The increase in chronic diseases in childhood highlights the need for a biopsychosocial approach to deal with the complexity of these health conditions. The International Classification of Functioning, Disability, and...The increase in chronic diseases in childhood highlights the need for a biopsychosocial approach to deal with the complexity of these health conditions. The International Classification of Functioning, Disability, and Health (ICF) results from the need to implement new explanatory evaluative and therapeutic models. Thus, the present systematic review aims to identify published studies on the use of the ICF in chronic childhood diseases. As a secondary objective, to map the themes that have already been studied in the area to support the discussion on the expansion of the use of this classification in health services. The systematic review followed the PRISMA protocol, and the model was the PICO acronym, where Population was children and adolescents with chronic diseases, Intervention/Exposure was evaluation based on ICF concepts, Comparator was any tool, instrument, or intervention, and outcome was direct or indirect use of the ICF. We selected eight articles, five of which used the ICF as a conceptual tool and three as a classification system, divided into the following themes: quality of life, evaluation of patients (without using coding) and mapping the inclusion of the activity’s results and participation in clinical trials. Thus, use of the ICF in clinical practice is still incipient, although it has been recommended in guidelines. Further studies are necessary to expand the number of contributions by the ICF and to develop the necessary approaches for understanding the classification’s use.展开更多
BACKGROUND Korean National Health Insurance(NHI)claims database provides large-cohort.However,studies regarding accuracy of administrative database for pancreatic cancer(PC)have not been reported.We aimed to identify ...BACKGROUND Korean National Health Insurance(NHI)claims database provides large-cohort.However,studies regarding accuracy of administrative database for pancreatic cancer(PC)have not been reported.We aimed to identify accuracy of NHI database regarding PC classified by international classification of disease(ICD)-10 codes.AIM To identify the accuracy and usefulness of administrative database in PC and the accurate ICD codes for PC with location.METHODS Study and control groups were collected from 2003 to 2016 at Seoul National University Bundang Hospital.Cases of PC were identified in NHI database by international classification of diseases,10th revision edition(ICD-10 codes)supported with V codes.V code is issued by medical doctors for covering 95%of medical cost by Korean government.According to pathologic reports,definite or possible diagnoses were defined using medical records,images,and pathology.RESULTS A total of 1846 cases with PC and controls were collected.Among PC,only 410(22.2%)cases were identified as specific cancer sites including head in 234(12.7%)cases,tail in 104(5.6%)cases and body in 72(3.9%)cases.Among PC,910(49.3%)cases were diagnosed by definite criteria.Most of these were adenocarcinoma(98.0%).The rates of definite diagnosis of PC were highest in head(70.1%)followed by body(47.2%)and tail(43.3%).False-positive cases were pancreatic cystic neoplasm and metastasis to the pancreas.In terms of the overall diagnosis of PC,sensitivity,specificity,positive predictive value,and negative predictive value were 99.95%,98.72%,98.70%,and 99.95%,respectively.Diagnostic accuracy was similar both in terms of diagnostic criteria and tumor locations.CONCLUSION Korean NHI claims database collected according to ICD-10 code with V code for PC showed good accuracy.展开更多
BACKGROUND with the widespread application of computer network systems in the medical field,the plan-do-check-action(PDCA)and the international classification of diseases tenth edition(ICD-10)coding system have also a...BACKGROUND with the widespread application of computer network systems in the medical field,the plan-do-check-action(PDCA)and the international classification of diseases tenth edition(ICD-10)coding system have also achieved favorable results in clinical medical record management.However,research on their combined application is relatively lacking.Objective:it was to explore the impact of network systems and PDCA management mode on ICD-10 encoding.Material and Method:a retrospective collection of 768 discharged medical records from the Medical Record Management Department of Meishan People’s Hospital was conducted.They were divided into a control group(n=232)and an observation group(n=536)based on whether the PDCA management mode was implemented.The two sets of coding accuracy,time spent,case completion rate,satisfaction,and other indicators were compared.AIM To study the adoption of network and PDCA in the ICD-10.METHODS A retrospective collection of 768 discharged medical records from the Medical Record Management Department of Meishan People’s Hospital was conducted.They were divided into a control group(n=232)and an observation group(n=536)based on whether the PDCA management mode was implemented.The two sets of coding accuracy,time spent,case completion rate,satisfaction,and other indicators were compared.RESULTS In the 3,6,12,18,and 24 months of PDCA cycle management mode,the coding accuracy and medical record completion rate were higher,and the coding time was lower in the observation group as against the controls(P<0.05).The satisfaction of coders(80.22%vs 53.45%)and patients(84.89%vs 51.72%)in the observation group was markedly higher as against the controls(P<0.05).CONCLUSION The combination of computer networks and PDCA can improve the accuracy,efficiency,completion rate,and satisfaction of ICD-10 coding.展开更多
The global incidence and prevalence of diabetes mellitus(DM)have reached epidemic proportions.Estimates indicate that more than 360 million people will be affected by DM by 2030.All of these individuals will be at ris...The global incidence and prevalence of diabetes mellitus(DM)have reached epidemic proportions.Estimates indicate that more than 360 million people will be affected by DM by 2030.All of these individuals will be at risk of developing diabetic retinopathy(DR).It is extremely important to categorize,classify and stage the severity of DR in order to establish adequate therapy.With proper management more than 90%of cases of visual loss can be prevented.The purpose of the current paper is to review the classification of DR with a special emphasis on the International Clinical Disease Severity Scale for DR.This new classification is simple to use,easy to remember and based on scientific evidence.It does not require specialized examinations such as optical coherence tomography or fluorescein angiography.It is based on clinical examination and applying the Early Treatment of Diabetic Retinopathy Study 4:2:1 rule.展开更多
Background:The 11th revision of the International Classification of Diseases and Related Health Problems(ICD-11)was released on June 18,2018,by the World Health Organization and will come into effect on January 1,2022...Background:The 11th revision of the International Classification of Diseases and Related Health Problems(ICD-11)was released on June 18,2018,by the World Health Organization and will come into effect on January 1,2022.Apart from the chapters on the classification of diseases in the conventional medicine(CM),a new chapter,traditional medicine(TM)conditions–Module 1,was added.Low back pain(LBP)is one of the common reasons for the physician visits.The classification codes for LBP in the ICD-11 are vital to documenting accurate clinical diagnoses.Methods:The qualitative case study method was adopted.The secondary use data for 100 patients were randomly selected using the ICD-11 online interface to find the classification codes for both the CM section and the TM Conditions–Module 1(TM1)section for LBP diagnosis.Results:Of the 27 codes obtained from the CM section,six codes were not relevant to LBP,whereas the other 21 codes represented diagnoses of LBP and its related diseases or syndromes.In the TM1 section,six codes for different patterns and disorders represented the diagnoses for LBP from the TM perspective.Conclusion:This study indicates that specific diagnoses of LBP can be represented by the combination of CM classification codes and TM1 classification codes in the ICD-11;the CM codes represent specific and accurate clinical diagnoses for LBP,whereas the TM1 codes add more accuracy to the diagnoses of different patterns from the TM perspective.展开更多
In 2018,the 11^(th) Edition of the International Classification of Diseases(ICD-11)defined a diagnostic code list for standard traditional medicine(TM)conditions.The codes improve patient safety by providing more comp...In 2018,the 11^(th) Edition of the International Classification of Diseases(ICD-11)defined a diagnostic code list for standard traditional medicine(TM)conditions.The codes improve patient safety by providing more comprehensive and accurate medical records for hospitals in the Western Pacific Region.In these facilities,TM is often a standard of care for those populations.In several mainstream media sources,writers are circumventing evidence-based peer-reviewed medical literature by unduly influencing public opinion and,in this case,against the new ICD-11 codes.The dangers imposed by the transgression of popular writing onto the discipline of peer-reviewed works are present since best practices in medical record-keeping will fail without the inclusion of TM in the ICD-11 codes.Such failures directly affect the health of the patients and policymakers in regions where TM and conventional medicine are combined.This article investigates the boundaries between substantial evidence and popular opinion.In this era where media is used to manipulate evidence,the reader’s use of sound judgment and critical thought are thwarted.This article also challenges three controversial themes in pop literature,including the threat to endangered species,increased patient risk,and contaminants in the TM.These themes are made without evidence and are,in fact,of flawed logic.There is no reason to assume that improved medical record-keeping and knowledge of patient cases increase risks.展开更多
The International Classification of Diseases(ICD)is an international standard and tool for epidemiological in-vestigation,health management,and clinical diagnosis with a fundamental role in intelligent medical care.Th...The International Classification of Diseases(ICD)is an international standard and tool for epidemiological in-vestigation,health management,and clinical diagnosis with a fundamental role in intelligent medical care.The assignment of ICD codes to health-related documents has become a focus of academic research,and numerous studies have developed the process of ICD coding from manual to automated work.In this survey,we review the developmental history of this task in recent decades in depth,from the rules-based stage,through the traditional machine learning stage,to the neural-network-based stage.Various methods have been introduced to solve this problem by using different techniques,and we report a performance comparison of different methods on the pub-licly available Medical Information Mart for Intensive Care dataset.Next,we summarize four major challenges of this task:(1)the large label space,(2)the unbalanced label distribution,(3)the long text of documents,and(4)the interpretability of coding.Various solutions that have been proposed to solve these problems are analyzed.Further,we discuss the applications of ICD coding,from mortality statistics to payments based on disease-related groups and hospital performance management.In addition,we discuss different ways of considering and evaluat-ing this task,and how it has been transformed into a learnable problem.We also provide details of the commonly used datasets.Overall,this survey aims to provide a reference and possible prospective directions for follow-up research work.展开更多
In the 11th revision of the International Classification of Diseases(ICD),the World Health Organization included traditional medicine disorders and patterns originated from ancient Chinese medicine that are commonly u...In the 11th revision of the International Classification of Diseases(ICD),the World Health Organization included traditional medicine disorders and patterns originated from ancient Chinese medicine that are commonly used in China,Japan,Korea and elsewhere around the world.For the first time,a chapter on traditional medicine was incorporated,which has completely changed the status quo on the lack of information on traditional medicine and health statistics in the ICD.In this study,we systematically analyzed the background,structure,content and characteristics of the Traditional Medicine chapter,with focus on its positive effects on promoting the development and utilization of Traditional Chinese Medicine worldwide.展开更多
目的:筛选出脊髓损伤患者神经源性膀胱的国际功能、残疾、健康分类核心类目。方法:通过ISCOS提供的开放脊髓损伤数据库(international SCI data sets)筛选出和神经源性膀胱相关的基础数据库,整理出这些数据库的每个变量。利用WHO-FIC合...目的:筛选出脊髓损伤患者神经源性膀胱的国际功能、残疾、健康分类核心类目。方法:通过ISCOS提供的开放脊髓损伤数据库(international SCI data sets)筛选出和神经源性膀胱相关的基础数据库,整理出这些数据库的每个变量。利用WHO-FIC合作中心ICF研究组开发的ICF与结局测量工具间联系和匹配的原则,采用专业人员对内容定性联系和匹配的方法,将针对筛选出的变量与ICF综合版测量项目进行联系和匹配。整理匹配的ICF项目生成神经源性膀胱ICF核心要素。结果:通过对比2名研究者筛选相同变量,合并相近的变量,剔除与神经源性膀胱不相关的变量,最终纳入85项。共提取有明确意义的概念60个,可与ICF联系、匹配的概念46个。与ICF联系、匹配后共得出神经源性膀胱ICF核心类目40项,其中身体功能16项、身体结构8项、活动和参与9项、环境因素与个人因素7项。结论:系统回顾研究法初步筛选出脊髓损伤患者神经源性膀胱ICF核心类目,为神经源性膀胱评估、治疗提供了更全面的框架。展开更多
目的基于《国际功能、残疾和健康分类》(ICF)的理论与方法,分析远程康复在冠心病患者中应用的研究及现状。方法检索建库至2022年5月5日,PubMed、Web of Science、中国知网和万方数据关于远程康复在冠心病患者中应用的研究。基于ICF,采用...目的基于《国际功能、残疾和健康分类》(ICF)的理论与方法,分析远程康复在冠心病患者中应用的研究及现状。方法检索建库至2022年5月5日,PubMed、Web of Science、中国知网和万方数据关于远程康复在冠心病患者中应用的研究。基于ICF,采用Scoping综述方法分析远程康复应用于冠心病患者时的干预措施、评价方法和指标、康复结果以及影响因素等。结果共检索文献4172篇,最终纳入15篇,来自5个国家,多数文献源于医学、公共健康相关主题期刊,研究主要集中在2015年至2022年。远程康复的主要内容包括成立远程康复小组、建立个人健康档案、身体活动、运动监测、提供相关知识、专业人员沟通指导及问题解答、提供心理支持、自我报告、医务人员监督提醒9个要素。根据ICF架构,远程康复促进冠心病患者功能康复主要体现在身体功能(包括b1精神功能,b4心血管、血液、免疫和呼吸系统功能,b5消化、代谢和内分泌系统功能,b7神经肌肉骨骼和运动有关的功能)和活动与参与(包括d2一般任务和要求,d4活动,d7人际交往和人际关系,d8主要生活领域,d9社区、社会和公民生活),影响冠心病患者活动与参与的因素主要有环境因素和个人因素,主要包括e1用品和技术,e3支持和相互联系,e4态度,e5服务、体制和政策等。结论本研究总结了冠心病患者远程康复的9个内容要素,并基于ICF分析远程康复对冠心病患者的效果及其相关影响因素。展开更多
目的运用《国际疾病分类第十一次修订本》(ICD-11)和《国际功能、残疾和健康分类》(ICF)构建社区慢性病老年人身体活动融合慢性病管理健康干预模式的健康效益的研究架构,综合分析针对社区慢性病老年人身体活动融合慢性病管理3类干预模...目的运用《国际疾病分类第十一次修订本》(ICD-11)和《国际功能、残疾和健康分类》(ICF)构建社区慢性病老年人身体活动融合慢性病管理健康干预模式的健康效益的研究架构,综合分析针对社区慢性病老年人身体活动融合慢性病管理3类干预模式的干预方案和健康结局。方法检索中国知网、Web of Science、PubMed、EBSCO,收集建库至2023年5月公开发表有关社区慢性病老年人社区慢性病管理、身体活动、运动康复、身体活动处方干预及其健康结局相关的文献,进行Scoping综述。结果纳入8篇文献,来自4个国家,涉及568项随机对照试验和4359例参与者(50~72岁),发表日期集中在2017年至2022年。社区慢性病老年人健康干预模式可分为3类:社区卫生服务模式(慢性病管理与运动康复)、社区体育活动模式(预防与健康促进)和混合模式(两者结合)。社区卫生服务模式以社区慢性病管理为主,融合社区体育活动,涉及身体活动干预、健康教育、饮食干预、监测与动机干预、护理协调等;时间6~24个月,属性为康复、健康促进,人员涉及医生、护士、营养师、药剂师、社会工作者和初级保健临床医生。社区体育活动模式主要涉及在社区环境中为慢性病老年人设计并实施不同身体活动,提供相关建议和指导、个性化强化和支持;主要有步行、骑自行车、热身运动、心肺适能、肌肉力量和平衡训练、协调和拉伸运动、太极拳、瑜伽、气功、水上运动等形式;每次活动10~150 min,强度为低等~剧烈,持续8~12个月,干预属性为预防、健康促进,人员涉及临床工作人员、初级卫生保健人员、运动干预专家、医生、护士、社会工作者、获得相关认证的运动教练员。混合模式涉及慢性病预防和管理计划,包括身体活动咨询、身体活动相关的生活方式干预,个性化健康指导和运动方案的设计;时间6~12个月,属性为预防、康复和健康促进,人员涉及体育教练和退休专业运动人员、营养师、护士、私人培训师、全科医生、作业治疗师、理疗师。健康结局主要涉及身体功能相关指标,如体质量减轻,血压、腰围、收缩压、甘油三酯和高密度脂蛋白胆固醇水平改善,心脏风险降低,关节炎、带状疱疹疼痛缓解,认知功能改善,抑郁症状改善;活动相关方面,如体适能改善,涉及身体敏捷性和动态平衡能力、灵活性、肌力、有氧耐力;身体活动量增加,如低等~剧烈运动或娱乐活动时间增加,跌倒风险降低,日常身体活动水平改善,自我效能感增强,社会参与水平提高。结论社区慢性病老年人身体活动与健康服务可归为3类干预模式,即社区卫生服务模式、社区体育活动模式和混合模式。在社区层面,融合身体活动和慢性病管理等社区卫生服务的综合干预,可改善社区慢性病老年人的健康状况,管理慢性病相关症状,改进身体和心理功能,提高体育活动参与水平,提升生活质量与福祉。混合模式将身体活动融入社区健康服务,可使社区慢性病老年人获得综合性健康干预,得到更显著的健康和健康相关效益。展开更多
文摘The increase in chronic diseases in childhood highlights the need for a biopsychosocial approach to deal with the complexity of these health conditions. The International Classification of Functioning, Disability, and Health (ICF) results from the need to implement new explanatory evaluative and therapeutic models. Thus, the present systematic review aims to identify published studies on the use of the ICF in chronic childhood diseases. As a secondary objective, to map the themes that have already been studied in the area to support the discussion on the expansion of the use of this classification in health services. The systematic review followed the PRISMA protocol, and the model was the PICO acronym, where Population was children and adolescents with chronic diseases, Intervention/Exposure was evaluation based on ICF concepts, Comparator was any tool, instrument, or intervention, and outcome was direct or indirect use of the ICF. We selected eight articles, five of which used the ICF as a conceptual tool and three as a classification system, divided into the following themes: quality of life, evaluation of patients (without using coding) and mapping the inclusion of the activity’s results and participation in clinical trials. Thus, use of the ICF in clinical practice is still incipient, although it has been recommended in guidelines. Further studies are necessary to expand the number of contributions by the ICF and to develop the necessary approaches for understanding the classification’s use.
基金Supported by the National Research Foundation of Korea,No.2011-0030001
文摘BACKGROUND Korean National Health Insurance(NHI)claims database provides large-cohort.However,studies regarding accuracy of administrative database for pancreatic cancer(PC)have not been reported.We aimed to identify accuracy of NHI database regarding PC classified by international classification of disease(ICD)-10 codes.AIM To identify the accuracy and usefulness of administrative database in PC and the accurate ICD codes for PC with location.METHODS Study and control groups were collected from 2003 to 2016 at Seoul National University Bundang Hospital.Cases of PC were identified in NHI database by international classification of diseases,10th revision edition(ICD-10 codes)supported with V codes.V code is issued by medical doctors for covering 95%of medical cost by Korean government.According to pathologic reports,definite or possible diagnoses were defined using medical records,images,and pathology.RESULTS A total of 1846 cases with PC and controls were collected.Among PC,only 410(22.2%)cases were identified as specific cancer sites including head in 234(12.7%)cases,tail in 104(5.6%)cases and body in 72(3.9%)cases.Among PC,910(49.3%)cases were diagnosed by definite criteria.Most of these were adenocarcinoma(98.0%).The rates of definite diagnosis of PC were highest in head(70.1%)followed by body(47.2%)and tail(43.3%).False-positive cases were pancreatic cystic neoplasm and metastasis to the pancreas.In terms of the overall diagnosis of PC,sensitivity,specificity,positive predictive value,and negative predictive value were 99.95%,98.72%,98.70%,and 99.95%,respectively.Diagnostic accuracy was similar both in terms of diagnostic criteria and tumor locations.CONCLUSION Korean NHI claims database collected according to ICD-10 code with V code for PC showed good accuracy.
文摘BACKGROUND with the widespread application of computer network systems in the medical field,the plan-do-check-action(PDCA)and the international classification of diseases tenth edition(ICD-10)coding system have also achieved favorable results in clinical medical record management.However,research on their combined application is relatively lacking.Objective:it was to explore the impact of network systems and PDCA management mode on ICD-10 encoding.Material and Method:a retrospective collection of 768 discharged medical records from the Medical Record Management Department of Meishan People’s Hospital was conducted.They were divided into a control group(n=232)and an observation group(n=536)based on whether the PDCA management mode was implemented.The two sets of coding accuracy,time spent,case completion rate,satisfaction,and other indicators were compared.AIM To study the adoption of network and PDCA in the ICD-10.METHODS A retrospective collection of 768 discharged medical records from the Medical Record Management Department of Meishan People’s Hospital was conducted.They were divided into a control group(n=232)and an observation group(n=536)based on whether the PDCA management mode was implemented.The two sets of coding accuracy,time spent,case completion rate,satisfaction,and other indicators were compared.RESULTS In the 3,6,12,18,and 24 months of PDCA cycle management mode,the coding accuracy and medical record completion rate were higher,and the coding time was lower in the observation group as against the controls(P<0.05).The satisfaction of coders(80.22%vs 53.45%)and patients(84.89%vs 51.72%)in the observation group was markedly higher as against the controls(P<0.05).CONCLUSION The combination of computer networks and PDCA can improve the accuracy,efficiency,completion rate,and satisfaction of ICD-10 coding.
文摘The global incidence and prevalence of diabetes mellitus(DM)have reached epidemic proportions.Estimates indicate that more than 360 million people will be affected by DM by 2030.All of these individuals will be at risk of developing diabetic retinopathy(DR).It is extremely important to categorize,classify and stage the severity of DR in order to establish adequate therapy.With proper management more than 90%of cases of visual loss can be prevented.The purpose of the current paper is to review the classification of DR with a special emphasis on the International Clinical Disease Severity Scale for DR.This new classification is simple to use,easy to remember and based on scientific evidence.It does not require specialized examinations such as optical coherence tomography or fluorescein angiography.It is based on clinical examination and applying the Early Treatment of Diabetic Retinopathy Study 4:2:1 rule.
文摘Background:The 11th revision of the International Classification of Diseases and Related Health Problems(ICD-11)was released on June 18,2018,by the World Health Organization and will come into effect on January 1,2022.Apart from the chapters on the classification of diseases in the conventional medicine(CM),a new chapter,traditional medicine(TM)conditions–Module 1,was added.Low back pain(LBP)is one of the common reasons for the physician visits.The classification codes for LBP in the ICD-11 are vital to documenting accurate clinical diagnoses.Methods:The qualitative case study method was adopted.The secondary use data for 100 patients were randomly selected using the ICD-11 online interface to find the classification codes for both the CM section and the TM Conditions–Module 1(TM1)section for LBP diagnosis.Results:Of the 27 codes obtained from the CM section,six codes were not relevant to LBP,whereas the other 21 codes represented diagnoses of LBP and its related diseases or syndromes.In the TM1 section,six codes for different patterns and disorders represented the diagnoses for LBP from the TM perspective.Conclusion:This study indicates that specific diagnoses of LBP can be represented by the combination of CM classification codes and TM1 classification codes in the ICD-11;the CM codes represent specific and accurate clinical diagnoses for LBP,whereas the TM1 codes add more accuracy to the diagnoses of different patterns from the TM perspective.
基金financed by grants from the National Major Science and Technology Projects of China (No. YB2019023)Independent Project of China Academy of Chinese Medical Sciences (No. ZZ12-002)
文摘In 2018,the 11^(th) Edition of the International Classification of Diseases(ICD-11)defined a diagnostic code list for standard traditional medicine(TM)conditions.The codes improve patient safety by providing more comprehensive and accurate medical records for hospitals in the Western Pacific Region.In these facilities,TM is often a standard of care for those populations.In several mainstream media sources,writers are circumventing evidence-based peer-reviewed medical literature by unduly influencing public opinion and,in this case,against the new ICD-11 codes.The dangers imposed by the transgression of popular writing onto the discipline of peer-reviewed works are present since best practices in medical record-keeping will fail without the inclusion of TM in the ICD-11 codes.Such failures directly affect the health of the patients and policymakers in regions where TM and conventional medicine are combined.This article investigates the boundaries between substantial evidence and popular opinion.In this era where media is used to manipulate evidence,the reader’s use of sound judgment and critical thought are thwarted.This article also challenges three controversial themes in pop literature,including the threat to endangered species,increased patient risk,and contaminants in the TM.These themes are made without evidence and are,in fact,of flawed logic.There is no reason to assume that improved medical record-keeping and knowledge of patient cases increase risks.
基金Beijing Municipal Natural Science Foundation(Grant No.M22012)BUPT Excellent Ph.D.Students Foundation(Grant No.CX2021122).
文摘The International Classification of Diseases(ICD)is an international standard and tool for epidemiological in-vestigation,health management,and clinical diagnosis with a fundamental role in intelligent medical care.The assignment of ICD codes to health-related documents has become a focus of academic research,and numerous studies have developed the process of ICD coding from manual to automated work.In this survey,we review the developmental history of this task in recent decades in depth,from the rules-based stage,through the traditional machine learning stage,to the neural-network-based stage.Various methods have been introduced to solve this problem by using different techniques,and we report a performance comparison of different methods on the pub-licly available Medical Information Mart for Intensive Care dataset.Next,we summarize four major challenges of this task:(1)the large label space,(2)the unbalanced label distribution,(3)the long text of documents,and(4)the interpretability of coding.Various solutions that have been proposed to solve these problems are analyzed.Further,we discuss the applications of ICD coding,from mortality statistics to payments based on disease-related groups and hospital performance management.In addition,we discuss different ways of considering and evaluat-ing this task,and how it has been transformed into a learnable problem.We also provide details of the commonly used datasets.Overall,this survey aims to provide a reference and possible prospective directions for follow-up research work.
文摘In the 11th revision of the International Classification of Diseases(ICD),the World Health Organization included traditional medicine disorders and patterns originated from ancient Chinese medicine that are commonly used in China,Japan,Korea and elsewhere around the world.For the first time,a chapter on traditional medicine was incorporated,which has completely changed the status quo on the lack of information on traditional medicine and health statistics in the ICD.In this study,we systematically analyzed the background,structure,content and characteristics of the Traditional Medicine chapter,with focus on its positive effects on promoting the development and utilization of Traditional Chinese Medicine worldwide.
文摘目的:筛选出脊髓损伤患者神经源性膀胱的国际功能、残疾、健康分类核心类目。方法:通过ISCOS提供的开放脊髓损伤数据库(international SCI data sets)筛选出和神经源性膀胱相关的基础数据库,整理出这些数据库的每个变量。利用WHO-FIC合作中心ICF研究组开发的ICF与结局测量工具间联系和匹配的原则,采用专业人员对内容定性联系和匹配的方法,将针对筛选出的变量与ICF综合版测量项目进行联系和匹配。整理匹配的ICF项目生成神经源性膀胱ICF核心要素。结果:通过对比2名研究者筛选相同变量,合并相近的变量,剔除与神经源性膀胱不相关的变量,最终纳入85项。共提取有明确意义的概念60个,可与ICF联系、匹配的概念46个。与ICF联系、匹配后共得出神经源性膀胱ICF核心类目40项,其中身体功能16项、身体结构8项、活动和参与9项、环境因素与个人因素7项。结论:系统回顾研究法初步筛选出脊髓损伤患者神经源性膀胱ICF核心类目,为神经源性膀胱评估、治疗提供了更全面的框架。
文摘目的基于《国际功能、残疾和健康分类》(ICF)的理论与方法,分析远程康复在冠心病患者中应用的研究及现状。方法检索建库至2022年5月5日,PubMed、Web of Science、中国知网和万方数据关于远程康复在冠心病患者中应用的研究。基于ICF,采用Scoping综述方法分析远程康复应用于冠心病患者时的干预措施、评价方法和指标、康复结果以及影响因素等。结果共检索文献4172篇,最终纳入15篇,来自5个国家,多数文献源于医学、公共健康相关主题期刊,研究主要集中在2015年至2022年。远程康复的主要内容包括成立远程康复小组、建立个人健康档案、身体活动、运动监测、提供相关知识、专业人员沟通指导及问题解答、提供心理支持、自我报告、医务人员监督提醒9个要素。根据ICF架构,远程康复促进冠心病患者功能康复主要体现在身体功能(包括b1精神功能,b4心血管、血液、免疫和呼吸系统功能,b5消化、代谢和内分泌系统功能,b7神经肌肉骨骼和运动有关的功能)和活动与参与(包括d2一般任务和要求,d4活动,d7人际交往和人际关系,d8主要生活领域,d9社区、社会和公民生活),影响冠心病患者活动与参与的因素主要有环境因素和个人因素,主要包括e1用品和技术,e3支持和相互联系,e4态度,e5服务、体制和政策等。结论本研究总结了冠心病患者远程康复的9个内容要素,并基于ICF分析远程康复对冠心病患者的效果及其相关影响因素。
文摘目的运用《国际疾病分类第十一次修订本》(ICD-11)和《国际功能、残疾和健康分类》(ICF)构建社区慢性病老年人身体活动融合慢性病管理健康干预模式的健康效益的研究架构,综合分析针对社区慢性病老年人身体活动融合慢性病管理3类干预模式的干预方案和健康结局。方法检索中国知网、Web of Science、PubMed、EBSCO,收集建库至2023年5月公开发表有关社区慢性病老年人社区慢性病管理、身体活动、运动康复、身体活动处方干预及其健康结局相关的文献,进行Scoping综述。结果纳入8篇文献,来自4个国家,涉及568项随机对照试验和4359例参与者(50~72岁),发表日期集中在2017年至2022年。社区慢性病老年人健康干预模式可分为3类:社区卫生服务模式(慢性病管理与运动康复)、社区体育活动模式(预防与健康促进)和混合模式(两者结合)。社区卫生服务模式以社区慢性病管理为主,融合社区体育活动,涉及身体活动干预、健康教育、饮食干预、监测与动机干预、护理协调等;时间6~24个月,属性为康复、健康促进,人员涉及医生、护士、营养师、药剂师、社会工作者和初级保健临床医生。社区体育活动模式主要涉及在社区环境中为慢性病老年人设计并实施不同身体活动,提供相关建议和指导、个性化强化和支持;主要有步行、骑自行车、热身运动、心肺适能、肌肉力量和平衡训练、协调和拉伸运动、太极拳、瑜伽、气功、水上运动等形式;每次活动10~150 min,强度为低等~剧烈,持续8~12个月,干预属性为预防、健康促进,人员涉及临床工作人员、初级卫生保健人员、运动干预专家、医生、护士、社会工作者、获得相关认证的运动教练员。混合模式涉及慢性病预防和管理计划,包括身体活动咨询、身体活动相关的生活方式干预,个性化健康指导和运动方案的设计;时间6~12个月,属性为预防、康复和健康促进,人员涉及体育教练和退休专业运动人员、营养师、护士、私人培训师、全科医生、作业治疗师、理疗师。健康结局主要涉及身体功能相关指标,如体质量减轻,血压、腰围、收缩压、甘油三酯和高密度脂蛋白胆固醇水平改善,心脏风险降低,关节炎、带状疱疹疼痛缓解,认知功能改善,抑郁症状改善;活动相关方面,如体适能改善,涉及身体敏捷性和动态平衡能力、灵活性、肌力、有氧耐力;身体活动量增加,如低等~剧烈运动或娱乐活动时间增加,跌倒风险降低,日常身体活动水平改善,自我效能感增强,社会参与水平提高。结论社区慢性病老年人身体活动与健康服务可归为3类干预模式,即社区卫生服务模式、社区体育活动模式和混合模式。在社区层面,融合身体活动和慢性病管理等社区卫生服务的综合干预,可改善社区慢性病老年人的健康状况,管理慢性病相关症状,改进身体和心理功能,提高体育活动参与水平,提升生活质量与福祉。混合模式将身体活动融入社区健康服务,可使社区慢性病老年人获得综合性健康干预,得到更显著的健康和健康相关效益。
