Classification algorithms to improve the accuracy of identifying patients hospitalized with community-acquired pneumonia using administrative data.

SUMMARYIn epidemiological studies of community-acquired pneumonia (CAP) that utilize administrative data, cases are typically defined by the presence of a pneumonia hospital discharge diagnosis code. However, not all such hospitalizations represent true CAP cases. We identified 3991 hospitalizations...

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Publicado en:Epidemiology & Infection Vol. 139; no. 9; pp. 1296 - 1307
Autores principales: Yu O, Nelson JC, Bounds L, Jackson LA
Formato: research Journal Article
Publicado: Cambridge University Press Sep2011
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2011
      vid: 139
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      pub: Cambridge University Press
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        104668687
        2011233472
        10.1017/S0950268810002529
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        104668687
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        atl: Classification algorithms to improve the accuracy of identifying patients hospitalized with community-acquired pneumonia using administrative data.
      aug:
        au:
          Yu O
          Nelson JC
          Bounds L
          Jackson LA
        affil: Biostatistics Unit, Group Health Research Institute, Seattle, WA, USA.
      sug:
        subj:
          Community-Acquired Infections Classification
          Community-Acquired Infections Epidemiology
          Pneumonia Classification
          Pneumonia Epidemiology
          Adolescence
          Adult
          Aged
          Aged, 80 and Over
          Classification Algorithms
          Child
          Child, Preschool
          Community-Acquired Infections Diagnosis
          Female
          Hospitalization Statistics and Numerical Data
          Infant
          Infant, Newborn
          Male
          Middle Age
          Pneumonia Diagnosis
          Predictive Value of Tests
          Sensitivity and Specificity
          Adolescent: 13-18 years
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Infant: 1-23 months
          Infant, Newborn: birth-1 month
          Middle Aged: 45-64 years
          Female
          Male
      ab: SUMMARYIn epidemiological studies of community-acquired pneumonia (CAP) that utilize administrative data, cases are typically defined by the presence of a pneumonia hospital discharge diagnosis code. However, not all such hospitalizations represent true CAP cases. We identified 3991 hospitalizations during 1997-2005 in a managed care organization, and validated them as CAP or not by reviewing medical records. To improve the accuracy of CAP identification, classification algorithms that incorporated additional administrative information associated with the hospitalization were developed using the classification and regression tree analysis. We found that a pneumonia code designated as the primary discharge diagnosis and duration of hospital stay improved the classification of CAP hospitalizations. Compared to the commonly used method that is based on the presence of a primary discharge diagnosis code of pneumonia alone, these algorithms had higher sensitivity (81-98%) and positive predictive values (82-84%) with only modest decreases in specificity (48-82%) and negative predictive values (75-90%).
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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