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The ability of the ICD-AIS map to identify seriously injured patients in road traffic accidents-A study from Finland.

https://arctichealth.org/en/permalink/ahliterature299598
Source
Traffic Inj Prev. 2018; 19(8):819-824
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
2018
Author
Noora Airaksinen
Ilona Nurmi-Lüthje
Heikki Kröger
Peter Lüthje
Author Affiliation
a Faculty of Heath Sciences , University of Eastern Finland , Kuopio , Finland.
Source
Traffic Inj Prev. 2018; 19(8):819-824
Date
2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Abbreviated Injury Scale
Accidents, Traffic - statistics & numerical data
Finland
Humans
Injury Severity Score
Medical Records - statistics & numerical data
Retrospective Studies
Abstract
In Finland, the severity of road traffic injuries is determined using the International Classification of Diseases, 10th Revision, Finnish Modification (ICD-10-FM) injury codes from Finnish Hospital Discharge data and the automatic conversion tool (ICD-AIS map) developed by the Association for the Advancement of Automotive Medicine (AAAM). The aim of this study was to evaluate the ability of the ICD-AIS map to identify seriously injured patients due to traffic accidents in Finnish injury data by comparing the severity rating generated by an expert and by the ICD-AIS map.
Our data came from the North Kymi Hospital (level 2 trauma center at the time of the study). The data included 574 patients who were injured in traffic accidents during 2 years. The severity rating (Maximum Abbreviated Injury Scale [MAIS] 3+) of each patient was recorded retrospectively by an expert based on information from patient records. In addition, the rating was generated from ICD-10 injury codes by the ICD-AIS map conversion tool. These 2 ratings were compared by road user categories and the strength of agreement was described using Cohen's kappa.
The proportion of seriously injured patients was 10.1% as defined by the expert and 6.6% as generated by the ICD-AIS map; exact agreement was 65.5%. The highest concordance was for pedestrians (exact agreement 100%) and the weakest for moped drivers and motorcyclists (46.7%). Furthermore, the overall strength of agreement of the severity ratings (slightly or seriously injured) between the expert and the ICD-AIS map was good (??=?0.70). Most (65%) of the conversion problems were misclassifications caused by the simplicity of the Finnish ICD-10 injury codes compared to the injury codes used in the ICD-AIS map. In Finland, the injuries are recorded mainly with 4-digit codes and, infrequently, with 5-digit codes, whereas the ICD-AIS map defines up to 6-digit codes.
For this sample of simplified ICD-10-FM codes, the ICD-AIS map underestimated the number of seriously injured patients. The mapping result could be improved if at least open and closed fractures of extremities and visceral contusions and ruptures had separate codes. In addition, there were a few injury codes that should be considered for inclusion in the map.
PubMed ID
30543466 View in PubMed
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[Analysis of mortality rates among patients with pulmonary tuberculosis].

https://arctichealth.org/en/permalink/ahliterature200917
Source
Probl Tuberk. 1999;(4):12-3
Publication Type
Article
Date
1999
Author
Kh Kh Zhamborov
Source
Probl Tuberk. 1999;(4):12-3
Date
1999
Language
Russian
Publication Type
Article
Keywords
Adult
Female
Humans
Male
Medical Records - statistics & numerical data
Middle Aged
Outpatients - statistics & numerical data
Russia - epidemiology
Survival Rate
Tuberculosis, Pulmonary - mortality
Abstract
The outpatient medical cards and history cases of those who died, autopsy protocols of 428 dead patients with various forms of tuberculosis were analyzed. Of them, 86 patients had been followed up less than a year. The patients treated with antituberculous drugs died not only from a progressive specific process, but from nonspecific complications. The factors predisposing to death were late detection of tuberculosis and irregular treatment, alcohol and drug abuse.
PubMed ID
10479924 View in PubMed
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Assessment of headache diagnosis. A comparative population study of a clinical interview with a diagnostic headache diary.

https://arctichealth.org/en/permalink/ahliterature165737
Source
Cephalalgia. 2007 Jan;27(1):1-8
Publication Type
Article
Date
Jan-2007
Author
D. Phillip
Ac Lyngberg
R. Jensen
Author Affiliation
Danish Headache Centre, Department of Neurology, Copenhagen University Hospital, Glostrup, Denmark. dphillip@dadlnet.dk
Source
Cephalalgia. 2007 Jan;27(1):1-8
Date
Jan-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Denmark - epidemiology
Female
Headache - classification - diagnosis - epidemiology
Humans
Incidence
Male
Medical History Taking - statistics & numerical data
Medical Records - statistics & numerical data
Middle Aged
Reproducibility of Results
Risk Assessment - methods
Risk factors
Sensitivity and specificity
Abstract
The level of agreement between headache information, attained by clinical interview and headache diary, was evaluated in subjects who frequently suffered from headache and were participating in an epidemiological study of headache. One hundred and six subjects were interviewed and asked to complete a diary for a period of 4-8 weeks; 46% completed the study. For migraine the diary and clinical diagnoses demonstrated agreement in 82%, kappa value 0.57, sensitivity 90% and specificity 64%. For tension-type headache they demonstrated agreement in 87%, kappa value 0.39, sensitivity 97%, specificity 29% and a good agreement of frequency of tension-type headache was also obtained. In migraine, but not in tension-type headache, accompanying symptoms tended to be overestimated in the interview. The diary was not useful for the diagnosis of migraine with aura, but proved valuable in distinguishing between migraine and tension-type headache, and in the identification of coexisting headache disorders. Combined use of a diagnostic diary and clinical interview is recommended.
PubMed ID
17212676 View in PubMed
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The association between patient-reported incidents in hospitals and estimated rates of patient harm.

https://arctichealth.org/en/permalink/ahliterature268446
Source
Int J Qual Health Care. 2015 Feb;27(1):26-30
Publication Type
Article
Date
Feb-2015
Author
Oyvind Bjertnaes
Ellen Tveter Deilkås
Kjersti Eeg Skudal
Hilde Hestad Iversen
Anne Mette Bjerkan
Source
Int J Qual Health Care. 2015 Feb;27(1):26-30
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Data Collection - methods
Humans
Medical Errors - statistics & numerical data
Medical Records - statistics & numerical data
Norway
Patient Harm - statistics & numerical data
Patient Safety
Risk Management - statistics & numerical data
Safety Management
Abstract
The aim of this study was to test the association between the rates of patient-reported incidents and patient harm documented in the patient record.
The study was a secondary analysis of two national hospital assessments conducted in 2011.
Hospital services in Norway.
The patient survey was a standard national patient-experience survey conducted at the hospital level for all 63 hospitals in Norway. The medical record review was performed by 47 Global Trigger Tools (GTTs) in all 19 hospital trusts and 4 private hospitals. The two data sets were matched at the unit level, yielding comparable patient experiences and GTT data for 7 departments, 16 hospitals and 11 hospital trusts.
No intervention.
The correlation at the unit level between the patient-reported incident in hospital instrument (PRIH-I) and estimated rates of patient harm from the GTT.
The PRIH-I index was significantly correlated with all patient-reported experience indicators at the individual level, with estimates for all patient harm events (Categories E-I) at the unit level (r = 0.62, P
PubMed ID
25417226 View in PubMed
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Changes in patients visiting a homeopathic clinic in Norway from 1994 to 2004.

https://arctichealth.org/en/permalink/ahliterature29403
Source
Homeopathy. 2005 Oct;94(4):222-8
Publication Type
Article
Date
Oct-2005
Author
P. Viksveen
A. Steinsbekk
Author Affiliation
Stavanger Homeopati Senter, Stavanger, Norway. homeopat@email.com
Source
Homeopathy. 2005 Oct;94(4):222-8
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Attitude to Health
Child
Child, Preschool
Chronic Disease - epidemiology - therapy
Family Practice - statistics & numerical data
Female
Homeopathy - methods - standards - statistics & numerical data
Humans
Infant
Male
Medical Records - statistics & numerical data
Norway - epidemiology
Office visits - statistics & numerical data
Patient Satisfaction - statistics & numerical data
Retrospective Studies
Time Factors
Treatment Outcome
Abstract
AIM: There are a few examining changes in patient groups seeking homeopathic care. This study describes changes in complaints and characteristics of patients visiting a homeopathic clinic in Norway from 1994/1995 to 2003/2004. METHODS: Two surveys were conducted, each including data for 700 patients who had visited the same homeopathic clinic, with five (1995) and seven (2004) homeopaths, respectively. Data on patients' gender, age, occupation, reason for encounter and where they had heard about homeopathy and the homeopathic clinic were registered by the homeopaths. In 2004, the patients also answered questions on the previous use of conventional treatment and how long it took them to decide to consult a homeopath. RESULTS: There are no changes in the reason for encounter and gender proportions between 1995 and 2004. Over 36% of patients were under the age of 16 in 2004, compared to 26% in 1995. Most patients still consult homeopaths through a lay referral network. In 2004, more than 60% made an appointment with a homeopath within the first month of first considering it. CONCLUSION: There are few changes in the characteristics of this homeopathic patient population. There is a need for studies that explore the 'why question'; Why an increasing percentage of patients are children? Why people with higher education and why certain age groups visit homeopaths more frequently than others?
PubMed ID
16226199 View in PubMed
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Clinical cues for detection of people with undiscovered depression in primary health care: a case-control study.

https://arctichealth.org/en/permalink/ahliterature261464
Source
Prim Health Care Res Dev. 2014 Jul;15(3):324-30
Publication Type
Article
Date
Jul-2014
Author
Lena Flyckt
Ejda Hassler
Louise Lotfi
Ingvar Krakau
Gunnar H Nilsson
Source
Prim Health Care Res Dev. 2014 Jul;15(3):324-30
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Case-Control Studies
Comorbidity
Depressive Disorder - diagnosis - epidemiology
Female
Humans
Male
Medical Records - statistics & numerical data
Middle Aged
Primary Health Care - methods
Severity of Illness Index
Sleep Disorders - epidemiology
Sweden
Young Adult
Abstract
To identify clinical cues indicative of depression in medical records of cases in primary care with undetected depression.
Depressive disorders are common; the lifetime risk for men and women is 27% and 45%, respectively. Despite effective treatment methods such as antidepressants and cognitive behavioural therapy, depression often remains undiscovered in primary care, with great implications both on the individual and societal level.
Clinical cues indicating depression were sought in medical records the year before an opportunistic screening for depression in primary care. In a previous study of 221 patients in the waiting room of a primary care centre during 10 randomly selected days, 45 (20%) showed signs of depression (MADRS-S ? 12) and 60% of these were verified as having depressive disorders (Prime-MD). These 45 patients constitute the cases in the present study. Age- and gender-matched controls were selected among those who scored below the chosen cut-off level.
Seventeen (38%) of the 45 cases compared with eight (18%) of the 45 controls had one or more cues [odds ratio (OR) 2.81; 95% confidence interval (CI): 1.06-7.43]. Sleep disturbance showed the greatest difference between cases and controls (OR 4.53; 95% CI: 1.17-17.55). A significant relationship was found between severity of depression, frequency of cues and lower functional level. Cues were twice as common in patients with undetected depression and their functional level was lower. A two-stage procedure, screening and a structured diagnostic interview, is recommended when sleep disturbances and lowered function are present.
PubMed ID
23953229 View in PubMed
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Clinically relevant drug-drug interactions among elderly people with dementia.

https://arctichealth.org/en/permalink/ahliterature296857
Source
Eur J Clin Pharmacol. 2018 Oct; 74(10):1351-1360
Publication Type
Journal Article
Date
Oct-2018
Author
Eva Sönnerstam
Maria Sjölander
Hugo Lövheim
Maria Gustafsson
Author Affiliation
Department of Pharmacology and Clinical Neuroscience, Division of Pharmacology, Umeå University, 901 87, Umeå, Sweden. eva.sonnerstam@umu.se.
Source
Eur J Clin Pharmacol. 2018 Oct; 74(10):1351-1360
Date
Oct-2018
Language
English
Publication Type
Journal Article
Keywords
Aged
Aging - physiology - psychology
Dementia - epidemiology
Dose-Response Relationship, Drug
Drug Interactions
Drug Therapy, Combination - adverse effects - statistics & numerical data
Drug-Related Side Effects and Adverse Reactions - epidemiology - etiology - prevention & control
Female
Humans
Male
Medical Records - statistics & numerical data
Medication Therapy Management - standards
Pharmaceutical Preparations - classification
Prevalence
Quality Improvement
Risk factors
Sweden - epidemiology
Abstract
Increased numbers of drugs and changes in pharmacokinetic and pharmacodynamic parameters among elderly people contribute to increased prevalence of adverse drug reactions. Drug-drug interactions (DDIs) are an important reason for admission to hospital and elderly people with dementia are particularly vulnerable. The aims of the present study were to assess the occurrence and characteristics of clinically relevant DDIs and to investigate potential risk factors associated with DDIs among elderly people with dementia.
People =?65 years with dementia, admitted to two hospitals in Northern Sweden, were included. The medical records of 458 patients were reviewed. Clinically relevant DDIs were identified using the Janusmed interactions database. Pharmacological classification was conducted using Stockley's classification system.
A total of 401 DDIs were identified among 43.2% of the study population, of which 98.5% had interactions that may require dose adjustment and 7.6% had drug combinations that should be avoided. Pharmacodynamic interactions were most common, of which furosemide-citalopram (n?=?35) were most frequently observed. Omeprazol-citalopram (n?=?25) was the most common drug combination among pharmacokinetic interactions. Citalopram and warfarin were the most commonly involved drug substances. An association was found between a higher number of medications being prescribed and having at least one DDI.
Clinically relevant drug-drug interactions are prevalent among elderly people with dementia living in Northern Sweden. Drug-drug interactions should be identified in order to manage and prevent adverse outcomes. This is particularly important among this group of people especially when multiple medications are being prescribed.
PubMed ID
29967921 View in PubMed
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Cohort profile: the Copenhagen School Health Records Register.

https://arctichealth.org/en/permalink/ahliterature92401
Source
Int J Epidemiol. 2009 Jun;38(3):656-62
Publication Type
Article
Date
Jun-2009

Comorbidity information in older patients at an emergency visit: self-report vs. administrative data had poor agreement but similar predictive validity.

https://arctichealth.org/en/permalink/ahliterature157859
Source
J Clin Epidemiol. 2008 May;61(5):511-5
Publication Type
Article
Date
May-2008
Author
Stephanie R Susser
Jane McCusker
Eric Belzile
Author Affiliation
Faculty of Medicine, McGill University, Canada.
Source
J Clin Epidemiol. 2008 May;61(5):511-5
Date
May-2008
Language
English
Publication Type
Article
Keywords
Aged
Comorbidity
Educational Status
Emergency Service, Hospital
Female
Geriatric Assessment
Health Services - utilization
Health Status Indicators
Hospitalization - statistics & numerical data
Humans
Male
Medical Records - statistics & numerical data
Quebec - epidemiology
Reproducibility of Results
Self Disclosure
Abstract
The objectives of this study were (1) to ascertain the level of agreement between the Charlson Comorbidity Index (CCI) based on self-report vs. administrative records, and factors affecting agreement and (2) to compare the predictive validity of the two indices in a sample of older emergency department (ED) patients.
The study was a secondary analysis of data from a randomized trial of an ED-based intervention. The self-report and administrative CCI were compared using the intraclass correlation coefficient (ICC). Factors examined for effect on agreement included health service utilization, age, and sex. The predictive validity of the indices was compared using subsequent health services utilization and functional decline as outcomes. Participants (n=520) were recruited at four university-affiliated Montreal hospitals. Eligibility criteria included 65 years of age or older, able to speak English or French, and discharged to the community.
Agreement between the two sources was poor to fair (overall weighted ICC 0.43 [95% confidence interval [CI]: 0.40, 0.47]). The predictive validity was similar for the two indices (area under the receiver-operating characteristic curve 0.51-0.66, depending on the outcomes).
Agreement between self-report and administrative comorbidity data is only poor to fair but both have comparable predictive validity.
PubMed ID
18394546 View in PubMed
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Comparing clinical and administrative data for profiling hospitals on postdischarge medication use by patients with acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature155408
Source
Am Heart J. 2008 Sep;156(3):595-605
Publication Type
Article
Date
Sep-2008
Author
Peter C Austin
Linda Donovan
Lingsong Yun
Jack V Tu
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. peter.austin@ices.on.ca
Source
Am Heart J. 2008 Sep;156(3):595-605
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Aged
Canada
Cohort Studies
Databases, Factual
Drug Prescriptions - statistics & numerical data
Evidence-Based Medicine
Hospital Administration - statistics & numerical data
Hospitals - statistics & numerical data
Humans
Medical Records - statistics & numerical data
Myocardial Infarction - drug therapy
Patient Discharge
Recurrence - prevention & control
Retrospective Studies
Abstract
Postdischarge medication use is frequently used as a measure of hospital performance, with many reports produced using clinical data obtained from chart reviews. The introduction of a drug benefit program administered by the Centers for Medicare and Medicaid Services presents an opportunity to use administrative data for routine reporting on hospital performance. We determined the concordance between hospital-specific prescribing rates of evidence-based medical therapies obtained from clinical and administrative data in Ontario, Canada.
This was a retrospective cohort study using data on patients discharged from 102 hospitals in Ontario, Canada with acute myocardial infarction (AMI) between April 1, 1999, and March 31, 2001. We compared hospital-specific rates of discharge prescribing in AMI patients, determined using clinical data obtained using retrospective chart review with hospital-specific rates of prescriptions filled within 30 days of hospital discharge in elderly patients using administrative data.
There was a moderate agreement between hospital-specific rates of discharge prescriptions written for AMI patients in clinical data with hospital-specific rates of prescriptions filled using administrative data. Although differences in rates were, on average, small between the 2 data sources, there was moderate variation in the differences between these 2 rates across hospitals. There was very strong agreement between rates of discharge prescribing in all patients and in ideal patients with no contraindications, both determined using clinical data.
Post-AMI discharge prescribing in all patients determined using clinical data is an excellent proxy for prescribing in ideal patients using clinical data. However, there is weaker agreement between administrative and clinical data.
PubMed ID
18760146 View in PubMed
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67 records – page 1 of 7.