韩国在临床实用编码规则下进行ICD-11分类的现场试验,以澄清不一致的原因。

Hyunkyung Lee, Yeojin Lee
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引用次数: 0

摘要

背景:世界卫生组织(世卫组织)于2019年5月宣布发布第11版《国际疾病分类》(ICD)。虽然韩国统计局自2017年以来一直参与正在进行的ICD-11研究,但由于参与者的编码结果差异很大,我们无法在以前的研究中就病例情景临床编码的黄金标准达成一致。目的:本研究的目的是通过使用明确的临床编码规则来识别和澄清这些不一致的原因,从而提高ICD-11临床编码的准确性和一致性。方法:采用预实验设计。在《ICD-11死亡率和发病率统计(2022年3月)》中,针对诊断术语和病例情景进行了两项临床编码现场试验(FTs)。在第一次FT中,通过分析结果得出临床编码规则,而第二次FT是在第一次FT设定的临床编码规则下进行的。结果:在两次FT中,诊断术语的准确率(分别为75.8%和71.8%)高于病例情景(62.5%和71.9%)。准确率低的主要原因是后协调。结论:对于病例情景临床编码,准确率较低的原因可能是参与者之间聚类方法的差异。这表明,如果通过使用清晰的编码指南来减少聚类方法之间的差异,可以提高ICD-11临床编码的准确性。为每个机构的各种模棱两可的情况提供指南,并在主干代码中提供适当的协调后清单,也可能是有效的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Korean field trial of ICD-11 classification under practical clinical coding rules to clarify the reasons for inconsistencies.

Background: The World Health Organization (WHO) announced the release of the 11th edition of the International Classification of Diseases (ICD) in May 2019. Although Statistics Korea has been involved in the ongoing research on ICD-11 since 2017, we have been unable to achieve agreement on the gold standards for case scenario clinical coding in previous studies due to high levels of variance in the coding results of participants. Objective: The purpose of this study was to enhance clinical coding accuracy and consistency in ICD-11 by identifying and clarifying the reasons for these inconsistencies through the use of clear clinical coding rules. Method: A pre-experimental design was applied. Two clinical coding field trials (FTs) were conducted in 'ICD-11 for Mortality and Morbidity Statistics (2022 Mar)' targeting diagnostic terms and case scenarios. In the first FT, clinical coding rules were derived by analysing the results, while the second FT was performed under the clinical coding rules set by the first FT. Results: Across the two FTs, accuracy rates for diagnostic terms (75.8% and 71.8%, respectively) were higher than for case scenarios (62.5% and 71.9%). The main reason for the low accuracy levels was post-coordination. Conclusion: For case scenario clinical coding, low accuracy could be explained by variance in clustering methods between participants. This suggests that the accuracy of ICD-11 clinical coding could be increased if the variance between clustering methods can be reduced through the use of a clear coding guide. A guide for various ambiguous cases in each institution and the provision of a proper post-coordination list in the stem code could also be effective.

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