OBJECTIVES:The International Classification of Diseases 10th Revision (ICD-10) system used in the English hospital administrative database (Hospital Episode Statistics (HES)) does not contain a specific code for oesophageal high-grade dysplasia (HGD). The aim of this paper was to examine how patients with HGD were coded in HES and whether it was done consistently. SETTING:National population-based cohort study of patients with newly diagnosed with HGD in England. The study used data collected prospectively as part of the National Oesophago-Gastric Cancer Audit (NOGCA). These records were linked to HES to investigate the pattern of ICD-10 codes recorded for these patients at the time of diagnosis. PARTICIPANTS:All patients with a new diagnosis of HGD between 1 April 2013 and 31 March 2014 in England, who had data submitted to the NOGCA. OUTCOMES MEASURED:The main outcome assessed was the pattern of primary and secondary ICD-10 diagnostic codes recorded in the HES records at endoscopy at the time of diagnosis of HGD. RESULTS:Among 452 patients with a new diagnosis of HGD between 1 April 2013 and 31 March 2014, Barrett's oesophagus was the only condition coded in 200 (44.2%) HES records. Records for 59 patients (13.1%) contained no oesophageal conditions. The remaining 193 patients had various diagnostic codes recorded, 93 included a diagnosis of Barrett's oesophagus and 57 included a diagnosis of oesophageal/gastric cardia cancer. CONCLUSIONS:HES is not suitable to support national studies looking at the management of HGD. This is one reason for the UK to adopt an extended ICD system (akin to ICD-10-CM).

译文

目的:在英国医院行政数据库(医院发作统计数据(HES))中使用的国际疾病分类第十次修订版(ICD-10)系统未包含针对食管高度不典型增生(HGD)的特定代码。本文的目的是研究如何在HES中对HGD患者进行编码,以及编码是否一致。
地点:英国新诊断为HGD的患者的全国人群队列研究。该研究使用了前瞻性收集的数据作为国家食管胃癌审核(NOGCA)的一部分。这些记录与HES相关联,以调查在诊断时为这些患者记录的ICD-10代码的模式。
参与者:2013年4月1日至2014年3月31日期间在英国诊断为HGD的所有新患者,并已向NOGCA提交了数据。
评估的结果:评估的主要结果是在诊断HGD时内窥镜检查中记录在HES记录中的主要和次要ICD-10诊断代码的模式。
结果:2013年4月1日至2014年3月31日期间,有452例新诊断为HGD的患者中,Barrett食管是200例(44.2%)HES记录中唯一编码的疾病。 59例患者(13.1%)的记录没有食道疾病。其余193例患者记录了各种诊断代码,其中93例诊断为Barrett食道,57例诊断为食道/胃card门癌。
结论:HES不适合支持有关HGD管理的国家研究。这是英国采用扩展的ICD系统(类似于ICD-10-CM)的原因之一。

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