1. Accuracy of Diagnostic Codes for Identifying Brief Resolved Unexplained Events
- Author
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Nirav Shastri, Matthew Hall, Adam Cohen, Erin Sullivan, Victoria Wilkins, Manoj K. Mittal, Allayne Stephans, Joel S. Tieder, Amy M. DeLaroche, Ron L. Kaplan, and Mark I. Neuman
- Subjects
Pediatrics ,medicine.medical_specialty ,Hospitalized patients ,Population ,MEDLINE ,Brief, Resolved, Unexplained Event ,03 medical and health sciences ,0302 clinical medicine ,International Classification of Diseases ,030225 pediatrics ,medicine ,Humans ,030212 general & internal medicine ,education ,Child ,Retrospective Studies ,education.field_of_study ,business.industry ,Retrospective cohort study ,General Medicine ,Predictive value ,Patient Discharge ,Case ascertainment ,Pediatrics, Perinatology and Child Health ,Diagnosis code ,business ,Emergency Service, Hospital - Abstract
OBJECTIVES To evaluate International Classification of Diseases, 10th Revision (ICD-10) coding strategies for the identification of patients with a brief resolved unexplained event (BRUE). METHODS Multicenter retrospective cohort study, including patients aged RESULTS Of 4512 records reviewed, 1646 (36.5%) of these patients met the American Academy of Pediatrics criteria for BRUE on ED presentation, 1016 (61.7%) were hospitalized, and 959 (58.3%) had no explanation on discharge. Among ED discharges, the BRUE ICD-10 code alone was optimal for case ascertainment (sensitivity: 89.8% to 92.8%; positive predictive value: 51.7% to 72.0%). For hospitalized patients, ICD-10 codes related to the clinical characteristics of BRUE are preferred (specificity 93.2%, positive predictive value 32.7% to 46.3%). CONCLUSIONS The BRUE ICD-10 code and/or the diagnostic codes for the characteristics of BRUE are recommended, but the choice between approaches depends on the investigative purpose and the specific BRUE population and setting of interest.
- Published
- 2021