Systematic review: development of a consensus code set to identify cirrhosis in electronic health records

Shearer, Jessica; González, Juan José; Min, Thazin; Parker, Richard; Jones, Rebecca; Su, Grace L.; Tapper, Elliot B.; Rowe, Ian

doi:10.1111/apt.16806

Cited by 25 publications

(43 citation statements)

References 39 publications

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“…The incidence of claims was calculated for people with cirrhosis and liver transplantation. This was accomplished by searching the electronic medical records for patients with validated diagnosis codes for cirrhosis 7 and for all patients who had received or undergone a liver transplant. We could not determine a denominator for CLD as many (eg, NAFLD, alcohol-associated liver disease) have insensitive diagnostic codes.…”

Section: Methodsmentioning

confidence: 99%

“…We rendered all CLDs and cirrhosis complications into validated diagnostic codes 7 to pull closed cases attributed to those diagnostic codes from Candello’s Comparative Benchmarking System. (Supplementary Table 1, http://links.lww.com/HC9/A247 ) Candello is a division of the Risk Management Foundation and the Controlled Risk Insurance Company.…”

Section: Methodsmentioning

confidence: 99%

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Medical malpractice claims in Hepatology: Rates, Reasons, and Results

Holman

McKeown

Quinn³

et al. 2023

Hepatology Communications

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Background: Clinicians are motivated to provide safe, high-quality care to patients with chronic liver disease. This includes the desire to avoid litigation. Data are limited regarding the actual sources of medicolegal risk in chronic liver disease. Methods: We conducted a review of a national liability insurer (Candello) with an additional granular analysis of our institution’s registry of liability claims. We included closed cases involving chronic liver disease-related encounters between 2012 and 2021. We determined rates of legal claims from a denominator of unique patients with cirrhosis or transplant care seen over the study period. Results: Local database: We retrieved 39 claims of which 15 involved patients with non-cirrhotic chronic liver disease, 13 involved cirrhosis (0.06% incidence), and 11 involved patients who underwent transplantation (0.6% incidence). Most claims involved periprocedural complications. Others included adverse reactions to prophylactic plasma transfusion, medication-induced HE, and falls/fractures. National database: We found 94 claims related to liver disease out of 102,575 (0.09%) total claims. Overall, 56% involved diagnosis-related issues (failure/delay in ordering a diagnostic test, failure to appreciate and reconcile a symptom/sign or result, or the misinterpretation of a diagnostic study). Miscommunication between providers and between providers and patients was implicated in 22% of cases. Patient behavior-related factors (nonadherence with scheduled appointments, treatments, or diagnostic testing) factored in 20% of cases. Selection or the management of therapy played a role in 7% of cases. Very rarely were cases associated with technical skill (4%), house staff supervision (3%), or weekend/holiday care (1%). Fifty-one (55%) claims involved HCC. Conclusion: We provide the rates and reasons for medical malpractice claims in hepatology.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Medical malpractice claims in Hepatology: Rates, Reasons, and Results

Holman

McKeown

Quinn³

et al. 2023

Hepatology Communications

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“…Algorithms that use a combination of ICD codes, or a combination of ICD codes and laboratory results, could improve diagnostic accuracy 36 , 113 , 115 , 122 . One systematic review has identified nine ICD-10 codes that have been used to identify cirrhosis most frequently in the literature 118 . When validated in Europe and North America, this set of nine ICD-10 codes had greater sensitivity than the code set most frequently used in the literature 121 , and maintained a high positive predictive value (83–89%).…”

Section: Trends In the Aetiology Of Cirrhosismentioning

confidence: 99%

“…When validated in Europe and North America, this set of nine ICD-10 codes had greater sensitivity than the code set most frequently used in the literature 121 , and maintained a high positive predictive value (83–89%). This consensus code set could, therefore, be a useful tool for identification of cirrhosis in large databases and health records, and should be further validated in regions outside North America and Europe 118 .…”

Section: Trends In the Aetiology Of Cirrhosismentioning

confidence: 99%

Global epidemiology of cirrhosis — aetiology, trends and predictions

Huang

Terrault

Tacke

et al. 2023

Nat Rev Gastroenterol Hepatol

206

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Cirrhosis is an important cause of morbidity and mortality in people with chronic liver disease worldwide. In 2019, cirrhosis was associated with 2.4% of global deaths. Owing to the rising prevalence of obesity and increased alcohol consumption on the one hand, and improvements in the management of hepatitis B virus and hepatitis C virus infections on the other, the epidemiology and burden of cirrhosis are changing. In this Review, we highlight global trends in the epidemiology of cirrhosis, discuss the contributions of various aetiologies of liver disease, examine projections for the burden of cirrhosis, and suggest future directions to tackle this condition. Although viral hepatitis remains the leading cause of cirrhosis worldwide, the prevalence of non-alcoholic fatty liver disease (NAFLD) and alcohol-associated cirrhosis are rising in several regions of the world. The global number of deaths from cirrhosis increased between 2012 and 2017, but age-standardized death rates (ASDRs) declined. However, the ASDR for NAFLD-associated cirrhosis increased over this period, whereas ASDRs for other aetiologies of cirrhosis declined. The number of deaths from cirrhosis is projected to increase in the next decade. For these reasons, greater efforts are required to facilitate primary prevention, early detection and treatment of liver disease, and to improve access to care.

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“…Additional comorbidity covariates included diagnoses for cirrhosis, hepatitis B virus infection, hepatitis C virus infection, and alcohol-related diseases. These diagnoses were considered for the period of time from one year before cancer diagnosis to six months after diagnosis [39][40][41].…”

Section: Plos Onementioning

confidence: 99%

Sodium-glucose cotransporter 2 (SGLT2) inhibitor initiation and hepatocellular carcinoma prognosis

et al. 2022

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Introduction Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs. Emerging findings from laboratory studies indicate that SGLT2 inhibitors can improve liver function and suppress the proliferation of hepatocellular carcinoma (HCC) cells. The aim of this study was to test the hypothesis that initiation of SGLT2 inhibitors improves HCC prognosis in a human population. Methods We used National Surveillance, Epidemiology and End Results (SEER)—Medicare linked data in the United States to evaluate the role of SGLT2 inhibitor initiation on the survival of HCC patients. 3,185 HCC patients newly diagnosed between 2014 and 2017 aged 66 years or older with pre-existing type 2 diabetes were included and followed to the end of 2019. Information on SGLT2 inhibitor initiation was extracted from the Medicare Part D file. Results SGLT2 inhibitor initiation was associated with significantly lower mortality risk after adjusting for potential confounders (HR = 0.68, 95% CI = 0.54–0.86) with stronger association for longer duration of use (HR = 0.60, 95% CI = 0.41–0.88). Further, we found that SGLT2 inhibitor initiation was associated with a lower risk mortality risk ranging from 14% to 60% regardless of patient demographic variables, tumor characteristics, and cancer treatments. Conclusion Our large SEER-Medicare linked data study indicates that SGLT2 inhibitor initiation was associated with improved overall survival of HCC patients with pre-existing type 2 diabetes compared with no SGLT2 inhibitor use. Further studies are needed to confirm our findings and elucidate the possible mechanisms behind the association.

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Systematic review: development of a consensus code set to identify cirrhosis in electronic health records

Cited by 25 publications

References 39 publications

Medical malpractice claims in Hepatology: Rates, Reasons, and Results

Medical malpractice claims in Hepatology: Rates, Reasons, and Results

Global epidemiology of cirrhosis — aetiology, trends and predictions

Sodium-glucose cotransporter 2 (SGLT2) inhibitor initiation and hepatocellular carcinoma prognosis

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