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评价美国国立医学图书馆(NLM)值集权威中心(VSAC)ICD-10-CM 值集之间的差异:以常见慢性病诊断为例,探讨其影响及潜在解决方案。

Evaluation of Discrepancies Among National Library of Medicine (NLM) Value Set Authority Center (VSAC) ICD-10-CM Value Sets: Case Study for Diagnoses of Common Chronic Conditions, Implications, and Potential Solutions.

机构信息

Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah.

出版信息

AMIA Annu Symp Proc. 2024 Jan 11;2023:1087-1095. eCollection 2023.

Abstract

The National Library of Medicine (NLM)'s Value Set Authority Center (VSAC) is a crowd-sourced repository with a potential for substantial discrepancy among value sets for the same clinical concepts. To characterize this potential problem, we identified the most common chronic conditions affecting US adults and assessed for discrepancy among VSAC ICD-10-CM value sets for these conditions. An analysis of 32 value sets for 12 conditions identified that a median of 45% of codes for a given condition were potentially problematic (included in at least one, but not all, theoretically equivalent value sets). These problematic codes were used to document clinical care for potentially over 20 million patients in a data warehouse of approximately 150 million US adults. Users of VSAC diagnosis value sets should be cognizant of the prevalence of these discrepancies and take proactive steps to mitigate their impact. Further research is warranted to characterize and address this issue.

摘要

美国国家医学图书馆(NLM)的价值集权威中心(VSAC)是一个众包存储库,对于同一临床概念的价值集可能存在很大差异。为了描述这个潜在的问题,我们确定了影响美国成年人的最常见慢性病,并评估了这些病症的 VSAC ICD-10-CM 价值集之间的差异。对 12 种病症的 32 个价值集的分析表明,给定病症的代码中中位数为 45%(包含在至少一个,但不是所有理论上等价的价值集中)可能存在问题。这些有问题的代码被用来记录大约 1.5 亿美国成年人的数据库中超过 2000 万患者的临床护理。VSAC 诊断价值集的用户应该意识到这些差异的普遍性,并采取积极措施来减轻其影响。需要进一步研究来描述和解决这个问题。

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