Query check CCI each count vs LOS: Difference between revisions

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{{Data Integrity Check
{{Data Integrity Check
|DIC_summary=Confirm that a [[:Category:Labs Imaging]] count is not unreasonably high
|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_firmness=soft check
|DIC_timing=complete
|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_status=needs review
|DIC_app=CCMDB.accdb
|DIC_app=CCMDB.accdb
|DIC_backlogged=No
|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
*LOS based on calendar dates = [[Dispo DtTm]] - ([[Accept DtTm]]/first [[Service tmp entry]]) + 1
|?Has CCI Collection Mode=Collection mode
** if patient is still in the unit,  [[Dispo DtTm]] is replaced by today's date
|sort=Has CCI Collection Mode,Has CCI Picklist Code
*** check is marked as only running on complete records, if that is so then we don't need to replace with today's date
|order=asc,asc
*Chest X-ray (CXR) per patient day = Number of chest X-rays / LOS Based on calendar dates
}}
 
{| class="wikitable sortable"
! 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}}


== Checks ==
== Checks ==
=== CCI collect count each ===
This uses [[Function LOS()]] to calculate the [[LOS]].  
*[[AXR (abdominal plain X-ray)]] 3.OT.10.VA
*[[Blood gas, arterial]] 2.ZZ.13.RE
*[[Blood gas, venous]] 2.ZZ.13.RA
*[[CXR (plain film)]] 3.GY.10.VA


"CCI collect count each" count should not be higher than:
=== [[Template:CCI collect count each|CCI collect count each]] and [[Template:CCI collect each|CCI collect each]] ===
* if LOS < 1, 5
These should be checked.
* if LOS 1-50, LOS * 2
* if LOS > 50, LOS


=== CCI collect count days ===
=== [[Template:CCI collect count days|CCI collect count days]] ===
"CCI collect count days" should not be higher than LOS. See [[query check_CCI_vs_LOS_count_days]].  
Implemented by [[query check_CCI_vs_LOS_count_days_component]] and [[query check_CCI_vs_LOS_count_days_picklist]].


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


=== CCI collect each ===
== Log ==
{{DJ |
* 2024-04-24 -
* Any checks required for these?
** implemented LOS <7 and count >10 (i.e. double digits, because that's a likely fumble finger mistake)
**none except that the dates should be within the LOS which I think  you already have and no dup of dates.--[[User:JMojica|JMojica]] 15:54, 2022 January 19 (CST)}}
** initially this was supposed to be for CXR, then general imaging, now all sorts of CCI entries
 
* 2022-02-10 - confirmed that this would not be affected by the change of including a time in the [[Px Date]]
== Remaining Discussion - cross check by boarding loc?  ==
* 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)
{{Discuss | who = Julie | question =
* ... 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)
** 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. [[User:Ttenbergen|Ttenbergen]] 15:52, 2021 September 2 (CDT)
*** I am checking the sum of all counts in CCI since collectors can enter them over time, so for now I can do a cross check over overall LOS. If we want to break the cross check down further, let's discuss. [[User:Ttenbergen|Ttenbergen]] 16:49, 2021 September 15 (CDT)
**** i think what you did is OK. no need to split by each boarding loc. --[[User:JMojica|JMojica]] 15:56, 2022 January 19 (CST)}}
 
 
 
{{Todo
| who = Tina
| todo_added = 2021-09-08
| todo_action = 2021-09-08
| question =  _dev_CCMDB
* Confirm that this will work with the time components of [[Px Date]].
}}


== Related articles ==
== Related articles ==

Latest revision as of 16:50, 2024 April 24

Data Integrity Checks
Summary: Confirm that a Category:Labs Imaging count is not unreasonably high
Related: 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
Firmness: soft check
Timing: complete
App: CCMDB.accdb
Coding: query check_CCI_each_count_vs_LOS
Uses L Problem table: not relevant for this app
Status: needs review
Implementation Date: not entered
Backlogged: No
  • Cargo


  • SMW


  • Categories: 
  • form:

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

CCI codes considered

 CodeCollection mode
Blood gas, venous2.ZZ.13.RACCI collect count each
Blood gas, arterial2.ZZ.13.RECCI collect count each
CXR (plain film)3.GY.10.VACCI collect count each
AXR (abdominal plain X-ray)3.OT.10.VACCI collect count each
Angiogram, aortic (any part of aorta)3.ID.10.V^CCI collect each
Angiogram, pulmonary artery (pulmonary arteriogram)3.IM.10.V^CCI collect each
Angiogram, coronary (diagnostic cardiac catheterization)3.IP.10.V^CCI collect each
Cardiac CT or Cardiac CT angiogram (with or without coronary arteries)3.IP.20CCI collect each
ECHO (echocardiogram of heart)3.IP.30CCI collect each
Cardiac MRI3.IP.40CCI collect each
Cardiac nuclear scan (e.g. MUGA)3.IP.70CCI collect each
Angiogram, cerebral (including vertebral arteries)3.JM.10.V^CCI collect each
CT of chest with PE protocol (CT angiogram of pulmonary vessels)3.JY.20CCI collect each
Angiogram, artery NOS (except specifically coded)3.KV.10.VXCCI collect each
Angiogram, vein3.KX.10.VCCCI collect each

Checks

This uses Function LOS() to calculate the LOS.

CCI collect count each and CCI collect each

These should be checked.

CCI collect count days

Implemented by query check_CCI_vs_LOS_count_days_component and query check_CCI_vs_LOS_count_days_picklist.

CCI collect count units

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

Log

  • 2024-04-24 -
    • implemented LOS <7 and count >10 (i.e. double digits, because that's a likely fumble finger mistake)
    • initially this was supposed to be for CXR, then general imaging, now all sorts of CCI entries
  • 2022-02-10 - confirmed that this would not be affected by the change of including a time in the Px Date
  • 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

Related articles:
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