Administrative health data validity: Changes over 19 years
Bibliographic record
Abstract
ObjectiveTo evaluate validity of hospital-discharged abstract administrative health data (DAD) over years through chart reviews. MethodsWe analyzed three chart review cohorts (4,008 patients in 2003, 3,045 in 2015, and 9,024 in 2022) in Calgary, Canada. Nurse reviewers determined the presence or absence of 17 clinical conditions employing similar protocols. The reviews were linked with DAD using a unique lifetime identifier, chart number, and admission date. We evaluated the validity of DAD, coded in ICD-10-Canada version, in recording conditions by comparing against chart reviews. The C-statistics was calculated in predicting in-hospital mortality. ResultsThe mean difference in prevalence between chart reviews and DAD for these 17 conditions was 2.1% in 2003, 7.6% in 2015, and 6.3% in 2022. However, some conditions were relatively stable, such as diabetes (1.9%, 2.1%, and 1.1%) and metastatic cancer (0.3%, 1.1%, and 0.4%). For 17 conditions, the sensitivity ranged 39.6-85.1% in 2003, 1.3-85.2% in 2015, and 3.0-89.7% in 2022. The C-statistics for in-hospital mortality based on DAD was 0.84 in 2003, 0.81 in 2015, and 0.78 in 2022. ConclusionDAD increasingly under-coded conditions over 19 years. The validity of DAD decreased but remained relatively stable for certain conditions mandated for coding. The under-coding exerted minimal impact on in-hospital mortality prediction. ImplicationsThe under-coding could be primarily due to the increase of hospital patient volumes and the limited time allocated to coders. Consequently, there is a need to develop artificial intelligence methods based on electronic medical records to support coding practices and improve coding quality.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.027 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.005 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".