IMPORTANCE International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes are used to characterize coronavirus disease 2019 (COVID-19)-related symptoms. Their accuracy is unknown, which could affect downstream analyses. OBJECTIVE To compare the performance of fever-, cough-, and dyspnea-specific ICD-10 codes with medical record review among patients tested for COVID-19. DESIGN, SETTING, AND PARTICIPANTS This cohort study included patients who underwent quantitative reverse transcriptase-polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 at University of Utah Health from March 10 to April 6, 2020. Data analysis was performed in April 2020. MAIN OUTCOMES AND MEASURES The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ICD-10 codes for fever (R50*), cough (R05*), and dyspnea (R06.0*) were compared with manual medical record review. Performance was calculated overall and stratified by COVID-19 test result, sex, age group (<50, 50-64, and >64 years), and inpatient status. Bootstrapping was used to generate 95% CIs, and Pearson χ 2 tests were used to compare different subgroups. RESULTS Among 2201 patients tested for COVD-19, the mean (SD) age was 42 (17) years; 1201 (55%) were female, 1569 (71%) were White, and 282 (13%) were Hispanic or Latino. The prevalence of fever was 66% (1444 patients), that of cough was 88% (1930 patients), and that of dyspnea was 64% (1399 patients). For fever, the sensitivity of ICD-10 codes was 0.26 (95% CI, 0.24-0.29), specificity was 0.98 (95% CI, 0.96-0.99), PPV was 0.96 (95% CI, 0.93-0.97), and NPV was 0.41 (95% CI, 0.39-0.43). For cough, the sensitivity of ICD-10 codes was 0.44 (95% CI, 0.42-0.46), specificity was 0.88 (95% CI, 0.84-0.92), PPV was 0.96 (95% CI, 0.95-0.97), and NPV was 0.18 (95% CI, 0.16-0.20). For dyspnea, the sensitivity of ICD-10 codes was 0.24 (95% CI, 0.22-0.26), specificity was 0.97 (95% CI, 0.96-0.98), PPV was 0.93 (95% CI, 0.90-0.96), and NPV was 0.42 (95% CI, 0.40-0.44). ICD-10 code performance was better for inpatients than for outpatients for fever (χ 2 = 41.30; P < .001) and dyspnea (χ 2 = 14.25; P = .003) but not for cough (χ 2 = 5.13; P = .16). CONCLUSIONS AND RELEVANCE These findings suggest that ICD-10 codes lack sensitivity and have poor NPV for symptoms associated with COVID-19. This inaccuracy has implications for any downstream data model, scientific discovery, or surveillance that relies on these codes.
Although many researchers have examined the prevalence of stereotypy in individuals with developmental disabilities, the results of previous studies have not been aggregated and analyzed methodically. Thus, we conducted a systematic review of studies reporting the prevalence of stereotypy in individuals with developmental disabilities. Our results indicated that the average prevalence of stereotypy across studies was 61% and that individuals with autism spectrum disorders had the highest reported prevalence (i.e., 88%) across specific diagnoses. Children and adults generally had similar overall prevalence measures, but the specific forms varied with age and diagnosis. Studies using the Repetitive Behavior Scale-Revised and the Autism Diagnostic Schedule-Revised generally reported higher estimates of prevalence of specific forms of stereotypy when compared to the Behavior Problem Inventory. However, the latter seemed more sensitive than the Aberrant Behavior Checklist for overall prevalence. Studies with a low risk of bias found a lower prevalence of stereotypy than those with a high risk of bias. Our results underline the importance of continuing research efforts to improve the assessment and treatment of stereotypy in individuals with developmental disabilities.
Applying the theory of the intergenerational transmission of divorce, this paper examines the consequences of parental divorce on three aspects of the life course of children: union formation, nonmarital fertility, and marital dissolution. The 1995 Canadian General Social Survey (GSS) is used to estimate various regression models (Cox proportional hazards). Results show that children of divorced parents have a significantly higher likelihood to have births outside of marriage, enter into cohabiting unions, and to experience higher levels of divorce. Throughout the paper, attention is placed on the markedly different behaviour observed in Quebec compared to elsewhere in Canada.
Working papers of the Max Planck Institute for Demographic Research receive only limited review. Views or opinions expressed in working papers are attributable to the authors and do not necessarily refl ect those of the Institute.
Monoparentalité et recomposition familiale font dorénavant partie de la vie familiale. Dans ce contexte, souvent les parents séparés ne vivent plus au quotidien avec leurs enfants, sans que ne s’éteignent les droits et les obligations qui les unissent. Le maintien de ces relations parent-enfants met en cause la pertinence de la définition statistique de la famille fondée sur la corésidence. Les résultats d’une analyse fondée sur l’Enquête sociale générale de 2001 réalisée par Statistique Canada montrent que le nombre de ménages qui, à un moment ou l’autre, accueillent des enfants de moins de 18 ans augmente de 13 %, lorsque l’on tient compte du réseau familial extra-résidentiel. La vérification de l’existence de relations concrètes entre parents et enfants qui ne vivent pas ensemble rencontre cependant des embûches liées aux perceptions divergentes des parents selon qu’ils habitent ou non avec leurs enfants, ainsi qu’aux difficultés associées à la représentativité des échantillons des parents non résidants.Lone-parenthood and step-parenthood are now part of contemporary family life. In this context, separated parents often do not live on a daily basis with their children, while still assuming rights and responsibilities towards them. The maintenance of these parent-children relationships questions the relevance of the traditional definition of the family based on co-residence. An analysis of the 2001 General Social Survey conducted by Statistics Canada shows a 13 % increase in the number of households that include children aged less than 18 years, when taking into account the extra-residential family network. Verifying the existence of concrete relationships between family members who are not living together proves, however, to be difficult, because of the divergent perceptions of parents depending on whether or not they live with their children, and of the problems associated with reaching a representative sample of non-residing parents
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