Implementation of data management and effect on chronic disease coding in a primary care organisation: A parallel cohort observational study

Greiver, Michelle; Wintemute, Kimberly; Aliarzadeh, Babak; Martin, Ken; Khan, Shahriar; Jackson, Donald A.; Leggett, Jannet Ann; Lambert-Lanning, Anita; Siu, Maggie

doi:10.14236/jhi.v23i3.843

Cited by 8 publications

(8 citation statements)

References 36 publications

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“…For this reason, we only used data beginning in March 2006. We found no evidence that speaks directly to changes in coding behavior over time; however, we did identify studies that spoke of the need to intervene in order to improve coding [19, 20]. This may suggest that, in the absence of interventions, it is unlikely coding behavior would have changed substantially over time.…”

Section: Discussionmentioning

confidence: 80%

Identifying musculoskeletal conditions in electronic medical records: a prevalence and validation study using the Deliver Primary Healthcare Information (DELPHI) database

Ryan

Maddocks

McKay

et al. 2019

BMC Musculoskelet Disord

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Background Musculoskeletal (MSK) conditions are a common presentation in primary care. This study sought to determine the prevalence of MSK conditions in primary care in Ontario and to validate the extent to which health administrative date billing codes accurately represent MSK diagnoses. Methods De-identified electronic medical records (EMR) from the DELPHI database in southwestern Ontario, which contains 2493 patients (55.6% female, mean age 50.3 years (SD = 22.2)) and 21,964 encounters (July 1, 2006-June 30, 2010) were used for the analyses. Outcomes included: validation measures of agreement between International Classification of Diseases (ICD-9) diagnostic codes (health administrative data) and International Classification of Primary Care (ICPC) diagnoses defined as the reference standard, time to first ICD-9 code, prevalence, and healthcare utilization. Results There were 2940 true positive MSK encounters with primary care practitioners for 998 patients. Performance of the ICD-9 diagnostic codes included sensitivity = 76.5%, specificity = 95.2%, PPV = 94.6%, and NPV = 78.7%, compared to the ICPC reference standard. The majority of 998 patients were coded with both an ICPC and ICD-9 MSK code at their first or second encounter (67.4%). However, 23.5% of patients with the ICPC reference standard MSK were never coded with ICD-9. Four-year prevalence of MSK was 52.3% and varied by age (4.5% 0-17 years, 20.1% 18–44, 42.7% 45–64, and 32.7% 65+). Patients at MSK encounters had a higher number of: investigations (17.9% compared to 9.1%, p < .0001); referrals (17.6% compared to 14.3%, p < .0001); and prescriptions for opioids (17.2% compared to 5.3%, p < .0001). Conclusions This study determined the prevalence of musculoskeletal conditions in primary care in Ontario using a reference standard definition. The study highlighted the value of using primary care ICPC codes to validate a definition for musculoskeletal conditions. Health administrative data can be used to ascertain the presence of musculoskeletal conditions; however, ICD-9 codes may underrepresent the prevalence of MSK conditions. Electronic supplementary material The online version of this article (10.1186/s12891-019-2568-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 80%

Identifying musculoskeletal conditions in electronic medical records: a prevalence and validation study using the Deliver Primary Healthcare Information (DELPHI) database

Ryan

Maddocks

McKay

et al. 2019

BMC Musculoskelet Disord

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“…Following the development and piloting of the STROBE-M score checklist, we conducted a more formal evaluation of its inter-rater agreement. One reviewer (VL) selected 45 observational study publications (15 each from cross-sectional (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37), cohort (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52), and case-control study (53-67) from ìPubMed databaseî published in the time period of 1 st March 2016 to 31 st May 2016 with the filters of English language, human studies, and full text availability. Irrelevant publications (opinion or critique of previous studies, letters to editors, meta-analysis were excluded (Fig.…”

Section: Inter-rater Agreement Of Strobe-m Score Checklistmentioning

confidence: 99%

Development of a Quantitative Scoring Method for Strobe Checklist

Limaye¹,

Limaye²,

Pitani³

et al. 2018

Acta Poloniae Pharmaceutica - Drug Research

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Evidence-based medicine (EBM) has brought a substantial change in medical practice and clinical care approach (1-3). It has helped to focus on valid and reliable information to make sound decisions in the area of disease management. Although randomized controlled trials (RCTs) are considered as the reference standard and provide valuable evidence about the efficacy of new treatments, yet they do not answer all important questions about the specific treatment. Most of the knowledge in clinical practice comes from observational studies from which we can gain further experience to plan interventional studies in regards to efficacy, safety and tolerability of approved medicines (4). An observational study is defined as a study that provides estimates and examines associations of events in their natural settings without recourse to experimental intervention (5). It includes cohort studies (CO) ñ prospective and retrospective, crosssectional studies (CS), and case-control studies (CC) (6). Current evidence suggests that observational studies, such as those discussed earlier, both com

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“…Greiver et al demonstrate how adding standardised codes back into the computerised medical record improves data quality for chronic diseases 6. This initially seemed to me to be a scary idea with risks of miscoding or misclassification – which can be commonplace, even in a condition like diabetes 7.…”

Section: Data Qualitymentioning

confidence: 99%

In this issue - Don’t make assumptions about integrated systems, data quality, utilisation of technology, or access to routine data

Lusignan

2016

jhi

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Implementation of data management and effect on chronic disease coding in a primary care organisation: A parallel cohort observational study

Abstract: Data management activities were associated with an increase in standardized coding for chronic conditions. Exploring requirements to scale and spread this approach in Canadian primary care organisations may be worthwhile.

Cited by 8 publications

References 36 publications

Identifying musculoskeletal conditions in electronic medical records: a prevalence and validation study using the Deliver Primary Healthcare Information (DELPHI) database

Identifying musculoskeletal conditions in electronic medical records: a prevalence and validation study using the Deliver Primary Healthcare Information (DELPHI) database

Development of a Quantitative Scoring Method for Strobe Checklist

In this issue - Don’t make assumptions about integrated systems, data quality, utilisation of technology, or access to routine data

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