Ono Academic College, Israel.
Baruch College, USA.
Health Informatics J. 2020 Mar;26(1):218-232. doi: 10.1177/1460458218824708. Epub 2019 Jan 23.
Diagnostic complexity is an important contextual factor affecting a variety of medical outcomes. Existing measurements of diagnosis complexity either rely on crude proxies or use fine-grained measures that employ indicators from proprietary data that are not readily available. Hence, the study of this important construct in fields such as medical informatics has been hampered by the difficulty of measuring diagnostic complexity. This article presents a novel approach for conceptualizing and operationalizing diagnostic task complexity as a multi-dimensional construct, which employs the readily available International Classification of Diseases codes from medical encounters in hospitals and uses Analytic Hierarchical Process methodology. We demonstrate the reliability of the proposed approach and show that despite using a relatively simple procedure, it is able to predict readmission rates just as well as (or even better) than some of the sophisticated measures that have been used in recent studies (namely, the LaCE score index).
诊断的复杂性是影响各种医疗结果的一个重要的背景因素。现有的诊断复杂性测量方法要么依赖于粗略的替代指标,要么使用精细的度量方法,这些方法使用的指标来自专有数据,不易获取。因此,在医学信息学等领域,由于诊断复杂性的测量难度,对这一重要结构的研究受到了阻碍。本文提出了一种将诊断任务复杂性概念化为多维结构的新方法,该方法使用医院就诊中现成的国际疾病分类代码,并采用层次分析法方法。我们验证了所提出方法的可靠性,并表明,尽管使用了相对简单的程序,但它能够预测再入院率的效果与一些在最近的研究中使用的复杂方法(即 LaCE 评分指数)一样好(甚至更好)。