Change for Apache Chronic to ICD10 from separate variable

From CCMDB Wiki

We used to collect Chronic Health APACHE as its own variable. When we moved to ICD10 collection we realized we would be able to tag which diagnoses make up APACHE Comorbidities in ICD10 codes and then start using those for the calculation of the APACHE Score in Created Variables CC maker query/Created Variables CC table.

Next steps

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Implementation

Created Variables Common maker 2021 query uses created_APACHE_Chronic query to derive this.

Discrepancies

We found some, and some are in literature, but apparently the difference is not statistically significant, so we are going ahead anyway. Ttenbergen 19:57, 2022 February 17 (CST)   

Before we actually change over to using ICD10 instead of Chronic Health APACHE, we need to be sure that the data is equivalent. Tina set up Created_APACHEChronic_comparison query. This query lists almost 5000 records for which there are inconsistencies.

MetCa

  • Checked 4 and in all cases the mets had not been code in ICD10; seems to be a problem at HSC and STB but not GRA (ex: H8_HSC_SICb-2690, H8_HSC_CC-3317, HSC_SICd-2596, HSC_SICb-2216)

7CVS minExert

  • Angina was never coded; this may be consistent with not coding every toenail when dealing with an ICU patient? This seems to only be a problem at STB. (ex: STB_MICU-32783, STB_CICU-16181, STB_ACCU-40208)

Questionable: STB_CICU-16388 Angina pectoris, stable or NOS, which according to its page doesn't map to APACHE como.

8ImmunoComp

Drug-induced immunosuppression was added 2021-04-19 to make sure this situation can be encoded with just CCI/ICD10 codes. Any Profile with Dispo after 2021-04-19 should have either a immunosupporessing dx or the drug code.

  • emailed Lisa examples S7_STB_ACCU-34329, H9_HSC_CC-3499 (HIV?), H8_HSC_CC-3165 for more input Ttenbergen 10:07, 2021 December 9 (CST)

NoCH

There appear to be a lot of NoCH entries where DXs that might turn them into other values are present. Some common ones seem to be COPD, without exacerbation, Asthma, without acute exacerbation, Respiratory failure (insufficiency), chronic, but there are many others.

General distribution differences between laptops for APACHE Chronic

There appear to be differences between laptops for the distribution of APACHE Chronic values. Some may be legitimate due to differences between sites.

  • Emailed Julie and Lisa to find out if they have thoughts on these numbers. Ttenbergen 11:16, 2021 December 9 (CST)

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