Highlights ► So far the promising TMPM-ICD9 has outperformed ISS. ► We compared TMPM-ICD9 vs. ISS, measuring also the completeness of the underlying coding. ► TMPM predicted worse than ISS, but ICD coding was also less complete than AIS one. ► Although not a limit of TMPM itself, this may help define its practical utility.

    Abstract Background TMPM-ICD9 is the latest injury-severity measure based on empirical estimation from ICD-9-CM codes. It is candidate to replace expert-based AIS measures worldwide because of easier accessibility and better predictive performances. In Italy and other countries administrative ICD coding is generally less complete than dedicated AIS coding. We attempted to ascertain how this affects TMPM performances. Methods Discrimination (c statistics) and calibration (calibration curves, Akaike's criterion) of hierarchical logistic regression models for hospital mortality comprising TMPM or ISS were compared using trauma-registry data on 3570 patients of years 2007–2009. The completeness of AIS vs. ICD-9-CM coding was also investigated through the ratio of the respective numbers of codes per patient. Model discrimination was further analyzed after stratification according to the above ratio (>1 and ≤1). Results The models with TMPM showed worse performances. The differences, concerned calibration (graphical evidence) in univariate models and discrimination (−1.2% of area under the ROC curve, p <0.05) in models completed with age, gender, mechanism of injury, motor GCS and systolic pressure. In parallel, ICD coding was less complete than AIS, as expected: 68% of patients had a ratio >1. The discrimination of TMPM vs. ISS models improved when the ratio changed from >1 to ≤1. Conclusions The predictive performances of TMPM-ICD9 vs. ISS were lower than in the previous studies; the sub-optimal quality of ICD coding was a main cause. Imperfect administrative coding may hence hamper the TMPM-ICD9 revolution, although in our setting the negligible differences and the ready availability of administrative data may still give reason for adopting TMPM-ICD9.


    Zugriff

    Zugriff prüfen

    Verfügbarkeit in meiner Bibliothek prüfen

    Bestellung bei Subito €


    Exportieren, teilen und zitieren



    Titel :

    Is the TMPM-ICD9 revolution in trauma risk-adjustment compatible with imperfect administrative coding?


    Beteiligte:

    Erschienen in:

    Erscheinungsdatum :

    2011-05-12


    Format / Umfang :

    5 pages




    Medientyp :

    Aufsatz (Zeitschrift)


    Format :

    Elektronische Ressource


    Sprache :

    Englisch





    HDTV/CDTV Compatible Coding with Recursive Estimation

    Chiang, T. / Anastassiou, D. / IEEE; Signal Processing Society | British Library Conference Proceedings | 1994



    Impact of Administrative Division Adjustment on Location and Accessibility of Heifei, China

    Zhu, C.H. / Xie, H.M. / Zhou, W.X. et al. | British Library Conference Proceedings | 2013


    H.264-Compatible Spatially Scalable Video Coding with In-band Prediction

    Jin, X. / Sun, X. / Wu, F. et al. | British Library Conference Proceedings | 2005