Accuracy of Administrative Code Data for the Surveillance of Healthcare-Associated Infections: A Systematic Review and Meta-Analysis
Accuracy of Administrative Code Data for the Surveillance of Healthcare-Associated Infections: A Systematic Review and Meta-Analysis
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DOI：
10.1093/cid/cit737
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发表时间：
2014-03-01
影响因子：
11.8
通讯作者：
Perencevich, Eli N.
中科院分区：
文献类型：
--
作者：
Goto, Michihiko;Ohl, Michael E.;Perencevich, Eli N.
行政代码数据（ACD），如国际疾病分类，第九次修订，临床修改代码，广泛用于监测和公共报告计划，以确定医疗保健相关感染（HAIs）；然而，人们对它们的准确性知之甚少。本系统综述总结了ACD检测特定HAIs准确性的证据，包括导尿管相关尿路感染、艰难梭菌感染（CDI）、中央线相关血流感染、呼吸机相关肺炎/事件、术后肺炎、耐甲氧西林金黄色葡萄球菌和手术部位感染（ssi）。我们对ssi和cdi进行了荟萃分析，其中有可接受数量的初步研究。对于这两种情况，ACD具有中等敏感性和高特异性，但检测其他HAIs的证据有限。在目前HAIs患病率较低的情况下，ACD算法的阳性预测值较低。ACD对于许多HAIs的检测可能是不准确的，应该谨慎地用于监测和报告目的。
Administrative code data (ACD), such as International Classifications of Diseases, Ninth Revision, Clinical Modification codes, are widely used in surveillance and public reporting programs that seek to identify healthcare-associated infections (HAIs); however, little is known about their accuracy. This systematic review summarizes evidence for the accuracy of ACD for the detection of selected HAIs, including catheter-associated urinary tract infection, Clostridium difficile infection (CDI), central line-associated bloodstream infection, ventilator-associated pneumonia/events, postprocedure pneumonia, methicillin-resistant Staphylococcus aureus, and surgical site infections (SSIs). We conducted meta-analysis for SSIs and CDIs, where acceptable numbers of primary studies were available. For these 2 conditions, ACD have moderate sensitivity and high specificity, but evidence for detection of other HAIs is limited. With current low prevalence of HAIs, the positive predictive value of ACD algorithms would be low. ACD may be inaccurate for detection of many HAIs and should be used cautiously for surveillance and reporting purposes.