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Record W4416672440 · doi:10.1186/s12913-025-13716-3

How does the mapped ICD data in an EHR system compare to the hospital DAD data in Alberta, Canada?

2025· article· en· W4416672440 on OpenAlex
Namneet Sandhu, Debbie Onos, Bing Li, Danielle A. Southern, Jeffrey A. Bakal, Abdel Aziz Shaheen, Glenda Tower, Kathleen Addison, Hude Quan

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
fundA Canadian funder is recorded on the work.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenueBMC Health Services Research · 2025
Typearticle
Languageen
FieldHealth Professions
TopicMedical Coding and Health Information
Canadian institutionsProvincial Laboratory of Public HealthCanadian Patient Safety InstituteAlberta Health ServicesAlberta HealthUniversity of Calgary
FundersCanadian Institutes of Health Research
KeywordsHealth informaticsHealth administrationCoding (social sciences)TerminologyNursing researchICD-10Public healthSNOMED CT

Abstract

fetched live from OpenAlex

BACKGROUND AND OBJECTIVE: Coding by human coders is burdensome to healthcare systems requiring advanced computerized techniques. Epic has collaborated with Intelligent Medical Objects (IMO) solution to integrate a solution where the clinical interface terminology is mapped to the International Classification of Diseases (ICD). This study assesses the agreement between the solution mapped ICD-10-CA codes in Alberta, Canada's EHR system (based on Epic) to the human coded ICD-10-CA codes in hospital Discharge Abstract Database (DAD). DESIGN AND SETTING: In this retrospective analysis conducted in Alberta, Canada, we linked records in the acute care hospital DAD with the province wide EHR system for admissions between April 2021 and March 2024. MAIN OUTCOME(S) AND MEASURE(S): The primary outcome was the level of agreement between the solution mapped ICD-10-CA codes from the 'hospital problem list' in the EHR and hospital DAD data. The analysis was conducted at 3-digit and 4-digit ICD code level for main diagnosis and any diagnosis, and further stratified by physician specialty, hospital type and location, and length-of-stay. RESULTS: A total of 603,437 unique hospital records were linked between hospital DAD and EHR. The average level of agreement at 3-digit level of ICD-10-CA code for main diagnosis was 47.5% and any diagnosis was 37.0%. The average number of diagnoses coded by human coders in hospital DAD was higher than the solution mapped data in EHR. The agreement varied by specialty and length-of-stay with specialties with more complex patients and longer stays showing the lowest levels of agreement. CONCLUSION: Level of agreement between solution mapped EHR and hospital DAD for ICD-10-CA data was low, indicating significant differences between terminology mappings and the coding process.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.019
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesScience and technology studies, Research integrity
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.525
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0190.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.002
Science and technology studies0.0020.000
Scholarly communication0.0000.001
Open science0.0050.003
Research integrity0.0000.002
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.306
GPT teacher head0.541
Teacher spread0.235 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it