Controlling Dx Type for ICD10 codes: Difference between revisions

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{{Data Integrity Check
{{Data Integrity Check
| DIC_summary = Controlling Dx Type for ICD10 codes
| DIC_summary = Some dxs can't be [[Dx Type]]s [[Primary Admit Diagnosis]], [[Comorbid Diagnosis]], [[Admit Diagnosis]] or [[Acquired Diagnosis]]
| DIC_related_concepts = ICD10 Diagnoses
| DIC_related_concepts = ICD10 Diagnoses; Primary Admit Diagnosis; Comorbid Diagnosis; Admit Diagnosis; Acquired Diagnosis; Dx Type
| DIC_firmness = hard check
| DIC_firmness = hard check
| DIC_timing = complete
| DIC_timing = complete
| DIC_app = CCMDB.mdb
| DIC_app = CCMDB.accdb
| DIC_coding = how to find this in containing program, eg. SAS file, function name, query name...
| DIC_coding =  
| DIC_status = needs review
| DIC_status = declined
| DIC_implementation_date = date change was rolled out / first applied
| DIC_implementation_date =  
}}
}}


{{DA | Charlson Admit Como - this is part of that discussion
After considerable discussion over years it was decided that this would be very complicated to implement and that the effort wouldn't bring enough positive results to be worth it.  
* I have emailed Allan the table with all Dxs to set them as Como_allowed, Admit_allowed, Acquired_allowed. Will set up infrastructure to contain this once I have data. Ttenbergen 12:31, 2019 February 13 (CST)
** '''Ignore until at least April.'''}}


Many of the items on the [[ICD10 Diagnosis List]] are not suitable as certain [[Dx Type]]s.
{{Collapsable| always=See proposed solution and discussion| full=
Examples:
* [[Severe sepsis]], [[VAP]], recurrent Pneumonia should never be a [[Comorbid Diagnosis]]
* [[Past history, removal of breast (mastectomy)]] should never be an [[Acquired Diagnosis / Complication]] or [[Admit Diagnosis]]
* many more


We would like a way to detect when such inconsistencies happen.  
== Decision to decline ==
Allan, Barret and Lisa and some collectors all at some point tried to generate the reference list for this. In all cases, a lot of it is almost trivial, but for some of it the decisions are almost impossible. The ultimate reason to decline was because the use of diagnoses as part of [[Combined ICD10 codes]] means they might be used for just about anything to express an unusual situation, and we ''want'' to be able to use them for this. So, we decided the cross checks would not be worth it. Decision made [[Task_Team_Meeting_-_Rolling_Agenda_and_Minutes_2023#ICU Database Task Group Meeting – April 19, 2023]].


== Proposed Solution 1 ==
== Proposed Solution ==
Encode which codes can '''not''' be of a particular type; this will likely be fewer checks, and it will also likely be an easier and more deterministic answer without ifs-thens-buts; it will be a slightly less tight check but with fewer false positives.
* Add three columns to the [[s_ICD10 table]]:
* Add three columns to the [[s_ICD10 table]]:
** como_not_allowed
** comorbid_not_allowed ([[Comorbid Diagnosis]])
** admit_not_allowed
** admit_not_allowed ([[Admit Diagnosis]]
** acquired_not_allowed
** acquired_not_allowed ([[Acquired Diagnosis]])
* populate the columns
** primary_not_allowed ([[Primary Admit Diagnosis]])
** default answers:  NO in comorbid and YES in Admit, Acquired
* put cross checks into [[CCMDB.mdb]] to prevent bad entries
 
=== why do this change outside the wiki? ===
The change will require editing every single record in the [[ICD10 Diagnosis List]], so doing it on the wiki would be time-prohibitive. If we do it externally the new fields would be imported into the wiki, which would then again be the master repository for this.
 
* We will use a tool like [https://en.wikipedia.org/wiki/Wikipedia:AutoWikiBrowser AutoWikiBrowser]] or similar to get the changes integrated into pages.
 
== Implementation ==
It was decided that this is worth doing, and that the above is a reasonable way to do it.
 
{{Discuss | who=Tina| question = not needed at go-live; Need to export the list and plan process that includes the extra items below. To export, see [[S_ICD10_table#Query_to_populate_s_ICD10_table_from_wiki]]. }}


== If we do this, should we do more?  ==
== If we do this, should we do more?  ==
* Discussed but rejected possibility to restrict impossible dx / [[sex field]] combinations.  
* Discussed but '''rejected''' possibility to restrict impossible dx / [[sex field]] combinations.  
* this would be the right time to also fix/implement the following:  
* this would be the right time to also fix/implement the following:  
** is_pathogen: see [[:Category:Infection requiring pathogen]]
** is_pathogen: see [[:Category:Infection requiring pathogen]]
** pathogen requirement (see [[:Category:Infection requiring pathogen]], [[:Category:Infection requiring pathogen]], [[:Category:Potential infection]])
** pathogen requirement (see [[:Category:Infection requiring pathogen]], [[:Category:Infection requiring pathogen]], [[:Category:Potential infection]])
** min nr of combined codes field
** min nr of combined codes field
}}


== Related Articles ==
== Related Articles ==

Latest revision as of 10:04, 2023 April 27

Data Integrity Checks
Summary: Some dxs can't be Dx Types Primary Admit Diagnosis, Comorbid Diagnosis, Admit Diagnosis or Acquired Diagnosis
Related: ICD10 Diagnoses, Primary Admit Diagnosis, Comorbid Diagnosis, Admit Diagnosis, Acquired Diagnosis, Dx Type
Firmness: hard check
Timing: complete
App: CCMDB.accdb
Coding:
Uses L Problem table: not relevant for this app
Status: declined
Implementation Date:
Backlogged: true
  • Cargo


  • SMW


  • Categories: 
  • form:

After considerable discussion over years it was decided that this would be very complicated to implement and that the effort wouldn't bring enough positive results to be worth it.

See proposed solution and discussion   

Decision to decline

Allan, Barret and Lisa and some collectors all at some point tried to generate the reference list for this. In all cases, a lot of it is almost trivial, but for some of it the decisions are almost impossible. The ultimate reason to decline was because the use of diagnoses as part of Combined ICD10 codes means they might be used for just about anything to express an unusual situation, and we want to be able to use them for this. So, we decided the cross checks would not be worth it. Decision made Task_Team_Meeting_-_Rolling_Agenda_and_Minutes_2023#ICU Database Task Group Meeting – April 19, 2023.

Proposed Solution

Encode which codes can not be of a particular type; this will likely be fewer checks, and it will also likely be an easier and more deterministic answer without ifs-thens-buts; it will be a slightly less tight check but with fewer false positives.

If we do this, should we do more?

Related Articles

Related articles:
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