Predictive Ability of Positive Clinical Culture Results and International Classification of Diseases, Ninth Revision, to Identify and Classify Noninvasive Staphylococcus aureus Infections: A Validation Study

2010 ◽  
Vol 31 (07) ◽  
pp. 694-700 ◽  
Author(s):  
LaRee A. Tracy ◽  
Jon P. Furuno ◽  
Anthony D. Harris ◽  
Mary Singer ◽  
Patricia Langenberg ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Confidence Interval ◽  
Predictive Value ◽  
Positive Culture ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Clinical Culture ◽  
Classification Of Diseases ◽  
Definition Of

Objective.To develop and validate an algorithm to identify and classify noninvasive infections due toStaphylococcus aureusby using positive clinical culture results and administrative data.Design.Retrospective cohort study.Setting.Veterans Affairs Maryland Health Care System.Methods.Data were collected retrospectively on allS. aureusclinical culture results from samples obtained from nonsterile body sites during October 1998 through September 2008 and associated administrative claims records. An algorithm was developed to identify noninvasive infections on the basis of a uniqueS. aureus-positive culture result from a nonsterile site sample with a matchingInternational Classification of Diseases, Ninth Revision (ICD-9-CM), code for infection at time of sampling. Medical records of a subset of cases were reviewed to find the proportion of true noninvasive infections (cases that met the Centers for Disease Control and Prevention National Healthcare Safety Network [NHSN] definition of infection). Positive predictive value (PPV) and negative predictive value (NPV) were calculated for all infections and according to body site of infection.Results.We identified 4,621 uniqueS. aureus-positive culture results, of which 2,816 (60.9%) results met our algorithm definition of noninvasiveS. aureusinfection and 1,805 (39.1%) results lacked a matchingICD-9-CMcode. Among 96 cases that met our algorithm criteria for noninvasiveS. aureusinfection, 76 also met the NHSN criteria (PPV, 79.2% [95% confidence interval, 70.0%–86.1%]). Among 98 cases that failed to meet the algorithm criteria, 80 did not meet the NHSN criteria (NPV, 81.6% [95% confidence interval, 72.8%–88.0%]). The PPV of all culture results was 55.4%. The algorithm was most predictive for skin and soft-tissue infections and bone and joint infections.Conclusion.When culture-based surveillance methods are used, the addition of administrativeICD-9-CMcodes for infection can increase the PPV of true noninvasiveS. aureusinfection over the use of positive culture results alone.

scholarly journals Predictive Ability of Positive Clinical Culture Results and International Classification of Diseases, Ninth Revision, to Identify and Classify Noninvasive Staphylococcus aureus Infections: A Validation Study

2010 ◽  
Vol 31 (7) ◽  
pp. 694-700 ◽  
Author(s):  
LaRee A. Tracy ◽  
Jon P. Furuno ◽  
Anthony D. Harris ◽  
Mary Singer ◽  
Patricia Langenberg ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Confidence Interval ◽  
Predictive Value ◽  
Positive Culture ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Clinical Culture ◽  
Classification Of Diseases ◽  
Definition Of

Objective.To develop and validate an algorithm to identify and classify noninvasive infections due to Staphylococcus aureus by using positive clinical culture results and administrative data.Design.Retrospective cohort study.Setting.Veterans Affairs Maryland Health Care System.Methods.Data were collected retrospectively on all S. aureus clinical culture results from samples obtained from nonsterile body sites during October 1998 through September 2008 and associated administrative claims records. An algorithm was developed to identify noninvasive infections on the basis of a unique S. aureus-positive culture result from a nonsterile site sample with a matching International Classification of Diseases, Ninth Revision (ICD-9-CM), code for infection at time of sampling. Medical records of a subset of cases were reviewed to find the proportion of true noninvasive infections (cases that met the Centers for Disease Control and Prevention National Healthcare Safety Network [NHSN] definition of infection). Positive predictive value (PPV) and negative predictive value (NPV) were calculated for all infections and according to body site of infection.Results.We identified 4,621 unique S. aureus-positive culture results, of which 2,816 (60.9%) results met our algorithm definition of noninvasive S. aureus infection and 1,805 (39.1%) results lacked a matching ICD-9-CM code. Among 96 cases that met our algorithm criteria for noninvasive S. aureus infection, 76 also met the NHSN criteria (PPV, 79.2% [95% confidence interval, 70.0%–86.1%]). Among 98 cases that failed to meet the algorithm criteria, 80 did not meet the NHSN criteria (NPV, 81.6% [95% confidence interval, 72.8%–88.0%]). The PPV of all culture results was 55.4%. The algorithm was most predictive for skin and soft-tissue infections and bone and joint infections.Conclusion.When culture-based surveillance methods are used, the addition of administrative ICD-9-CM codes for infection can increase the PPV of true noninvasive S. aureus infection over the use of positive culture results alone.

Use of International Classification of Diseases, Ninth Revision Clinical Modification Codes and Medication Use Data to Identify Nosocomial Clostridium difficile Infection

2009 ◽  
Vol 30 (11) ◽  
pp. 1070-1076 ◽  
Author(s):  
Mia Schmiedeskamp ◽  
Spencer Harpe ◽  
Ronald Polk ◽  
Michael Oinonen ◽  
Amy Pakyz
Keyword(s):  
Drug Therapy ◽  
Clostridium Difficile ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Adult Patients ◽  
Classification Of Diseases ◽  
Sensitivity Specificity

Objective.The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for Clostridium difficile infection (CDI) is used for surveillance of CDI. However, the ICD-9-CM code alone cannot separate nosocomial cases from cases acquired outside the institution. The purpose of this study was to determine whether combining the ICD-9-CM code with medication treatment data for CDI in hospitalized patients could enable us to distinguish between patients with nosocomial CDI and patients who were admitted with CDI. The primary objective was to compare the sensitivity, specificity, and predictive value of using the combination of ICD-9-CM code for CDI and CDI treatment records to identify cases of nosocomial CDI with the sensitivity, specificity, and predictive value of using the ICD-9-CM code alone.Design.Validation sample cross-sectional study.Setting.Academic health center.Methods.Administrative claims data from July 1, 2004, to June 30, 2005, were queried to identify adults discharged with an ICD-9-CM code for CDI and to find documentation of CDI therapy with oral vancomycin or metronidazole. Laboratory and medical records were queried to identify symptomatic CDI toxin-positive adult patients with nosocomial CDI and were compared with records of patients whose cases were predicted to be nosocomial by means of ICD-9-CM code and CDI therapy data.Results.Of 23,920 adult patients discharged from the hospital, 62 had nosocomial CDI according to symptoms and toxin assay. The sensitivity of the ICD-9-CM code alone for identifying nosocomial CDI was 96.8%, the specificity was 99.6%, the positive predictive value was 40.8%, and the negative predictive value was 100%. When CDI drug therapy was included with the ICD-9-CM code, the sensitivity ranged from 58.1% to 85.5%, specificity was virtually unchanged, and the range in positive predictive value was 37.9%–80.0%.Conclusion.Combining the ICD-9-CM code for CDI with drug therapy information increased the positive predictive value for nosocomial CDI but decreased the sensitivity.

Evaluation of International Classification of Diseases, Ninth Revision, Clinical Modification Codes for Reporting Methicillin-Resistant Staphylococcus aureus Infections at a Hospital in Illinois

2010 ◽  
Vol 31 (05) ◽  
pp. 463-468 ◽  
Author(s):  
Melissa K. Schaefer ◽  
Katherine Ellingson ◽  
Craig Conover ◽  
Alicia E. Genisca ◽  
Donna Currie ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
Mrsa Infection ◽  
Healthcare Associated

Background. States, including Illinois, have passed legislation mandating the use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for reporting healthcare-associated infections, such as methicillin-resistant Staphylococcus aureus (MRSA). Objective. To evaluate the sensitivity of ICD-9-CM code combinations for detection of MRSA infection and to understand implications for reporting. Methods. We reviewed discharge and microbiology databases from July through August of 2005, 2006, and 2007 for ICD-9-CM codes or microbiology results suggesting MRSA infection at a tertiary care hospital near Chicago, Illinois. Medical records were reviewed to confirm MRSA infection. Time from admission to first positive MRSA culture result was evaluated to identify hospital-onset MRSA (HO-MRSA) infections. The sensitivity of MRSA code combinations for detecting confirmed MRSA infections was calculated using all codes present in the discharge record (up to 15); the effect of reviewing only 9 diagnosis codes, the number reported to the Centers for Medicare and Medicaid Services, was also evaluated. The sensitivity of the combination of diagnosis codes for detection of HO-MRSA infections was compared with that for community-onset MRSA (CO-MRSA) infections. Results. We identified 571 potential MRSA infections with the use of screening criteria; 403 (71%) were confirmed MRSA infections, of which 61 (15%) were classified as HO-MRSA. The sensitivity of MRSA code combinations was 59% for all confirmed MRSA infections when 15 diagnoses were reviewed compared with 31% if only 9 diagnoses were reviewed (P < .001). The sensitivity of code combinations was 33% for HO-MRSA infections compared with 62% for CO-MRSA infections (P < .001). Conclusions. Limiting analysis to 9 diagnosis codes resulted in low sensitivity. Furthermore, code combinations were better at revealing CO-MRSA infections than HO-MRSA infections. These limitations could compromise the validity of ICD-9-CM codes for interfacility comparisons and for reporting of healthcare-associated MRSA infections.

scholarly journals Estimated Burden of Methicillin-Resistant Staphylococcus aureus in California Hospitals after Changes to Administrative Codes, 2005–2010

2013 ◽  
Vol 34 (11) ◽  
pp. 1218-1221 ◽  
Author(s):  
David M. Tehrani ◽  
Chenghua Cao ◽  
Homin Kwark ◽  
Susan S. Huang
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Methicillin Resistant ◽  
Classification Of Diseases ◽  
The Impact

We assess the impact of revised International Classification of Diseases, Ninth Revision, codes on methicillin-resistant Staphylococcus aureus burden in California hospitals. Codes were rapidly adopted, demonstrating new capture of colonization and continued relatively stable capture of infections. Nevertheless, despite new colonization codes, coded data demonstrated poor retention between serial hospitalizations.

scholarly journals Epilepsy is a disease!

1994 ◽  
Vol 52 (4) ◽  
pp. 596-597
Author(s):  
Walter Oleschko Arruda
Keyword(s):  
International Classification Of Diseases ◽  
International Classification ◽  
Generic Term ◽  
Classification Of Diseases ◽  
Definition Of

According to the definition of disease, epilepsy shall not be considered neither a symptom nor a syndrome. Epilepsy is a generic term for a group of diseases characterized by seizures. It implies a state quite distinct from health. Therefore it seems worthy to keep epilepsy as such in the International Classification of Diseases (ICD).

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