College of Nursing, University of Tennessee, Knoxville, Knoxville, TN, USA.
Department of Health Services Policy and Management, Center for Effectiveness Research in Orthopedics, University of South Carolina, Columbia, SC, USA.
West J Nurs Res. 2020 Jun;42(6):454-461. doi: 10.1177/0193945919867266. Epub 2019 Jul 29.
The original pediatric complex chronic conditions (CCC) classification system developed in 2000/2001 is the gold standard in classifying children with life-limiting illnesses. It was significantly modified in 2014; yet the two systems have not been evaluated. The objective of this study was to evaluate the agreement and validity of the original versus the modified CCC classification systems. Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) data from 2012 was used with a sample of infant decedents less than 1 years. The agreement (i.e., Cohen's Kappa Statistic) and validity (i.e., sensitivity, specificity, and positive predictive value [PPV]) statistics were calculated. Among the 10,175 infants that were classified, the modified system performed well in identifying infants who had a CCC, and it captured infants that the original classification did not. The modified system represents an improvement over the original, but additional testing is warranted.
原始儿科复杂慢性疾病（CCC）分类系统于 2000/2001 年开发，是对患有生命有限疾病的儿童进行分类的金标准。该系统于 2014 年进行了重大修改；但这两个系统尚未进行评估。本研究的目的是评估原始与修改后的 CCC 分类系统的一致性和有效性。使用了来自 2012 年医疗保健成本和利用项目（HCUP）儿童住院数据库（KID）的数据，样本为不到 1 岁的婴儿死者。计算了一致性（即 Cohen's Kappa 统计量）和有效性（即敏感性、特异性和阳性预测值 [PPV]）统计量。在被分类的 10175 名婴儿中，修改后的系统在识别患有 CCC 的婴儿方面表现良好，并且能够捕捉到原始分类未识别的婴儿。修改后的系统优于原始系统，但需要进一步测试。
