Query check CCI each count vs LOS: Difference between revisions

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{{Data Integrity Check

|DIC_summary=Confirm that a [[:Category:Labs Imaging]] count is not unreasonably high

|DIC_related_concepts=CXR (plain film); ~~LOS~~; ~~Arrive DtTm~~; ~~Dispo DtTm~~

|DIC_related_concepts=Blood gas, venous; Blood gas, arterial; CXR (plain film); Angiogram, aortic (any part of aorta); Angiogram, coronary (diagnostic cardiac catheterization); ECHO (echocardiogram of heart); Cardiac CT or Cardiac CT angiogram (with or without coronary arteries); Cardiac MRI; Cardiac nuclear scan (e.g. MUGA); Angiogram, cerebral (including vertebral arteries); CT of chest with PE protocol (CT angiogram of pulmonary vessels); Angiogram, artery NOS (except specifically coded); Angiogram, vein; Angiogram, pulmonary artery (pulmonary arteriogram); AXR (abdominal plain X-ray); LOS

|DIC_firmness=soft check

|DIC_timing=complete

|DIC_coding=query ''~~check_CCI_CXR_vs_LOS~~''

|DIC_coding=query ''check_CCI_each_count_vs_LOS''

|DIC_status=needs review

|DIC_app=CCMDB.accdb

|DIC_backlogged=No

}}

We have had some ~~medical [[:Category:Labs Imaging]]~~ count entries that are so high that they are likely errors.

We have had some CCI count entries that are so high that they are likely errors.

=== ~~What are likely maximum entries~~? ===

=== CCI codes considered ===

~~The count per patient stay is related~~ to the [[LOS]]. The threshold limits are either Mean + 3 Standard Deviation or Maximum value of Chest X-ray count per patient day for various LOS category listed in the table below. They are derived from July 1988 to June 2017 Lab data. The LOS is based on calendar dates where partial stay is considered as full day.

{{#ask: [[Has CCI Picklist Code::2.ZZ.13.RA||2.ZZ.13.RE||3.GY.10.VA||3.ID.10.V^||3.IP.10.V^||3.IP.30||3.IP.20||3.IP.40||3.IP.70||3.JM.10.V^||3.JY.20||3.KV.10.VX||3.KX.10.VC||3.IM.10.V^||3.OT.10.VA]]

|?Has CCI Picklist Code=Code

|?Has CCI Collection Mode=Collection mode

|sort=Has CCI Collection Mode,Has CCI Picklist Code

|order=asc,asc

}}

== Checks ==

This uses [[Function LOS()]] to calculate the [[LOS]].

*LOS based on calendar dates = [[~~Dispo DtTm~~]] ~~- (~~[[~~Accept DtTm~~]]~~/first [[Service tmp entry]]) + 1~~

=== [[Template:CCI collect count each|CCI collect count each]] and [[Template:CCI collect each|CCI collect each]] ===

** if patient is still in the unit, [[Dispo DtTm]] is replaced by today's date

These should be checked.

*** check is marked as only running on complete records, if that is so then we don't need to replace with today's date

*Chest X-ray (CXR) per patient day = Number of chest X-rays / LOS Based on calendar dates

{| ~~class~~=~~"wikitable sortable"~~

=== [[Template:CCI collect count days|CCI collect count days]] ===

~~! LOS_days !! N !! Mean !! Std Dev !! Minimum !! Median !! 75th Pctl !! 90th Pctl !! 95th Pctl !! 99th Pctl !! Maximum !! mean + 3 Std Dev !! Limits of CXR per patient day~~

Implemented by [[query check_CCI_vs_LOS_count_days_component]] and [[query check_CCI_vs_LOS_count_days_picklist]].

|-

~~||1 ||4021||1.16||0.42||1||1||1||2||2||3||5||2.42||5~~

|-

~~||2 ||23910||0.83||0.31||0.5||1||1||1||1.5||2||4||1.76||4~~

|-

~~||3-10 ||52600||0.64||0.34||0.1||0.67||0.88||1||1.25||1.6||3||1.66||3~~

|-

~~||11-20||7784||0.7||0.31||0.05||0.71||0.92||1.09||1.19||1.42||2.47||1.63||2~~

|-

~~||21-30||1870||0.68||0.3||0.03||0.69||0.9||1.05||1.14||1.36||2.57||1.58||2~~

|-

~~||31-40||660||0.62||0.3||0.03||0.64||0.84||1||1.09||1.32||1.67||1.52||2~~

|-

~~||41-50||311||0.54||0.29||0.02||0.53||0.73||0.93||1.02||1.21||1.58||1.41||2~~

|-

~~||51-100||347||0.41||0.26||0.02||0.38||0.6||0.76||0.85||1.12||1.2||1.19||1~~

|-

~~||> 100||101||0.19||0.21||0~~.~~01||0.11||0.2||0.48||0.73||0.88||1.09||0.82||1~~

|-

|}

~~{{CCMDB~~.~~accdb cross checks triggering for correct values}}~~

=== [[Template:CCI collect count units|CCI collect count units]] ===

Discussed with Julie that this one is likely uncheckable. [[User:Ttenbergen|Ttenbergen]] 15:47, 2021 September 2 (CDT)

~~{{TT |~~

== Log ==

* is there a function we can use for the threshold? That would be easier to implement than a list like that. If SAS as a way to generate functions (like excel does for its trendlines) then could you run that? [[User:Ttenbergen|Ttenbergen]] 09:02, 2021 September 2 (CDT)

* 2024-04-24 -

** ~~looks like from the list above, the mean plus 3 std of 2 per day is common except when~~ LOS <~~1. we can use the function twice of LOS~~. ~~the CXR should not exceed twice of LOS~~. ~~when LOS <1~~, ~~should not exceed 5. When LOS is 51 or more, should not exceed LOS. --[[User:JMojica|JMojica]] 09:18, 2021 September 2 (CDT~~)

** implemented LOS <7 and count >10 (i.e. double digits, because that's a likely fumble finger mistake)

*** this ~~cross check is not just~~ for CXR, ~~but any CCI. Do those numbers still make sense? Or does the same check for~~ all CCI ~~not make sense? I am OK if we only want to check for CXR. [[User:Ttenbergen|Ttenbergen]] 14:11, 2021 September 2 (CDT)~~

** initially this was supposed to be for CXR, then general imaging, now all sorts of CCI entries

**** yes, i think applicable to the CCI count each (CXR, AXR and Blood gasses). ECMO count days should not exceed LOS. For Transfusion count units, I need to run the stats. This reminds me of another concern - ~~should this be done vis~~-a-vis to boarding loc. if pt moves to another loc, enter a separate CXR entry starting on the next boarding loc date. Are we over doing these CCIs - too much work, are they needed? In the CC report, I need only a separation of CXR for HSC MICU and HSC SICU. This would not be a ~~problem if we are handling continuous stay of MICU and SICU service~~ in ~~two records and not as one record in patient follow model. --~~[[~~User:JMojica|JMojica~~]] ~~14:36, 2021 September 2 (CDT)~~

* 2022-02-10 - confirmed that this would not be affected by the change of including a time in the [[Px Date]]

***** discussed with Julie~~: make soft~~ check~~, no more than LOS*2 for count each; count days should not be > LOS; count units is likely uncheckable.~~ [[~~User:Ttenbergen|Ttenbergen~~]] ~~15:47, 2021 September 2~~ (~~CDT~~) }}

* 2022-01-19 - Julie confirmed that we don't need to check this per [[Boarding Loc]] - per profile is enough (especially since it's a soft check)

== Related articles ==

Line 56:

Line 43:

[[Category:Labs]]

[[Category:Length of stay]]

[[Category:CCI Px check]]

[[Category:Data Integrity Checks]]

@@ Line 1: / Line 1: @@
 {{Data Integrity Check
 |DIC_summary=Confirm that a [[:Category:Labs Imaging]] count is not unreasonably high
-|DIC_related_concepts=CXR (plain film); LOS; Arrive DtTm; Dispo DtTm
+|DIC_related_concepts=Blood gas, venous; Blood gas, arterial; CXR (plain film); Angiogram, aortic (any part of aorta); Angiogram, coronary (diagnostic cardiac catheterization); ECHO (echocardiogram of heart); Cardiac CT or Cardiac CT angiogram (with or without coronary arteries); Cardiac MRI; Cardiac nuclear scan (e.g. MUGA); Angiogram, cerebral (including vertebral arteries); CT of chest with PE protocol (CT angiogram of pulmonary vessels); Angiogram, artery NOS (except specifically coded); Angiogram, vein; Angiogram, pulmonary artery (pulmonary arteriogram); AXR (abdominal plain X-ray); LOS
 |DIC_firmness=soft check
 |DIC_timing=complete
-|DIC_coding=query ''check_CCI_CXR_vs_LOS''
+|DIC_coding=query ''check_CCI_each_count_vs_LOS''
 |DIC_status=needs review
 |DIC_app=CCMDB.accdb
 |DIC_backlogged=No
 }}
-We have had some medical [[:Category:Labs Imaging]] count entries that are so high that they are likely errors.
+We have had some CCI count entries that are so high that they are likely errors.
-=== What are likely maximum entries? ===
+=== CCI codes considered ===
-The count per patient stay is related to the [[LOS]]. The threshold limits are either Mean + 3 Standard Deviation or Maximum value of Chest X-ray count per patient day for various LOS category listed in the table below.  They are derived from July 1988 to June 2017 Lab data. The LOS is based on calendar dates where partial stay is considered as  full day.
+{{#ask: [[Has CCI Picklist Code::2.ZZ.13.RA||2.ZZ.13.RE||3.GY.10.VA||3.ID.10.V^||3.IP.10.V^||3.IP.30||3.IP.20||3.IP.40||3.IP.70||3.JM.10.V^||3.JY.20||3.KV.10.VX||3.KX.10.VC||3.IM.10.V^||3.OT.10.VA]]
+ |?Has CCI Picklist Code=Code
+ |?Has CCI Collection Mode=Collection mode
+ |sort=Has CCI Collection Mode,Has CCI Picklist Code
+ |order=asc,asc
+}}
+== Checks ==
+This uses [[Function LOS()]] to calculate the [[LOS]].
-*LOS based on calendar dates = [[Dispo DtTm]] - ([[Accept DtTm]]/first [[Service tmp entry]]) + 1
+=== [[Template:CCI collect count each|CCI collect count each]] and [[Template:CCI collect each|CCI collect each]] ===
-** if patient is still in the unit,  [[Dispo DtTm]] is replaced by today's date
+These should be checked.
-*** check is marked as only running on complete records, if that is so then we don't need to replace with today's date
-*Chest X-ray (CXR) per patient day = Number of chest X-rays / LOS Based on calendar dates
-{| class="wikitable sortable"
+=== [[Template:CCI collect count days|CCI collect count days]] ===
-! LOS_days !! N !! Mean !! Std Dev !! Minimum !! Median !! 75th Pctl !! 90th Pctl !! 95th Pctl !! 99th Pctl !! Maximum !! mean + 3 Std Dev !! Limits of CXR per patient day
+Implemented by [[query check_CCI_vs_LOS_count_days_component]] and [[query check_CCI_vs_LOS_count_days_picklist]].
-|-
-||1     ||4021||1.16||0.42||1||1||1||2||2||3||5||2.42||5
-|-
-||2     ||23910||0.83||0.31||0.5||1||1||1||1.5||2||4||1.76||4
-|-
-||3-10  ||52600||0.64||0.34||0.1||0.67||0.88||1||1.25||1.6||3||1.66||3
-|-
-||11-20||7784||0.7||0.31||0.05||0.71||0.92||1.09||1.19||1.42||2.47||1.63||2
-|-
-||21-30||1870||0.68||0.3||0.03||0.69||0.9||1.05||1.14||1.36||2.57||1.58||2
-|-
-||31-40||660||0.62||0.3||0.03||0.64||0.84||1||1.09||1.32||1.67||1.52||2
-|-
-||41-50||311||0.54||0.29||0.02||0.53||0.73||0.93||1.02||1.21||1.58||1.41||2
-|-
-||51-100||347||0.41||0.26||0.02||0.38||0.6||0.76||0.85||1.12||1.2||1.19||1
-|-
-||> 100||101||0.19||0.21||0.01||0.11||0.2||0.48||0.73||0.88||1.09||0.82||1
-|-
-|}
-{{CCMDB.accdb cross checks triggering for correct values}}
+=== [[Template:CCI collect count units|CCI collect count units]] ===
+Discussed with Julie that this one is likely uncheckable. [[User:Ttenbergen|Ttenbergen]] 15:47, 2021 September 2 (CDT)
-{{TT |
+== Log ==
-* is there a function we can use for the threshold? That would be easier to implement than a list like that. If SAS as a way to generate functions (like excel does for its trendlines) then could you run that? [[User:Ttenbergen|Ttenbergen]] 09:02, 2021 September 2 (CDT)
+* 2024-04-24 -
-** looks like from the list above,  the mean plus 3 std of 2 per day is common except when LOS <1.  we can use the function twice of LOS.  the CXR should not exceed  twice of LOS.  when LOS <1, should not exceed 5. When LOS is 51 or more, should not exceed LOS.  --[[User:JMojica|JMojica]] 09:18, 2021 September 2 (CDT)
+** implemented LOS <7 and count >10 (i.e. double digits, because that's a likely fumble finger mistake)
-*** this cross check is not just for CXR, but any CCI. Do those numbers still make sense? Or does the same check for all CCI not make sense? I am OK if we only want to check for CXR. [[User:Ttenbergen|Ttenbergen]] 14:11, 2021 September 2 (CDT)
+** initially this was supposed to be for CXR, then general imaging, now all sorts of CCI entries
-**** yes, i think applicable to the CCI count each (CXR, AXR and Blood gasses).  ECMO count days should not exceed LOS.  For Transfusion count units, I need to run the stats. This reminds me of another concern - should this be done vis-a-vis to boarding loc. if pt moves to another loc, enter a separate CXR entry starting on the next boarding loc date.  Are we over doing these CCIs - too much work, are they needed?  In the CC report, I need only a separation of CXR for HSC MICU and HSC SICU.  This would not be a problem if we are handling  continuous stay of MICU and SICU service  in two records and not as one record in patient follow model.  --[[User:JMojica|JMojica]] 14:36, 2021 September 2 (CDT)
+* 2022-02-10 - confirmed that this would not be affected by the change of including a time in the [[Px Date]]
-***** discussed with Julie: make soft check, no more than LOS*2 for count each; count days should not be > LOS; count units is likely uncheckable. [[User:Ttenbergen|Ttenbergen]] 15:47, 2021 September 2 (CDT) }}
+* 2022-01-19 - Julie confirmed that we don't need to check this per [[Boarding Loc]] - per profile is enough (especially since it's a soft check)
 == Related articles ==
@@ Line 56: / Line 43: @@
 [[Category:Labs]]
 [[Category:Length of stay]]
+[[Category:CCI Px check]]
+[[Category:Data Integrity Checks]]