Statistician

From CCMDB Wiki

p:Julie Mojica is the full time Statistician for the Critical Care and Medicine Database.

She provides Statistical Analysis and Reporting using our data.

The Statistician is a member of the Steering Committee & the Task Team.

Questions on wiki

Here is a list of questions driven by the Template:Discuss that have been flagged for Julie.

77

 QuestionModification date
"Modification date" is a predefined property that corresponds to the date of the last modification of a subject and is provided by Semantic MediaWiki.
Last editor is
"Last editor is" is a predefined property that contains the page name of the user who created the last revision and is provided by Semantic MediaWiki.
Panelling or Discharge PlanningThat link no longer goes anywhere, the heading is not on that page. Can the reference be deleted from here, or do we need to review? And, how will this affect the use of the Category:Awaiting/delayed transfer codes? Ttenbergen 14:51, 2018 September 6 (CDT)
28 November 2018 04:53:25Ttenbergen
Previous Location field
  • "We are aware that this may affect categorization under APACHE II but will collect like this for now. This will need to be dealt with when we move to ICD10." - Julie, I don't know what this comment is about, I just came across it when cleaning out things we need to take care of in going to ICD10. I can't think of what we would need to take care of here, if you can't either please take the comment out.
21 December 2018 16:10:01Ttenbergen
Check pre acute consistentwhat exactly do we want to check for? Please also have a look at the stuff below that doesn't specifically have your name. This requested check ties into a bunch of things and if we want the check we need to be sure that instructions stay consistent and lose ends are tied up.
There was a previous attempt to address some of this in Care levels in the community; this page and it need to be consistent, and consistently linked from the relevant field definitions. If we can get it short enough we might make a template to apply the instructions to each of the field pages.
How does Chronic Health Facility fit into this?
There was talk about comparing Postal Codes to known PCH Postal Codes. Since these might Include other buildings at the same site that are not PCHs, this check can at best be a soft check. Please add the list of these postal codes here.
  • from a data perspective, what do you mean by "admitted directly"? If I were to build a check, where would I find that? OR maybe I don't need to know, but then I need to have a definition of what combination of data would be an error.

Integrity check


  • ... unless they are discharged somewhere else entirely, like another ward. So what do we really mean with this? That they can't come from one PCH and go to another or maybe "home" after all?
    • I realize this maybe hard to do. what I mean here is that if one is already a PCH resident, when leaving the hospital, the dispo location must be a PCH location too. or is a patient is already in CHF, the destination when leaving the hospital must either be a CHF or another PCH.


  • Need to look at the PCH Postal code data.

It may be relevant to this check that we have ICD10 Imprisonment/incarceration and other info in Prison / Jail / Correctional Institution.
21 December 2018 16:09:26Ttenbergen
CAM positive (TISS Item)
  • Did these ever get better? Ttenbergen 12:44, 2017 May 11 (CDT) Does anything need to be done about this? Ttenbergen 20:15, 2018 November 27 (CST)
31 December 2018 06:41:52Ttenbergen
Reporting from ICD10/CCI
  • We made this page early on to make sure that we address any reporting concerns you have about ICD10. Are the TASK questions still relevant? If not, could you please take them out? If you have other things relating to this that should go to task, pls stick them in here.


Will Julie be able to come up with usable groupings of diagnoses? In the current system she grouped by main diagnosis, but that concept is gone. Will ICD10 blocks implemented by S ICD10 Block Dxs table be sufficient? Ttenbergen 22:57, 2018 March 20 (CDT)

  • Different procedures would be listed with the same CCI code; will Julie easily interpret and utilize CCI codes for reporting?
  • Do we care that we will not be able to differentiate between a Blakemore tube from an Upper GI scope with banding or hemostasis, when in CCI they both look the same: (T) Stomach, pylorus... and Control of Bleeding. --LKolesar 14:11, 2018 May 1 (CDT)
    • discussed at task 14:08, 2018 June 20 (CDT), Julie to review what she needs and we will discuss again Ttenbergen 14:08, 2018 June 20 (CDT)

This is part of the discussion with Julie about Apache diagnoses today I think Ttenbergen 08:49, 2019 January 10 (CST)
10 January 2019 14:49:53Ttenbergen
Correcting Person IDs
  • Do we need to change this process? If so we likely need a section in Changing PHINs


  • When we talked about this 2018 November 7 it seemed like this might not be OK after all, and that we have handed out this data as if this number never changes.
7 November 2018 20:43:19Ttenbergen
Transfer-for Organ Transplantation
  • Do we use this in a specific report? If not we should probably consider dropping it, it's an odd thing to collect.Ttenbergen 23:00, 2012 December 12 (EST)
    • we have 12 in ICU database to date. 2 coded in 2011 and 1 in 2010......rest random back to 1994.
      • Julie, do you use this? Do we need to do anything about this DX? A counterpart does not exist in ICD10. Ttenbergen 19:49, 2018 November 27 (CST)
28 November 2018 01:50:05Ttenbergen
Notes field
Yes, I use the primary diagnosis for the reason of readmission even if the record status is incomplete. --JMojica 09:07, 2018 December 6 (CST)
20 December 2018 19:46:33Ttenbergen
Drug or biological substance/agent NOS, adverse effect
  • Had code T88.7 when we first started but was later changed to this code. I have deleted the original code from the tables, but it might still linger in other references. Once you are sure you don't need this info, please delete the comment. Since this would only exist in test data we don't need to keep it long-term.
1 December 2018 05:45:16Ttenbergen
Changing PHINs
  • does that ever happen, and how do we deal with it?


  • Pagasa, are there other things you do in this case? Probably change for other encounters if not just a typo. Anything else? Ttenbergen 11:55, 2017 September 18 (CDT)


  • How about if a person's insurance status changes or they move in or out of Province? Should we change those PHINs? If we wanted to keep the same person_ID for different PHINs we would need to remove the first step in Generate Person IDs that blows away Person_IDs for duplicate PHINs. but: if we remove that step we will no longer make sure that the scenario of multiple PHINs per Person_ID doesn't happen accidentally.
7 November 2018 21:07:06Ttenbergen
Deceased patients
  • Is that really what you want? It will give fact that patient died, but miss new location.


  • Is that really what you want? It will give occupancy but miss actual time of death.


to be done likely after DSM: add destinations to organ donor deaths.
1 Julie asks:

Once that is implemented, I can set up Check dx implying death across encounters.
CFE button "open suspect links" also needs to be dealt with when this is done. And needs to be documented.
7 January 2019 14:39:21Ttenbergen
Comfort Care
  • We may be able to stop this when ICD10 comes; but continued collection wont break anything.


  • Julie, can you add here why this can stop when ICD10 comes? Is it because we will start collecting Palliative care? Because that is not really the same definition...
4 January 2019 02:25:16Ttenbergen
Resistance to antimicrobials, methicillin (anti-staph penicillins)
  • Julie, the above question specifically affects some projects you work with as well - do you think unifying this rule will be a problem for any of them?


Also affected are :

Does anyone think making this one rule for all will be a problem?

31 October 2018 20:50:53Trish Ostryzniuk
APACHE Comorbidities in ICD10 codes
  • Need to update from Allan's email 2018-11-26, but he said he would need to review this in light of the changes that had been made to ICD10 and CCI since he and Julie discussed. Ttenbergen 00:36, 2018 November 27 (CST)


  • There was a comment on Chronic Health APACHE about extracting the APACHE Comos from comorbid diagnoses instead using the ranges Allan provided. Provided this list is updated to the newest ranges Allan has provided, do you see a problem with using this approach instead and stopping collection of the Chronic Health APACHE field going forward?
23 December 2018 04:06:53Ttenbergen
S ICD10 Blocks table
  • There had been talk of you and Allan using these blocks; will you use them? If not we likely have no use for them and I will take them out. Ttenbergen 15:49, 2018 October 30 (CDT)
30 October 2018 20:49:54Ttenbergen
Primary Admit Diagnosis
  • They are used in the periodic quarter and fiscal year reports of both the Critical Care and Medicine Programs. (Julie)
    • are the two I linked to above those reports? Ttenbergen 14:03, 2015 April 20 (CDT)


z PIC

  • that can be deleted when ICD10 implementation is complete.
28 November 2018 04:43:31Ttenbergen
Check Inf Potential Infection must have pathogen or alt combined code
  • This would cause extra collection work, since there are quite a few potential infections (most of the NOS codes are potential infections), and a lot of them would not usually be infections. Do we really want to do this or can we decline it?
  • 9 November 2018 02:32:12Ttenbergen
    Medical Assistance In Dying
    • When we started out this dx used code U23, but then as of 2018-07-17 ICD10 actually added a code for this so we changed ours to that code. I don't really think we are interested in keeping that very early test data, so this comment can probably just go, and we can delete them. I am removing the code from our s_ICD10 table.
    31 December 2018 15:58:59Dr. Allan Garland
    L ICD10 APACHE Dx query
    • You and Allan discussed what should be on the list. At some point we will need to integrate the result into this query. Did you end up including Acquireds? Since the first 24hrs might include them, but they might happen later, and the difference is not clear from Dx_Date? Ttenbergen 20:20, 2018 November 24 (CST)
    25 November 2018 02:20:14Ttenbergen
    Check VAP vs TISS ventilated 7 January 2019 04:24:41Ttenbergen
    Data dictionarysomething went wrong with this query and it has no data
    Attempt at a easier to follow data dictionary. Is this what you had in mind?
     Yes, this is what I have in  mind. Thanks.  Some suggestions: 
    
    • I just notice some start dates are not the actual start dates - It is important for the users to know how far back the data are available so they can decide the covered period of their study. is it possible to change the date to actual earliest collection start date (not 1 Jan 1900). --JMojica 10:05, 2019 January 3 (CST)
      • The start and end dates are stored on the individual pages. If the list shows 1900 then they were not filled in. If you know what they are and fill them in then this page will list them. I can also change the default if-not-filled value in templates to something other than 1900-01-01. I just needed a value for ranges and filters to work. Ttenbergen 14:49, 2019 January 3 (CST)
    • add a column for program (Critical care only or Medicine only or both).
      • I can do that, but the table is already getting quite wide for a web page. Can we lose any of the columns we currently have? The info you mean is always visible in the pages themselves as well, in case that's sufficient. But, yes, we can tweak what the tables should show. It is done in Template:DataDictionaryQuery (details visible once you edit it...) and removing fields would be easy enough. I can show you how to add fields. Or I can add them once we confirm what we want.

    Tina has changed the ICD10 and CCI templates to use a startdate of 2019-01-01 and will change other default dates as I receive dates Julie wants me to use.
    14 January 2019 11:34:54Ttenbergen
    STB E6
    • are you still running these? Ttenbergen 21:06, 2018 November 24 (CST)
    25 November 2018 03:06:17Ttenbergen
    Bronchitis, acute or chronic not specified, infectious or noninfectious
    • bringing you in on existing discussion


    APACHE CHRONIC stuff related coding schemas

    • This does not trigger APACHE Acute Dxs in ICD10 codes while some other dxs that seem no more "intense" do. Is that right?
      • AG REPLY --- Leave it OUT, it's a wastebasket code and could be acute disorders. ALSO, in Feb we'll shift from tick boxes for the AP2 comorbs to identification via ICD10, for which I've made the coding already.
        • Julie has investigated the APACHE conversion further since this was brought up, so she should be included in any further conversation about this. Ttenbergen 14:45, 2018 August 6 (CDT)
    20 December 2018 22:33:51Ttenbergen
    Query TISS Errors CAM positive vs Dx
  • elsewhere on the wiki there was a comment about checking Confusion/Delirium against CAM positive (TISS Item). I don't think this was actually being done. Is such a check needed? If so we would need a list of dxs for ICD10 where that are relatable to CAM.

  • I am not actually sure what is supposed to be tested here... that CAM and Dilirium always show up together?
    is there a sensible list that could be used for this, or should this check be declined?
    7 January 2019 02:56:02Ttenbergen
    Palliative Service
    • there was a question about palliation at beginning vs end of stay. It was discussed at task but never cleaned up. Could you have a look a this page? If this is all no longer an option, please delete the section. If it was resolved, then what did we decide? Or was that why we starte Comfort Care? Ttenbergen 00:01, 2018 November 27 (CST)
    28 November 2018 04:55:03Ttenbergen
    Query NDC Dxs vs TISS Dialysis
    • AG REPLY -- This is challenging since not everyone with either ARF or CRF gets dialysis AND not everybody who gets dialysis has renal failure -- e.g. dialysis is also occasionally used for drug overdoses, volume overload, and a very few other things.
    7 January 2019 02:51:51Ttenbergen
    Check organ donors must be dead 24 December 2018 18:47:30Ttenbergen
    Check CRF vs ARF across multiple encountersI think this section is largely old rules that no longer apply with how we define Comorbid Diagnosis now, ie if something was clearly present before admission we can now code it, even if it had not been diagnosed. Are any of these still required, with that in mind? Ttenbergen 21:17, 2018 October 26 (CDT)
    • Using the ICD10 renal codes, we still need to know when the transition from acute to chronic occurs - so we can decide whether the multiple encounters consistency checking is still relevant. --JMojica 11:51, 2018 November 14 (CST)
      1. is the transition on the next hospital stay? Example in this hospital stay, patient is diagnosed with ARF and stayed continuously in both ICU and ward in same or different hospital. On the next hospital stay, he is now chronic renal patient.
      2. Or the transition is on the next ICU or ward stay? Ex. the first stay is ICU and diagnosed with ARF. then patient was transferred in a ward of same or diff hospital - is he now a chronic renal patient?
      • The data collection instructions are in the related pages, and additional info is in Renal Coding Considerations for ICD10, but they are a beast of a network of concepts. Those might tell you how we currently propose to collect the renal codes, but not necessarily what you or the users of the data would want. Usually these cross checks would be driven by what you need for data requests, so do our proposed instructions line up with how you want to use this? Or is this maybe too case-by-case of a concept to even make a cross check? Ttenbergen 18:59, 2019 January 6 (CST)
    7 January 2019 00:59:22Ttenbergen
    Charlson Comorbidity scoring in ICD10 codesCan you have a look at this page and the queries/tables it describes to see if it makes sense?2 January 2019 21:58:47Ttenbergen
    ICU Var 6 - AMADid we transition the following into tmp or otherwise? Ttenbergen 13:58, 2017 June 6 (CDT) If we did not then this question can just be removed, but if we did move this elsewhere we should explain where to.3 January 2019 21:31:41Ttenbergen
    Severe SepsisI don't think this was ever implemented, can't find any evidence of it. Do we need it? Ttenbergen 11:04, 2018 September 25 (CDT)31 December 2018 21:36:56Ttenbergen
    LOS Medicine per hospital admissionthis still talks about TMSX... what is the new status of this field?
    I think you made several of these at some point. Did we do anything even categorize them? If we annotate them right we can include them in the Data dictionary ...
    4 January 2019 02:34:53Ttenbergen
    AaDO2I wonder if "null" is actually intended here, or if it was supposed to be 0. Ttenbergen 14:44, 2017 January 8 (CST)
    • AaDO2 is null if there is no data for FIO2, PaO2 and PaCO2. However, no data was set to zero value instead of null. In addition, AaDO2 and the corresponding score are required only when FIO2 >= 50%, otherwise should be treated as null. (Similarly with PO2 score, it is required when FIO2 < 50% and otherwise should be treated as null. When FIO2 =0, both AaDO2 and its score and PO2 score should be null.) Are we setting null to zero to facilitate the programming calculation? Is it possible to differentiate null from valid zero in both L_LOG and created_variables_CC - will the work be big? In L_LOG, these are the FIO2, CO2, PO2 and SerCO2. 14:49, 2017 March 16 (CDT)
    3 January 2019 06:36:25Ttenbergen
    S dispo.loc typeThis value is not yet encoded on the wiki as Property:Collection Location Location Type for locations that have their own article, but maybe it should be. Should it be? Ttenbergen 09:46, 2017 November 9 (CST)
    Indeed, what is the description? Especially in contrast to S dispo.service type; when you give the answer, please put it behind "element_description" above and delete this question.
    25 October 2018 03:37:29Ttenbergen
    QA Septic ShockIs "Every entry for project QA Septic must have either a date or a time." a request for a cross check? or does that check exist already?3 January 2019 05:41:09Ttenbergen
    Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)Is this still part of Critical Care Vital Signs Monitoring? Ttenbergen 17:22, 2018 May 31 (CDT)20 December 2018 16:50:43Ttenbergen
    HSC IICU Collection GuideIs this still relevant after workload redistribution? Ttenbergen 11:47, 2015 May 20 (CDT) And is this how you want it?16 January 2019 16:08:27Ttenbergen
    Bed holdsJulie seems to set the limit at 1 day - emailed Julie Ttenbergen 10:07, 2016 November 10 (CST)
    duplication on wiki needs to be cleaned up once we are on same page
    Laura and Tina discussed this and there clearly are different understandings about this. Need to review. LKolesar 14:43, 2017 March 1 (CST)
    3 January 2019 22:22:52Ttenbergen
    SAS Data Integrity ChecksNow that we have a structure for cross-checks we should add those you do in SAS to here as well, using the same structure as for those listed in Data Integrity Checks Ttenbergen 20:46, 2018 October 26 (CDT)30 October 2018 01:48:15Ttenbergen
    Chart Review ListsThis is linked from the front page and intended to give an idea of how one could use our data. Is there anything on Publications that would be a good example for how our DB was used for this? If not, should we take it out? With nothing here it doesn't look very good coming from front page.3 January 2019 22:31:09Ttenbergen
    Pre-OP Admit - Research Patient - CardiovascularThis is not coded under ICD10 or CCI. Do we report this, and therefore need to accommodate otherwise, or how will we treat this? We have Preparatory care (incl preop optimization) but that doesn't capture the full concept. Ttenbergen 22:45, 2018 November 27 (CST)31 December 2018 03:05:46Ttenbergen
    Pre op Admit-Cardiovasc PatientThis is not coded under ICD10 or CCI. Do we report this, and therefore need to accommodate otherwise, or how will we treat this? We have Preparatory care (incl preop optimization) but that doesn't capture the full concept. Ttenbergen 22:45, 2018 November 27 (CST)31 December 2018 03:06:12Ttenbergen
    Validation against Patient Registry DataThis page was started long ago to keep track of our attempt to get access to the registry. I think it would be good to re-convene on it so we have a central point where past efforts and current efforts can be tracked. That would also make it easier to take it to task or steering and have consistent info. Do you have a log of this somewhere? We can rename it if you want.3 January 2019 21:26:12Ttenbergen
    ADL General Collection InformationWhat else in addition to ALERT Scale Calculation uses this?4 January 2019 02:25:07Ttenbergen
    Query s ICD10 Chapter block dxsany other plans for these?11 January 2019 05:15:41Ttenbergen
    Characteristics and Outcomes of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Admissions in Intensive Care Units in Manitobado we have any reference for this one? how did we support this publication?3 January 2019 22:29:18Ttenbergen
    A citywide analysis of the utilization of common laboratory tests and imaging procedures in ICUshow did we support this abstract?3 January 2019 21:18:30Ttenbergen
    Epidemiology of Critically Ill Patients in Intensive Care Units: A Population-based Observational Studyhow did we support this publication?3 January 2019 21:13:36Ttenbergen
    Changes Over Time in Intensive Care Unit Admission Diagnoses: A Population-Based Analysishow did we support this publication?3 January 2019 21:12:51Ttenbergen
    A Population-based Analysis of Leaving the Hospital Against Medical Advice: Incidence and Predictorshow did we support this publication?3 January 2019 21:14:04Ttenbergen
    Rates of Readmission and Death Associated with Leaving Hospital Against Medical Advice: A Population-based Studyhow did we support this publication?3 January 2019 21:13:51Ttenbergen
    Increased Incidence of Critical Illness in Psoriasishow did we support this publication?3 January 2019 21:13:38Ttenbergen
    Eliminating Needless Testing in Intensive Care - An Information Based Team Management Approachhow did we support this publication?3 January 2019 21:12:57Ttenbergen
    Health Care Utilization Before and After Intensive Care Unit Admission In Multiple Sclerosishow did we support this publication?3 January 2019 21:14:05Ttenbergen
    A Population-based Observational Study of ICU-Related Outcomes: With Emphasis on Post-Hospital Outcomeshow did we support this publication?3 January 2019 21:13:51Ttenbergen
    Age related changes in intensive care bed utilization over time: A population based study.how did we support this publication?3 January 2019 21:13:38Ttenbergen
    Outcomes of chronic dialysis patients admitted to the intensive care unithow did we support this publication?3 January 2019 21:12:57Ttenbergen
    Quality Improvement in Critical Care: Selection and Development of Quality Indicatorshow did we support this publication?3 January 2019 21:14:27Ttenbergen
    Comparison of different methods to describe intensive care bed usehow did we support this publication?3 January 2019 21:12:31Ttenbergen
    Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shockhow did we support this publication?3 January 2019 21:13:52Ttenbergen
    Long-term outcomes of end-stage renal disease patients admitted to the ICU Nephrology Dialysis Transplanthow did we support this publication?3 January 2019 21:13:42Ttenbergen
    Predictors of ICU admission and outcomes one year post admission in persons with IBD: A population based studyhow did we support this publication?3 January 2019 21:13:07Ttenbergen
    Surge Capacity: Analysis of Census Fluctuations to Estimate the Number of Intensive Care Unit Beds Neededhow did we support this publication?3 January 2019 21:14:29Ttenbergen
    Specific Reporting Requirements Improves the Accuracy of Administrative Data for Identifying Intensive Care Unit Admissionhow did we support this publication?3 January 2019 21:12:46Ttenbergen
    Population Trends in Substances Used in Deliberate Self Poisoning Admissions to the ICU between 2000-2010how did we support this publication?3 January 2019 21:13:59Ttenbergen
    Comparing Use Of Intensive Care Units Between Rural And Urban Canadian Populationshow did we support this publication?3 January 2019 21:13:43Ttenbergen
    Hospitalization is associated with subsequent disability in multiple sclerosishow did we support this publication?3 January 2019 21:13:36Ttenbergen
    Laboratory Testing in the Intensive Care: Does the Admitting Hospital Affect Costs?how did we support this publication?3 January 2019 21:14:32Ttenbergen
    Intensive Care Unit Admission in Multiple Sclerosis: Increased Incidence and Increased Mortalityhow did we support this publication?3 January 2019 21:12:46Ttenbergen
    Relationship Between Apache II SAcore & Combined Laboratory & Pharmacy Costs in ICU Survivors and Nonsurvivorshow did we support this publication?3 January 2019 21:14:02Ttenbergen
    End Stage Renal Disease Status and Critical Illness in the Elderlyhow did we support this publication?3 January 2019 21:13:43Ttenbergen
    Statistical Analysisnot summarized4 January 2019 02:37:01Ttenbergen
    S dispo.service typenot summarized3 January 2019 21:49:57Ttenbergen
    Base Population for Researchnot summarized3 January 2019 21:52:34Ttenbergen
    Encephalopathy, septic or metabolicq
  • Does this category include hepatic encephalopathy--LKolesar 10:36, 2018 July 26 (CDT)
    • AG REPLY -- NO. For that use one of the above
      • Julie, this will mean losing the detail that encephalopathy was present. Does that matter to you at the data request end? Ttenbergen 15:36, 2018 September 6 (CDT)
  • 18 November 2018 05:49:41Ttenbergen
    QA Infection CLIwill we still need to collect this in ICD10, since I think all the data now lives in the dx codes as well. I am holding off on implementing Query s tmp QAInf tmp no dx until resolved. There is no need to continue the QA infection VAP/CLI project since the dates are now collected for acquired ICD10. I will get the data from the L_ICD10 dx table for reporting. Thus the crosscheck queries are no longer needed except the one about LT 48HRS after admit. Also the instruction to email the QI Officer should continue. Also the --JMojica 11:57, 2018 December 273 January 2019 05:08:43Ttenbergen
    QA Infection VAPwill we still need to collect this in ICD10, since I think all the data now lives in the dx codes as well. I am holding off on implementing Query s tmp QAInf tmp no dx until resolved. same reply as in QA CLI. --JMojica 12:04, 2018 December 27 (CST)3 January 2019 05:08:29Ttenbergen


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