Moving Beyond Administrative Data Sets and Coding Data

[摘要] In the study by Harris et al1 in this issue of Hospital Pediatrics , the authors attempted to compare the identification of central line–associated bloodstream infections (CLABSIs) by using administrative coding data versus clinical criteria from the Centers for Disease Control and Prevention that are reported to a voluntary infection control network. The authors demonstrated that more CLABSIs were reported with the voluntary network ( n = 138) than with the administrative data ( n = 76). In analyzing the data, using the infection control network as the gold standard, they found that CLABSI identification by using coding data had a sensitivity of 35% with a positive predictive value of 63%.Their study1 outlines some of the potential pitfalls and problems with using coding data to study clinical outcomes. In the case of CLABSIs, before 2007, these infections were coded with a nonspecific International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code that included infections associated with many devices, such as arterial lines or pacemakers. The use of nonspecific codes makes it difficult to accurately use coding data for the purposes of clinical outcomes research. For example, researchers attempting to study apparent life-threatening events in children before 2009, when the first specific code for these events was introduced, had to search for such disparate codes as apnea, cyanosis, and reflux.2 The upcoming introduction of International Classification of Diseases, 10th Revision, Clinical Modification, in the United States will reportedly help alleviate this concern. The number and specificity of codes have been increased substantially over those currently …

[学科分类] 儿科学

[关键词] Campylobacter;proljev;dob