Adoption of network and plan-do-check-action in the international classification of disease 10 coding

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.

Rehabilitation of shoulder paresis caused by herpes zoster according to the International Classification of Functioning, Disability and Health A case report

We describe the case of a 73-year-old man with left shoulder paresis caused by a herpes zoster infection of the left C5 dermatomes. The patient had been affected by pain for 10 days, a skin rash on his left shoulder and back for 5 days, and weakness of his left shoulder for 2 days before admission. Eiectromyography revealed denervation discharges from the left supraspinatus, infraspinatus and deltoid muscles, which was compatible with radiculopathy showing after zoster infection. The patient was examined in accordance with the International Classification of Functioning, Disability and Health, and treated with range-of-movement and strengthening exercises as well as activities of daily living and social participation. At 14 months after the onset of the condition, muscle strength had returned to normal. Electromyography revealed that motor unit action potentials were largely normal. These results indicate that the rehabilitation of paresis caused by herpes zoster can obtain positive results with suitable movement training.

Traditional Medicine Diagnostic Codes in ICD-11 and Alternative Diagnostic Classifications in the Mainstream Healthcare

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.

Chronic Diseases of Childhood and the International Classification of Functioning, Disability, and Health: A Systematic Review

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.

Operational definitions and measurement of externalizing behavior problems:An integrative review including research models and clinical diagnostic systems

Measurement of externalizing disorders such as antisocial disorders,attentiondeficit/hyperactivity disorder or borderline disorder have relevant implications for the daily lives of people with these disorders.While the Diagnostic and Statistical Manual of Mental Disorders(DSM)and the International Classification of Diseases(ICD)have provided the diagnostic framework for decades,recent dimensional frameworks question the categorical approach of psychopathology,inherent in traditional nosotaxies.Tests and instruments develop under the DSM or ICD framework preferentially adopt this categorical approach,providing diagnostic labels.In contrast,dimensional measurement instruments provide an individualized profile for the domains that comprise the externalizing spectrum,but are less widely used in practice.Current paper aims to review the operational definitions of externalizing disorders defined under these different frameworks,revise the different measurement alternatives existing,and provide an integrative operational definition.First,an analysis of the operational definition of externalizing disorders among the DSM/ICD diagnostic systems and the recent Hierarchical Taxonomy of Psychopathology(HiTOP)model is carried out.Then,in order to analyze the coverage of operational definitions found,a description of measurement instruments among each conceptualization is provided.Three phases in the development of the ICD and DSM diagnosis systems can be observed with direct implications for measurement.ICD and DSM versions have progressively introduced systematicity,providing more detailed descriptions of diagnostic criteria and categories that ease the measurement instrument development.However,it is questioned whether the DSM/ICD systems adequately modelize externalizing disorders,and therefore their measurement.More recent theoretical approaches,such as the HiTOP model seek to overcome some of the criticism raised towards the classification systems.Nevertheless,several issues concerning this model raise mesasurement challenges.A revision of the instruments underneath each approach shows incomplete coverage of externalizing disorders among the existing instruments.Efforts to bring nosotaxies together with other theoretical models of psychopathology and personality are still needed.The integrative operational definition of externalizing disorders provided may help to gather clinical practice and research.

A dynamic two-zone model of continuous fluidized bed layering granulation with internal product classification

A dynamic two-zone model is proposed to address the formation of granulation and drying zones in fluidized bed layering granulation processes with internal product classification. The model assumes a constant volume for the granulation zone, but a variable overall volume for the fluidized bed to account for classified product removal. The model is used to study the effect of various process parameters on dynamics and process stability. Stability is shown to depend on the separation diameter of product removal and the flow rate of the injected liquid. A lower and upper range of separation diameters with stable process behavior are found. In an intermediate range instability in the form of self-sustained oscillations is observed. The lower stability boundary is in qualitative agreement with recent experimental observations （Schmidt, Bück, ＆ Tsotsas, 2015）; the upper boundary was reported in a theoretical paper by Vreman, Van Lare, and Hounslow （2009） based on a single zone model.

Human Brucellosis Mimicking Axial Spondyloarthritis: a Challenge for Rheumatologists when Applying the 2009 ASAS Criteria

Although the development of the 2009 Sp A classification criteria by Assessment of Spondylo Arthritis international Society（ASAS） represents an important step towards a better definition of the early disease stage particularly in axial spondyloarthritis（ax Sp A）, the specificity of the criteria has been criticized these days. As the commonest zoonotic infection worldwide, human brucellosis can mimic a large number of diseases, including Sp A. This study was performed to determine the frequency of rheumatologic manifestations in patients with brucellosis and the chance of misdiagnosing them as having ax Sp A in central China. The results showed that clinical manifestations of ax Sp A could be observed in brucellosis. Over half of patients had back pain, and one fifth of the patients with back pain were less than 45 years old at onset and had the symptom for more than 3 months. Two young males were falsely classified as suffering from ax Sp A according to the ASAS criteria, and one with MRI proved sacroiliitis was once given Etanercept for treatment. Therefore, differential diagnosis including human brucellosis should always be kept in mind when applying the ASAS criteria, even in traditionally non-endemic areas.

Multi-analysis with mathematic model of 3125 non-thyrogenous masses of the neck

Objective： To systematically analyze and summarize non-thyrogenous masses of the neck （NTMN） by consideration of new areas, a large sample size and multiple-aspect analysis. Methods： Our research involved 3125 NTMN cases. We summarized the proportion of various NTMN and the distribution of the neck diseases based on the new international classification. The clinical traits such as sexual proportion and age, etc, were analyzed along with the unknown primary cervical metastatic carcinomas （UPCMC）, and built up a mathematical model based on the data above. Results： There were 68 different diseases identified. Among all the NTMN, the percentage of metastatic carcinomas was 63.3%. The neck masses with a focus above the clavicle comprised 62.3% of the metastatic carcinomas whose focuses were clear. Moreover, other results almost supported the ＂rule of 80%＂. There was an obvious distribution of traits at every sub level. For example, there were 23 different diseases in level Ⅲ, of which the most common was lymphoma. UPCMC made up 12.3% of all metastatic carcinomas. The clinic cases could be analyzed by our model even to form a primary diagnosis which showed a high coincident rate with clinic diagnosis. Conclusion： NTMN are complex and various, with a definite distribution in each neck level. Data relating component character, sex ratio and UPCMC et al to the clinical traits of NTMN will provide vigorous support for clinical applications. The mathematical model could be an efficient method to synthetically analyze complicate data of NTMN.

Studies of layout of world machine tools industry based on patent analysis

As the foundation of an industrialized country nowadays,machine tools industry is regarded as the engine of industrial development of a country.The developed countries,such as USA,Germany and Japan,have widely deployed the technology of using the patent in order to keep their strength in various fields.This research examins the CNC machine tools industry in the world by using the patent analysis method.It first gives an overview about the world patent application in CNC machine tools industry from 1963 to 2010 and divides the development of the industry into five stages.It also lists the patent application of the world top 20 countries,where the top 5 countries are compared.The patents of the world top 10 companies of machine tools manufacturers are mapped according to the international patent classification(IPC),and the future trends of world machine tools industry are discussed.Finally conclusions and suggestions are presented.

Multi-Analysis of Non-Thyrogenous Masses of the Neck

OBJECTIVE To systematically analyze and summarize non-thyroge-nous masses of the neck(NTMN)by consideration of new areas,a large sample size and multiple-aspect analysis.METHODS Our research involved 3,125 NTMN cases.We summarized the proportion of various NTMN and the distribution of the neck diseases based on the new international classification.The clinical traits such as sexual proportion and age,etc,were analyzed along with the unknown pri-mary cervical metastatic carcinomas(UPCMC),multiple nodular NTMN and tubercular lymphadenitis.RESULTS There were 68 different diseases identified.Among all the NTMN,the percentage of metastatic carcinomas was 63.3%.The neck masses with a focus above the clavicle comprised 62.3% of the metastatic carcinomas whose focuses were clear.Moreover,other results almost sup-ported the “rule of 80%”.There was an obvious distribution of traits at every sub level.For example,there were 23 different diseases in level III,of which the most common was lymphoma.UPCMC made up 12.3% of all metastatic carcinomas.Multiple NTMN were composed of lymphoma,metastatic car-cinoma and tubercular lymphadenitis,etc.For tubercular lymphadenitis pa-tients,the patients without tubercular toxic symptoms comprised 77.1% of all tubercular lymphadenitis patients.CONCLUSION NTMN are complex and various,with a definite distribu-tion in each neck level.Data relating the sex ratio,UPCMC,multiple nodular NTMN and tubercular lymphadenitis to the clinical traits of NTMN will provide support for clinical applications.

Visualization analysis of the international standard ISO/TC 249 for traditional Chinese medicine

Objective This study proposes to visually review the current situation and progress of standards sets by the International Organization for Standardization/Technical Committee on Traditional Chinese Medicine(ISO/TC 249). The review aims to explore the development strategies of the standards, which will exhibit the considerable impact on the economy, trade and exchanges, and cooperation in the area of traditional Chinese medicine(TCM).Methods ISO/TC 249 standards were searched on the ISO website, and their title, proposed time, current stage, scope, and classification were obtained for further summarization. Gephi was utilized to portray the co-occurrence network graph of the ISO/TC 249 standards subject.Results In ISO/TC 249, there were 116 standards, including 81 published standards and 35 developing standards by April 30, 2022. Two withdrawal standards were published after revision, which were not counted in the total standards. The number of published standards has been increasing since the first standard was published in 2014, whose title was “Sterile acupuncture needles for single use”. Among these standards, 17.24%(20/116) standards were in review, 56.03%(65/116) in publication, 3.45%(4/116) in approval, 5.17%(6/116) in enquiry,3.45%(4/116) in committee, and 14.66%(17/116) in preparation, respectively. With 116 standards, most of the research focused on the medicament, as its classification of the International Classification for Standards(ICS) showed the proportion reaching 49.54%. The network analysis data revealed that the top five most frequent words were “materials” “root” “requirements” “products” and “system”, after removing the noise data, such as prepositions,conjunctions, and pronouns. Additionally, the word “system” co-exists with the terms “computerized” “coding” “image” “tongue” and “analysis”;the word “requirement” co-exists with“manufacturing” “decoction” “process” and “materials”;whereas the word “devices” coexists with “pulse” “electric” “skin” and “measurement”.Conclusion With the increased diversification and complexity of problems, the development of standards is also oriented to multidisciplinary fields to cultivate the interdisciplinary talents, and especially the international standardization talents of compound TCM. Multi-angle analysis, formulation, and demonstration of standards, in line with industry needs in different disciplines, enhance the availability of standards and the ability to serve the industry.

On the Issue of Commercial Insurance and Commercial Insurance Market in the Slovak Republic

The article is concentrated on the Slovak commercial insurance, commercial insurance market, non-life insurance, and international risks on the Slovak Republic. Since 1 May 2004, the Slovak insurance market has been part of the uniform European Union insurance market, which includes over 5,000 insurance companies. After Slovakia’s admission to the European Union, several legislative changes have been adopted in the area of commercial insurance industry, which also influenced non-life insurance and the insurance of international risks as part of non-life risks. The most recent act in the area of commercial insurance mentioned in the paper is the Act of the National Council SR No. 39/2015 Coll. on Insurance, in which there are legislative changes in life and also non-life insurance. Basic terms are defined and commented on in the first two chapters （Lowry, Rawlings, ＆ Merkin, 2015）. The nature of international risks as part of non-life risks is described in the second chapter. International risks are classified in the third chapter; international risks are subdivided in the paper into commercial or trade risks, political and economic risks, and special types of risks.

Application of the international classification of functioning, disability and health in China

Implementation of the International Classification of Functioning, Disability and Health （ICF） started in 2001 with the unanimous endorsement of the classification by the 54th World Health Organization （WHO） as a framework for describing and measuring health and disability. In recent years, the ICF has been increasingly applied to research and development in China, and has influenced the policies of the Chinese Disabled Person Enterprise and Chinese Rehabilitation Career. This paper introduces the translation, training and spread of ICF and its application in the fields of medicine, society and education in China.

Representation of Specific Diagnosis for Low Back Pain Using the 11^(th) Revision of International Classification of Diseases and Related Health Problems: Perspectives of Conventional Medicine and Traditional Medicine

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.

A survey of automated International Classification of Diseases coding:development,challenges,and applications

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.

Impact of hospital type on risk-adjusted,traffic-related 30-day mortality:a population-based registry study

Background:Traffic incidents are still a major contributor to hospital admissions and trauma-related mortality.The aim of this nationwide study was to examine risk-adjusted traffic injury mortality to determine whether hospital type was an independent survival factor.Methods:Data on all patients admitted to Swedish hospitals with traffic-related injuries,based on International Classification of Diseases codes,between 2001 and 2011 were extracted from the Swedish inpatient and cause of death registries.Using the binary outcome measure of death or survival,data were analysed using logistic regression,adjusting for age,sex,comorbidity,severity of injury and hospital type.The severity of injury was established using the International Classification of Diseases Injury Severity Score(ICISS).Results:The final study population consisted of 152,693 hospital admissions.Young individuals(0–25 years of age)were overrepresented,accounting for 41%of traffic-related injuries.Men were overrepresented in all age categories.Fatalities at university hospitals had the lowest mean(SD)ICISS 0.68(0.19).Regional and county hospitals had mean ICISS 0.75(0.15)and 0.77(0.15),respectively,for fatal traffic incidents.The crude overall mortality in the study population was 1193,with a mean ICISS 0.72(0.17).Fatalities at university hospitals had the lowest mean ICISS 0.68(0.19).Regional and county hospitals had mean ICISS 0.75(0.15)and 0.77(0.15),respectively,for fatal traffic incidents.When regional and county hospitals were merged into one group and its risk-adjusted mortality compared with university hospitals,no significant difference was found.A comparison between hospital groups with the most severely injured patients(ICISS0.85)also did not show a significant difference(odds ratio,1.13;95%confidence interval,0.97–1.32).Conclusions:This study shows that,in Sweden,the type of hospital does not influence risk adjusted traffic related mortality,where the most severely injured patients are transported to the university hospitals and centralization of treatment is common.