National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (2)
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- Ambulatory Care and Surgery (2)
- Behavioral Health (1)
- Brain Injury (2)
- Caregiving (2)
- Care Management (1)
- Children/Adolescents (8)
- Chronic Conditions (1)
- Critical Care (1)
- Dementia (3)
- Diabetes (2)
- Diagnostic Safety and Quality (2)
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- Disabilities (1)
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- Long-Term Care (1)
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- Medication: Safety (1)
- Mortality (2)
- (-) Neurological Disorders (33)
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- Rehabilitation (1)
- Risk (4)
- Screening (1)
- Sickle Cell Disease (1)
- Skin Conditions (1)
- Sleep Problems (1)
- Social Determinants of Health (2)
- Stress (3)
- Stroke (1)
- Surgery (5)
- Tools & Toolkits (1)
- Trauma (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 33 Research Studies DisplayedSiegler JE, Albright KC, George AJ
Time to neurological deterioration in ischemic stroke.
This study examined the time to neurological deterioration (ND) in ischemic stroke. The study concluded that despite having similar stroke severity and age, patients with nonreversible causes of ND had significantly shorter median time to ND when compared to patients with reversible causes of ND.
AHRQ-funded; HS013852.
Citation: Siegler JE, Albright KC, George AJ .
Time to neurological deterioration in ischemic stroke.
Med Student Res J 2017 Winter;4:18-24. doi: 10.15404/msrj/03.2016.0005..
Keywords: Neurological Disorders, Outcomes, Stroke
Williams CN, Kirby A, Piantino J
If you build it, they will come: Initial experience with a multi-disciplinary pediatric neurocritical care follow-up clinic.
To address morbidities in Pediatric Neurocritical Care survivors, collaboration between Pediatric Neurology and Pediatric Critical Care created a multidisciplinary follow-up clinic providing specialized evaluations after discharge. Clinic referrals applied to all Pediatric Neurocritical Care patients regardless of admission severity of illness. Here, the authors report an initial case series, which revealed a population that is heterogenous in age, ranging from 1 month to 18 years, and in diagnoses.
AHRQ-funded; HS022981.
Citation: Williams CN, Kirby A, Piantino J .
If you build it, they will come: Initial experience with a multi-disciplinary pediatric neurocritical care follow-up clinic.
Children 2017 Sep 19;4(9). doi: 10.3390/children4090083.
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Keywords: Brain Injury, Critical Care, Neurological Disorders, Patient-Centered Healthcare, Children/Adolescents
Ing C, Hegarty MK, Perkins JW
Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.
A study was done of children age 10 years who had volatile anaesthetic (VA) exposure sometime during their early childhood. Researchers were trying to determine if the duration of exposure affected long-term language and cognitive ability. Data was obtained from the Western Australian Pregnancy Cohort (Raine) Study. The cohort was divided by duration of total VA exposure before age three years. They concluded that children exposed to less than 35 minutes VA did not differ from unexposed children, but there were lower language scores in children who had experienced greater than 35 minutes.
AHRQ-funded; HS022941.
Citation: Ing C, Hegarty MK, Perkins JW .
Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.
Br J Anaesth 2017 Sep 1;119(3):532-40. doi: 10.1093/bja/aew413..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Medication, Neurological Disorders, Patient Safety
Fosnacht AM, Patel S, Yucus C
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
This study aimed to primarily prevent Alzheimer's disease and related disorders through electronic medical record (EMR)-based screening, risk assessments, interventions, and surveillance. The investigators are translating research into primary prevention of Alzheimer's disease and related disorders in their health system and aim to shift the paradigm in Neurology from brain disease to brain health.
AHRQ-funded; HS024057.
Citation: Fosnacht AM, Patel S, Yucus C .
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
J Prev Alzheimers Dis 2017;4(3):157-64. doi: 10.14283/jpad.2017.3..
Keywords: Dementia, Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Prevention
Jorgensen SM, Carnahan RM, Weckmann MT
Validity of the delirium observation screening scale in identifying delirium in home hospice patients.
The Delirium Observation Screening Scale (DOS) was developed to improve delirium recognition but has yet to be validated in the home hospice setting. This pilot study aimed to explore the accuracy of the DOS for identifying delirium in home hospice patients. It concluded that the DOS appears to be an accurate way to screen for delirium in home hospice patients.
AHRQ-funded; HS022666.
Citation: Jorgensen SM, Carnahan RM, Weckmann MT .
Validity of the delirium observation screening scale in identifying delirium in home hospice patients.
Am J Hosp Palliat Care 2017 Sep;34(8):744-47. doi: 10.1177/1049909116658468.
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Keywords: Diagnostic Safety and Quality, Elderly, Home Healthcare, Neurological Disorders, Palliative Care
Jutkowitz E, Kuntz KM, Dowd B
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
This study used cross-sectional data (Aging, Demographics, and Memory Study) to estimate probabilities of experiencing outcomes by clinical features. It found that no clinical feature predicted the probability of having out-of-pocket medical expenditures. For those with medical expenditures, higher cognition and poorer function were associated with more spending.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, Kuntz KM, Dowd B .
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
Alzheimers Dement 2017 Jul;13(7):801-09. doi: 10.1016/j.jalz.2016.12.011.
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Keywords: Caregiving, Dementia, Elderly, Healthcare Costs, Long-Term Care, Neurological Disorders, Nursing Homes
Krishnan S, York MK, Backus D
Coping with caregiver burnout when caring for a person with neurodegenerative disease: a guide for caregivers.
It is important for you to know if you have caregiver burnout, or the common triggers that may cause your burnout. By recognizing and addressing these factors, you will be able to take healthy and manageable control over your caregiver duties. The authors offer a number of specific recommendations to relieve caregiver stress and burden.
AHRQ-funded; HS022134.
Citation: Krishnan S, York MK, Backus D .
Coping with caregiver burnout when caring for a person with neurodegenerative disease: a guide for caregivers.
Arch Phys Med Rehabil 2017 Apr;98(4):805-07. doi: 10.1016/j.apmr.2016.11.002.
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Keywords: Caregiving, Neurological Disorders, Stress
Curtin CM, Kenney D, Suarez P
A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release.
This trial tested whether perioperative administration of minocycline reduced time to pain resolution (TPR) after standardized hand surgeries with known prolonged pain profiles: carpal tunnel release and trigger finger release. It found that oral administration of minocycline did not reduce TPR after minor hand surgery. There was evidence that minocycline might increase length of pain in those with increased posttraumatic stress disorder symptoms.
AHRQ-funded; HS024096.
Citation: Curtin CM, Kenney D, Suarez P .
A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release.
J Hand Surg Am 2017 Mar;42(3):166-74. doi: 10.1016/j.jhsa.2016.12.011.
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Keywords: Neurological Disorders, Medication, Pain, Stress, Surgery
Stone B, Hester G, Jackson D
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Gastroesophageal reflux (GER), aspiration, and secondary complications lead to morbidity and mortality in children with neurologic impairment (NI), dysphagia, and gastrostomy feeding. Fundoplication and gastrojejunal (GJ) feeding can reduce risk. A comparison of GJ to fundoplication using first-year postprocedure reflux-related hospitalization (RRH) rates found that in children with NI, GER, and dysphagia,:fundoplication and GJ feeding have similar RRH outcomes.
AHRQ-funded; HS019862.
Citation: Stone B, Hester G, Jackson D .
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Hosp Pediatr 2017 Mar;7(3):140-48. doi: 10.1542/hpeds.2016-0126.
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Keywords: Children/Adolescents, Digestive Disease and Health, Neurological Disorders, Nutrition, Outcomes, Treatments
Jutkowitz E, MacLehose RF, Gaugler JE
Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients.
This study examined the effect of sociodemographic and clinical risk factors on cognitive, functional, and behavioral declines in incident dementia patients. Age of onset, region of residence, and history of hypertension and psychiatric problems predicted behaviors at diagnosis. Cognition explained changes in behavior. Sociodemographic characteristics and clinical comorbidities predicted cognitive and functional changes. Only cognitive status explained behavioral decline.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, MacLehose RF, Gaugler JE .
Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients.
J Gerontol A Biol Sci Med Sci 2017 Feb;72(2):251-58. doi: 10.1093/gerona/glw079.
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Keywords: Dementia, Elderly, Behavioral Health, Neurological Disorders, Risk, Social Determinants of Health
Storzbach D, Twamley EW, Roost MS
Compensatory cognitive training for Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans with mild traumatic brain injury.
The purpose of the study was to evaluate the efficacy of group-based compensatory cognitive training (CCT) for veterans with a history of mild traumatic brain injury. Veterans who participated in CCT reported significantly fewer cognitive and memory difficulties and greater use of cognitive strategies. They also demonstrated significant improvements on neurocognitive tests of attention, learning, and executive functioning, which were 3 of the cognitive domains targeted in CCT.
AHRQ-funded; HS022981.
Citation: Storzbach D, Twamley EW, Roost MS .
Compensatory cognitive training for Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans with mild traumatic brain injury.
J Head Trauma Rehabil 2017 Jan/Feb;32(1):16-24. doi: 10.1097/htr.0000000000000228.
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Keywords: Brain Injury, Neurological Disorders, Patient-Centered Outcomes Research, Trauma
Nuckols T, Conlon C, Robbins M
Quality of care for work-associated carpal tunnel syndrome.
This study evaluated the quality of care provided to individuals with workers' compensation claims related to carpal tunnel syndrome and identified patient characteristics associated with receiving better care. Overall, 81.6 percent of care adhered to recommended standards. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, sex, and race/ethnicity were not associated with quality.
AHRQ-funded; HS018982.
Citation: Nuckols T, Conlon C, Robbins M .
Quality of care for work-associated carpal tunnel syndrome.
J Occup Environ Med 2017 Jan;59(1):47-53. doi: 10.1097/jom.0000000000000916.
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Keywords: Guidelines, Quality of Care, Neurological Disorders, Patient-Centered Healthcare, Quality Indicators (QIs)
Narayanan J, Dobrin S, Choi J
Structured clinical documentation in the electronic medical record to improve quality and to support practice-based research in epilepsy.
The researchers describe a stepwise process for building structured clinical documentation support tools in the electronic medical record (EMR) that define best practices in epilepsy, and describe how they incorporated these toolkits into their clinical workflow. These tools write notes and capture hundreds of fields of data including several score tests. They also summarize brain imaging, blood laboratory, and electroencephalography results, and document neuromodulation treatments.
AHRQ-funded; HS024057.
Citation: Narayanan J, Dobrin S, Choi J .
Structured clinical documentation in the electronic medical record to improve quality and to support practice-based research in epilepsy.
Epilepsia 2017 Jan;58(1):68-76. doi: 10.1111/epi.13607.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Quality of Care, Quality Improvement, Tools & Toolkits, Workflow
Biermacka JM, Chung SJ, Amasu SM
Genome-wide gene-environment interaction analysis of pesticide exposure and risk of Parkinson's disease.
The researchers performed the first genome-wide gene-environment interaction analysis of pesticide exposure and risk of Parkinson's disease (PD). They concluded that although no significant interactions were identified, several of the genes with suggestive evidence of gene-environment interaction effects have biological plausibility for PD risk.
AHRQ-funded; HS024057.
Citation: Biermacka JM, Chung SJ, Amasu SM .
Genome-wide gene-environment interaction analysis of pesticide exposure and risk of Parkinson's disease.
Parkinsonism Relat Disord 2016 Nov;32:25-30. doi: 10.1016/j.parkreldis.2016.08.002.
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Keywords: Genetics, Risk, Neurological Disorders
Kesselheim AS, Bykov K, Gagne JJ
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
The researchers estimated the risk of seizure-related events associated with refilling antiepileptic drugs (AED) with generic AEDs and the effect of switching between different manufacturers of the same generic drug. They found that among patients on a generic AED, refilling the same AED was associated with an elevated risk of seizure-related event; however, there was no additional risk from switching during that refill to a different manufacturer.
AHRQ-funded; HS022193.
Citation: Kesselheim AS, Bykov K, Gagne JJ .
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
Neurology 2016 Oct 25;87(17):1796-801. doi: 10.1212/wnl.0000000000003259.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Neurological Disorders, Patient Safety, Risk
Carlozzi NE, Schilling SG, Lai JS
HDQLIFE: the development of two new computer adaptive tests for use in Huntington disease, speech difficulties, and swallowing difficulties.
The authors developed a patient-reported outcome measure for use in the Huntington Disease Health-Related Quality of Life (HDQLIFE) Measurement System that focused on the impact that difficulties with speech and swallowing have on health-related quality of life in Huntington disease. These measures may have clinical utility in other populations where speech and swallowing difficulties are prevalent.
AHRQ-funded; HS023313.
Citation: Carlozzi NE, Schilling SG, Lai JS .
HDQLIFE: the development of two new computer adaptive tests for use in Huntington disease, speech difficulties, and swallowing difficulties.
Qual Life Res 2016 Oct;25(10):2417-27. doi: 10.1007/s11136-016-1273-y.
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Keywords: Neurological Disorders, Quality of Life, Patient-Centered Outcomes Research, Health Information Technology (HIT), Quality Measures
Carmody D, Pastore AN, Landmeier KA
Patients with KCNJ11-related diabetes frequently have neuropsychological impairments compared with sibling controls.
This study compared neurodevelopmental outcomes in patients with KCNJ11 mutations and their sibling controls. It found that patients with KCNJ11-related diabetes without global developmental delay had significant differences compared with sibling controls on a range of assessments including IQ, measures of academic achievement and executive function.
AHRQ-funded; HS023007.
Citation: Carmody D, Pastore AN, Landmeier KA .
Patients with KCNJ11-related diabetes frequently have neuropsychological impairments compared with sibling controls.
Diabet Med 2016 Oct;33(10):1380-6. doi: 10.1111/dme.13159.
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Keywords: Children/Adolescents, Diabetes, Disabilities, Neurological Disorders, Newborns/Infants
Dy CJ, Baty J, Saeed MJ
A population-based analysis of time to surgery and travel distances for brachial plexus surgery.
Since the published brachial plexus injuries (BPI) experience is largely from individual centers, the authors used a population-based approach to evaluate the delivery of care for patients with BPI. They found that nearly one third of patients underwent BPI surgery more than 1 year after the injury, with patients initially treated at smaller hospitals at risk for undergoing delayed BPI surgery. These findings can inform efforts to expedite timely referral of patients with BPI to experienced centers.
AHRQ-funded; HS019455.
Citation: Dy CJ, Baty J, Saeed MJ .
A population-based analysis of time to surgery and travel distances for brachial plexus surgery.
J Hand Surg Am 2016 Sep;41(9):903-09.e3. doi: 10.1016/j.jhsa.2016.07.054.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Delivery, Surgery, Neurological Disorders
Conlon C, Asch S, Hanson M
Assessing the value of high-quality care for work-associated carpal tunnel syndrome in a large integrated health care system: study design.
The researchers described the design of a study that is assessing quality of care for work-associated carpal tunnel syndrome and associations with clinical outcomes and costs. They found that time off work was generally short and related to surgery. They recommended systematic efforts to evaluate and improve quality of medical care for this condition.
AHRQ-funded; HS018982.
Citation: Conlon C, Asch S, Hanson M .
Assessing the value of high-quality care for work-associated carpal tunnel syndrome in a large integrated health care system: study design.
Perm J 2016 Fall;20(4):87-95. doi: 10.7812/tpp/15-220.
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Keywords: Healthcare Delivery, Quality of Care, Injuries and Wounds, Neurological Disorders, Patient-Centered Outcomes Research
Senders A, Sando K, Wahbeh H
Managing psychological stress in the multiple sclerosis medical visit: patient perspectives and unmet needs.
Psychological stress can negatively impact multiple sclerosis. To further understand how stress is addressed in the multiple sclerosis medical visit, 34 people with multiple sclerosis participated in focus groups. Transcripts were analyzed by inductive thematic analysis. The majority of participants did not discuss stress with their provider, citing barriers to communication such as lack of time, poor coordination between specialties, physician reliance on pharmaceutical prescription, and patient lack of self-advocacy. Participants recommended several ways to better manage psychological well-being in the clinical setting. These findings provide a foundation for future studies aimed at minimizing the detrimental effect of stress in multiple sclerosis.
AHRQ-funded; HS017582.
Citation: Senders A, Sando K, Wahbeh H .
Managing psychological stress in the multiple sclerosis medical visit: patient perspectives and unmet needs.
J Health Psychol 2016 Aug;21(8):1676-87. doi: 10.1177/1359105314562084.
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Keywords: Care Management, Neurological Disorders, Ambulatory Care and Surgery, Stress
Gavinski K, Carnahan R, Weckmann M
Validation of the delirium observation screening scale in a hospitalized older population.
The authors studied the accuracy of the Delirium Observation Screening Scale (DOS) as a screening tool in hospitalized patients over age 64. They also investigated the user-friendliness of the tool. They determined that DOS is an accurate and easy way to screen for delirium in older inpatients.
AHRQ-funded; HS022666.
Citation: Gavinski K, Carnahan R, Weckmann M .
Validation of the delirium observation screening scale in a hospitalized older population.
J Hosp Med 2016 Jul;11(7):494-7. doi: 10.1002/jhm.2580.
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Keywords: Elderly, Hospitalization, Neurological Disorders, Screening
Crawford RD, Jonassaint CR
Adults with sickle cell disease may perform cognitive tests as well as controls when processing speed is taken into account: a preliminary case-control study.
The authors aimed to: (1) evaluate cognitive function among adults with sickle cell disease using a computer-administered neuropsychological test; and (2) replicate previously identified differences in processing speed between patients with sickle cell disease and controls.They replicated previous findings showing a greater than 10-point deficit in processing speed among patients with sickle cell disease. However, when differences in processing speed are taken into account, patients perform equally well or better than controls on cognitive tasks.
AHRQ-funded; HS022989.
Citation: Crawford RD, Jonassaint CR .
Adults with sickle cell disease may perform cognitive tests as well as controls when processing speed is taken into account: a preliminary case-control study.
J Adv Nurs 2016 Jun;72(6):1409-16. doi: 10.1111/jan.12755.
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Keywords: Neurological Disorders, Sickle Cell Disease
Naidech AM, Polnaszek KL, Berman MD
Hematoma locations predicting delirium symptoms after intracerebral hemorrhage.
The researchers tested the hypothesis that hematoma location is predictive of delirium symptoms in patients with intracerebral hemorrhage. Identifying 90 patients with intracerebral hemorrhage, they found that acute delirium symptoms were predicted by hematoma of right-hemisphere subcortical white matter and parahippocampal gyrus. The authors concluded that disruption of large-scale brain networks that normally support attention and conscious awareness was thus associated with acute delirium symptoms.
AHRQ-funded; HS023437.
Citation: Naidech AM, Polnaszek KL, Berman MD .
Hematoma locations predicting delirium symptoms after intracerebral hemorrhage.
Neurocrit Care 2016 Jun;24(3):397-403. doi: 10.1007/s12028-015-0210-1.
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Keywords: Neurological Disorders, Patient-Centered Outcomes Research, Quality of Life
Williams RC, Elston RC, Kumar P
Selecting SNPs informative for African, American Indian and European Ancestry: application to the Family Investigation of Nephropathy and Diabetes (FIND).
The researchers studied individual genetic ancestry (IGA) in four samples in the Family Investigation of Nephropathy and Diabetes (FIND). They found that the identified set of ancestry informtive markers (AIMs) may be particularly useful for estimating genetic admixture in populations from the Americas. They concluded that odds ratios for the associations of IGA with disease are consistent with what is known about the incidence and prevalence of diabetic nephropathy in these populations.
AHRQ-funded; HS008365.
Citation: Williams RC, Elston RC, Kumar P .
Selecting SNPs informative for African, American Indian and European Ancestry: application to the Family Investigation of Nephropathy and Diabetes (FIND).
BMC Genomics 2016 May 4;17:325. doi: 10.1186/s12864-016-2654-x.
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Keywords: Diabetes, Family Health and History, Genetics, Neurological Disorders, Racial and Ethnic Minorities
Ladner TR, Greenberg JK, Guerrero N
Chiari malformation type I surgery in pediatric patients. part 1: validation of an ICD-9-CM code search algorithm.
The researchers sought to validate two ICD-9-CM code algorithms using hospital billing data to identify pediatric patients undergoing Chiari malformation Type I (CM-I) decompression surgery. They found that an ICD-9-CM algorithm requiring a primary diagnosis of CM-I has excellent positive predictive value and very good sensitivity for identifying CM-I decompression surgery in pediatric patients. They concluded that these results establish a basis for utilizing administrative billing data to assess pediatric CM-I treatment outcomes.
AHRQ-funded; HS019455.
Citation: Ladner TR, Greenberg JK, Guerrero N .
Chiari malformation type I surgery in pediatric patients. part 1: validation of an ICD-9-CM code search algorithm.
J Neurosurg Pediatr 2016 May;17(5):519-24. doi: 10.3171/2015.10.peds15370.
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Keywords: Children/Adolescents, Neurological Disorders, Surgery