使用国家电子伤害监督系统（NEISS）对儿童创伤性脑损伤进行监测：选择合适的病例定义。
Surveillance of paediatric traumatic brain injuries using the NEISS: choosing an appropriate case definition.
作者信息
Thompson Meghan C, Wheeler Krista K, Shi Junxin, Smith Gary A, Groner Jonathan I, Haley Kathryn J, Xiang Huiyun
机构信息
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital , Columbus, OH , USA .
出版信息
Brain Inj. 2014;28(4):431-7. doi: 10.3109/02699052.2014.887146. Epub 2014 Feb 24.
OBJECTIVE
To evaluate the definition of traumatic brain injury (TBI) in the National Electronic Injury Surveillance System (NEISS) and compare TBI case ascertainment using NEISS vs. ICD-9-CM diagnosis coding.
METHODS
Two data samples from a NEISS participating emergency department (ED) in 2008 were compared: (1) NEISS records meeting the recommended NEISS TBI definition and (2) Hospital ED records meeting the ICD-9-CM CDC recommended TBI definition. The sensitivity and positive predictive value were calculated for the NEISS definition using the ICD-9-CM definition as the gold standard. Further analyses were performed to describe cases characterized as TBIs in both datasets and to determine why some cases were not classified as TBIs in both datasets.
RESULTS
There were 1834 TBI cases captured by the NEISS and 1836 TBI cases captured by the ICD-9-CM coded ED record, but only 1542 were eligible for inclusion in NEISS. There were 1403 cases classified as TBIs by both the NEISS and ICD-9-CM diagnosis codes. The NEISS TBI definition had a sensitivity of 91.0% (95% CI = 89.6-92.4%) and positive predictive value of 76.5% (95% CI = 74.6-78.4%).
CONCLUSIONS
Using the NEISS TBI definition presented in this paper would standardize and improve the accuracy of TBI research using the NEISS.
目的
评估国家电子伤害监测系统（NEISS）中创伤性脑损伤（TBI）的定义，并比较使用NEISS与国际疾病分类第九版临床修订本（ICD-9-CM）诊断编码确定TBI病例的情况。
方法
比较了2008年来自一家参与NEISS的急诊科（ED）的两个数据样本：（1）符合推荐的NEISS TBI定义的NEISS记录，以及（2）符合ICD-9-CM疾病控制与预防中心（CDC）推荐的TBI定义的医院ED记录。以ICD-9-CM定义为金标准，计算NEISS定义的敏感性和阳性预测值。进行了进一步分析，以描述两个数据集中被归类为TBI的病例，并确定为何有些病例在两个数据集中未被归类为TBI。
结果
NEISS捕获了1834例TBI病例，ICD-9-CM编码的ED记录捕获了1836例TBI病例，但只有1542例符合纳入NEISS的条件。NEISS和ICD-9-CM诊断编码均将1403例病例归类为TBI。NEISS TBI定义的敏感性为91.0%（95%置信区间=89.6-92.4%），阳性预测值为76.5%（95%置信区间=74.6-78.4%）。
结论
使用本文提出的NEISS TBI定义将使使用NEISS进行的TBI研究标准化并提高其准确性。
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