Is it possible to identify cases of coronary artery bypass graft postoperative surgical site infection accurately from claims data?

Background: Claims data has usually been used in recent studies to identify cases of healthcare-associated infection. However, several studies have indicated that the ICD-9-CM codes might be inappropriate for identifying such cases from claims data; therefore, several researchers developed alternati...

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Publicado en:BMC Medical Informatics & Decision Making Vol. 14; no. 1; pp. 42 - 43
Autores principales: Yu, Tsung-Hsien, Hou, Yu-Chang, Lin, Kuan-Chia, Chung, Kuo-Piao
Formato: research Journal Article
Publicado: BioMed Central 2014
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Is it possible to identify cases of coronary artery bypass graft postoperative surgical site infection accurately from claims data?
      aug:
        au:
          Yu, Tsung-Hsien
          Hou, Yu-Chang
          Lin, Kuan-Chia
          Chung, Kuo-Piao
        affil: Institute of Healthcare Policy and Management, National Taiwan University, Taipei, Taiwan. kpchung@ntu.edu.tw.
      sug:
        subj:
          Coronary Artery Bypass Adverse Effects
          Epidemiology
          Insurance
          National Health Programs
          Surgical Wound Infection Epidemiology
          Aged
          Antibiotics Therapeutic Use
          Female
          Health Status Indicators
          Human
          International Classification of Diseases
          Male
          Middle Age
          Models, Statistical
          Retrospective Design
          Sensitivity and Specificity
          Surgical Wound Infection Drug Therapy
          Surgical Wound Infection Etiology
          Taiwan
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Claims data has usually been used in recent studies to identify cases of healthcare-associated infection. However, several studies have indicated that the ICD-9-CM codes might be inappropriate for identifying such cases from claims data; therefore, several researchers developed alternative identification models to correctly identify more cases from claims data. The purpose of this study was to investigate three common approaches to develop alternative models for the identification of cases of coronary artery bypass graft (CABG) surgical site infection, and to compare the performance between these models and the ICD-9-CM model.Methods: The 2005-2008 National Health Insurance claims data and healthcare-associated infection surveillance data from two medical centers were used in this study for model development and model verification. In addition to the use of ICD-9-CM codes, this study also used classification algorithms, a multivariable regression model, and a decision tree model in the development of alternative identification models. In the classification algorithms, we defined three levels (strict, moderate, and loose) of the criteria in terms of their strictness. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were used to evaluate the performance of each model.Results: The ICD-9-CM-based model showed good specificity and negative predictive value, but sensitivity and positive predictive value were poor. Performances of the other models were varied, except for negative predictive value. Among the models, the performance of the decision tree model was excellent, especially in terms of positive predictive value.Conclusion: The accuracy of identification of cases of CABG surgical site infection is an important issue in claims data. Use of the decision tree model to identify such cases can improve the accuracy of patient-level outcome research. This model should be considered when performing future research using claims data.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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