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; Service tmp entry; 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
}}
}}
* Not currently implemented; starting point for the query exists but doesn't yet include Julie's values. Also, isn't being called from anywhere.  
We have had some CCI count entries that are so high that they are likely errors.


=== Discussion ===
=== CCI codes considered ===
{{Discuss |
{{#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]]
* Just came across this... the started query includes additional dxs now, as per [[#CCI collect count each]]. Does the proposed accepted count make sense for all the dxs? Your validation table was for CXR. [[User:Ttenbergen|Ttenbergen]] 11:50, 2023 May 3 (CDT)
|?Has CCI Picklist Code=Code
** Did some checking on all 13 LAB Imaging from CCI picklist and found counts more than the LOS only in ECHO, AXR and CXR. Emailed Lisa and Pagasa March 14, 2024 to check if correct or not. Waiting for their feedbacks. In the email, I also propose another query (e.g. the counts per calendar day per patient must not be more than one) as alternative to the threshold limits LOS +- 3 STD shown below. --[[User:JMojica|JMojica]] 10:55, 2024 March 18 (CDT)
|?Has CCI Collection Mode=Collection mode
*** That query is tighter and would therefore have more false positives. What does Lisa think about that? [[User:Ttenbergen|Ttenbergen]] 09:51, 2024 March 20 (CDT)
|sort=Has CCI Collection Mode,Has CCI Picklist Code
**** I made some limits per LOS group for CXR, AXR, ECHO and Blood gases and emailed the results to Tina and Lisa 3/25/2024 for discussion. ---[[User:JMojica|JMojica]] 13:28, 2024 March 25 (CDT)
|order=asc,asc
***** Further emails with Julie and Lisa about details. Discussed with Lisa who is reviewing some of the errors and will hold off until she is done. [[User:Ttenbergen|Ttenbergen]] 12:46, 2024 April 8 (CDT)
}}
}}
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 = [[Function LOS()|Function LOS()]] + 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
{| 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 ==
This uses [[Function LOS()]] to calculate the [[LOS]].  
This uses [[Function LOS()]] to calculate the [[LOS]].  


=== CCI collect count each ===
=== [[Template:CCI collect count each|CCI collect count each]] and [[Template:CCI collect each|CCI collect each]] ===
* [[AXR (abdominal plain X-ray)]] 3.OT.10.VA
These should be checked.  
* [[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 days|CCI collect count days]] ===
* if LOS < 1, 5
Implemented by [[query check_CCI_vs_LOS_count_days_component]] and [[query check_CCI_vs_LOS_count_days_picklist]].
* if LOS 1-50, LOS * 2
* if LOS > 50, LOS


=== CCI collect count days ===
=== [[Template:CCI collect count units|CCI collect count units]] ===
"CCI collect count days" should not be higher than LOS. See [[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. [[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 ===
Discussed with Julie and no specific checks required for this one.


== Log ==
== 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]]
* 2022-02-10 - 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)
* 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)

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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