Query check CCI CXR vs LOS: Difference between revisions

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== disucssion ==
== disucssion ==
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{{Todo
| who = Tina
| todo_added = 2021-09-02
| todo_action = 2021-09-02
| question =
* 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)
* 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)
** 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)
** 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)

Revision as of 10:07, 2021 September 8

Data Integrity Checks
Summary: Confirm that a Category:Labs Imaging count is not unreasonably high
Related: CXR (plain film), LOS, Arrive DtTm, Dispo DtTm
Firmness: soft check
Timing: complete
App: CCMDB.accdb
Coding: query check_CCI_CXR_vs_LOS
Uses L Problem table: not relevant for this app
Status: needs review
Implementation Date: not entered
Backlogged: No
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We have had some medical Category:Labs Imaging count entries that are so high that they are likely errors.

What are likely maximum entries?

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.

  • LOS based on calendar dates = Dispo DtTm - (Accept DtTm/first Service tmp entry) + 1
    • if patient is still in the unit, Dispo DtTm is replaced by today's date
      • 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
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
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

If the actual correct data leads to a cross-check error CCMDB.accdb will not allow you to send. In that case, enter a value that is acceptable and then email the Data Processor using the "generate email" button.

disucssion

  • 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? Ttenbergen 09:02, 2021 September 2 (CDT)
    • 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. --JMojica 09:18, 2021 September 2 (CDT)
      • 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. Ttenbergen 14:11, 2021 September 2 (CDT)
        • 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. --JMojica 14:36, 2021 September 2 (CDT)
          • 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. Ttenbergen 15:47, 2021 September 2 (CDT)
            • additional decision needed from Px Date - if we do collect different dttms for each Boarding Loc then the count needs to be per Boarding Loc LOS, not overall LOS. Ttenbergen 15:52, 2021 September 2 (CDT)
  • added: 2021-09-02
  • action: 2021-09-02
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