Trauma and Injury Research Center, Dell Children's Medical Center of Central Texas, Austin, Texas, USA.
Austin Regional Campus, University of Texas Health Science Center at Houston, Austin, Texas, USA.
Inj Prev. 2021 Mar;27(S1):i71-i74. doi: 10.1136/injuryprev-2019-043513.
This retrospective study examined the accuracy of the International Classification of Diseases, Clinical Modification (ICD-10-CM) coding for physical child abuse among patients less than 18 years of age who were evaluated due to concern for physical abuse by a multidisciplinary child protection team (MCPT) during 2016-2017 (N=312) in a paediatric level I trauma centre. Sensitivity, specificity, predictive values and diagnostic OR for ICD-10-CM coding were calculated and stratified by admission status, using as a reference standard the abuse determination of the MCPT recorded in a hospital registry. Among inpatients, child physical abuse coding sensitivity was 55.6% (95% CI 41.4% to 69.1%) and specificity was 78.6% (95% CI 59.0% to 91.7%), with diagnostic OR of 4.58 (95% CI 1.64 to 12.70). Among outpatients, sensitivity was 22.2% (95% CI 15.5% to 30.2%) and specificity was 86.3% (95% CI 77.7% to 92.5%), with diagnostic OR of 1.80 (95% CI 0.89 to 3.64). Use of ICD-10-CM coded data sets alone for surveillance may significantly underestimate the occurrence of physical child abuse.
本回顾性研究调查了在 2016 年至 2017 年期间，由多学科儿童保护小组（MCPT）因怀疑身体虐待而评估的 312 名年龄小于 18 岁的患者中，国际疾病分类，临床修订版（ICD-10-CM）对身体虐待的编码准确性。在儿科一级创伤中心。计算了 ICD-10-CM 编码的敏感性、特异性、预测值和诊断比值比，并按入院状态进行分层，以 MCPT 在医院登记处记录的虐待确定作为参考标准。在住院患者中，儿童身体虐待编码的敏感性为 55.6%（95%CI 41.4%至 69.1%），特异性为 78.6%（95%CI 59.0%至 91.7%），诊断比值比为 4.58（95%CI 1.64 至 12.70）。在门诊患者中，敏感性为 22.2%（95%CI 15.5%至 30.2%），特异性为 86.3%（95%CI 77.7%至 92.5%），诊断比值比为 1.80（95%CI 0.89 至 3.64）。仅使用 ICD-10-CM 编码数据集进行监测可能会大大低估身体虐待的发生。
