Objective The purpose of this study was to evaluate the accuracy of t he Intern ational Classification of Diseases-9th revision codes for preeclampsia and ecla mpsia. Study design The University of Illinois Medical Ce...Objective The purpose of this study was to evaluate the accuracy of t he Intern ational Classification of Diseases-9th revision codes for preeclampsia and ecla mpsia. Study design The University of Illinois Medical Center at Chicago dischar ge database was used to identify 135 women from 1999 through 2001 whose disease was coded as having preeclampsia or eclampsia. With American College of Obstetri cs and Gynecology criteria as the gold standard, the diagnosis that was determin ed through chart review was compared with the International Classification of Di seases-9th revision code that was present in the discharge database. Patients w ere classified as true cases if the International Classification of Diseases-9t h revision code matched the American College of Obstetricians and Gynecologists diagnosis; the positive predictive value of the code was then calculated. Result s The overall positive predictive value for the complete sample was only 54%, b ut the positive predictive value for severe preeclampsia was 84.8%, which was h igh compared with mild preeclampsia (45.3%) and eclampsia (41.7%). Diagnostic (clinician) error was the most common reason for miscoding error. Conclusion The findings suggest that International Classification of Diseases-9th revision co des for preeclampsia/eclampsia vary greatly in their accuracy of diagnosis. Ther efore, a review of medical records is required when data are being gathered on t he incidence of preeclampsia and eclampsia.展开更多
Objectives: To determine the pre-malignant and malignant potential o f endomet rial polyps and to assess whether different clinical parameters are associated w ith malignancy in the polyps. Study design: Four hundred ...Objectives: To determine the pre-malignant and malignant potential o f endomet rial polyps and to assess whether different clinical parameters are associated w ith malignancy in the polyps. Study design: Four hundred and thirty consecutive cases of hysteroscopic diagnosis of endometrial polyp were retriev ed. The medical records, preoperative vaginal sonography results and histopathol ogy findings were reviewed. Statistical analysis was performed. Results: Hystero scopy truly identi-fied endometrial polyps in 95.7%of the cases. In 11.4%case s, hyperplasia without atypia was found in the endometrial polyp. In 3.3 and 3.0 %of women pre-malignant or malignant conditions were found in the polyp. Older age, menopause status and polyps larger than 1.5 cm were associated with signif icant pre-malignant or malignant changes, although the positive predictive valu e for malignancy was low. All the malignant polyps were diagnosed only in postme nopausal women. The presence of postmenopausal or irregular vaginal bleeding, wa s not a predictor of malignancy in the polyp. Conclusions: Postmenopausal women with endometrial polyps are at increased risk of malignancy in the polyp. Those patients, whether symptomatic or not should be evaluated by hysteroscopic resect ion of the polyps. Asymptomatic premenopausal patients with polyps smaller than 1.5 cm can be observed.展开更多
文摘Objective The purpose of this study was to evaluate the accuracy of t he Intern ational Classification of Diseases-9th revision codes for preeclampsia and ecla mpsia. Study design The University of Illinois Medical Center at Chicago dischar ge database was used to identify 135 women from 1999 through 2001 whose disease was coded as having preeclampsia or eclampsia. With American College of Obstetri cs and Gynecology criteria as the gold standard, the diagnosis that was determin ed through chart review was compared with the International Classification of Di seases-9th revision code that was present in the discharge database. Patients w ere classified as true cases if the International Classification of Diseases-9t h revision code matched the American College of Obstetricians and Gynecologists diagnosis; the positive predictive value of the code was then calculated. Result s The overall positive predictive value for the complete sample was only 54%, b ut the positive predictive value for severe preeclampsia was 84.8%, which was h igh compared with mild preeclampsia (45.3%) and eclampsia (41.7%). Diagnostic (clinician) error was the most common reason for miscoding error. Conclusion The findings suggest that International Classification of Diseases-9th revision co des for preeclampsia/eclampsia vary greatly in their accuracy of diagnosis. Ther efore, a review of medical records is required when data are being gathered on t he incidence of preeclampsia and eclampsia.
文摘Objectives: To determine the pre-malignant and malignant potential o f endomet rial polyps and to assess whether different clinical parameters are associated w ith malignancy in the polyps. Study design: Four hundred and thirty consecutive cases of hysteroscopic diagnosis of endometrial polyp were retriev ed. The medical records, preoperative vaginal sonography results and histopathol ogy findings were reviewed. Statistical analysis was performed. Results: Hystero scopy truly identi-fied endometrial polyps in 95.7%of the cases. In 11.4%case s, hyperplasia without atypia was found in the endometrial polyp. In 3.3 and 3.0 %of women pre-malignant or malignant conditions were found in the polyp. Older age, menopause status and polyps larger than 1.5 cm were associated with signif icant pre-malignant or malignant changes, although the positive predictive valu e for malignancy was low. All the malignant polyps were diagnosed only in postme nopausal women. The presence of postmenopausal or irregular vaginal bleeding, wa s not a predictor of malignancy in the polyp. Conclusions: Postmenopausal women with endometrial polyps are at increased risk of malignancy in the polyp. Those patients, whether symptomatic or not should be evaluated by hysteroscopic resect ion of the polyps. Asymptomatic premenopausal patients with polyps smaller than 1.5 cm can be observed.
