• Title/Summary/Keyword: ICD-10

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Validity of the diagnosis of diabetic microvascular complications in Korean national health insurance claim data

  • Kim, Hyung Jun;Park, Moo-Seok;Kim, Jee-Eun;Song, Tae-Jin
    • Annals of Clinical Neurophysiology
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    • v.24 no.1
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    • pp.7-16
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    • 2022
  • Background: There is inadequate information on the validation of diabetic microvascular complications in the Korean National Health Insurance Service data set. We aimed to validate the diagnostic algorithms regarding the nephropathy, neuropathy, and retinopathy of diabetes. Methods: From various secondary and tertiary medical centers, we selected 6,493 patients aged ≥ 40 years who were diagnosed with diabetic microvascular complications more than once based on codes in the 10th version of the International Classification of Diseases (ICD-10). During 2019 and 2020, we randomly selected the diagnoses of 200 patients, 100 from each of two hospitals. The positive predictive value (PPV), negative predictive value, error rate, sensitivity, and specificity were determined for each diabetic microvascular complication according to the ICD-10 codes, laboratory findings, diagnostic studies, and treatment procedure codes. Results: Among the 200 patients who visited the hospital more than once and had the diagnostic codes of diabetic microvascular complications, 142, 110, and 154 patients were confirmed to have the gold standard of diabetic nephropathy (PPV, 71.0%), diabetic neuropathy (PPV, 55.0%), and diabetic retinopathy (PPV, 77.0%), respectively. The PPV and specificity of diabetic nephropathy (PPV, 71.0-81.4%; specificity, 10.3-53.4%), diabetic neuropathy (PPV, 55.0-81.3%; specificity, 66.7-76.7%) and diabetic retinopathy (PPV, 77.0-96.6%; specificity, 2.2-89.1%) increased after combining them with the laboratory findings, diagnostic studies, and treatment procedures codes. These change trends were observed similarly for both hospitals. Conclusions: Defining diabetic microvascular complications using ICD-10 codes and their related examination codes may be a feasible method for studying diabetic complications.

Comparative Study on Three Algorithms of the ICD-10 Charlson Comorbidity Index with Myocardial Infarction Patients (Charlson 동반질환의 ICD-10 알고리즘 예측력 비교연구)

  • Kim, Kyoung-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.1
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    • pp.42-49
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    • 2010
  • Objectives: To compare the performance of three International Statistical Classification of Diseases, 10th Revision translations of the Charlson comorbidities when predicting in-hospital among patients with myocardial infarction (MI). Methods: MI patients ${\geq}20$ years of age with the first admission during 2006 were identified(n=20,280). Charlson comorbidities were drawn from Heath Insurance Claims Data managed by Health Insurance Review and Assessment Service in Korea. Comparisions for various conditions included (a) three algorithms (Halfon, Sundararajan, and Quan algorithms), (b) lookback periods (1-, 3- and 5-years), (c) data range (admission data, admission and ambulatory data), and (d) diagnosis range (primary diagnosis and first secondary diagnoses, all diagnoses). The performance of each procedure was measured with the c-statistic derived from multiple logistic regression adjusted for age, sex, admission type and Charlson comorbidity index. A bootstrapping procedure was done to determine the approximate 95% confidence interval. Results: Among the 20,280 patients, the mean age was 63.3 years, 67.8% were men and 7.1% died while hospitalized. The Quan and Sundararajan algorithms produced higher prevalences than the Halfon algorithm. The c-statistic of the Quan algorithm was slightly higher, but not significantly different, than that of other two algorithms under all conditions. There was no evidence that on longer lookback periods, additional data, and diagnoses improved the predictive ability. Conclusions: In health services study of MI patients using Health Insurance Claims Data, the present results suggest that the Quan Algorithm using a 1-year lookback involving primary diagnosis and the first secondary diagnosis is adequate in predicting in-hospital mortality.

Respiratory Health Effects of Fine Particles(PM2.5) in Seoul (서울시 미세입자(PM2.5)의 호흡기질환 사망과의 연관성 연구)

  • Kang, Choong-Min;Park, Sung-Kyun;SunWoo, Young;Kang, Byung-Wook;Lee, Hak-Sung
    • Journal of Korean Society for Atmospheric Environment
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    • v.22 no.5
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    • pp.554-563
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    • 2006
  • Numerous epidemiological studies have shown stronger associations between $PM_{2.5}$ and both mortality and morbidity than $PM_{10}$. The association of $PM_{2.5}$ with respiratory mortality was examined in Seoul, during the period of $1996{\sim}2002$. Because $PM_{2.5}$ data were available for only 10% of this time period, a prediction regression model was developed to estimate $PM_{2.5}$ concentration. Death count due to respiratory-related diseases(total respiratory mortality; ICD-10, J00-J98) and death counts(cause-specific mortality) due to pneumonia(ICD-10, J12-J18), COPD(ICD-10, J40-J44) and asthma(ICD-10, J45-J46) were considered in this study. Averaged daily mortality was 5.6 for total respiratory mortality and 1.1 to 1.6 for cause-specific mortality. Generalized additive Poisson models controlling for confounders were used to evaluate the acute effects of particle exposures on total respiratory mortality and cause-specific mortality. An IQR increase in 5-day moving average of $PM_{2.5}(22.6{\mu}g/m^3)$ was associated with an 8.2%(95% CI: 4.5 to 12.1%) increase in total respiratory mortality The association of $PM_{2.5}$ was stronger for the elderly ($\geq$65 years old, 10.1%, 95% CI: 5.8 to 14.5%) and for males(8.9%, 95% CI: 2.1 to 11.3%). A $10{\mu}g/m^3$ increase in 5-day moving average of $PM_{2.5}$ was strongly associated with total respiratory mortality in winter(9.5%, 95% CI: 6.6 to 12.4%), followed by spring(3.1%, 95% CI: -1.2 to 7.5%), which was a different pattern with the finding in North American cities. However, our results are generally consistent with those observed in recent epidemiological studies, and suggest that $PM_{2.5}$ has a stronger effect on respiratory mortality in Seoul.

A Study on Neuropsychiatric Symptoms and Signs of Disease Pattern in Korean Medicine (한의병증에 대한 신경정신과적 증상 기술 연구)

  • Jang, Jae-Soon;Kim, Ka-Na;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.4
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    • pp.249-259
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    • 2016
  • Objectives: This study aimed to develop a standard understanding of neuropsychiatric symptoms and signs of Disease Pattern Identification/syndrome in Korean Medicine. Methods: We investigated various published articles, and the proposals are based on a comparative analysis between Korean medicine literature and DSM5, ICD-10. To improve our understanding, we engaged in a consultation through discussions with the advisory committee. Results: We describe the physical and neuropsychiatric symptoms in a modern sense of the major disease Pattern in Korean Medicine. We also proposed a profound understanding of the neuropsychiatric symptoms and signs of Disease Pattern Identification/syndrome in Korean Medicine. Conclusions: Compared with DSM5, ICD-10, the system of neuropsychiatric diagnosis in Korean medicine, could be profoundly organized into a system in a modern sense. It would be helpful to apply this understanding to clinical practices. There are several points of consideration in this study. The system of neuropsychiatric diagnosis in Korean medicine cannot be a perfect match for DSM5 or ICD-10. In addition, we could not reach a complete consensus on the disease pattern. Although there are some limitations to this study, it is meaningful to have an understanding of the neuropsychiatric symptoms and signs in Korean medicine through discussions with the advisory committee. This trial is expected to be applicable to related research in the future.

Effect of Honey on the Change of Enzyme Activity in Rats (벌꿀이 흰쥐의 효소활성에 미치는 영향)

  • 정동현;백승화;박성수
    • The Korean Journal of Food And Nutrition
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    • v.10 no.1
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    • pp.65-73
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    • 1997
  • The purpose of the study was to find an effect of honey on the enzyme activity of Sprague Dawley rats. All experimental rats were fed ad libitum for seven weeks with 68% saccharide diet and at same time fed administratively with 10% and 20% water solution of acacia, sumac, polyflower honey, and sucrose, respectively. The level of LDH activity in serum of rat taken diet with acasia, sumac, and polyflower honey were increased in comparison with the control group. The level of $\alpha$-HBDH activity in serum of rat taken diet with acasia, sumac, polyflower honey, and sugar solution were increased than that other honey solution. The level of GOT and GPT activity in serum was increased by the feeding of solution of 20% acacia honey. The level of ICD activity in serum of rat taken diet with sumac honey was increased but was decreased notably by the feeding of polyflower honey. The level of G-6-P DH activity in whole blood of rat taken diet with honey solutions were decreased, but the level of aldolase activity in serum of rat taken diet with honey solutions were increased.

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Epidemiologic Study of Operative Treatment for Spinal Metastasis in Thailand : A Review of National Healthcare Data from 2005 to 2014

  • Luksanapruksa, Panya;Santipas, Borriwat;Ruangchainikom, Monchai;Korwutthikulrangsri, Ekkapoj;Pichaisak, Witchate;Wilartratsami, Sirichai
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.57-63
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    • 2022
  • Objective : To study the factors relating to operative treatment for spinal metastasis in Thailand during 2005-2014 and to determine the hospital costs, mortality rate, and incidence of perioperative complication. Methods : Inpatient reimbursement data from 2005 to 2014 was reviewed from three national healthcare organizations, including the National Health Security Office, the Social Security Office, and the Comptroller General's Department. The search criteria were secondary malignant neoplasm of bone and bone marrow patients (International Classification of Diseases 10th revision, Thai modification codes [ICD 10-TM], C79.5 and C79.8) who underwent spinal surgical treatment (ICD 9th revision, clinical modification procedure with extension codes [ICD 9-CM], 03.0, 03.4, 03.09, and 81.0) during 2005-2014. Epidemiology, comorbidity, and perioperative complication were analyzed. Results : During the study period, the number of spinal metastasis patients who underwent operative treatment was significantly increased from 0.30 to 0.59 per 100000 (p<0.001). More males (56.14%) underwent surgical treatment for spinal metastasis than females. The most common age group was 45-64 (55.1%). The most common primary tumor sites were the unknown origin, lung, breast, prostate, and hepatocellular/bile duct. Interestingly, the proportion of hepatocellular/bile duct, breast, and lung cancer was significantly increased (p<0.001). The number of patients who had comorbidity or in-hospital complication significantly increased over time (p<0.01); however, the in-hospital mortality rate decreased. Conclusion : During the last decade, operative treatment for spinal metastasis increased in Thailand. The overall in-hospital complication rate increased; however, the in-hospital mortality rate decreased.

Health Care Utilization of Workers with Skin Disease in Inchon (인천지역 일부 근로자들의 피부질환으로 인한 의료이용에 관한 연구)

  • Song, Jae-Seok;Won, Jong-Uk;Roh, Jae-Hoon;Ahn, Yeon-Soon
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.2
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    • pp.206-214
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    • 1999
  • Objectives: This study was carried out to identify relation of health care utilization due to skin disease(ICD-10, L00-L99) and characteristics(sex, age, exposure status, type of industry, size of enterprise) of workers. Methods: We made new database composed of 30,536 workers' health examination results in one specific health examination institute in Inchon and data of medical insurance utilization due to skin disease in 4 medical insurance associations for enterprise from January, 1995 to December, 1997 And we analyzed determinants of health care utilization due to skin disease of workers. Results: Among 30,536 study subjects, 8,837(28.9%) workers and 4,181 (13.7%) workers utilized medical insurance due to total skin disease(ICD-10, L00-L99) and contact dermatitis(ICD-10, L23-L25), respectively. Female workers(p<.001), workers exposed to organic solvents(p<.05), workers if manufacturing industries(p<.05, p<.01, respectively) and in large scale enterprises(p<.001) utilized more medical insurance due to total skin disease and contact dermatitis than male workers, workers not exposed to organic solvents, workers in non-manufacturing industries and small scale enterprises. With multiple logistic regression analysis, significant explanatory variables affecting workers' medical utilization due to total skin disease and dermatitis and eczema(ICD-10, L20-L30) in total workers were sex, age, specific chemicals and size of enterprises. And age, type of industries, organic solvents, specific chemicals and size of enterprises were significant explanatory variables related to medical insurance utilization due to dermatitis and eczema and contact dermatitis in male workers. Conclusion: From the above results, we found that workers exposed to organic solvents utilized more medical insurance due to skin disease than workers not exposed to. And, comparing to workers in large scale enterprises, workers in small scale enterprises may have unmet medical care utilization due to skin disease. Therefore we have to establish counterplan to manage occupational skin disease of high risk group(organic solvent exposure group) and to satisfy unmet medical care utilization of workers in small scale enterprises.

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Survey of research on the optimal design of sea harbours

  • Diab, Hassan;Younes, Rafic;Lafon, Pascal
    • International Journal of Naval Architecture and Ocean Engineering
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    • v.9 no.4
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    • pp.460-472
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    • 2017
  • The design of harbours, as with any other system design, must be an optimization process. In this study, a global examination of the different constraints in coastal engineering was performed and an optimization problem was defined. The problem has multiple objectives, and the criteria to be minimized are the structure cost and wave height disturbance inside a harbour. As concluded in this survey, the constraints are predefined parameters, mandatory constraints or optional constraints. All of these constraints are categorized into four categories: environmental, fluid mechanical, structural and manoeuvring.

Study on Common Conceptual Terms as a Premise for Korean Classification of Disease in Oriental Medicine in Connection with ICD-10 (ICD 연계 한의질병분류를 위한 전제로서의 공통개념어 연구)

  • Chi, Gyoo-Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.4
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    • pp.718-724
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    • 2008
  • In order to classify diseases of oriental medicine in liaison with International Classification of Diseases, there should be intermediation and sharing concepts between the two in addition to proper classification. Classification units were settled for differentiation of diseases or syndromes first. And second, the standard forms of disease classification system were proposed. Third, this classification system was made of serial groupings of syndrome under the traditional disease name. Fourth, the location of disease and the interrelation between different syndromes were depicted with diagram in order to define more clearly. As the results and conclusion, The classification units were composed of 2 categories; topology, organ, meridian, somatic structure, body fluid units for description and various regulatory unit terms of western and traditional medicine for explanation. The mixed classification model of western diseases and traditional syndromes(證) was adopted as a fundamental classification system containing disease by exterior pathogen, systemic internal diseases, psychoneuronal diseases, metabolic diseases, diseases of sense organs, supportive structure diseases, obstetric-gynecology diseases, child diseases, 4-type constitutional diseases. And those were differentiated with generalized, localized, functional, oncogenic, environmental features in detail. The cause, site, condition, dispositions must be expressed in each disease name too. The types of diagnosis using classification system are principal and final diagnosis, principal procedure, main conditions, and these are applied to this Korean classification system equally. For more clarification of differentiation, a plane topological map and three dimensional coordinates were proposed to manifest the location, features and relation of disease itself or each other.

Behavioural and Metabolic Risk Factors for Mortality from Colon and Rectum Cancer: Analysis of Data from the Asia-Pacific Cohort Studies Collaboration

  • Morrison, David Stewart;Parr, Christine Louise;Lam, Tai Hing;Ueshima, Hirotsugu;Kim, Hyeon Chang;Jee, Sun Ha;Murakami, Yoshitaka;Giles, Graham;Fang, Xianghua;Barzi, Federica;Batty, George David;Huxley, Rachel Rita;Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1083-1087
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    • 2013
  • Background: Colorectal cancer has several modifiable behavioural risk factors but their relationship to the risk of colon and rectum cancer separately and between countries with high and low incidence is not clear. Methods: Data from participants in the Asia Pacific Cohort Studies Collaboration (APCSC) were used to estimate mortality from colon (International Classification of Diseases, revision 9 (ICD-9) 153, ICD-10 C18) and rectum (ICD-9 154, ICD-10 C19-20) cancers. Data on age, body mass index (BMI), serum cholesterol, height, smoking, physical activity, alcohol and diabetes mellitus were entered into Cox proportional hazards models. Results: 600,427 adults contributed 4,281,239 person-years follow-up. The mean ages (SD) for Asian and Australia/New Zealand cohorts were 44.0 (9.5) and 53.4 (14.5) years, respectively. 455 colon and 158 rectum cancer deaths were observed. Increasing age, BMI and attained adult height were associated with increased hazards of death from colorectal cancer, and physical activity was associated with a reduced hazard. After multiple adjustment, any physical activity was associated with a 28% lower hazard of colon cancer mortality (HR 0.72, 95%CI 0.53-0.96) and lower rectum cancer mortality (HR 0.75, 95%CI 0.45-1.27). A 2cm increase in height increased colon and all colorectal cancer mortality by 7% and 6% respectively. Conclusions: Physical inactivity and greater BMI are modifiable risk factors for colon cancer in both Western and Asian populations. Further efforts are needed to promote physical activity and reduce obesity while biological research is needed to understand the mechanisms by which they act to cause cancer mortality.