Evidence map›Paper›PMID 24200398›Full record

ArticleThe Annals of thoracic surgery2014

Accuracy of the all patient refined diagnosis related groups classification system in congenital heart surgery.

Aimee S Parnell, Justine Shults, J William Gaynor, Mary B Leonard, Dingwei Dai, Chris Feudtner

Abstract read
In one paragraph

Article in The Annals of thoracic surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Aimee S ParnellDepartment of Pediatrics, Children's Healthcare of Mississippi, University of Mississippi School of Medicine, Jackson, Mississippi. Electronic address: aparnell@umc.edu.
Justine ShultsDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
J William GaynorDepartment of Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Mary B LeonardDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Dingwei DaiDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Chris FeudtnerDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Funding

Pediatric Hospital Epidemiology and Outcomes Research Training ProgramT32HD060550 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI Christopher Peter Bonafide, John Chris Feudtner · 2010 to 2026
$6.8M
Patient Oriented Research in Vitamin D Deficiency in CKDK24DK076808 · NIDDK · STANFORD UNIVERSITY · PI LEONARD, MARY BETH · 2007 to 2016
$1.7M
NICHD NIH HHS 5T32HD060550-02NICHD NIH HHS T32 HD060550NIDDK NIH HHS K24 DK076808
6 · The paper itself

Abstract

backgroundAdministrative data are increasingly used to evaluate clinical outcomes and quality of care in pediatric congenital heart surgery (CHS) programs. Several published analyses of large pediatric administrative data sets have relied on the All Patient Refined Diagnosis Related Groups (APR-DRG, version 24) diagnostic classification system. The accuracy of this classification system for patients undergoing CHS is unclear.

methodsWe performed a retrospective cohort study of all 14,098 patients 0 to 5 years of age undergoing any of six selected congenital heart operations, ranging in complexity from isolated closure of a ventricular septal defect to single-ventricle palliation, at 40 tertiary-care pediatric centers in the Pediatric Health Information Systems database between 2007 and 2010. Assigned APR-DRGs (cardiac versus noncardiac) were compared using χ2 or Fisher's exact tests between those patients admitted during the first day of life versus later and between those receiving extracorporeal membrane oxygenation support versus those not. Recursive partitioning was used to assess the greatest determinants of APR-DRG type in the model.

resultsEvery patient admitted on day 1 of life was assigned to a noncardiac APR-DRG (p<0.001 for each procedure). Similarly, use of extracorporeal membrane oxygenation was highly associated with misclassification of CHS patients into a noncardiac APR-DRG (p<0.001 for each procedure). Cases misclassified into a noncardiac APR-DRG experienced a significantly increased mortality (p<0.001).

conclusionsIn classifying patients undergoing CHS, APR-DRG coding has systematic misclassifications, which may result in inaccurate reporting of CHS case volumes and mortality.

Indexed as

Cardiac Surgical ProceduresDiagnosis-Related GroupsChild, PreschoolCohort StudiesFemaleHeart Defects, CongenitalHumansInfantInfant, NewbornMaleReproducibility of ResultsRetrospective Studies20214All Patient Refined Diagnosis Related GroupsAPR-DRGCHScongenital heart surgeryday of life 1 admissionDOL1D-TGAd-transposition of the great arteries, with or without VSDECMOextracorporeal membrane support oxygenationHLHShypoplastic left heart syndromeICD-9-CMPediatric Hospital Information SystemsPHIStetralogy of FallotTOFusing International Classification of Diseases, 9th Revision, Clinical Modificationventricular septal defectVSD

Identifiers

PMID24200398
PMCPMC4624088

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.