standardization of interfaces has been proposed to secure a common framework compatible with different types of information. Some embodiments in this country includes; (1) Interface Standards on Clinical Laboratory Information For information exchange, the format and reporting comments used in the media systems were standardized under the sponsorship of The Medical Information System Development Center, with a publication issued on 1993. (2) Standardization of Laboratory Test Code Standardization of codes for information exchange has been established under the sponsorship of The Japan Society of Clinical Pathology (Laboratory Test Coding Committee), through the systematization of laboratory test code used in media systems. A publication entitled "Classification & Coding for Clinical Laboratory Tests (8th edition in 1992, 9th edition in 1994 and supplement in 1996)" has been issued. The system for "Classification & Coding for Clinical Laboratory Tests" is divided into 5 components; (1) analyte code, (2) identification code, (3) specimen code, (4) methodology code, and (5) data classification code. The Laboratory test codes are precisely classified by "(1) analyte code", and then are identified by combination of additional codes such as specimen and methodology codes. In this year, we are making a new easily-used-codes composed of 5 Arabic figures.

Clinical Laboratory Information Systems↗

Application and evaluation of a caring code in clinical nursing education.

This study evaluated the effectiveness of the Caring Code, a tool for teaching caring to nursing students during clinical practice. An experimental, longitudinal design was used. A sample of 480 students from a 5-year junior nursing college program in Taiwan was randomly divided into experimental and control groups. Each member of the experimental group carried a copy of the Caring Code, the content of which was explained by the clinical instructors at the beginning of clinical practice, and about which reminders were provided weekly. A questionnaire was distributed to the patients during the nursing students' 1-year clinical practice, once prior to the implementation of the Caring Code and twice afterwards, to obtain quantitative data on the caring behaviors of the two student groups. Instructors and nursing students were interviewed for their experiences and perceptions of using the Caring Code. The Caring Code had a statistically significant positive effect on student caring behavior.

Adult↗

Predictive value of clinical diagnostic codes for the CDC case definition of pelvic inflammatory disease (PID): implications for surveillance.

BACKGROUND: Reporting of pelvic inflammatory disease (PID) from private providers could be incomplete because of time and staff constraints, lack of knowledge of reporting requirements and of case definitions. Reporting burden can be alleviated with the use of administrative data. GOAL: The goal of this study was to determine the validity of clinical diagnostic codes assigned in electronic medical records (EMR) for identifying PID and their use in enhancing surveillance. STUDY DESIGN: A random sample of 296 records with a PID International Classification of Diseases, 9th Revision (ICD-9), code (614.9) were reviewed to assess for the presence of the Centers for Disease Control and Prevention (CDC) criteria for the case definition of PID. We used the records meeting the CDC clinical case definition criteria as the reference standard to determine the sensitivity, specificity, and predictive values of various data elements. RESULTS: Used alone, the positive predictive value (PPV) of ICD-9 code 614.9 for a CDC case definition of PID was 18.1%. The PPV increased to 100% and 56% when the ICD-9 code visit was associated with a positive test for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT), respectively. CONCLUSION: In this multispecialty group practice, a positive test for GC and CT coupled with ICD-9 code 614.9 could be used to enhance reporting of cases of PID.

Adult↗