Implementation of Writing Across the Curriculum (WAC) learning approaches in social work and sociology gerontology courses.

PubMed

Kolb, Patricia

2013-01-01

This article describes the goals and methods of the international Writing Across the Curriculum (WAC) movement in higher education, and WAC-enriched learning approaches that the author used in teaching a social work gerontology practice course and a sociological theories of aging course. The author's in-class, low-stakes, nongraded writing assignments facilitated students' development of knowledge about gerontological practice and sociological theories, as well as analytical thinking. The assignments are influenced by WAC's perspective that when students write their reactions to information, their understanding and retention of information improves; that writing can facilitate the application of new content to students' own lives and interests; and that increased frequency of writing increases writing comfort and maintenance and can result in the improvement of writing skills. The students' reactions to the assignments have been very positive.

The Future of WAC-Plenary Address, International Writing across the Curriculum Conference, (Ninth, Austin, Texas, May 2008 )

ERIC Educational Resources Information Center

McLeod, Susan H.

2008-01-01

In this Plenary Address given at the 9th IWAC Conference in 2008, Susan McLeod (who started her first WAC program in 1982) speculates about the future of the WAC movement. She focuses on four issues: The changing nature of communication and the cultural lag in assignment design, the question of who is in charge of the program, the ascendancy of…

Empowering Student Writing Tutors as WAC Liaisons in Secondary Schools

ERIC Educational Resources Information Center

Jensen, Amber

2012-01-01

A pilot program in a public high school positions experienced student writing center tutors to become WAC liaisons who foster writing across the curriculum by raising questions, identifying needs, and providing support to their teachers with the goal of strengthening writing instruction school-wide. This article discusses the background and…

Nevada Administrative Code for Special Education Programs.

ERIC Educational Resources Information Center

Nevada State Dept. of Education, Carson City. Special Education Branch.

This document presents excerpts from Chapter 388 of the Nevada Administrative Code, which concerns definitions, eligibility, and programs for students who are disabled or gifted/talented. The first section gathers together 36 relevant definitions from the Code for such concepts as "adaptive behavior,""autism,""gifted and…

Electroconvulsive therapy: administrative codes, legislation, and professional recommendations.

PubMed

Harris, Victoria

2006-01-01

Government regulatory involvement in electroconvulsive therapy (ECT) is due to several factors, including patient advocate groups, prior abuse by psychiatrists, and a general trend of state authority to move into areas traditionally governed by medical authorities. Regardless of the specific reasons, ECT is both highly effective in the treatment of many psychiatric disorders and heavily regulated by state administrative codes and legislation. The purpose of this article is to conduct a systematic review of the state administrative codes and legislation for the 50 states, the District of Columbia, and Puerto Rico and to compare the findings with professional recommendations for the administration of ECT.

Pairing WAC and Quantitative Reasoning through Portfolio Assessment and Faculty Development

ERIC Educational Resources Information Center

Rutz, Carol; Grawe, Nathan D.

2009-01-01

Writing across the curriculum has been a pedagogy associated with faculty development since the earliest days of the movement. Carleton College, an early adopter of WAC pedagogy and faculty development, has, in the last decade, added portfolio assessment to the combination with positive results. Among the unexpected consequences has been a…

Report on Analyses of WAC Samples of Evaporator Overheads - 2004

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oji, L

2005-03-18

In November and December of 2004, the Tank Farm submitted annual samples from 2F, 2H and 3H Evaporator Overhead streams for characterization to verify compliance with the new Effluent Treatment Facility (ETF) Waste Acceptance Criteria (WAC) and to look for organic species. With the exception of slightly high ammonia in the 2F evaporator overheads and high radiation control guide number for the 3H and 2F evaporator overhead samples, all the overheads samples were found to be in compliance with the Effluent Treatment Facility WAC. The ammonium concentration in the 2F-evaporator overhead, at 33 mg/L, was above the ETF waste watermore » collection tank (WWCT) limits of 28 mg/L. The RCG Number for the 3H and 2F evaporator samples at, respectively, 1.38E-02 and 8.24E-03 were higher than the WWCT limit of 7.69E-03. The analytical detection limits for americium-241 and radium-226 in the evaporator samples were not consistently met because of low WWCT detection limits and insufficient evaporator samples.« less

Validation of Carotid Artery Revascularization Coding in Ontario Health Administrative Databases.

PubMed

Hussain, Mohamad A; Mamdani, Muhammad; Saposnik, Gustavo; Tu, Jack V; Turkel-Parrella, David; Spears, Julian; Al-Omran, Mohammed

2016-04-02

The positive predictive value (PPV) of carotid endarterectomy (CEA) and carotid artery stenting (CAS) procedure and post-operative complication coding were assessed in Ontario health administrative databases. Between 1 April 2002 and 31 March 2014, a random sample of 428 patients were identified using Canadian Classification of Health Intervention (CCI) procedure codes and Ontario Health Insurance Plan (OHIP) billing codes from administrative data. A blinded chart review was conducted at two high-volume vascular centers to assess the level of agreement between the administrative records and the corresponding patients' hospital charts. PPV was calculated with 95% confidence intervals (CIs) to estimate the validity of CEA and CAS coding, utilizing hospital charts as the gold standard. Sensitivity of CEA and CAS coding were also assessed by linking two independent databases of 540 CEA-treated patients (Ontario Stroke Registry) and 140 CAS-treated patients (single-center CAS database) to administrative records. PPV for CEA ranged from 99% to 100% and sensitivity ranged from 81.5% to 89.6% using CCI and OHIP codes. A CCI code with a PPV of 87% (95% CI, 78.8-92.9) and sensitivity of 92.9% (95% CI, 87.4-96.1) in identifying CAS was also identified. PPV for post-admission complication diagnosis coding was 71.4% (95% CI, 53.7-85.4) for stroke/transient ischemic attack, and 82.4% (95% CI, 56.6-96.2) for myocardial infarction. Our analysis demonstrated that the codes used in administrative databases accurately identify CEA and CAS-treated patients. Researchers can confidently use administrative data to conduct population-based studies of CEA and CAS.

Validating abortion procedure coding in Canadian administrative databases.

PubMed

Samiedaluie, Saied; Peterson, Sandra; Brant, Rollin; Kaczorowski, Janusz; Norman, Wendy V

2016-07-12

The British Columbia (BC) Ministry of Health collects abortion procedure data in the Medical Services Plan (MSP) physician billings database and in the hospital information Discharge Abstracts Database (DAD). Our study seeks to validate abortion procedure coding in these databases. Two randomized controlled trials enrolled a cohort of 1031 women undergoing abortion. The researcher collected database includes both enrollment and follow up chart review data. The study cohort was linked to MSP and DAD data to identify all abortions events captured in the administrative databases. We compared clinical chart data on abortion procedures with health administrative data. We considered a match to occur if an abortion related code was found in administrative data within 30 days of the date of the same event documented in a clinical chart. Among 1158 abortion events performed during enrollment and follow-up period, 99.1 % were found in at least one of the administrative data sources. The sensitivities for the two databases, evaluated using a gold standard, were 97.7 % (95 % confidence interval (CI): 96.6-98.5) for the MSP database and 91.9 % (95 % CI: 90.0-93.4) for the DAD. Abortion events coded in the BC health administrative databases are highly accurate. Single-payer health administrative databases at the provincial level in Canada have the potential to offer valid data reflecting abortion events. ClinicalTrials.gov Identifier NCT01174225 , Current Controlled Trials ISRCTN19506752 .

47 CFR 52.15 - Central office code administration.

Code of Federal Regulations, 2012 CFR

2012-10-01

... functions. The NANPA shall perform its CO Code administration functions in accordance with the published... by telecommunications carriers to perform internal administrative or operational functions necessary... another telecommunications carrier or non-carrier entity for the purpose of providing telecommunications...

Scanning for safety: an integrated approach to improved bar-code medication administration.

PubMed

Early, Cynde; Riha, Chris; Martin, Jennifer; Lowdon, Karen W; Harvey, Ellen M

2011-03-01

This is a review of lessons learned in the postimplementation evaluation of a bar-code medication administration technology implemented at a major tertiary-care hospital in 2001. In 2006, with a bar-code medication administration scan compliance rate of 82%, a near-miss sentinel event prompted review of this technology as part of an institutional recommitment to a "culture of safety." Multifaceted problems with bar-code medication administration created an environment of circumventing safeguards as demonstrated by an increase in manual overrides to ensure timely medication administration. A multiprofessional team composed of nursing, pharmacy, human resources, quality, and technical services formalized. Each step in the bar-code medication administration process was reviewed. Technology, process, and educational solutions were identified and implemented systematically. Overall compliance with bar-code medication administration rose from 82% to 97%, which resulted in a calculated cost avoidance of more than $2.8 million during this time frame of the project.

Effect of bar-code technology on the safety of medication administration.

PubMed

Poon, Eric G; Keohane, Carol A; Yoon, Catherine S; Ditmore, Matthew; Bane, Anne; Levtzion-Korach, Osnat; Moniz, Thomas; Rothschild, Jeffrey M; Kachalia, Allen B; Hayes, Judy; Churchill, William W; Lipsitz, Stuart; Whittemore, Anthony D; Bates, David W; Gandhi, Tejal K

2010-05-06

Serious medication errors are common in hospitals and often occur during order transcription or administration of medication. To help prevent such errors, technology has been developed to verify medications by incorporating bar-code verification technology within an electronic medication-administration system (bar-code eMAR). We conducted a before-and-after, quasi-experimental study in an academic medical center that was implementing the bar-code eMAR. We assessed rates of errors in order transcription and medication administration on units before and after implementation of the bar-code eMAR. Errors that involved early or late administration of medications were classified as timing errors and all others as nontiming errors. Two clinicians reviewed the errors to determine their potential to harm patients and classified those that could be harmful as potential adverse drug events. We observed 14,041 medication administrations and reviewed 3082 order transcriptions. Observers noted 776 nontiming errors in medication administration on units that did not use the bar-code eMAR (an 11.5% error rate) versus 495 such errors on units that did use it (a 6.8% error rate)--a 41.4% relative reduction in errors (P<0.001). The rate of potential adverse drug events (other than those associated with timing errors) fell from 3.1% without the use of the bar-code eMAR to 1.6% with its use, representing a 50.8% relative reduction (P<0.001). The rate of timing errors in medication administration fell by 27.3% (P<0.001), but the rate of potential adverse drug events associated with timing errors did not change significantly. Transcription errors occurred at a rate of 6.1% on units that did not use the bar-code eMAR but were completely eliminated on units that did use it. Use of the bar-code eMAR substantially reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events, although it did not eliminate such errors. Our data show

Idaho National Engineering Laboratory code assessment of the Rocky Flats transuranic waste

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1995-07-01

This report is an assessment of the content codes associated with transuranic waste shipped from the Rocky Flats Plant in Golden, Colorado, to INEL. The primary objective of this document is to characterize and describe the transuranic wastes shipped to INEL from Rocky Flats by item description code (IDC). This information will aid INEL in determining if the waste meets the waste acceptance criteria (WAC) of the Waste Isolation Pilot Plant (WIPP). The waste covered by this content code assessment was shipped from Rocky Flats between 1985 and 1989. These years coincide with the dates for information available in themore » Rocky Flats Solid Waste Information Management System (SWIMS). The majority of waste shipped during this time was certified to the existing WIPP WAC. This waste is referred to as precertified waste. Reassessment of these precertified waste containers is necessary because of changes in the WIPP WAC. To accomplish this assessment, the analytical and process knowledge available on the various IDCs used at Rocky Flats were evaluated. Rocky Flats sources for this information include employee interviews, SWIMS, Transuranic Waste Certification Program, Transuranic Waste Inspection Procedure, Backlog Waste Baseline Books, WIPP Experimental Waste Characterization Program (headspace analysis), and other related documents, procedures, and programs. Summaries are provided of: (a) certification information, (b) waste description, (c) generation source, (d) recovery method, (e) waste packaging and handling information, (f) container preparation information, (g) assay information, (h) inspection information, (i) analytical data, and (j) RCRA characterization.« less

Nurses' attitudes toward the use of the bar-coding medication administration system.

PubMed

Marini, Sana Daya; Hasman, Arie; Huijer, Huda Abu-Saad; Dimassi, Hani

2010-01-01

This study determines nurses' attitudes toward bar-coding medication administration system use. Some of the factors underlying the successful use of bar-coding medication administration systems that are viewed as a connotative indicator of users' attitudes were used to gather data that describe the attitudinal basis for system adoption and use decisions in terms of subjective satisfaction. Only 67 nurses in the United States had the chance to respond to the e-questionnaire posted on the CARING list server for the months of June and July 2007. Participants rated their satisfaction with bar-coding medication administration system use based on system functionality, usability, and its positive/negative impact on the nursing practice. Results showed, to some extent, positive attitude, but the image profile draws attention to nurses' concerns for improving certain system characteristics. The high bar-coding medication administration system skills revealed a more negative perception of the system by the nursing staff. The reasons underlying dissatisfaction with bar-coding medication administration use by skillful users are an important source of knowledge that can be helpful for system development as well as system deployment. As a result, strengthening bar-coding medication administration system usability by magnifying its ability to eliminate medication errors and the contributing factors, maximizing system functionality by ascertaining its power as an extra eye in the medication administration process, and impacting the clinical nursing practice positively by being helpful to nurses, speeding up the medication administration process, and being user-friendly can offer a congenial settings for establishing positive attitude toward system use, which in turn leads to successful bar-coding medication administration system use.

Portfolio Partnerships between Faculty and WAC: Lessons from Disciplinary Practice, Reflection, and Transformation

ERIC Educational Resources Information Center

Peters, Brad; Robertson, Julie Fisher

2007-01-01

In portfolio assessment, WAC helps other disciplines increase programmatic integrity and accountability. This analysis of a portfolio partnership also shows composition faculty how a dynamic culture of assessment helps us protect what we do well, improve what we need to do better, and solve problems as writing instruction keeps pace with…

The accuracy of burn diagnosis codes in health administrative data: A validation study.

PubMed

Mason, Stephanie A; Nathens, Avery B; Byrne, James P; Fowler, Rob; Gonzalez, Alejandro; Karanicolas, Paul J; Moineddin, Rahim; Jeschke, Marc G

2017-03-01

Health administrative databases may provide rich sources of data for the study of outcomes following burn. We aimed to determine the accuracy of International Classification of Diseases diagnoses codes for burn in a population-based administrative database. Data from a regional burn center's clinical registry of patients admitted between 2006-2013 were linked to administrative databases. Burn total body surface area (TBSA), depth, mechanism, and inhalation injury were compared between the registry and administrative records. The sensitivity, specificity, and positive and negative predictive values were determined, and coding agreement was assessed with the kappa statistic. 1215 burn center patients were linked to administrative records. TBSA codes were highly sensitive and specific for ≥10 and ≥20% TBSA (89/93% sensitive and 95/97% specific), with excellent agreement (κ, 0.85/κ, 0.88). Codes were weakly sensitive (68%) in identifying ≥10% TBSA full-thickness burn, though highly specific (86%) with moderate agreement (κ, 0.46). Codes for inhalation injury had limited sensitivity (43%) but high specificity (99%) with moderate agreement (κ, 0.54). Burn mechanism had excellent coding agreement (κ, 0.84). Administrative data diagnosis codes accurately identify burn by burn size and mechanism, while identification of inhalation injury or full-thickness burns is less sensitive but highly specific. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Energy Efficiency Program Administrators and Building Energy Codes

EPA Pesticide Factsheets

Explore how energy efficiency program administrators have helped advance building energy codes at federal, state, and local levels—using technical, institutional, financial, and other resources—and discusses potential next steps.

Reconciliation of international administrative coding systems for comparison of colorectal surgery outcome.

PubMed

Munasinghe, A; Chang, D; Mamidanna, R; Middleton, S; Joy, M; Penninckx, F; Darzi, A; Livingston, E; Faiz, O

2014-07-01

Significant variation in colorectal surgery outcomes exists between different countries. Better understanding of the sources of variable outcomes using administrative data requires alignment of differing clinical coding systems. We aimed to map similar diagnoses and procedures across administrative coding systems used in different countries. Administrative data were collected in a central database as part of the Global Comparators (GC) Project. In order to unify these data, a systematic translation of diagnostic and procedural codes was undertaken. Codes for colorectal diagnoses, resections, operative complications and reoperative interventions were mapped across the respective national healthcare administrative coding systems. Discharge data from January 2006 to June 2011 for patients who had undergone colorectal surgical resections were analysed to generate risk-adjusted models for mortality, length of stay, readmissions and reoperations. In all, 52 544 case records were collated from 31 institutions in five countries. Mapping of all the coding systems was achieved so that diagnosis and procedures from the participant countries could be compared. Using the aligned coding systems to develop risk-adjusted models, the 30-day mortality rate for colorectal surgery was 3.95% (95% CI 0.86-7.54), the 30-day readmission rate was 11.05% (5.67-17.61), the 28-day reoperation rate was 6.13% (3.68-9.66) and the mean length of stay was 14 (7.65-46.76) days. The linkage of international hospital administrative data that we developed enabled comparison of documented surgical outcomes between countries. This methodology may facilitate international benchmarking. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

GLD100 - Lunar topography from LROC WAC stereo

NASA Astrophysics Data System (ADS)

Scholten, F.; Oberst, J.; Robinson, M. S.

2011-10-01

The LROC WAC instrument of the LRO mission comprises substantial stereo image data from adjacent orbits. Multiple coverage of the entire surface of the Moon at a mean ground scale of 75 m/pxl has already been achieved within the first two years of the mission. We applied photogrammetric stereo processing methods for the derivation of a 100 m raster DTM (digital terrain model), called GLD100, from several tens of thousands stereo models. The GLD100 covers the lunar surface between 80° northern and southern latitude. Polar regions are excluded because of poor illumination and stereo conditions. Vertical differences of the GLD100 to altimetry data from the LRO LOLA instrument are small, the mean deviation is typically about 20 m, without systematic lateral or vertical offsets.

The Application of Writing across the Curriculum (WAC) Techniques in a Systems Analysis & Design Flipped Classroom

ERIC Educational Resources Information Center

Saulnier, Bruce

2016-01-01

To more effectively meet the expectations of industry for entry-level IT employees, a case is made for the inclusion of writing throughout the Computer Information Systems (CIS) curriculum. "Writing Across the Curriculum" ("WAC") principles are explained, and it is opined that both Writing to Learn (WTL) and Writing in the…

Validity of administrative coding in identifying patients with upper urinary tract calculi.

PubMed

Semins, Michelle J; Trock, Bruce J; Matlaga, Brian R

2010-07-01

Administrative databases are increasingly used for epidemiological investigations. We performed a study to assess the validity of ICD-9 codes for upper urinary tract stone disease in an administrative database. We retrieved the records of all inpatients and outpatients at Johns Hopkins Hospital between November 2007 and October 2008 with an ICD-9 code of 592, 592.0, 592.1 or 592.9 as one of the first 3 diagnosis codes. A random number generator selected 100 encounters for further review. We considered a patient to have a true diagnosis of an upper tract stone if the medical records specifically referenced a kidney stone event, or included current or past treatment for a kidney stone. Descriptive and comparative analyses were performed. A total of 8,245 encounters coded as upper tract calculus were identified and 100 were randomly selected for review. Two patients could not be identified within the electronic medical record and were excluded from the study. The positive predictive value of using all ICD-9 codes for an upper tract calculus (592, 592.0, 592.1) to identify subjects with renal or ureteral stones was 95.9%. For 592.0 only the positive predictive value was 85%. However, although the positive predictive value for 592.1 only was 100%, 26 subjects (76%) with a ureteral stone were not appropriately billed with this code. ICD-9 coding for urinary calculi is likely to be sufficiently valid to be useful in studies using administrative data to analyze stone disease. However, ICD-9 coding is not a reliable means to distinguish between subjects with renal and ureteral calculi. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

18 CFR 410.1 - Basin regulations-Water Code and Administrative Manual-Part III Water Quality Regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Basin regulations-Water Code and Administrative Manual-Part III Water Quality Regulations. 410.1 Section 410.1 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL BASIN REGULATIONS; WATER CODE AND ADMINISTRATIVE MANUAL-PART III...

18 CFR 410.1 - Basin regulations-Water Code and Administrative Manual-Part III Water Quality Regulations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Basin regulations-Water Code and Administrative Manual-Part III Water Quality Regulations. 410.1 Section 410.1 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL BASIN REGULATIONS; WATER CODE AND ADMINISTRATIVE MANUAL-PART III...

18 CFR 410.1 - Basin regulations-Water Code and Administrative Manual-Part III Water Quality Regulations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Basin regulations-Water Code and Administrative Manual-Part III Water Quality Regulations. 410.1 Section 410.1 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL BASIN REGULATIONS; WATER CODE AND ADMINISTRATIVE MANUAL-PART III...

18 CFR 410.1 - Basin regulations-Water Code and Administrative Manual-Part III Water Quality Regulations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Basin regulations-Water Code and Administrative Manual-Part III Water Quality Regulations. 410.1 Section 410.1 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL BASIN REGULATIONS; WATER CODE AND ADMINISTRATIVE MANUAL-PART III...

77 FR 18716 - Transportation Security Administration Postal Zip Code Change; Technical Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... organizational changes and it has no substantive effect on the public. DATES: Effective March 28, 2012. FOR... No. 1572-9] Transportation Security Administration Postal Zip Code Change; Technical Amendment AGENCY: Transportation Security Administration, DHS. ACTION: Final rule. SUMMARY: This rule is a technical change to...

Baffling system for the Wide Angle Camera (WAC) of ROSETTA mission

NASA Astrophysics Data System (ADS)

Brunello, Pierfrancesco; Peron, Fabio; Barbieri, Cesare; Fornasier, Sonia

2000-10-01

After the experience of GIOTTO fly-by to comet Halley in 1986, the European Space Agency planned to improve the scientific knowledge of these astronomical objects by means of an even more ambitious rendezvous mission with another comet (P/Wirtanen). This mission, named ROSETTA, will go on from 2003 to 2013, ending after the comet perihelion phase and including also the fly-by with two asteroids of the main belt (140 Siwa and 4979 Otawara). Scientific priority of the mission is the in situ investigation of the cometary nucleus, with the aim of better understanding the formation and the composition of planetesimals and their evolution over the last 4.5 billions of years. In this context, the Authors were involved in the design of the baffling for the Wide Angle Camera (WAC) of the imaging system (OSIRIS) carried on board of the spacecraft. Scientific requirements for the WAC are : a large field of view (FOV) of 12 degree(s) x 12 degree(s) with a resolution of 100 (mu) rad per pixel, UV response, and a contrast ratio of 10-4 in order to detect gaseous and dusty features close to the nucleus of the comet. TO achieve these performances, a fairly novel class of optical solutions employing off-axis sections of concentric mirrors was explored. Regarding baffling, the peculiar demand was the rejection of stray-light generated by the optics for sources within the FOV, since the optical entrance aperture is located at the level of the secondary mirror (instead of the primary as usual). This paper describes the baffle design and analyzes its performances, calculated by numerical simulation with ray tracing methods, at different angles of incidence of the light, for sources both outside and inside the field of view.

Results for the First, Second, and Third Quarter Calendar Year 2015 Tank 50H WAC slurry samples chemical and radionuclide contaminants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crawford, C.

2016-02-18

This report details the chemical and radionuclide contaminant results for the characterization of the Calendar Year (CY) 2015 First, Second, and Third Quarter sampling of Tank 50H for the Saltstone Waste Acceptance Criteria (WAC) in effect at that time. Information from this characterization will be used by Defense Waste Processing Facility (DWPF) & Saltstone Facility Engineering (D&S-FE) to support the transfer of low-level aqueous waste from Tank 50H to the Salt Feed Tank in the Saltstone Facility in Z-Area, where the waste will be immobilized. This information is also used to update the Tank 50H Waste Characterization System. Previous memorandamore » documenting the WAC analyses results have been issued for these three samples.« less

Integrating Bar-Code Medication Administration Competencies in the Curriculum: Implications for Nursing Education and Interprofessional Collaboration.

PubMed

Angel, Vini M; Friedman, Marvin H; Friedman, Andrea L

This article describes an innovative project involving the integration of bar-code medication administration technology competencies in the nursing curriculum through interprofessional collaboration among nursing, pharmacy, and computer science disciplines. A description of the bar-code medication administration technology project and lessons learned are presented.

The Impact of Bar Code Medication Administration Technology on Reported Medication Errors

ERIC Educational Resources Information Center

Holecek, Andrea

2011-01-01

The use of bar-code medication administration technology is on the rise in acute care facilities in the United States. The technology is purported to decrease medication errors that occur at the point of administration. How significantly this technology affects actual rate and severity of error is unknown. This descriptive, longitudinal research…

Using Modified-ISS Model to Evaluate Medication Administration Safety During Bar Code Medication Administration Implementation in Taiwan Regional Teaching Hospital.

PubMed

Ma, Pei-Luen; Jheng, Yan-Wun; Jheng, Bi-Wei; Hou, I-Ching

2017-01-01

Bar code medication administration (BCMA) could reduce medical errors and promote patient safety. This research uses modified information systems success model (M-ISS model) to evaluate nurses' acceptance to BCMA. The result showed moderate correlation between medication administration safety (MAS) to system quality, information quality, service quality, user satisfaction, and limited satisfaction.

"A Way to Talk about the Institution as Opposed to Just My Field": WAC Fellowships and Graduate Student Professional Development

ERIC Educational Resources Information Center

Cripps, Michael J.; Hall, Jonathan; Robinson, Heather M.

2016-01-01

The teaching assistantship is a venerable model for funding graduate studies, staffing undergraduate courses, and providing pedagogical support for emerging college and university instructors. In this article, we present a variation of this model of graduate student support: the WAC Fellowship at the City University of New York. Using survey data…

Improved accuracy of co-morbidity coding over time after the introduction of ICD-10 administrative data

PubMed Central

2011-01-01

Background Co-morbidity information derived from administrative data needs to be validated to allow its regular use. We assessed evolution in the accuracy of coding for Charlson and Elixhauser co-morbidities at three time points over a 5-year period, following the introduction of the International Classification of Diseases, 10th Revision (ICD-10), coding of hospital discharges. Methods Cross-sectional time trend evaluation study of coding accuracy using hospital chart data of 3'499 randomly selected patients who were discharged in 1999, 2001 and 2003, from two teaching and one non-teaching hospital in Switzerland. We measured sensitivity, positive predictive and Kappa values for agreement between administrative data coded with ICD-10 and chart data as the 'reference standard' for recording 36 co-morbidities. Results For the 17 the Charlson co-morbidities, the sensitivity - median (min-max) - was 36.5% (17.4-64.1) in 1999, 42.5% (22.2-64.6) in 2001 and 42.8% (8.4-75.6) in 2003. For the 29 Elixhauser co-morbidities, the sensitivity was 34.2% (1.9-64.1) in 1999, 38.6% (10.5-66.5) in 2001 and 41.6% (5.1-76.5) in 2003. Between 1999 and 2003, sensitivity estimates increased for 30 co-morbidities and decreased for 6 co-morbidities. The increase in sensitivities was statistically significant for six conditions and the decrease significant for one. Kappa values were increased for 29 co-morbidities and decreased for seven. Conclusions Accuracy of administrative data in recording clinical conditions improved slightly between 1999 and 2003. These findings are of relevance to all jurisdictions introducing new coding systems, because they demonstrate a phenomenon of improved administrative data accuracy that may relate to a coding 'learning curve' with the new coding system. PMID:21849089

Improved accuracy of co-morbidity coding over time after the introduction of ICD-10 administrative data.

PubMed

Januel, Jean-Marie; Luthi, Jean-Christophe; Quan, Hude; Borst, François; Taffé, Patrick; Ghali, William A; Burnand, Bernard

2011-08-18

Co-morbidity information derived from administrative data needs to be validated to allow its regular use. We assessed evolution in the accuracy of coding for Charlson and Elixhauser co-morbidities at three time points over a 5-year period, following the introduction of the International Classification of Diseases, 10th Revision (ICD-10), coding of hospital discharges. Cross-sectional time trend evaluation study of coding accuracy using hospital chart data of 3'499 randomly selected patients who were discharged in 1999, 2001 and 2003, from two teaching and one non-teaching hospital in Switzerland. We measured sensitivity, positive predictive and Kappa values for agreement between administrative data coded with ICD-10 and chart data as the 'reference standard' for recording 36 co-morbidities. For the 17 the Charlson co-morbidities, the sensitivity - median (min-max) - was 36.5% (17.4-64.1) in 1999, 42.5% (22.2-64.6) in 2001 and 42.8% (8.4-75.6) in 2003. For the 29 Elixhauser co-morbidities, the sensitivity was 34.2% (1.9-64.1) in 1999, 38.6% (10.5-66.5) in 2001 and 41.6% (5.1-76.5) in 2003. Between 1999 and 2003, sensitivity estimates increased for 30 co-morbidities and decreased for 6 co-morbidities. The increase in sensitivities was statistically significant for six conditions and the decrease significant for one. Kappa values were increased for 29 co-morbidities and decreased for seven. Accuracy of administrative data in recording clinical conditions improved slightly between 1999 and 2003. These findings are of relevance to all jurisdictions introducing new coding systems, because they demonstrate a phenomenon of improved administrative data accuracy that may relate to a coding 'learning curve' with the new coding system.

Analysis of the technology acceptance model in examining hospital nurses' behavioral intentions toward the use of bar code medication administration.

PubMed

Song, Lunar; Park, Byeonghwa; Oh, Kyeung Mi

2015-04-01

Serious medication errors continue to exist in hospitals, even though there is technology that could potentially eliminate them such as bar code medication administration. Little is known about the degree to which the culture of patient safety is associated with behavioral intention to use bar code medication administration. Based on the Technology Acceptance Model, this study evaluated the relationships among patient safety culture and perceived usefulness and perceived ease of use, and behavioral intention to use bar code medication administration technology among nurses in hospitals. Cross-sectional surveys with a convenience sample of 163 nurses using bar code medication administration were conducted. Feedback and communication about errors had a positive impact in predicting perceived usefulness (β=.26, P<.01) and perceived ease of use (β=.22, P<.05). In a multiple regression model predicting for behavioral intention, age had a negative impact (β=-.17, P<.05); however, teamwork within hospital units (β=.20, P<.05) and perceived usefulness (β=.35, P<.01) both had a positive impact on behavioral intention. The overall bar code medication administration behavioral intention model explained 24% (P<.001) of the variance. Identified factors influencing bar code medication administration behavioral intention can help inform hospitals to develop tailored interventions for RNs to reduce medication administration errors and increase patient safety by using this technology.

[Professor Wacław Kuśnierczyk (1908-1997)--Pro Memoria in the century of birthday].

PubMed

Brozek, Krzysztof; Kozakiewicz, Jacek; Kierzek, Andrzej

2009-01-01

Wacław Kuśnierczyk was born in 1908 in Sniatyń. He received the degree in medicine at Jan Kazimierz University in Lwów in 1932. He did his PhD degree under Professor Zaleski supervision in 1938 at Jan Kazimierz University. At that time he concentrated his scientific activity on research on tuberculosis. In 1953 he obtained the title of second degree specialist in ear, nose and throat diseases. He became a chief of Otolaryngology at Urban Hospital No 4 in Katowice in 1960. Since then this eminent physician was working on tumours located in upper respiratory tract and the possibility of its endoscopic diagnosis at Silesian Academy of Medicine in Katowice. As one of the first he pointed out the negative influence of smoking cigarettes on cancer of larynx. It was Wacław Kuśnierczyk who implemented new priorities for integrated programs in patient care, research, education and cancer prevention. He has published widely in peer reviewed journals and has edited or contributed to many books. He has given many major lectures and is the recipient of numerous prestigious awards for his scientific accomplishments. The achievement of Professor Kuśnierczyk were the valuable source of information for the physicians. In 1997, on the 31st of January he died in Katowice.

Coding of obesity in administrative hospital discharge abstract data: accuracy and impact for future research studies.

PubMed

Martin, Billie-Jean; Chen, Guanmin; Graham, Michelle; Quan, Hude

2014-02-13

Obesity is a pervasive problem and a popular subject of academic assessment. The ability to take advantage of existing data, such as administrative databases, to study obesity is appealing. The objective of our study was to assess the validity of obesity coding in an administrative database and compare the association between obesity and outcomes in an administrative database versus registry. This study was conducted using a coronary catheterization registry and an administrative database (Discharge Abstract Database (DAD)). A Body Mass Index (BMI) ≥30 kg/m2 within the registry defined obesity. In the DAD obesity was defined by diagnosis codes E65-E68 (ICD-10). The sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of an obesity diagnosis in the DAD was determined using obesity diagnosis in the registry as the referent. The association between obesity and outcomes was assessed. The study population of 17380 subjects was largely male (68.8%) with a mean BMI of 27.0 kg/m2. Obesity prevalence was lower in the DAD than registry (2.4% vs. 20.3%). A diagnosis of obesity in the DAD had a sensitivity 7.75%, specificity 98.98%, NPV 80.84% and PPV 65.94%. Obesity was associated with decreased risk of death or re-hospitalization, though non-significantly within the DAD. Obesity was significantly associated with an increased risk of cardiac procedure in both databases. Overall, obesity was poorly coded in the DAD. However, when coded, it was coded accurately. Administrative databases are not an optimal datasource for obesity prevalence and incidence surveillance but could be used to define obese cohorts for follow-up.

Results For The Fourth Quarter 2014 Tank 50 WAC Slurry Sample: Chemical And Radionuclide Contaminants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crawford, C.

2015-09-30

This report details the chemical and radionuclide contaminant results for the characterization of the Calendar Year (CY) 2014 Fourth Quarter sampling of Tank 50 for the Saltstone Waste Acceptance Criteria (WAC) in effect at that time. Information from this characterization will be used by DWPF & Saltstone Facility Engineering (DSFE) to support the transfer of low-level aqueous waste from Tank 50 to the Salt Feed Tank in the Saltstone Facility in Z-Area, where the waste will be immobilized. This information is also used to update the Tank 50 Waste Characterization System.

Accuracy of Administrative Codes for Distinguishing Positive Pressure Ventilation from High-Flow Nasal Cannula.

PubMed

Good, Ryan J; Leroue, Matthew K; Czaja, Angela S

2018-06-07

Noninvasive positive pressure ventilation (NIPPV) is increasingly used in critically ill pediatric patients, despite limited data on safety and efficacy. Administrative data may be a good resource for observational studies. Therefore, we sought to assess the performance of the International Classification of Diseases, Ninth Revision procedure code for NIPPV. Patients admitted to the PICU requiring NIPPV or heated high-flow nasal cannula (HHFNC) over the 11-month study period were identified from the Virtual PICU System database. The gold standard was manual review of the electronic health record to verify the use of NIPPV or HHFNC among the cohort. The presence or absence of a NIPPV procedure code was determined by using administrative data. Test characteristics with 95% confidence intervals (CIs) were generated, comparing administrative data with the gold standard. Among the cohort ( n = 562), the majority were younger than 5 years, and the most common primary diagnosis was bronchiolitis. Most (82%) required NIPPV, whereas 18% required only HHFNC. The NIPPV code had a sensitivity of 91.1% (95% CI: 88.2%-93.6%) and a specificity of 57.6% (95% CI: 47.2%-67.5%), with a positive likelihood ratio of 2.15 (95% CI: 1.70-2.71) and negative likelihood ratio of 0.15 (95% CI: 0.11-0.22). Among our critically ill pediatric cohort, NIPPV procedure codes had high sensitivity but only moderate specificity. On the basis of our study results, there is a risk of misclassification, specifically failure to identify children who require NIPPV, when using administrative data to study the use of NIPPV in this population. Copyright © 2018 by the American Academy of Pediatrics.

How rebates, copayments, and administration costs affect the cost-effectiveness of osteoporosis therapies.

PubMed

Ferko, Nicole C; Borisova, Natalie; Airia, Parisa; Grima, Daniel T; Thompson, Melissa F

2012-11-01

Because of rising drug expenditures, cost considerations have become essential, necessitating the requirement for cost-effectiveness analyses for managed care organizations (MCOs). The study objective is to examine the impact of various drug-cost components, in addition to wholesale acquisition cost (WAC), on the cost-effectiveness of osteoporosis therapies. A Markov model of osteoporosis was used to exemplify different drug cost scenarios. We examined the effect of varying rebates for oral bisphosphonates--risedronate and ibandronate--as well as considering the impact of varying copayments and administration costs for intravenous zoledronate. The population modeled was 1,000 American women, > or = 50 years with osteoporosis. Patients were followed for 1 year to reflect an annual budget review of formularies by MCOs. The cost of therapy was based on an adjusted WAC, and is referred to as net drug cost. The total annual cost incurred by an MCO for each drug regimen was calculated using the net drug cost and fracture cost. We estimated cost on a quality adjusted life year (QALY) basis. When considering different rebates, results for risedronate versus ibandronate vary from cost-savings (i.e., costs less and more effective) to approximately $70,000 per QALY. With no risedronate rebate, an ibandronate rebate of approximately 65% is required before cost per QALY surpasses $50,000. With rebates greater than 25% for risedronate, irrespective of ibandronate rebates, results become cost-saving. Results also showed the magnitude of cost savings to the MCO varied by as much as 65% when considering no administration cost and the highest coinsurance rate for zoledronate. Our study showed that cost-effectiveness varies considerably when factors in addition to the WAC are considered. This paper provides recommendations for pharmaceutical manufacturers and MCOs when developing and interpreting such analyses.

Patient safety with blood products administration using wireless and bar-code technology.

PubMed

Porcella, Aleta; Walker, Kristy

2005-01-01

Supported by a grant from the Agency for Healthcare Research and Quality, a University of Iowa Hospitals and Clinics interdisciplinary research team created an online data-capture-response tool utilizing wireless mobile devices and bar code technology to track and improve blood products administration process. The tool captures 1) sample collection, 2) sample arrival in the blood bank, 3) blood product dispense from blood bank, and 4) administration. At each step, the scanned patient wristband ID bar code is automatically compared to scanned identification barcode on requisition, sample, and/or product, and the system presents either a confirmation or an error message to the user. Following an eight-month, 5 unit, staged pilot, a 'big bang,' hospital-wide implementation occurred on February 7, 2005. Preliminary results from pilot data indicate that the new barcode process captures errors 3 to 10 times better than the old manual process.

Disease-Specific Trends of Comorbidity Coding and Implications for Risk Adjustment in Hospital Administrative Data.

PubMed

Nimptsch, Ulrike

2016-06-01

To investigate changes in comorbidity coding after the introduction of diagnosis related groups (DRGs) based prospective payment and whether trends differ regarding specific comorbidities. Nationwide administrative data (DRG statistics) from German acute care hospitals from 2005 to 2012. Observational study to analyze trends in comorbidity coding in patients hospitalized for common primary diseases and the effects on comorbidity-related risk of in-hospital death. Comorbidity coding was operationalized by Elixhauser diagnosis groups. The analyses focused on adult patients hospitalized for the primary diseases of heart failure, stroke, and pneumonia, as well as hip fracture. When focusing the total frequency of diagnosis groups per record, an increase in depth of coding was observed. Between-hospital variations in depth of coding were present throughout the observation period. Specific comorbidity increases were observed in 15 of the 31 diagnosis groups, and decreases in comorbidity were observed for 11 groups. In patients hospitalized for heart failure, shifts of comorbidity-related risk of in-hospital death occurred in nine diagnosis groups, in which eight groups were directed toward the null. Comorbidity-adjusted outcomes in longitudinal administrative data analyses may be biased by nonconstant risk over time, changes in completeness of coding, and between-hospital variations in coding. Accounting for such issues is important when the respective observation period coincides with changes in the reimbursement system or other conditions that are likely to alter clinical coding practice. © Health Research and Educational Trust.

Validity of Diagnostic Codes for Acute Stroke in Administrative Databases: A Systematic Review

PubMed Central

McCormick, Natalie; Bhole, Vidula; Lacaille, Diane; Avina-Zubieta, J. Antonio

2015-01-01

Objective To conduct a systematic review of studies reporting on the validity of International Classification of Diseases (ICD) codes for identifying stroke in administrative data. Methods MEDLINE and EMBASE were searched (inception to February 2015) for studies: (a) Using administrative data to identify stroke; or (b) Evaluating the validity of stroke codes in administrative data; and (c) Reporting validation statistics (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), or Kappa scores) for stroke, or data sufficient for their calculation. Additional articles were located by hand search (up to February 2015) of original papers. Studies solely evaluating codes for transient ischaemic attack were excluded. Data were extracted by two independent reviewers; article quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Results Seventy-seven studies published from 1976–2015 were included. The sensitivity of ICD-9 430-438/ICD-10 I60-I69 for any cerebrovascular disease was ≥ 82% in most [≥ 50%] studies, and specificity and NPV were both ≥ 95%. The PPV of these codes for any cerebrovascular disease was ≥ 81% in most studies, while the PPV specifically for acute stroke was ≤ 68%. In at least 50% of studies, PPVs were ≥ 93% for subarachnoid haemorrhage (ICD-9 430/ICD-10 I60), 89% for intracerebral haemorrhage (ICD-9 431/ICD-10 I61), and 82% for ischaemic stroke (ICD-9 434/ICD-10 I63 or ICD-9 434&436). For in-hospital deaths, sensitivity was 55%. For cerebrovascular disease or acute stroke as a cause-of-death on death certificates, sensitivity was ≤ 71% in most studies while PPV was ≥ 87%. Conclusions While most cases of prevalent cerebrovascular disease can be detected using 430-438/I60-I69 collectively, acute stroke must be defined using more specific codes. Most in-hospital deaths and death certificates with stroke as a cause-of-death correspond to true stroke deaths. Linking vital

Validity of administrative database code algorithms to identify vascular access placement, surgical revisions, and secondary patency.

PubMed

Al-Jaishi, Ahmed A; Moist, Louise M; Oliver, Matthew J; Nash, Danielle M; Fleet, Jamie L; Garg, Amit X; Lok, Charmaine E

2018-03-01

We assessed the validity of physician billing codes and hospital admission using International Classification of Diseases 10th revision codes to identify vascular access placement, secondary patency, and surgical revisions in administrative data. We included adults (≥18 years) with a vascular access placed between 1 April 2004 and 31 March 2013 at the University Health Network, Toronto. Our reference standard was a prospective vascular access database (VASPRO) that contains information on vascular access type and dates of placement, dates for failure, and any revisions. We used VASPRO to assess the validity of different administrative coding algorithms by calculating the sensitivity, specificity, and positive predictive values of vascular access events. The sensitivity (95% confidence interval) of the best performing algorithm to identify arteriovenous access placement was 86% (83%, 89%) and specificity was 92% (89%, 93%). The corresponding numbers to identify catheter insertion were 84% (82%, 86%) and 84% (80%, 87%), respectively. The sensitivity of the best performing coding algorithm to identify arteriovenous access surgical revisions was 81% (67%, 90%) and specificity was 89% (87%, 90%). The algorithm capturing arteriovenous access placement and catheter insertion had a positive predictive value greater than 90% and arteriovenous access surgical revisions had a positive predictive value of 20%. The duration of arteriovenous access secondary patency was on average 578 (553, 603) days in VASPRO and 555 (530, 580) days in administrative databases. Administrative data algorithms have fair to good operating characteristics to identify vascular access placement and arteriovenous access secondary patency. Low positive predictive values for surgical revisions algorithm suggest that administrative data should only be used to rule out the occurrence of an event.

ICD-10 codes used to identify adverse drug events in administrative data: a systematic review.

PubMed

Hohl, Corinne M; Karpov, Andrei; Reddekopp, Lisa; Doyle-Waters, Mimi; Stausberg, Jürgen

2014-01-01

Adverse drug events, the unintended and harmful effects of medications, are important outcome measures in health services research. Yet no universally accepted set of International Classification of Diseases (ICD) revision 10 codes or coding algorithms exists to ensure their consistent identification in administrative data. Our objective was to synthesize a comprehensive set of ICD-10 codes used to identify adverse drug events. We developed a systematic search strategy and applied it to five electronic reference databases. We searched relevant medical journals, conference proceedings, electronic grey literature and bibliographies of relevant studies, and contacted content experts for unpublished studies. One author reviewed the titles and abstracts for inclusion and exclusion criteria. Two authors reviewed eligible full-text articles and abstracted data in duplicate. Data were synthesized in a qualitative manner. Of 4241 titles identified, 41 were included. We found a total of 827 ICD-10 codes that have been used in the medical literature to identify adverse drug events. The median number of codes used to search for adverse drug events was 190 (IQR 156-289) with a large degree of variability between studies in the numbers and types of codes used. Authors commonly used external injury (Y40.0-59.9) and disease manifestation codes. Only two papers reported on the sensitivity of their code set. Substantial variability exists in the methods used to identify adverse drug events in administrative data. Our work may serve as a point of reference for future research and consensus building in this area.

ICD-10 codes used to identify adverse drug events in administrative data: a systematic review

PubMed Central

Hohl, Corinne M; Karpov, Andrei; Reddekopp, Lisa; Stausberg, Jürgen

2014-01-01

Background Adverse drug events, the unintended and harmful effects of medications, are important outcome measures in health services research. Yet no universally accepted set of International Classification of Diseases (ICD) revision 10 codes or coding algorithms exists to ensure their consistent identification in administrative data. Our objective was to synthesize a comprehensive set of ICD-10 codes used to identify adverse drug events. Methods We developed a systematic search strategy and applied it to five electronic reference databases. We searched relevant medical journals, conference proceedings, electronic grey literature and bibliographies of relevant studies, and contacted content experts for unpublished studies. One author reviewed the titles and abstracts for inclusion and exclusion criteria. Two authors reviewed eligible full-text articles and abstracted data in duplicate. Data were synthesized in a qualitative manner. Results Of 4241 titles identified, 41 were included. We found a total of 827 ICD-10 codes that have been used in the medical literature to identify adverse drug events. The median number of codes used to search for adverse drug events was 190 (IQR 156–289) with a large degree of variability between studies in the numbers and types of codes used. Authors commonly used external injury (Y40.0–59.9) and disease manifestation codes. Only two papers reported on the sensitivity of their code set. Conclusions Substantial variability exists in the methods used to identify adverse drug events in administrative data. Our work may serve as a point of reference for future research and consensus building in this area. PMID:24222671

Incidence and trends of central line associated pneumothorax using radiograph report text search versus administrative database codes.

PubMed

Reeson, Marc; Forster, Alan; van Walraven, Carl

2018-05-25

Central line associated pneumothorax (CLAP) could be a good quality of care indicator because they are objectively measured, clearly undesirable and possibly avoidable. We measured the incidence and trends of CLAP using radiograph report text search with manual review and compared them with measures using routinely collected health administrative data. For each hospitalisation to a tertiary care teaching hospital between 2002 and 2015, we searched all chest radiography reports for a central line with a sensitive computer algorithm. Screen positive reports were manually reviewed to confirm central lines. The index and subsequent chest radiography reports were screened for pneumothorax followed by manual confirmation. Diagnostic and procedural codes were used to identify CLAP in administrative data. In 685 044 hospitalisations, 10 819 underwent central line insertion (1.6%) with CLAP occurring 181 times (1.7%). CLAP risk did not change over time. Codes for CLAP were inaccurate (sensitivity 13.8%, positive predictive value 6.6%). However, overall code-based CLAP risk (1.8%) was almost identical to actual values possibly because patient strata with inflated CLAP risk were balanced by more common strata having underestimated CLAP risk. Code-based methods inflated central line incidence 2.2 times and erroneously concluded that CLAP risk decreased significantly over time. Using valid methods, CLAP incidence was similar to those in the literature but has not changed over time. Although administrative database codes for CLAP were very inaccurate, they generated CLAP risks very similar to actual values because of offsetting errors. In contrast to those from radiograph report text search with manual review, CLAP trends decreased significantly using administrative data. Hospital CLAP risk should not be measured using administrative data. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial

Coding algorithms for identifying patients with cirrhosis and hepatitis B or C virus using administrative data.

PubMed

Niu, Bolin; Forde, Kimberly A; Goldberg, David S

2015-01-01

Despite the use of administrative data to perform epidemiological and cost-effectiveness research on patients with hepatitis B or C virus (HBV, HCV), there are no data outside of the Veterans Health Administration validating whether International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes can accurately identify cirrhotic patients with HBV or HCV. The validation of such algorithms is necessary for future epidemiological studies. We evaluated the positive predictive value (PPV) of ICD-9-CM codes for identifying chronic HBV or HCV among cirrhotic patients within the University of Pennsylvania Health System, a large network that includes a tertiary care referral center, a community-based hospital, and multiple outpatient practices across southeastern Pennsylvania and southern New Jersey. We reviewed a random sample of 200 cirrhotic patients with ICD-9-CM codes for HCV and 150 cirrhotic patients with ICD-9-CM codes for HBV. The PPV of 1 inpatient or 2 outpatient HCV codes was 88.0% (168/191, 95% CI: 82.5-92.2%), while the PPV of 1 inpatient or 2 outpatient HBV codes was 81.3% (113/139, 95% CI: 73.8-87.4%). Several variations of the primary coding algorithm were evaluated to determine if different combinations of inpatient and/or outpatient ICD-9-CM codes could increase the PPV of the coding algorithm. ICD-9-CM codes can identify chronic HBV or HCV in cirrhotic patients with a high PPV and can be used in future epidemiologic studies to examine disease burden and the proper allocation of resources. Copyright © 2014 John Wiley & Sons, Ltd.

Lunar textural analysis based on WAC-derived kilometer-scale roughness and entropy maps

NASA Astrophysics Data System (ADS)

Li, Bo; Wang, XueQiang; Zhang, Jiang; Chen, Jian; Ling, Zongcheng

2016-06-01

In general, textures are thought to be some complicated repeated patterns formed by elements, or primitives which are sorted in certain rules. Lunar surfaces record the interactions between its outside environment and itself, thus, based on high-resolution DEM model or image data, there are some topographic features which have different roughness and entropy values or signatures on lunar surfaces. Textures of lunar surfaces can help us to concentrate on typical topographic and photometric variations and reveal the relationships between obvious features (craters, impact basins, sinuous rilles (SRs) and ridges) with resurfacing processes on the Moon. In this paper, the term surface roughness is an expression of the variability of a topographic or photometric surface at kilometer scale, and the term entropy can characterize the variability inherent in a geological and topographic unit and evaluate the uncertainty of predictions made by a given geological process. We use the statistical moments of gray-level histograms in different-sized neighborhoods (e.g., 3, 5, 10, 20, 40 and 80 pixels) to compute the kilometer-scale roughness and entropy values, using the mosaic image from 70°N to 70°S obtained by Lunar Reconnaissance Orbiter (LRO) Wide Angle Camera (WAC). Large roughness and entropy signatures were only found in the larger scale maps, while the smallest 3-pixel scale map had more disorderly and unsystematic textures. According to the entropy values in 10-pixel scale entropy map, we made a frequency curve and categorized lunar surfaces into three types, shadow effects, maria and highlands. A 2D scatter plot of entropy versus roughness values was produced and we found that there were two point clusters corresponding to the highlands and maria, respectively. In the last, we compared the topographic and photometric signatures derived from Lunar Orbiter Laser Altimeter (LOLA) data and WAC mosaic image. On the lunar surfaces, the ridges have obvious multilevel

18 CFR 410.1 - Basin regulations-Water Code and Administrative Manual-Part III Water Quality Regulations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Basin regulations-Water Code and Administrative Manual-Part III Water Quality Regulations. 410.1 Section 410.1 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL BASIN REGULATIONS; WATER...

Administrative database code accuracy did not vary notably with changes in disease prevalence.

PubMed

van Walraven, Carl; English, Shane; Austin, Peter C

2016-11-01

Previous mathematical analyses of diagnostic tests based on the categorization of a continuous measure have found that test sensitivity and specificity varies significantly by disease prevalence. This study determined if the accuracy of diagnostic codes varied by disease prevalence. We used data from two previous studies in which the true status of renal disease and primary subarachnoid hemorrhage, respectively, had been determined. In multiple stratified random samples from the two previous studies having varying disease prevalence, we measured the accuracy of diagnostic codes for each disease using sensitivity, specificity, and positive and negative predictive value. Diagnostic code sensitivity and specificity did not change notably within clinically sensible disease prevalence. In contrast, positive and negative predictive values changed significantly with disease prevalence. Disease prevalence had no important influence on the sensitivity and specificity of diagnostic codes in administrative databases. Copyright © 2016 Elsevier Inc. All rights reserved.

Barriers to data quality resulting from the process of coding health information to administrative data: a qualitative study.

PubMed

Lucyk, Kelsey; Tang, Karen; Quan, Hude

2017-11-22

Administrative health data are increasingly used for research and surveillance to inform decision-making because of its large sample sizes, geographic coverage, comprehensivity, and possibility for longitudinal follow-up. Within Canadian provinces, individuals are assigned unique personal health numbers that allow for linkage of administrative health records in that jurisdiction. It is therefore necessary to ensure that these data are of high quality, and that chart information is accurately coded to meet this end. Our objective is to explore the potential barriers that exist for high quality data coding through qualitative inquiry into the roles and responsibilities of medical chart coders. We conducted semi-structured interviews with 28 medical chart coders from Alberta, Canada. We used thematic analysis and open-coded each transcript to understand the process of administrative health data generation and identify barriers to its quality. The process of generating administrative health data is highly complex and involves a diverse workforce. As such, there are multiple points in this process that introduce challenges for high quality data. For coders, the main barriers to data quality occurred around chart documentation, variability in the interpretation of chart information, and high quota expectations. This study illustrates the complex nature of barriers to high quality coding, in the context of administrative data generation. The findings from this study may be of use to data users, researchers, and decision-makers who wish to better understand the limitations of their data or pursue interventions to improve data quality.

Coding algorithms for identifying patients with cirrhosis and hepatitis B or C virus using administrative data

PubMed Central

Niu, Bolin; Forde, Kimberly A; Goldberg, David S.

2014-01-01

Background & Aims Despite the use of administrative data to perform epidemiological and cost-effectiveness research on patients with hepatitis B or C virus (HBV, HCV), there are no data outside of the Veterans Health Administration validating whether International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes can accurately identify cirrhotic patients with HBV or HCV. The validation of such algorithms is necessary for future epidemiological studies. Methods We evaluated the positive predictive value (PPV) of ICD-9-CM codes for identifying chronic HBV or HCV among cirrhotic patients within the University of Pennsylvania Health System, a large network that includes a tertiary care referral center, a community-based hospital, and multiple outpatient practices across southeastern Pennsylvania and southern New Jersey. We reviewed a random sample of 200 cirrhotic patients with ICD-9-CM codes for HCV and 150 cirrhotic patients with ICD-9-CM codes for HBV. Results The PPV of 1 inpatient or 2 outpatient HCV codes was 88.0% (168/191, 95% CI: 82.5–92.2%), while the PPV of 1 inpatient or 2 outpatient HBV codes was 81.3% (113/139, 95% CI: 73.8–87.4%). Several variations of the primary coding algorithm were evaluated to determine if different combinations of inpatient and/or outpatient ICD-9-CM codes could increase the PPV of the coding algorithm. Conclusions ICD-9-CM codes can identify chronic HBV or HCV in cirrhotic patients with a high PPV, and can be used in future epidemiologic studies to examine disease burden and the proper allocation of resources. PMID:25335773

Minimum Standards for Student Conduct and Discipline, Including Suggested Guidelines and Model Codes. Oregon Administrative Rules 21-050 -- 21-085.

ERIC Educational Resources Information Center

Parnell, Dale

The guidelines and codes in this booklet were written to assist teachers and administrators strengthen their positions in times of legal and social confusion and in the face of challenges to administrative and staff authority. Model codes are provided for student (1) assembly, (2) dress and grooming, (3) motor vehicles, (4) search and seizure, (5)…

How to Create High-Impact Writing Assignments That Enhance Learning and Development and Reinvigorate WAC/WID Programs: What Almost 72,000 Undergraduates Taught Us

ERIC Educational Resources Information Center

Anderson, Paul; Anson, Chris M.; Gonyea, Robert M.; Paine, Charles

2016-01-01

This article reports on a study that suggests ways that Writing Across the Curriculum/Writing in the Disciplines (WAC/WID) programs can increase the effectiveness of their efforts, including implementation of writingintensive courses, which are one of the Association of American Colleges and Universities' High-Impact Educational Practices. The…

Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study.

PubMed

Weems, Shelley; Heller, Pamela; Fenton, Susan H

2015-01-01

The Veterans Health Administration (VHA) of the US Department of Veterans Affairs has been preparing for the October 1, 2015, conversion to the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS) for more than four years. The VHA's Office of Informatics and Analytics ICD-10 Program Management Office established an ICD-10 Learning Lab to explore expected operational challenges. This study was conducted to determine the effects of the classification system conversion on coding productivity. ICD codes are integral to VHA business processes and are used for purposes such as clinical studies, performance measurement, workload capture, cost determination, Veterans Equitable Resource Allocation (VERA) determination, morbidity and mortality classification, indexing of hospital records by disease and operations, data storage and retrieval, research purposes, and reimbursement. The data collection for this study occurred in multiple VHA sites across several months using standardized methods. It is commonly accepted that coding productivity will decrease with the implementation of ICD-10-CM/PCS. The findings of this study suggest that the decrease will be more significant for inpatient coding productivity (64.5 percent productivity decrease) than for ambulatory care coding productivity (6.7 percent productivity decrease). This study reveals the following important points regarding ICD-10-CM/PCS coding productivity: 1. Ambulatory care ICD-10-CM coding productivity is not expected to decrease as significantly as inpatient ICD-10-CM/PCS coding productivity. 2. Coder training and type of record (inpatient versus outpatient) affect coding productivity. 3. Inpatient coding productivity is decreased when a procedure requiring ICD-10-PCS coding is present. It is highly recommended that organizations perform their own analyses to determine the effects of ICD-10-CM/PCS implementation on coding productivity.

Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study

PubMed Central

Weems, Shelley; Heller, Pamela; Fenton, Susan H.

2015-01-01

The Veterans Health Administration (VHA) of the US Department of Veterans Affairs has been preparing for the October 1, 2015, conversion to the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS) for more than four years. The VHA's Office of Informatics and Analytics ICD-10 Program Management Office established an ICD-10 Learning Lab to explore expected operational challenges. This study was conducted to determine the effects of the classification system conversion on coding productivity. ICD codes are integral to VHA business processes and are used for purposes such as clinical studies, performance measurement, workload capture, cost determination, Veterans Equitable Resource Allocation (VERA) determination, morbidity and mortality classification, indexing of hospital records by disease and operations, data storage and retrieval, research purposes, and reimbursement. The data collection for this study occurred in multiple VHA sites across several months using standardized methods. It is commonly accepted that coding productivity will decrease with the implementation of ICD-10-CM/PCS. The findings of this study suggest that the decrease will be more significant for inpatient coding productivity (64.5 percent productivity decrease) than for ambulatory care coding productivity (6.7 percent productivity decrease). This study reveals the following important points regarding ICD-10-CM/PCS coding productivity: Ambulatory care ICD-10-CM coding productivity is not expected to decrease as significantly as inpatient ICD-10-CM/PCS coding productivity.Coder training and type of record (inpatient versus outpatient) affect coding productivity.Inpatient coding productivity is decreased when a procedure requiring ICD-10-PCS coding is present. It is highly recommended that organizations perform their own analyses to determine the effects of ICD-10-CM/PCS implementation on coding productivity. PMID:26396553

Administrative database concerns: accuracy of International Classification of Diseases, Ninth Revision coding is poor for preoperative anemia in patients undergoing spinal fusion.

PubMed

Golinvaux, Nicholas S; Bohl, Daniel D; Basques, Bryce A; Grauer, Jonathan N

2014-11-15

Cross-sectional study. To objectively evaluate the ability of International Classification of Diseases, Ninth Revision (ICD-9) codes, which are used as the foundation for administratively coded national databases, to identify preoperative anemia in patients undergoing spinal fusion. National database research in spine surgery continues to rise. However, the validity of studies based on administratively coded data, such as the Nationwide Inpatient Sample, are dependent on the accuracy of ICD-9 coding. Such coding has previously been found to have poor sensitivity to conditions such as obesity and infection. A cross-sectional study was performed at an academic medical center. Hospital-reported anemia ICD-9 codes (those used for administratively coded databases) were directly compared with the chart-documented preoperative hematocrits (true laboratory values). A patient was deemed to have preoperative anemia if the preoperative hematocrit was less than the lower end of the normal range (36.0% for females and 41.0% for males). The study included 260 patients. Of these, 37 patients (14.2%) were anemic; however, only 10 patients (3.8%) received an "anemia" ICD-9 code. Of the 10 patients coded as anemic, 7 were anemic by definition, whereas 3 were not, and thus were miscoded. This equates to an ICD-9 code sensitivity of 0.19, with a specificity of 0.99, and positive and negative predictive values of 0.70 and 0.88, respectively. This study uses preoperative anemia to demonstrate the potential inaccuracies of ICD-9 coding. These results have implications for publications using databases that are compiled from ICD-9 coding data. Furthermore, the findings of the current investigation raise concerns regarding the accuracy of additional comorbidities. Although administrative databases are powerful resources that provide large sample sizes, it is crucial that we further consider the quality of the data source relative to its intended purpose.

Accuracy of diagnosis codes to identify febrile young infants using administrative data.

PubMed

Aronson, Paul L; Williams, Derek J; Thurm, Cary; Tieder, Joel S; Alpern, Elizabeth R; Nigrovic, Lise E; Schondelmeyer, Amanda C; Balamuth, Fran; Myers, Angela L; McCulloh, Russell J; Alessandrini, Evaline A; Shah, Samir S; Browning, Whitney L; Hayes, Katie L; Feldman, Elana A; Neuman, Mark I

2015-12-01

Administrative data can be used to determine optimal management of febrile infants and aid clinical practice guideline development. Determine the most accurate International Classification of Diseases, Ninth Revision (ICD-9) diagnosis coding strategies for identification of febrile infants. Retrospective cross-sectional study. Eight emergency departments in the Pediatric Health Information System. Infants aged <90 days evaluated between July 1, 2012 and June 30, 2013 were randomly selected for medical record review from 1 of 4 ICD-9 diagnosis code groups: (1) discharge diagnosis of fever, (2) admission diagnosis of fever without discharge diagnosis of fever, (3) discharge diagnosis of serious infection without diagnosis of fever, and (4) no diagnosis of fever or serious infection. The ICD-9 diagnosis code groups were compared in 4 case-identification algorithms to a reference standard of fever ≥100.4°F documented in the medical record. Algorithm predictive accuracy was measured using sensitivity, specificity, and negative and positive predictive values. Among 1790 medical records reviewed, 766 (42.8%) infants had fever. Discharge diagnosis of fever demonstrated high specificity (98.2%, 95% confidence interval [CI]: 97.8-98.6) but low sensitivity (53.2%, 95% CI: 50.0-56.4). A case-identification algorithm of admission or discharge diagnosis of fever exhibited higher sensitivity (71.1%, 95% CI: 68.2-74.0), similar specificity (97.7%, 95% CI: 97.3-98.1), and the highest positive predictive value (86.9%, 95% CI: 84.5-89.3). A case-identification strategy that includes admission or discharge diagnosis of fever should be considered for febrile infant studies using administrative data, though underclassification of patients is a potential limitation. © 2015 Society of Hospital Medicine.

Using Procedure Codes to Define Radiation Toxicity in Administrative Data: The Devil is in the Details.

PubMed

Meyer, Anne-Marie; Kuo, Tzy-Mey; Chang, YunKyung; Carpenter, William R; Chen, Ronald C; Sturmer, Til

2017-05-01

Systematic coding systems are used to define clinically meaningful outcomes when leveraging administrative claims data for research. How and when these codes are applied within a research study can have implications for the study validity and their specificity can vary significantly depending on treatment received. Data are from the Surveillance, Epidemiology, and End Results-Medicare linked dataset. We use propensity score methods in a retrospective cohort of prostate cancer patients first examined in a recently published radiation oncology comparative effectiveness study. With the narrowly defined outcome definition, the toxicity event outcome rate ratio was 0.88 per 100 person-years (95% confidence interval, 0.71-1.08). With the broadly defined outcome, the rate ratio was comparable, with 0.89 per 100 person-years (95% confidence interval, 0.76-1.04), although individual event rates were doubled. Some evidence of surveillance bias was suggested by a higher rate of endoscopic procedures the first year of follow-up in patients who received proton therapy compared with those receiving intensity-modulated radiation treatment (11.15 vs. 8.90, respectively). This study demonstrates the risk of introducing bias through subjective application of procedure codes. Careful consideration is required when using procedure codes to define outcomes in administrative data.

Identifying Falls Risk Screenings Not Documented with Administrative Codes Using Natural Language Processing

PubMed Central

Zhu, Vivienne J; Walker, Tina D; Warren, Robert W; Jenny, Peggy B; Meystre, Stephane; Lenert, Leslie A

2017-01-01

Quality reporting that relies on coded administrative data alone may not completely and accurately depict providers’ performance. To assess this concern with a test case, we developed and evaluated a natural language processing (NLP) approach to identify falls risk screenings documented in clinical notes of patients without coded falls risk screening data. Extracting information from 1,558 clinical notes (mainly progress notes) from 144 eligible patients, we generated a lexicon of 38 keywords relevant to falls risk screening, 26 terms for pre-negation, and 35 terms for post-negation. The NLP algorithm identified 62 (out of the 144) patients who falls risk screening documented only in clinical notes and not coded. Manual review confirmed 59 patients as true positives and 77 patients as true negatives. Our NLP approach scored 0.92 for precision, 0.95 for recall, and 0.93 for F-measure. These results support the concept of utilizing NLP to enhance healthcare quality reporting. PMID:29854264

Bar Code Medication Administration Technology: Characterization of High-Alert Medication Triggers and Clinician Workarounds.

PubMed

Miller, Daniel F; Fortier, Christopher R; Garrison, Kelli L

2011-02-01

Bar code medication administration (BCMA) technology is gaining acceptance for its ability to prevent medication administration errors. However, studies suggest that improper use of BCMA technology can yield unsatisfactory error prevention and introduction of new potential medication errors. To evaluate the incidence of high-alert medication BCMA triggers and alert types and discuss the type of nursing and pharmacy workarounds occurring with the use of BCMA technology and the electronic medication administration record (eMAR). Medication scanning and override reports from January 1, 2008, through November 30, 2008, for all adult medical/surgical units were retrospectively evaluated for high-alert medication system triggers, alert types, and override reason documentation. An observational study of nursing workarounds on an adult medicine step-down unit was performed and an analysis of potential pharmacy workarounds affecting BCMA and the eMAR was also conducted. Seventeen percent of scanned medications triggered an error alert of which 55% were for high-alert medications. Insulin aspart, NPH insulin, hydromorphone, potassium chloride, and morphine were the top 5 high-alert medications that generated alert messages. Clinician override reasons for alerts were documented in only 23% of administrations. Observational studies assessing for nursing workarounds revealed a median of 3 clinician workarounds per administration. Specific nursing workarounds included a failure to scan medications/patient armband and scanning the bar code once the dosage has been removed from the unit-dose packaging. Analysis of pharmacy order entry process workarounds revealed the potential for missed doses, duplicate doses, and doses being scheduled at the wrong time. BCMA has the potential to prevent high-alert medication errors by alerting clinicians through alert messages. Nursing and pharmacy workarounds can limit the recognition of optimal safety outcomes and therefore workflow processes

Accuracy of Diagnosis Codes to Identify Febrile Young Infants Using Administrative Data

PubMed Central

Aronson, Paul L.; Williams, Derek J.; Thurm, Cary; Tieder, Joel S.; Alpern, Elizabeth R.; Nigrovic, Lise E.; Schondelmeyer, Amanda C.; Balamuth, Fran; Myers, Angela L.; McCulloh, Russell J.; Alessandrini, Evaline A.; Shah, Samir S.; Browning, Whitney L.; Hayes, Katie L.; Feldman, Elana A.; Neuman, Mark I.

2015-01-01

Background Administrative data can be used to determine optimal management of febrile infants and aid clinical practice guideline development. Objective Determine the most accurate International Classification of Diseases, 9th revision (ICD-9) diagnosis coding strategies for identification of febrile infants. Design Retrospective cross-sectional study. Setting Eight emergency departments in the Pediatric Health Information System. Patients Infants age < 90 days evaluated between July 1, 2012 and June 30, 2013 were randomly selected for medical record review from one of four ICD-9 diagnosis code groups: 1) discharge diagnosis of fever, 2) admission diagnosis of fever without discharge diagnosis of fever, 3) discharge diagnosis of serious infection without diagnosis of fever, and 4) no diagnosis of fever or serious infection. Exposure The ICD-9 diagnosis code groups were compared in four case-identification algorithms to a reference standard of fever ≥ 100.4°F documented in the medical record. Measurements Algorithm predictive accuracy was measured using sensitivity, specificity, negative and positive predictive values. Results Among 1790 medical records reviewed, 766 (42.8%) infants had fever. Discharge diagnosis of fever demonstrated high specificity (98.2%, 95% confidence interval [CI]: 97.8-98.6) but low sensitivity (53.2%, 95% CI: 50.0-56.4). A case-identification algorithm of admission or discharge diagnosis of fever exhibited higher sensitivity (71.1%, 95% CI: 68.2-74.0), similar specificity (97.7%, 95% CI: 97.3-98.1), and the highest positive predictive value (86.9%, 95% CI: 84.5-89.3). Conclusions A case-identification strategy that includes admission or discharge diagnosis of fever should be considered for febrile infant studies using administrative data, though under-classification of patients is a potential limitation. PMID:26248691

Accuracy of ICD-10 Coding System for Identifying Comorbidities and Infectious Conditions Using Data from a Thai University Hospital Administrative Database.

PubMed

Rattanaumpawan, Pinyo; Wongkamhla, Thanyarak; Thamlikitkul, Visanu

2016-04-01

To determine the accuracy of International Statistical Classification of Disease and Related Health Problems, 10th Revision (ICD-10) coding system in identifying comorbidities and infectious conditions using data from a Thai university hospital administrative database. A retrospective cross-sectional study was conducted among patients hospitalized in six general medicine wards at Siriraj Hospital. ICD-10 code data was identified and retrieved directly from the hospital administrative database. Patient comorbidities were captured using the ICD-10 coding algorithm for the Charlson comorbidity index. Infectious conditions were captured using the groups of ICD-10 diagnostic codes that were carefully prepared by two independent infectious disease specialists. Accuracy of ICD-10 codes combined with microbiological dataf or diagnosis of urinary tract infection (UTI) and bloodstream infection (BSI) was evaluated. Clinical data gathered from chart review was considered the gold standard in this study. Between February 1 and May 31, 2013, a chart review of 546 hospitalization records was conducted. The mean age of hospitalized patients was 62.8 ± 17.8 years and 65.9% of patients were female. Median length of stay [range] was 10.0 [1.0-353.0] days and hospital mortality was 21.8%. Conditions with ICD-10 codes that had good sensitivity (90% or higher) were diabetes mellitus and HIV infection. Conditions with ICD-10 codes that had good specificity (90% or higher) were cerebrovascular disease, chronic lung disease, diabetes mellitus, cancer HIV infection, and all infectious conditions. By combining ICD-10 codes with microbiological results, sensitivity increased from 49.5 to 66%for UTI and from 78.3 to 92.8%for BS. The ICD-10 coding algorithm is reliable only in some selected conditions, including underlying diabetes mellitus and HIV infection. Combining microbiological results with ICD-10 codes increased sensitivity of ICD-10 codes for identifying BSI. Future research is

Deriving ICD-10 Codes for Patient Safety Indicators for Large-scale Surveillance Using Administrative Hospital Data.

PubMed

Southern, Danielle A; Burnand, Bernard; Droesler, Saskia E; Flemons, Ward; Forster, Alan J; Gurevich, Yana; Harrison, James; Quan, Hude; Pincus, Harold A; Romano, Patrick S; Sundararajan, Vijaya; Kostanjsek, Nenad; Ghali, William A

2017-03-01

Existing administrative data patient safety indicators (PSIs) have been limited by uncertainty around the timing of onset of included diagnoses. We undertook de novo PSI development through a data-driven approach that drew upon "diagnosis timing" information available in some countries' administrative hospital data. Administrative database analysis and modified Delphi rating process. All hospitalized adults in Canada in 2009. We queried all hospitalizations for ICD-10-CA diagnosis codes arising during hospital stay. We then undertook a modified Delphi panel process to rate the extent to which each of the identified diagnoses has a potential link to suboptimal quality of care. We grouped the identified quality/safety-related diagnoses into relevant clinical categories. Lastly, we queried Alberta hospital discharge data to assess the frequency of the newly defined PSI events. Among 2,416,413 national hospitalizations, we found 2590 unique ICD-10-CA codes flagged as having arisen after admission. Seven panelists evaluated these in a 2-round review process, and identified a listing of 640 ICD-10-CA diagnosis codes judged to be linked to suboptimal quality of care and thus appropriate for inclusion in PSIs. These were then grouped by patient safety experts into 18 clinically relevant PSI categories. We then analyzed data on 2,381,652 Alberta hospital discharges from 2005 through 2012, and found that 134,299 (5.2%) hospitalizations had at least 1 PSI diagnosis. The resulting work creates a foundation for a new set of PSIs for routine large-scale surveillance of hospital and health system performance.

Coding in Muscle Disease.

PubMed

Jones, Lyell K; Ney, John P

2016-12-01

Accurate coding is critically important for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of administrative coding for patients with muscle disease and includes a case-based review of diagnostic and Evaluation and Management (E/M) coding principles in patients with myopathy. Procedural coding for electrodiagnostic studies and neuromuscular ultrasound is also reviewed.

Using Administrative Mental Health Indicators in Heart Failure Outcomes Research: Comparison of Clinical Records and International Classification of Disease Coding.

PubMed

Bender, Miriam; Smith, Tyler C

2016-01-01

Use of mental indication in health outcomes research is of growing interest to researchers. This study, as part of a larger research program, quantified agreement between administrative International Classification of Disease (ICD-9) coding for, and "gold standard" clinician documentation of, mental health issues (MHIs) in hospitalized heart failure (HF) patients to determine the validity of mental health administrative data for use in HF outcomes research. A 13% random sample (n = 504) was selected from all unique patients (n = 3,769) hospitalized with a primary HF diagnosis at 4 San Diego County community hospitals during 2009-2012. MHI was defined as ICD-9 discharge diagnostic coding 290-319. Records were audited for clinician documentation of MHI. A total of 43% (n = 216) had mental health clinician documentation; 33% (n = 164) had ICD-9 coding for MHI. ICD-9 code bundle 290-319 had 0.70 sensitivity, 0.97 specificity, and kappa 0.69 (95% confidence interval 0.61-0.79). More specific ICD-9 MHI code bundles had kappas ranging from 0.44 to 0.82 and sensitivities ranging from 42% to 82%. Agreement between ICD-9 coding and clinician documentation for a broadly defined MHI is substantial, and can validly "rule in" MHI for hospitalized patients with heart failure. More specific MHI code bundles had fair to almost perfect agreement, with a wide range of sensitivities for identifying patients with an MHI. Copyright © 2016 Elsevier Inc. All rights reserved.

Biases in detection of apparent "weekend effect" on outcome with administrative coding data: population based study of stroke.

PubMed

Li, Linxin; Rothwell, Peter M

2016-05-16

 To determine the accuracy of coding of admissions for stroke on weekdays versus weekends and any impact on apparent outcome.  Prospective population based stroke incidence study and a scoping review of previous studies of weekend effects in stroke.  Primary and secondary care of all individuals registered with nine general practices in Oxfordshire, United Kingdom (OXVASC, the Oxford Vascular Study).  All patients with clinically confirmed acute stroke in OXVASC identified with multiple overlapping methods of ascertainment in 2002-14 versus all acute stroke admissions identified by hospital diagnostic and mortality coding alone during the same period.  Accuracy of administrative coding data for all patients with confirmed stroke admitted to hospital in OXVASC. Difference between rates of "false positive" or "false negative" coding for weekday and weekend admissions. Impact of inaccurate coding on apparent case fatality at 30 days in weekday versus weekend admissions. Weekend effects on outcomes in patients with confirmed stroke admitted to hospital in OXVASC and impacts of other potential biases compared with those in the scoping review.  Among 92 728 study population, 2373 episodes of acute stroke were ascertained in OXVASC, of which 826 (34.8%) mainly minor events were managed without hospital admission, 60 (2.5%) occurred out of the area or abroad, and 195 (8.2%) occurred in hospital during an admission for a different reason. Of 1292 local hospital admissions for acute stroke, 973 (75.3%) were correctly identified by administrative coding. There was no bias in distribution of weekend versus weekday admission of the 319 strokes missed by coding. Of 1693 admissions for stroke identified by coding, 1055 (62.3%) were confirmed to be acute strokes after case adjudication. Among the 638 false positive coded cases, patients were more likely to be admitted on weekdays than at weekends (536 (41.0%) v 102 (26.5%); P<0.001), partly because of weekday elective

Wacław Szybalski's contribution to immunotherapy: HGPRT mutation & HAT selection as first steps to gene therapy and hybrid techniques in mammalian cells.

PubMed

Bigda, Jacek J; Koszałka, Patrycja

2013-08-10

In this report we describe Wacław Szybalski's fundamental contribution to gene therapy and immunotherapy. His 1962 PNAS paper (Szybalska and Szybalski, 1962) documented the first successful gene repair in mammalian cells. Furthermore, this was also the first report on the HAT selection method used later in many applications. Most importantly, somatic cell fusion and HAT selection were subsequently used to develop monoclonal antibody technology, which contributed significantly to the progress of today's medicine. Copyright © 2013 Elsevier B.V. All rights reserved.

Validation and optimisation of an ICD-10-coded case definition for sepsis using administrative health data

PubMed Central

Jolley, Rachel J; Jetté, Nathalie; Sawka, Keri Jo; Diep, Lucy; Goliath, Jade; Roberts, Derek J; Yipp, Bryan G; Doig, Christopher J

2015-01-01

Objective Administrative health data are important for health services and outcomes research. We optimised and validated in intensive care unit (ICU) patients an International Classification of Disease (ICD)-coded case definition for sepsis, and compared this with an existing definition. We also assessed the definition's performance in non-ICU (ward) patients. Setting and participants All adults (aged ≥18 years) admitted to a multisystem ICU with general medicosurgical ICU care from one of three tertiary care centres in the Calgary region in Alberta, Canada, between 1 January 2009 and 31 December 2012 were included. Research design Patient medical records were randomly selected and linked to the discharge abstract database. In ICU patients, we validated the Canadian Institute for Health Information (CIHI) ICD-10-CA (Canadian Revision)-coded definition for sepsis and severe sepsis against a reference standard medical chart review, and optimised this algorithm through examination of other conditions apparent in sepsis. Measures Sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results Sepsis was present in 604 of 1001 ICU patients (60.4%). The CIHI ICD-10-CA-coded definition for sepsis had Sn (46.4%), Sp (98.7%), PPV (98.2%) and NPV (54.7%); and for severe sepsis had Sn (47.2%), Sp (97.5%), PPV (95.3%) and NPV (63.2%). The optimised ICD-coded algorithm for sepsis increased Sn by 25.5% and NPV by 11.9% with slightly lowered Sp (85.4%) and PPV (88.2%). For severe sepsis both Sn (65.1%) and NPV (70.1%) increased, while Sp (88.2%) and PPV (85.6%) decreased slightly. Conclusions This study demonstrates that sepsis is highly undercoded in administrative data, thus under-ascertaining the true incidence of sepsis. The optimised ICD-coded definition has a higher validity with higher Sn and should be preferentially considered if used for surveillance purposes. PMID:26700284

Validation and optimisation of an ICD-10-coded case definition for sepsis using administrative health data.

PubMed

Jolley, Rachel J; Quan, Hude; Jetté, Nathalie; Sawka, Keri Jo; Diep, Lucy; Goliath, Jade; Roberts, Derek J; Yipp, Bryan G; Doig, Christopher J

2015-12-23

Administrative health data are important for health services and outcomes research. We optimised and validated in intensive care unit (ICU) patients an International Classification of Disease (ICD)-coded case definition for sepsis, and compared this with an existing definition. We also assessed the definition's performance in non-ICU (ward) patients. All adults (aged ≥ 18 years) admitted to a multisystem ICU with general medicosurgical ICU care from one of three tertiary care centres in the Calgary region in Alberta, Canada, between 1 January 2009 and 31 December 2012 were included. Patient medical records were randomly selected and linked to the discharge abstract database. In ICU patients, we validated the Canadian Institute for Health Information (CIHI) ICD-10-CA (Canadian Revision)-coded definition for sepsis and severe sepsis against a reference standard medical chart review, and optimised this algorithm through examination of other conditions apparent in sepsis. Sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were calculated. Sepsis was present in 604 of 1001 ICU patients (60.4%). The CIHI ICD-10-CA-coded definition for sepsis had Sn (46.4%), Sp (98.7%), PPV (98.2%) and NPV (54.7%); and for severe sepsis had Sn (47.2%), Sp (97.5%), PPV (95.3%) and NPV (63.2%). The optimised ICD-coded algorithm for sepsis increased Sn by 25.5% and NPV by 11.9% with slightly lowered Sp (85.4%) and PPV (88.2%). For severe sepsis both Sn (65.1%) and NPV (70.1%) increased, while Sp (88.2%) and PPV (85.6%) decreased slightly. This study demonstrates that sepsis is highly undercoded in administrative data, thus under-ascertaining the true incidence of sepsis. The optimised ICD-coded definition has a higher validity with higher Sn and should be preferentially considered if used for surveillance purposes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

Exploration of association rule mining for coding consistency and completeness assessment in inpatient administrative health data.

PubMed

Peng, Mingkai; Sundararajan, Vijaya; Williamson, Tyler; Minty, Evan P; Smith, Tony C; Doktorchik, Chelsea T A; Quan, Hude

2018-03-01

Data quality assessment is a challenging facet for research using coded administrative health data. Current assessment approaches are time and resource intensive. We explored whether association rule mining (ARM) can be used to develop rules for assessing data quality. We extracted 2013 and 2014 records from the hospital discharge abstract database (DAD) for patients between the ages of 55 and 65 from five acute care hospitals in Alberta, Canada. The ARM was conducted using the 2013 DAD to extract rules with support ≥0.0019 and confidence ≥0.5 using the bootstrap technique, and tested in the 2014 DAD. The rules were compared against the method of coding frequency and assessed for their ability to detect error introduced by two kinds of data manipulation: random permutation and random deletion. The association rules generally had clear clinical meanings. Comparing 2014 data to 2013 data (both original), there were 3 rules with a confidence difference >0.1, while coding frequency difference of codes in the right hand of rules was less than 0.004. After random permutation of 50% of codes in the 2014 data, average rule confidence dropped from 0.72 to 0.27 while coding frequency remained unchanged. Rule confidence decreased with the increase of coding deletion, as expected. Rule confidence was more sensitive to code deletion compared to coding frequency, with slope of change ranging from 1.7 to 184.9 with a median of 9.1. The ARM is a promising technique to assess data quality. It offers a systematic way to derive coding association rules hidden in data, and potentially provides a sensitive and efficient method of assessing data quality compared to standard methods. Copyright © 2018 Elsevier Inc. All rights reserved.

Biases in detection of apparent “weekend effect” on outcome with administrative coding data: population based study of stroke

PubMed Central

Li, Linxin

2016-01-01

Objectives To determine the accuracy of coding of admissions for stroke on weekdays versus weekends and any impact on apparent outcome. Design Prospective population based stroke incidence study and a scoping review of previous studies of weekend effects in stroke. Setting Primary and secondary care of all individuals registered with nine general practices in Oxfordshire, United Kingdom (OXVASC, the Oxford Vascular Study). Participants All patients with clinically confirmed acute stroke in OXVASC identified with multiple overlapping methods of ascertainment in 2002-14 versus all acute stroke admissions identified by hospital diagnostic and mortality coding alone during the same period. Main outcomes measures Accuracy of administrative coding data for all patients with confirmed stroke admitted to hospital in OXVASC. Difference between rates of “false positive” or “false negative” coding for weekday and weekend admissions. Impact of inaccurate coding on apparent case fatality at 30 days in weekday versus weekend admissions. Weekend effects on outcomes in patients with confirmed stroke admitted to hospital in OXVASC and impacts of other potential biases compared with those in the scoping review. Results Among 92 728 study population, 2373 episodes of acute stroke were ascertained in OXVASC, of which 826 (34.8%) mainly minor events were managed without hospital admission, 60 (2.5%) occurred out of the area or abroad, and 195 (8.2%) occurred in hospital during an admission for a different reason. Of 1292 local hospital admissions for acute stroke, 973 (75.3%) were correctly identified by administrative coding. There was no bias in distribution of weekend versus weekday admission of the 319 strokes missed by coding. Of 1693 admissions for stroke identified by coding, 1055 (62.3%) were confirmed to be acute strokes after case adjudication. Among the 638 false positive coded cases, patients were more likely to be admitted on weekdays than at weekends (536

Validation of coding algorithms for the identification of patients hospitalized for alcoholic hepatitis using administrative data.

PubMed

Pang, Jack X Q; Ross, Erin; Borman, Meredith A; Zimmer, Scott; Kaplan, Gilaad G; Heitman, Steven J; Swain, Mark G; Burak, Kelly W; Quan, Hude; Myers, Robert P

2015-09-11

Epidemiologic studies of alcoholic hepatitis (AH) have been hindered by the lack of a validated International Classification of Disease (ICD) coding algorithm for use with administrative data. Our objective was to validate coding algorithms for AH using a hospitalization database. The Hospital Discharge Abstract Database (DAD) was used to identify consecutive adults (≥18 years) hospitalized in the Calgary region with a diagnosis code for AH (ICD-10, K70.1) between 01/2008 and 08/2012. Medical records were reviewed to confirm the diagnosis of AH, defined as a history of heavy alcohol consumption, elevated AST and/or ALT (<300 U/L), serum bilirubin >34 μmol/L, and elevated INR. Subgroup analyses were performed according to the diagnosis field in which the code was recorded (primary vs. secondary) and AH severity. Algorithms that incorporated ICD-10 codes for cirrhosis and its complications were also examined. Of 228 potential AH cases, 122 patients had confirmed AH, corresponding to a positive predictive value (PPV) of 54% (95% CI 47-60%). PPV improved when AH was the primary versus a secondary diagnosis (67% vs. 21%; P < 0.001). Algorithms that included diagnosis codes for ascites (PPV 75%; 95% CI 63-86%), cirrhosis (PPV 60%; 47-73%), and gastrointestinal hemorrhage (PPV 62%; 51-73%) had improved performance, however, the prevalence of these diagnoses in confirmed AH cases was low (29-39%). In conclusion the low PPV of the diagnosis code for AH suggests that caution is necessary if this hospitalization database is used in large-scale epidemiologic studies of this condition.

Bootstrap imputation with a disease probability model minimized bias from misclassification due to administrative database codes.

PubMed

van Walraven, Carl

2017-04-01

Diagnostic codes used in administrative databases cause bias due to misclassification of patient disease status. It is unclear which methods minimize this bias. Serum creatinine measures were used to determine severe renal failure status in 50,074 hospitalized patients. The true prevalence of severe renal failure and its association with covariates were measured. These were compared to results for which renal failure status was determined using surrogate measures including the following: (1) diagnostic codes; (2) categorization of probability estimates of renal failure determined from a previously validated model; or (3) bootstrap methods imputation of disease status using model-derived probability estimates. Bias in estimates of severe renal failure prevalence and its association with covariates were minimal when bootstrap methods were used to impute renal failure status from model-based probability estimates. In contrast, biases were extensive when renal failure status was determined using codes or methods in which model-based condition probability was categorized. Bias due to misclassification from inaccurate diagnostic codes can be minimized using bootstrap methods to impute condition status using multivariable model-derived probability estimates. Copyright © 2017 Elsevier Inc. All rights reserved.

Creating a Culture of Safety Around Bar-Code Medication Administration: An Evidence-Based Evaluation Framework.

PubMed

Kelly, Kandace; Harrington, Linda; Matos, Pat; Turner, Barbara; Johnson, Constance

2016-01-01

Bar-code medication administration (BCMA) effectiveness is contingent upon compliance with best-practice protocols. We developed a 4-phased BCMA evaluation program to evaluate the degree of integration of current evidence into BCMA policies, procedures, and practices; identify barriers to best-practice BCMA use; and modify BCMA practice in concert with changes to the practice environment. This program provides an infrastructure for frontline nurses to partner with hospital leaders to continually evaluate and improve BCMA using a systematic process.

Effect of change in coding rules on recording diabetes in hospital administrative datasets.

PubMed

Assareh, Hassan; Achat, Helen M; Guevarra, Veth M; Stubbs, Joanne M

2016-10-01

During 2008-2011 Australian Coding Standards mandated a causal relationship between diabetes and inpatient care as a criterion for recording diabetes as a comorbidity in hospital administrative datasets. We aim to measure the effect of the causality mandate on recorded diabetes and associated inter-hospital variations. For patients with diabetes, all admissions between 2004 and 2013 to all New South Wales acute public hospitals were investigated. Poisson mixed models were employed to derive adjusted rates and variations. The non-recorded diabetes incidence rate was 20.7%. The causality mandate increased the incidence rate four fold during the change period, 2008-2011, compared to the pre- or post-change periods (32.5% vs 8.4% and 6.9%). The inter-hospital variation was also higher, with twice the difference in the non-recorded rate between hospitals with the highest and lowest rates (50% vs 24% and 27% risk gap). The variation decreased during the change period (29%), while the rate continued to rise (53%). Admission characteristics accounted for over 44% of the variation compared with at most two per cent attributable to patient or hospital characteristics. Contributing characteristics explained less of the variation within the change period compared to pre- or post-change (46% vs 58% and 53%). Hospital relative performance was not constant over time. The causality mandate substantially increased the non-recorded diabetes rate and associated inter-hospital variation. Longitudinal accumulation of clinical information at the patient level, and the development of appropriate adoption protocols to achieve comprehensive and timely implementation of coding changes are essential to supporting the integrity of hospital administrative datasets. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

45 CFR 162.1011 - Valid code sets.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Valid code sets. 162.1011 Section 162.1011 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1011 Valid code sets. Each code set is valid within the dates...

45 CFR 162.1011 - Valid code sets.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Valid code sets. 162.1011 Section 162.1011 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1011 Valid code sets. Each code set is valid within the dates...

45 CFR 162.1011 - Valid code sets.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Valid code sets. 162.1011 Section 162.1011 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1011 Valid code sets. Each code set is valid within the dates...

45 CFR 162.1011 - Valid code sets.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Valid code sets. 162.1011 Section 162.1011 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1011 Valid code sets. Each code set is valid within the dates...

45 CFR 162.1011 - Valid code sets.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Valid code sets. 162.1011 Section 162.1011 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1011 Valid code sets. Each code set is valid within the dates...

Minimizing human error in radiopharmaceutical preparation and administration via a bar code-enhanced nuclear pharmacy management system.

PubMed

Hakala, John L; Hung, Joseph C; Mosman, Elton A

2012-09-01

The objective of this project was to ensure correct radiopharmaceutical administration through the use of a bar code system that links patient and drug profiles with on-site information management systems. This new combined system would minimize the amount of manual human manipulation, which has proven to be a primary source of error. The most common reason for dosing errors is improper patient identification when a dose is obtained from the nuclear pharmacy or when a dose is administered. A standardized electronic transfer of information from radiopharmaceutical preparation to injection will further reduce the risk of misadministration. Value stream maps showing the flow of the patient dose information, as well as potential points of human error, were developed. Next, a future-state map was created that included proposed corrections for the most common critical sites of error. Transitioning the current process to the future state will require solutions that address these sites. To optimize the future-state process, a bar code system that links the on-site radiology management system with the nuclear pharmacy management system was proposed. A bar-coded wristband connects the patient directly to the electronic information systems. The bar code-enhanced process linking the patient dose with the electronic information reduces the number of crucial points for human error and provides a framework to ensure that the prepared dose reaches the correct patient. Although the proposed flowchart is designed for a site with an in-house central nuclear pharmacy, much of the framework could be applied by nuclear medicine facilities using unit doses. An electronic connection between information management systems to allow the tracking of a radiopharmaceutical from preparation to administration can be a useful tool in preventing the mistakes that are an unfortunate reality for any facility.

Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses

PubMed Central

Lurie, Jon D.; Tosteson, Anna N.A.; Deyo, Richard A.; Tosteson, Tor; Weinstein, James; Mirza, Sohail K.

2014-01-01

Study Design Retrospective analysis of Medicare claims linked to a multi-center clinical trial. Objective The Spine Patient Outcomes Research Trial (SPORT) provided a unique opportunity to examine the validity of a claims-based algorithm for grouping patients by surgical indication. SPORT enrolled patients for lumbar disc herniation, spinal stenosis, and degenerative spondylolisthesis. We compared the surgical indication derived from Medicare claims to that provided by SPORT surgeons, the “gold standard”. Summary of Background Data Administrative data are frequently used to report procedure rates, surgical safety outcomes, and costs in the management of spinal surgery. However, the accuracy of using diagnosis codes to classify patients by surgical indication has not been examined. Methods Medicare claims were link to beneficiaries enrolled in SPORT. The sensitivity and specificity of three claims-based approaches to group patients based on surgical indications were examined: 1) using the first listed diagnosis; 2) using all diagnoses independently; and 3) using a diagnosis hierarchy based on the support for fusion surgery. Results Medicare claims were obtained from 376 SPORT participants, including 21 with disc herniation, 183 with spinal stenosis, and 172 with degenerative spondylolisthesis. The hierarchical coding algorithm was the most accurate approach for classifying patients by surgical indication, with sensitivities of 76.2%, 88.1%, and 84.3% for disc herniation, spinal stenosis, and degenerative spondylolisthesis cohorts, respectively. The specificity was 98.3% for disc herniation, 83.2% for spinal stenosis, and 90.7% for degenerative spondylolisthesis. Misclassifications were primarily due to codes attributing more complex pathology to the case. Conclusion Standardized approaches for using claims data to accurately group patients by surgical indications has widespread interest. We found that a hierarchical coding approach correctly classified over 90

Association between workarounds and medication administration errors in bar-code-assisted medication administration in hospitals.

PubMed

van der Veen, Willem; van den Bemt, Patricia M L A; Wouters, Hans; Bates, David W; Twisk, Jos W R; de Gier, Johan J; Taxis, Katja; Duyvendak, Michiel; Luttikhuis, Karen Oude; Ros, Johannes J W; Vasbinder, Erwin C; Atrafi, Maryam; Brasse, Bjorn; Mangelaars, Iris

2018-04-01

To study the association of workarounds with medication administration errors using barcode-assisted medication administration (BCMA), and to determine the frequency and types of workarounds and medication administration errors. A prospective observational study in Dutch hospitals using BCMA to administer medication. Direct observation was used to collect data. Primary outcome measure was the proportion of medication administrations with one or more medication administration errors. Secondary outcome was the frequency and types of workarounds and medication administration errors. Univariate and multivariate multilevel logistic regression analysis were used to assess the association between workarounds and medication administration errors. Descriptive statistics were used for the secondary outcomes. We included 5793 medication administrations for 1230 inpatients. Workarounds were associated with medication administration errors (adjusted odds ratio 3.06 [95% CI: 2.49-3.78]). Most commonly, procedural workarounds were observed, such as not scanning at all (36%), not scanning patients because they did not wear a wristband (28%), incorrect medication scanning, multiple medication scanning, and ignoring alert signals (11%). Common types of medication administration errors were omissions (78%), administration of non-ordered drugs (8.0%), and wrong doses given (6.0%). Workarounds are associated with medication administration errors in hospitals using BCMA. These data suggest that BCMA needs more post-implementation evaluation if it is to achieve the intended benefits for medication safety. In hospitals using barcode-assisted medication administration, workarounds occurred in 66% of medication administrations and were associated with large numbers of medication administration errors.

The cost of implementing inpatient bar code medication administration.

PubMed

Sakowski, Julie Ann; Ketchel, Alan

2013-02-01

To calculate the costs associated with implementing and operating an inpatient bar-code medication administration (BCMA) system in the community hospital setting and to estimate the cost per harmful error prevented. This is a retrospective, observational study. Costs were calculated from the hospital perspective and a cost-consequence analysis was performed to estimate the cost per preventable adverse drug event averted. Costs were collected from financial records and key informant interviews at 4 not-for profit community hospitals. Costs included direct expenditures on capital, infrastructure, additional personnel, and the opportunity costs of time for existing personnel working on the project. The number of adverse drug events prevented using BCMA was estimated by multiplying the number of doses administered using BCMA by the rate of harmful errors prevented by interventions in response to system warnings. Our previous work found that BCMA identified and intercepted medication errors in 1.1% of doses administered, 9% of which potentially could have resulted in lasting harm. The cost of implementing and operating BCMA including electronic pharmacy management and drug repackaging over 5 years is $40,000 (range: $35,600 to $54,600) per BCMA-enabled bed and $2000 (range: $1800 to $2600) per harmful error prevented. BCMA can be an effective and potentially cost-saving tool for preventing the harm and costs associated with medication errors.

A Study of Clinical Coding Accuracy in Surgery: Implications for the Use of Administrative Big Data for Outcomes Management.

PubMed

Nouraei, S A R; Hudovsky, A; Frampton, A E; Mufti, U; White, N B; Wathen, C G; Sandhu, G S; Darzi, A

2015-06-01

Clinical coding is the translation of clinical activity into a coded language. Coded data drive hospital reimbursement and are used for audit and research, and benchmarking and outcomes management purposes. We undertook a 2-center audit of coding accuracy across surgery. Clinician-auditor multidisciplinary teams reviewed the coding of 30,127 patients and assessed accuracy at primary and secondary diagnosis and procedure levels, morbidity level, complications assignment, and financial variance. Postaudit data of a randomly selected sample of 400 cases were reaudited by an independent team. At least 1 coding change occurred in 15,402 patients (51%). There were 3911 (13%) and 3620 (12%) changes to primary diagnoses and procedures, respectively. In 5183 (17%) patients, the Health Resource Grouping changed, resulting in income variance of £3,974,544 (+6.2%). The morbidity level changed in 2116 (7%) patients (P < 0.001). The number of assigned complications rose from 2597 (8.6%) to 2979 (9.9%) (P < 0.001). Reaudit resulted in further primary diagnosis and procedure changes in 8.7% and 4.8% of patients, respectively. The coded data are a key engine for knowledge-driven health care provision. They are used, increasingly at individual surgeon level, to benchmark performance. Surgical clinical coding is prone to subjectivity, variability, and error (SVE). Having a specialty-by-specialty understanding of the nature and clinical significance of informatics variability and adopting strategies to reduce it, are necessary to allow accurate assumptions and informed decisions to be made concerning the scope and clinical applicability of administrative data in surgical outcomes improvement.

47 CFR 52.15 - Central office code administration.

Code of Federal Regulations, 2011 CFR

2011-10-01

... assignment databases; (3) Conducting the Numbering Resource Utilization and Forecast (NRUF) data collection... telecommunications carrier that receives numbering resources from the NANPA, a Pooling Administrator or another... Administrator. (2) State commissions may investigate and determine whether service providers have activated...

47 CFR 52.15 - Central office code administration.

Code of Federal Regulations, 2014 CFR

2014-10-01

... assignment databases; (3) Conducting the Numbering Resource Utilization and Forecast (NRUF) data collection... telecommunications carrier that receives numbering resources from the NANPA, a Pooling Administrator or another... Administrator. (2) State commissions may investigate and determine whether service providers have activated...

47 CFR 52.15 - Central office code administration.

Code of Federal Regulations, 2013 CFR

2013-10-01

... assignment databases; (3) Conducting the Numbering Resource Utilization and Forecast (NRUF) data collection... telecommunications carrier that receives numbering resources from the NANPA, a Pooling Administrator or another... Administrator. (2) State commissions may investigate and determine whether service providers have activated...

Coding of Barrett's oesophagus with high-grade dysplasia in national administrative databases: a population-based cohort study.

PubMed

Chadwick, Georgina; Varagunam, Mira; Brand, Christian; Riley, Stuart A; Maynard, Nick; Crosby, Tom; Michalowski, Julie; Cromwell, David A

2017-06-09

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. 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. 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. 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. 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. 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). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The Pacific Northwest Laboratory (PNL), operated by Battelle Memorial Institute under contract to the U.S. Department of Energy, operates tank systems for the U.S. Department of Energy, Richland Operations Office (DOE-RL), that contain dangerous waste constituents as defined by Washington State Department of Ecology (WDOE) Dangerous Waste Regulations, Washington Administrative Code (WAC) 173-303-040(18). Chapter 173-303-640(2) of the WAC requires the performance of integrity assessments for each existing tank system that treats or stores dangerous waste, except those operating under interim status with compliant secondary containment. This Integrity Assessment Plan (IAP) identifies all tasks that will be performed during the integritymore » assessment of the PNL-operated Radioactive Liquid Waste Systems (RLWS) associated with the 324 and 325 Buildings located in the 300 Area of the Hanford Site. It describes the inspections, tests, and analyses required to assess the integrity of the PNL RLWS (tanks, ancillary equipment, and secondary containment) and provides sufficient information for adequate budgeting and control of the assessment program. It also provides necessary information to permit the Independent, Qualified, Registered Professional Engineer (IQRPE) to approve the integrity assessment program.« less

24 CFR 200.925c - Model codes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Minimum Property Standards § 200.925c Model codes. (a... Plumbing Code, 1993 Edition, and the BOCA National Mechanical Code, 1993 Edition, excluding Chapter I, Administration, for the Building, Plumbing and Mechanical Codes and the references to fire retardant treated wood...

24 CFR 200.925c - Model codes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Minimum Property Standards § 200.925c Model codes. (a... Plumbing Code, 1993 Edition, and the BOCA National Mechanical Code, 1993 Edition, excluding Chapter I, Administration, for the Building, Plumbing and Mechanical Codes and the references to fire retardant treated wood...

22 CFR 139.4 - Responsibilities of the Program Administrator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of living, support infrastructure, and other relevant factors. The Program Administrator, from time... program regulations, including rules of the Program Administrator and the code of code of conduct; or the...

24 CFR 200.925c - Model codes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... below. (1) Model Building Codes—(i) The BOCA National Building Code, 1993 Edition, The BOCA National..., Administration, for the Building, Plumbing and Mechanical Codes and the references to fire retardant treated wood... number 2 (Chapter 7) of the Building Code, but including the Appendices of the Code. Available from...

24 CFR 200.925c - Model codes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... below. (1) Model Building Codes—(i) The BOCA National Building Code, 1993 Edition, The BOCA National..., Administration, for the Building, Plumbing and Mechanical Codes and the references to fire retardant treated wood... number 2 (Chapter 7) of the Building Code, but including the Appendices of the Code. Available from...

24 CFR 200.925c - Model codes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... below. (1) Model Building Codes—(i) The BOCA National Building Code, 1993 Edition, The BOCA National..., Administration, for the Building, Plumbing and Mechanical Codes and the references to fire retardant treated wood... number 2 (Chapter 7) of the Building Code, but including the Appendices of the Code. Available from...

Quarterly report of RCRA groundwater monitoring data for period January 1, 1993 through March 31, 1993

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-07-01

Hanford Site interim-status groundwater monitoring projects are conducted as either background, indicator parameter evaluation, or groundwater quality assessment monitoring programs as defined in the Resource Conservation and Recovery Act of 1976 (RCRA); and Interim Status Standards for Owners and Operators of Hazardous Waste Treatment, Storage, and Disposal Facilities, as amended (40 Code of Federal Regulations [CFR] 265). Compliance with the 40 CFR 265 regulations is required by the Washington Administrative Code (WAC) 173-303. This report contains data from Hanford Site groundwater monitoring projects. This quarterly report contains data received between March 8 and May 24, 1993, which are the cutoffmore » dates for this reporting period. This report may contain not only data from the January through March quarter but also data from earlier sampling events that were not previously reported.« less

Bar-code medication administration system for anesthetics: effects on documentation and billing.

PubMed

Nolen, Agatha L; Rodes, W Dyer

2008-04-01

The effects of using a new bar-code medication administration (BCMA) system for anesthetics to automate documentation of drug administration by anesthesiologists were studied. From October 1, 2004, to September 15, 2005, all medications administered to patients undergoing cardiac surgery were documented with a BCMA system at a large acute care facility. Drug claims data for 12 targeted anesthetics in diagnosis-related groups (DRGs) 104-111 were analyzed to determine the quantity of drugs charged and the revenue generated. Those data were compared with claims data for a historical case-control group (October 1, 2003, to September 15, 2004, for the same DRGs) for which medication use was documented manually. From October 1, 2005, to October 1, 2006, anesthesiologists for cardiac surgeries either voluntarily used the automated system or completed anesthesia records manually. A total of 870 cardiac surgery cases for which the BCMA system was used were evaluated. There were 961 cardiac surgery cases in the historical control group. The BCMA system increased the quantity of drugs documented per case by 21.7% and drug revenue captured per case by 18.8%. The time needed by operating-room pharmacy staff to process an anesthesia record for billing decreased by eight minutes per case. After two years, anesthesiologists voluntarily used the new technology on 100% of cardiac surgery patients. Implementation of a BCMA system for anesthetic use in cardiac surgery increased the quantity of drugs charged by 21.7% per case and drug revenue per case by 18.8%. Anesthesiologists continued to use the automated system on a voluntary basis after conclusion of the initial study.

Detecting chronic kidney disease in population-based administrative databases using an algorithm of hospital encounter and physician claim codes.

PubMed

Fleet, Jamie L; Dixon, Stephanie N; Shariff, Salimah Z; Quinn, Robert R; Nash, Danielle M; Harel, Ziv; Garg, Amit X

2013-04-05

Large, population-based administrative healthcare databases can be used to identify patients with chronic kidney disease (CKD) when serum creatinine laboratory results are unavailable. We examined the validity of algorithms that used combined hospital encounter and physician claims database codes for the detection of CKD in Ontario, Canada. We accrued 123,499 patients over the age of 65 from 2007 to 2010. All patients had a baseline serum creatinine value to estimate glomerular filtration rate (eGFR). We developed an algorithm of physician claims and hospital encounter codes to search administrative databases for the presence of CKD. We determined the sensitivity, specificity, positive and negative predictive values of this algorithm to detect our primary threshold of CKD, an eGFR <45 mL/min per 1.73 m² (15.4% of patients). We also assessed serum creatinine and eGFR values in patients with and without CKD codes (algorithm positive and negative, respectively). Our algorithm required evidence of at least one of eleven CKD codes and 7.7% of patients were algorithm positive. The sensitivity was 32.7% [95% confidence interval: (95% CI): 32.0 to 33.3%]. Sensitivity was lower in women compared to men (25.7 vs. 43.7%; p <0.001) and in the oldest age category (over 80 vs. 66 to 80; 28.4 vs. 37.6 %; p < 0.001). All specificities were over 94%. The positive and negative predictive values were 65.4% (95% CI: 64.4 to 66.3%) and 88.8% (95% CI: 88.6 to 89.0%), respectively. In algorithm positive patients, the median [interquartile range (IQR)] baseline serum creatinine value was 135 μmol/L (106 to 179 μmol/L) compared to 82 μmol/L (69 to 98 μmol/L) for algorithm negative patients. Corresponding eGFR values were 38 mL/min per 1.73 m² (26 to 51 mL/min per 1.73 m²) vs. 69 mL/min per 1.73 m² (56 to 82 mL/min per 1.73 m²), respectively. Patients with CKD as identified by our database algorithm had distinctly higher baseline serum creatinine values and lower eGFR values

Detecting chronic kidney disease in population-based administrative databases using an algorithm of hospital encounter and physician claim codes

PubMed Central

2013-01-01

Background Large, population-based administrative healthcare databases can be used to identify patients with chronic kidney disease (CKD) when serum creatinine laboratory results are unavailable. We examined the validity of algorithms that used combined hospital encounter and physician claims database codes for the detection of CKD in Ontario, Canada. Methods We accrued 123,499 patients over the age of 65 from 2007 to 2010. All patients had a baseline serum creatinine value to estimate glomerular filtration rate (eGFR). We developed an algorithm of physician claims and hospital encounter codes to search administrative databases for the presence of CKD. We determined the sensitivity, specificity, positive and negative predictive values of this algorithm to detect our primary threshold of CKD, an eGFR <45 mL/min per 1.73 m2 (15.4% of patients). We also assessed serum creatinine and eGFR values in patients with and without CKD codes (algorithm positive and negative, respectively). Results Our algorithm required evidence of at least one of eleven CKD codes and 7.7% of patients were algorithm positive. The sensitivity was 32.7% [95% confidence interval: (95% CI): 32.0 to 33.3%]. Sensitivity was lower in women compared to men (25.7 vs. 43.7%; p <0.001) and in the oldest age category (over 80 vs. 66 to 80; 28.4 vs. 37.6 %; p < 0.001). All specificities were over 94%. The positive and negative predictive values were 65.4% (95% CI: 64.4 to 66.3%) and 88.8% (95% CI: 88.6 to 89.0%), respectively. In algorithm positive patients, the median [interquartile range (IQR)] baseline serum creatinine value was 135 μmol/L (106 to 179 μmol/L) compared to 82 μmol/L (69 to 98 μmol/L) for algorithm negative patients. Corresponding eGFR values were 38 mL/min per 1.73 m2 (26 to 51 mL/min per 1.73 m2) vs. 69 mL/min per 1.73 m2 (56 to 82 mL/min per 1.73 m2), respectively. Conclusions Patients with CKD as identified by our database algorithm had distinctly higher baseline serum

Validity of ICD-9-CM codes for breast, lung and colorectal cancers in three Italian administrative healthcare databases: a diagnostic accuracy study protocol.

PubMed

Abraha, Iosief; Serraino, Diego; Giovannini, Gianni; Stracci, Fabrizio; Casucci, Paola; Alessandrini, Giuliana; Bidoli, Ettore; Chiari, Rita; Cirocchi, Roberto; De Giorgi, Marcello; Franchini, David; Vitale, Maria Francesca; Fusco, Mario; Montedori, Alessandro

2016-03-25

Administrative healthcare databases are useful tools to study healthcare outcomes and to monitor the health status of a population. Patients with cancer can be identified through disease-specific codes, prescriptions and physician claims, but prior validation is required to achieve an accurate case definition. The objective of this protocol is to assess the accuracy of International Classification of Diseases Ninth Revision-Clinical Modification (ICD-9-CM) codes for breast, lung and colorectal cancers in identifying patients diagnosed with the relative disease in three Italian administrative databases. Data from the administrative databases of Umbria Region (910,000 residents), Local Health Unit 3 of Napoli (1,170,000 residents) and Friuli--Venezia Giulia Region (1,227,000 residents) will be considered. In each administrative database, patients with the first occurrence of diagnosis of breast, lung or colorectal cancer between 2012 and 2014 will be identified using the following groups of ICD-9-CM codes in primary position: (1) 233.0 and (2) 174.x for breast cancer; (3) 162.x for lung cancer; (4) 153.x for colon cancer and (5) 154.0-154.1 and 154.8 for rectal cancer. Only incident cases will be considered, that is, excluding cases that have the same diagnosis in the 5 years (2007-2011) before the period of interest. A random sample of cases and non-cases will be selected from each administrative database and the corresponding medical charts will be assessed for validation by pairs of trained, independent reviewers. Case ascertainment within the medical charts will be based on (1) the presence of a primary nodular lesion in the breast, lung or colon-rectum, documented with imaging or endoscopy and (2) a cytological or histological documentation of cancer from a primary or metastatic site. Sensitivity and specificity with 95% CIs will be calculated. Study results will be disseminated widely through peer-reviewed publications and presentations at national and

28 CFR 36.608 - Guidance concerning model codes.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Guidance concerning model codes. 36.608... Codes § 36.608 Guidance concerning model codes. Upon application by an authorized representative of a... relevant model code and issue guidance concerning whether and in what respects the model code is consistent...

Kombucha brewing under the Food and Drug Administration model Food Code: risk analysis and processing guidance.

PubMed

Nummer, Brian A

2013-11-01

Kombucha is a fermented beverage made from brewed tea and sugar. The taste is slightly sweet and acidic and it may have residual carbon dioxide. Kombucha is consumed in many countries as a health beverage and it is gaining in popularity in the U.S. Consequently, many retailers and food service operators are seeking to brew this beverage on site. As a fermented beverage, kombucha would be categorized in the Food and Drug Administration model Food Code as a specialized process and would require a variance with submission of a food safety plan. This special report was created to assist both operators and regulators in preparing or reviewing a kombucha food safety plan.

77 FR 64837 - Federal Aviation Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-23

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Fourth Meeting: RTCA Special Committee 227, Standards of Navigation Performance AGENCY: Federal Aviation Administration (FAA), U.S... Operations Group, Federal Aviation Administration. [FR Doc. 2012-26034 Filed 10-22-12; 8:45 am] BILLING CODE...

78 FR 41183 - Federal Aviation Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Meeting: RTCA Program Management Committee AGENCY: Federal Aviation Administration (FAA), U.S. Department of Transportation (DOT). ACTION... Operations Group, Federal Aviation Administration. [FR Doc. 2013-16464 Filed 7-8-13; 8:45 am] BILLING CODE...

Practical guide to bar coding for patient medication safety.

PubMed

Neuenschwander, Mark; Cohen, Michael R; Vaida, Allen J; Patchett, Jeffrey A; Kelly, Jamie; Trohimovich, Barbara

2003-04-15

Bar coding for the medication administration step of the drug-use process is discussed. FDA will propose a rule in 2003 that would require bar-code labels on all human drugs and biologicals. Even with an FDA mandate, manufacturer procrastination and possible shifts in product availability are likely to slow progress. Such delays should not preclude health systems from adopting bar-code-enabled point-of-care (BPOC) systems to achieve gains in patient safety. Bar-code technology is a replacement for traditional keyboard data entry. The elements of bar coding are content, which determines the meaning; data format, which refers to the embedded data and symbology, which describes the "font" in which the machine-readable code is written. For a BPOC system to deliver an acceptable level of patient protection, the hospital must first establish reliable processes for a patient identification band, caregiver badge, and medication bar coding. Medications can have either drug-specific or patient-specific bar codes. Both varieties result in the desired code that supports patient's five rights of drug administration. When medications are not available from the manufacturer in immediate-container bar-coded packaging, other means of applying the bar code must be devised, including the use of repackaging equipment, overwrapping, manual bar coding, and outsourcing. Virtually all medications should be bar coded, the bar code on the label should be easily readable, and appropriate policies, procedures, and checks should be in place. Bar coding has the potential to be not only cost-effective but to produce a return on investment. By bar coding patient identification tags, caregiver badges, and immediate-container medications, health systems can substantially increase patient safety during medication administration.

Adjudication Decision Support (ADS) System Automated Approval Estimates for NACLC Investigations

DTIC Science & Technology

2007-05-01

each less than 1 week • Credit status: 21 open accounts Case 459 • Child born abroad of U.S. parents • Parent-in-law born in Hungary, said to...WAC attorney WAC chat room FAC account FAC authenticat FAC child custody WAC accus FAC avenge FAC child endangerment WAC addict FAC B&E WAC Child ...enforcement WAC adjournment WAC bad WAC child support WAC adjudicat FAC bail WAC chronic WAC advers FAC balance WAC civil case WAC advis WAC

Anonymization of Administrative Billing Codes with Repeated Diagnoses Through Censoring

PubMed Central

Tamersoy, Acar; Loukides, Grigorios; Denny, Joshua C.; Malin, Bradley

2010-01-01

Patient-specific data from electronic medical records (EMRs) is increasingly shared in a de-identified form to support research. However, EMRs are susceptible to noise, error, and variation, which can limit their utility for reuse. One way to enhance the utility of EMRs is to record the number of times diagnosis codes are assigned to a patient when this data is shared. This is, however, challenging because releasing such data may be leveraged to compromise patients’ identity. In this paper, we present an approach that, to the best of our knowledge, is the first that can prevent re-identification through repeated diagnosis codes. Our method transforms records to preserve privacy while retaining much of their utility. Experiments conducted using 2676 patients from the EMR system of the Vanderbilt University Medical Center verify that our method is able to retain an average of 95.4% of the diagnosis codes in a common data sharing scenario. PMID:21347085

Coding in Stroke and Other Cerebrovascular Diseases.

PubMed

Korb, Pearce J; Jones, William

2017-02-01

Accurate coding is critical for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of coding principles for patients with strokes and other cerebrovascular diseases and includes an illustrative case as a review of coding principles in a patient with acute stroke.

Validating malignant melanoma ICD-9-CM codes in Umbria, ASL Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study

PubMed Central

Orso, Massimiliano; Serraino, Diego; Fusco, Mario; Giovannini, Gianni; Casucci, Paola; Cozzolino, Francesco; Granata, Annalisa; Gobbato, Michele; Stracci, Fabrizio; Ciullo, Valerio; Vitale, Maria Francesca; Orlandi, Walter; Montedori, Alessandro; Bidoli, Ettore

2018-01-01

Objectives To assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying subjects with melanoma. Design A diagnostic accuracy study comparing melanoma ICD-9-CM codes (index test) with medical chart (reference standard). Case ascertainment was based on neoplastic lesion of the skin and a histological diagnosis from a primary or metastatic site positive for melanoma. Setting Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli Venezia Giulia (FVG) Region. Participants 112, 130 and 130 cases (subjects with melanoma) were randomly selected from Umbria, NA and FVG, respectively; 94 non-cases (subjects without melanoma) were randomly selected from each unit. Outcome measures Sensitivity and specificity for ICD-9-CM code 172.x located in primary position. Results The most common melanoma subtype was malignant melanoma of skin of trunk, except scrotum (ICD-9-CM code: 172.5), followed by malignant melanoma of skin of lower limb, including hip (ICD-9-CM code: 172.7). The mean age of the patients ranged from 60 to 61 years. Most of the diagnoses were performed in surgical departments. The sensitivities were 100% (95% CI 96% to 100%) for Umbria, 99% (95% CI 94% to 100%) for NA and 98% (95% CI 93% to 100%) for FVG. The specificities were 88% (95% CI 80% to 93%) for Umbria, 77% (95% CI 69% to 85%) for NA and 79% (95% CI 71% to 86%) for FVG. Conclusions The case definition for melanoma based on clinical or instrumental diagnosis, confirmed by histological examination, showed excellent sensitivities and good specificities in the three operative units. Administrative databases from the three operative units can be used for epidemiological and outcome research of melanoma. PMID:29678984

Validating malignant melanoma ICD-9-CM codes in Umbria, ASL Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study.

PubMed

Orso, Massimiliano; Serraino, Diego; Abraha, Iosief; Fusco, Mario; Giovannini, Gianni; Casucci, Paola; Cozzolino, Francesco; Granata, Annalisa; Gobbato, Michele; Stracci, Fabrizio; Ciullo, Valerio; Vitale, Maria Francesca; Eusebi, Paolo; Orlandi, Walter; Montedori, Alessandro; Bidoli, Ettore

2018-04-20

To assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying subjects with melanoma. A diagnostic accuracy study comparing melanoma ICD-9-CM codes (index test) with medical chart (reference standard). Case ascertainment was based on neoplastic lesion of the skin and a histological diagnosis from a primary or metastatic site positive for melanoma. Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli Venezia Giulia (FVG) Region. 112, 130 and 130 cases (subjects with melanoma) were randomly selected from Umbria, NA and FVG, respectively; 94 non-cases (subjects without melanoma) were randomly selected from each unit. Sensitivity and specificity for ICD-9-CM code 172.x located in primary position. The most common melanoma subtype was malignant melanoma of skin of trunk, except scrotum (ICD-9-CM code: 172.5), followed by malignant melanoma of skin of lower limb, including hip (ICD-9-CM code: 172.7). The mean age of the patients ranged from 60 to 61 years. Most of the diagnoses were performed in surgical departments.The sensitivities were 100% (95% CI 96% to 100%) for Umbria, 99% (95% CI 94% to 100%) for NA and 98% (95% CI 93% to 100%) for FVG. The specificities were 88% (95% CI 80% to 93%) for Umbria, 77% (95% CI 69% to 85%) for NA and 79% (95% CI 71% to 86%) for FVG. The case definition for melanoma based on clinical or instrumental diagnosis, confirmed by histological examination, showed excellent sensitivities and good specificities in the three operative units. Administrative databases from the three operative units can be used for epidemiological and outcome research of melanoma. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Marine Sciences Laboratory Radionuclide Air Emissions Report for Calendar Year 2013

DOE Office of Scientific and Technical Information (OSTI.GOV)

Snyder, Sandra F.; Barnett, J. Matthew; Ballinger, Marcel Y.

2014-05-01

The U.S. Department of Energy Office of Science (DOE-SC) Pacific Northwest Site Office (PNSO) has oversight and stewardship duties associated with the Pacific Northwest National Laboratory (PNNL) Marine Sciences Laboratory (MSL) located on Battelle Land – Sequim (Sequim). This report is prepared to document compliance with the Code of Federal Regulations (CFR), Title 40, Protection of the Environment, Part 61, National Emission Standards for Hazardous Air Pollutants (NESHAP), Subpart H, “National Emission Standards for Emissions of Radionuclides Other than Radon from Department of Energy Facilities” and Washington Administrative Code (WAC) Chapter 246-247, “Radiation Protection–Air Emissions.” The EDE to the Sequimmore » MEI due to routine operations in 2013 was 5E-05 mrem (5E-07 mSv). No non-routine emissions occurred in 2013. The MSL is in compliance with the federal and state 10 mrem/yr standard.« less

Marine Sciences Laboratory Radionuclide Air Emissions Report for Calendar Year 2014

DOE Office of Scientific and Technical Information (OSTI.GOV)

Snyder, Sandra F.; Barnett, J. Matthew

2015-05-04

The U.S. Department of Energy Office of Science (DOE-SC) Pacific Northwest Site Office (PNSO) has oversight and stewardship duties associated with the Pacific Northwest National Laboratory (PNNL) Marine Sciences Laboratory (MSL) located on Battelle Land – Sequim.This report is prepared to document compliance with the Code of Federal Regulations (CFR), Title 40, Protection of the Environment, Part 61, National Emission Standards for Hazardous Air Pollutants (NESHAP), Subpart H, ''National Emission Standards for Emissions of Radionuclides Other than Radon from Department of Energy Facilities” and Washington Administrative Code (WAC) Chapter 246-247, “Radiation Protection–Air Emissions.'' The EDE to the MSL MEI duemore » to routine operations in 2014 was 9E-05 mrem (9E-07 mSv). No non-routine emissions occurred in 2014. The MSL is in compliance with the federal and state 10 mrem/yr standard.« less

Phase II evaluation of clinical coding schemes: completeness, taxonomy, mapping, definitions, and clarity. CPRI Work Group on Codes and Structures.

PubMed

Campbell, J R; Carpenter, P; Sneiderman, C; Cohn, S; Chute, C G; Warren, J

1997-01-01

To compare three potential sources of controlled clinical terminology (READ codes version 3.1, SNOMED International, and Unified Medical Language System (UMLS) version 1.6) relative to attributes of completeness, clinical taxonomy, administrative mapping, term definitions and clarity (duplicate coding rate). The authors assembled 1929 source concept records from a variety of clinical information taken from four medical centers across the United States. The source data included medical as well as ample nursing terminology. The source records were coded in each scheme by an investigator and checked by the coding scheme owner. The codings were then scored by an independent panel of clinicians for acceptability. Codes were checked for definitions provided with the scheme. Codes for a random sample of source records were analyzed by an investigator for "parent" and "child" codes within the scheme. Parent and child pairs were scored by an independent panel of medical informatics specialists for clinical acceptability. Administrative and billing code mapping from the published scheme were reviewed for all coded records and analyzed by independent reviewers for accuracy. The investigator for each scheme exhaustively searched a sample of coded records for duplications. SNOMED was judged to be significantly more complete in coding the source material than the other schemes (SNOMED* 70%; READ 57%; UMLS 50%; *p < .00001). SNOMED also had a richer clinical taxonomy judged by the number of acceptable first-degree relatives per coded concept (SNOMED* 4.56, UMLS 3.17; READ 2.14, *p < .005). Only the UMLS provided any definitions; these were found for 49% of records which had a coding assignment. READ and UMLS had better administrative mappings (composite score: READ* 40.6%; UMLS* 36.1%; SNOMED 20.7%, *p < .00001), and SNOMED had substantially more duplications of coding assignments (duplication rate: READ 0%; UMLS 4.2%; SNOMED* 13.9%, *p < .004) associated with a loss of clarity

Phase II Evaluation of Clinical Coding Schemes

PubMed Central

Campbell, James R.; Carpenter, Paul; Sneiderman, Charles; Cohn, Simon; Chute, Christopher G.; Warren, Judith

1997-01-01

Abstract Objective: To compare three potential sources of controlled clinical terminology (READ codes version 3.1, SNOMED International, and Unified Medical Language System (UMLS) version 1.6) relative to attributes of completeness, clinical taxonomy, administrative mapping, term definitions and clarity (duplicate coding rate). Methods: The authors assembled 1929 source concept records from a variety of clinical information taken from four medical centers across the United States. The source data included medical as well as ample nursing terminology. The source records were coded in each scheme by an investigator and checked by the coding scheme owner. The codings were then scored by an independent panel of clinicians for acceptability. Codes were checked for definitions provided with the scheme. Codes for a random sample of source records were analyzed by an investigator for “parent” and “child” codes within the scheme. Parent and child pairs were scored by an independent panel of medical informatics specialists for clinical acceptability. Administrative and billing code mapping from the published scheme were reviewed for all coded records and analyzed by independent reviewers for accuracy. The investigator for each scheme exhaustively searched a sample of coded records for duplications. Results: SNOMED was judged to be significantly more complete in coding the source material than the other schemes (SNOMED* 70%; READ 57%; UMLS 50%; *p <.00001). SNOMED also had a richer clinical taxonomy judged by the number of acceptable first-degree relatives per coded concept (SNOMED* 4.56; UMLS 3.17; READ 2.14, *p <.005). Only the UMLS provided any definitions; these were found for 49% of records which had a coding assignment. READ and UMLS had better administrative mappings (composite score: READ* 40.6%; UMLS* 36.1%; SNOMED 20.7%, *p <. 00001), and SNOMED had substantially more duplications of coding assignments (duplication rate: READ 0%; UMLS 4.2%; SNOMED* 13.9%, *p

Validation of Living Donor Nephrectomy Codes

PubMed Central

Lam, Ngan N.; Lentine, Krista L.; Klarenbach, Scott; Sood, Manish M.; Kuwornu, Paul J.; Naylor, Kyla L.; Knoll, Gregory A.; Kim, S. Joseph; Young, Ann; Garg, Amit X.

2018-01-01

Background: Use of administrative data for outcomes assessment in living kidney donors is increasing given the rarity of complications and challenges with loss to follow-up. Objective: To assess the validity of living donor nephrectomy in health care administrative databases compared with the reference standard of manual chart review. Design: Retrospective cohort study. Setting: 5 major transplant centers in Ontario, Canada. Patients: Living kidney donors between 2003 and 2010. Measurements: Sensitivity and positive predictive value (PPV). Methods: Using administrative databases, we conducted a retrospective study to determine the validity of diagnostic and procedural codes for living donor nephrectomies. The reference standard was living donor nephrectomies identified through the province’s tissue and organ procurement agency, with verification by manual chart review. Operating characteristics (sensitivity and PPV) of various algorithms using diagnostic, procedural, and physician billing codes were calculated. Results: During the study period, there were a total of 1199 living donor nephrectomies. Overall, the best algorithm for identifying living kidney donors was the presence of 1 diagnostic code for kidney donor (ICD-10 Z52.4) and 1 procedural code for kidney procurement/excision (1PC58, 1PC89, 1PC91). Compared with the reference standard, this algorithm had a sensitivity of 97% and a PPV of 90%. The diagnostic and procedural codes performed better than the physician billing codes (sensitivity 60%, PPV 78%). Limitations: The donor chart review and validation study was performed in Ontario and may not be generalizable to other regions. Conclusions: An algorithm consisting of 1 diagnostic and 1 procedural code can be reliably used to conduct health services research that requires the accurate determination of living kidney donors at the population level. PMID:29662679

28 CFR 36.607 - Guidance concerning model codes.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Guidance concerning model codes. 36.607... BY PUBLIC ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.607 Guidance concerning model codes. Upon application by an authorized representative of a...

28 CFR 36.607 - Guidance concerning model codes.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Guidance concerning model codes. 36.607... BY PUBLIC ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.607 Guidance concerning model codes. Upon application by an authorized representative of a...

28 CFR 36.607 - Guidance concerning model codes.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Guidance concerning model codes. 36.607... BY PUBLIC ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.607 Guidance concerning model codes. Upon application by an authorized representative of a...

28 CFR 36.607 - Guidance concerning model codes.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Guidance concerning model codes. 36.607... BY PUBLIC ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes § 36.607 Guidance concerning model codes. Upon application by an authorized representative of a...

Operational test report -- Project W-320 cathodic protection systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bowman, T.J.

1998-06-16

Washington Administrative Code (WAC) 173-303-640 specifies that corrosion protection must be designed into tank systems that treat or store dangerous wastes. Project W-320, Waste Retrieval Sluicing System (WRSS), utilizes underground encased waste transfer piping between tanks 241-C-106 and 241-AY-102. Corrosion protection is afforded to the encasements of the WRSS waste transfer piping through the application of earthen ionic currents onto the surface of the piping encasements. Cathodic protection is used in conjunction with the protective coatings that are applied upon the WRSS encasement piping. WRSS installed two new two rectifier systems (46 and 47) and modified one rectifier system (31).more » WAC 173-303-640 specifies that the proper operation of cathodic protection systems must be confirmed within six months after initial installation. The WRSS cathodic protection systems were energized to begin continuous operation on 5/5/98. Sixteen days after the initial steady-state start-up of the WRSS rectifier systems, the operational testing was accomplished with procedure OTP-320-006 Rev/Mod A-0. This operational test report documents the OTP-320-006 results and documents the results of configuration testing of integrated piping and rectifier systems associated with the W-320 cathodic protection systems.« less

Exercise Administrator Administrative Instructions for Age Classes 1, 2 & 3. Year 11, October 1979-May 1980.

ERIC Educational Resources Information Center

Research Triangle Inst., Durham, NC.

This manual for Exercise Administrators of the National Assessment of Educational Progress; Second Literature Third Reading Assessment, consists of administrative instructions for use immediately preceding, during and after assessment sessions in schools. Definitions of racial/ethnic categories, associated codes, and guidelines for solicting…

NEVADA TEST SITE WASTE ACCEPTANCE CRITERIA, JUNE 2006

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION NEVADA SITE OFFICE

This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive (LLW) and mixed waste (MW) for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex (RWMC) for storage or disposal.

Nevada Test Site Waste Acceptance Criteria

DOE Office of Scientific and Technical Information (OSTI.GOV)

U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office

This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive (LLW) and mixed waste (MW) for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex (RWMC) for storage or disposal.

Accuracy of Administrative Billing Codes to Detect Urinary Tract Infection Hospitalizations

PubMed Central

Hall, Matthew; Auger, Katherine A.; Hain, Paul D.; Jerardi, Karen E.; Myers, Angela L.; Rahman, Suraiya S.; Williams, Derek J.; Shah, Samir S.

2011-01-01

BACKGROUND: Hospital billing data are frequently used for quality measures and research, but the accuracy of the use of discharge codes to identify urinary tract infections (UTIs) is unknown. OBJECTIVE: To determine the accuracy of International Classification of Diseases, 9th revision (ICD-9) discharge codes to identify children hospitalized with UTIs. METHODS: This multicenter study conducted in 5 children's hospitals included children aged 3 days to 18 years who had been admitted to the hospital, undergone a urinalysis or urine culture, and discharged from the hospital. Data were obtained from the pediatric health information system database and medical record review. With the use of 2 gold-standard methods, the positive predictive value (PPV) was calculated for individual and combined UTI codes and for common UTI identification strategies. PPV was measured for all groupings for which the UTI code was the principal discharge diagnosis. RESULTS: There were 833 patients in the study. The PPV was 50.3% with the use of the gold standard of laboratory-confirmed UTIs but increased to 85% with provider confirmation. Restriction of the study cohort to patients with a principle diagnosis of UTI improved the PPV for laboratory-confirmed UTI (61.2%) and provider-confirmed UTI (93.2%), as well as the ability to benchmark performance. Other common identification strategies did not markedly affect the PPV. CONCLUSIONS: ICD-9 codes can be used to identify patients with UTIs but are most accurate when UTI is the principal discharge diagnosis. The identification strategies reported in this study can be used to improve the accuracy and applicability of benchmarking measures. PMID:21768320

45 CFR 162.1002 - Medical data code sets.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Terminology, Fourth Edition (CPT-4), as maintained and distributed by the American Medical Association, for... 45 Public Welfare 1 2012-10-01 2012-10-01 false Medical data code sets. 162.1002 Section 162.1002... REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1002 Medical data code sets. The Secretary adopts the...

45 CFR 162.1002 - Medical data code sets.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Terminology, Fourth Edition (CPT-4), as maintained and distributed by the American Medical Association, for... 45 Public Welfare 1 2014-10-01 2014-10-01 false Medical data code sets. 162.1002 Section 162.1002... REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1002 Medical data code sets. The Secretary adopts the...

45 CFR 162.1002 - Medical data code sets.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Terminology, Fourth Edition (CPT-4), as maintained and distributed by the American Medical Association, for... 45 Public Welfare 1 2013-10-01 2013-10-01 false Medical data code sets. 162.1002 Section 162.1002... REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1002 Medical data code sets. The Secretary adopts the...

45 CFR 162.1002 - Medical data code sets.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Terminology, Fourth Edition (CPT-4), as maintained and distributed by the American Medical Association, for... 45 Public Welfare 1 2011-10-01 2011-10-01 false Medical data code sets. 162.1002 Section 162.1002... REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1002 Medical data code sets. The Secretary adopts the...

45 CFR 162.1002 - Medical data code sets.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Terminology, Fourth Edition (CPT-4), as maintained and distributed by the American Medical Association, for... 45 Public Welfare 1 2010-10-01 2010-10-01 false Medical data code sets. 162.1002 Section 162.1002... REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1002 Medical data code sets. The Secretary adopts the...

Under-coding of secondary conditions in coded hospital health data: Impact of co-existing conditions, death status and number of codes in a record.

PubMed

Peng, Mingkai; Southern, Danielle A; Williamson, Tyler; Quan, Hude

2017-12-01

This study examined the coding validity of hypertension, diabetes, obesity and depression related to the presence of their co-existing conditions, death status and the number of diagnosis codes in hospital discharge abstract database. We randomly selected 4007 discharge abstract database records from four teaching hospitals in Alberta, Canada and reviewed their charts to extract 31 conditions listed in Charlson and Elixhauser comorbidity indices. Conditions associated with the four study conditions were identified through multivariable logistic regression. Coding validity (i.e. sensitivity, positive predictive value) of the four conditions was related to the presence of their associated conditions. Sensitivity increased with increasing number of diagnosis code. Impact of death on coding validity is minimal. Coding validity of conditions is closely related to its clinical importance and complexity of patients' case mix. We recommend mandatory coding of certain secondary diagnosis to meet the need of health research based on administrative health data.

75 FR 61552 - Federal Railroad Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-05

... DEPARTMENT OF TRANSPORTATION Federal Railroad Administration Notice of Informational Filing In accordance with Section 236.913 of Title 49 of the Code of Federal Regulations (CFR), notice is hereby given that the Federal Railroad Administration (FRA) has received an informational filing from the Northeast...

76 FR 65183 - National Oceanic and Atmospheric Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-20

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration National Climate Assessment... Oceanic and Atmospheric Administration (NOAA), Department of Commerce (DOC). ACTION: Notice of open..., National Oceanic and Atmospheric Administration. [FR Doc. 2011-27113 Filed 10-19-11; 8:45 am] BILLING CODE...

Billing code algorithms to identify cases of peripheral artery disease from administrative data

PubMed Central

Fan, Jin; Arruda-Olson, Adelaide M; Leibson, Cynthia L; Smith, Carin; Liu, Guanghui; Bailey, Kent R; Kullo, Iftikhar J

2013-01-01

Objective To construct and validate billing code algorithms for identifying patients with peripheral arterial disease (PAD). Methods We extracted all encounters and line item details including PAD-related billing codes at Mayo Clinic Rochester, Minnesota, between July 1, 1997 and June 30, 2008; 22 712 patients evaluated in the vascular laboratory were divided into training and validation sets. Multiple logistic regression analysis was used to create an integer code score from the training dataset, and this was tested in the validation set. We applied a model-based code algorithm to patients evaluated in the vascular laboratory and compared this with a simpler algorithm (presence of at least one of the ICD-9 PAD codes 440.20–440.29). We also applied both algorithms to a community-based sample (n=4420), followed by a manual review. Results The logistic regression model performed well in both training and validation datasets (c statistic=0.91). In patients evaluated in the vascular laboratory, the model-based code algorithm provided better negative predictive value. The simpler algorithm was reasonably accurate for identification of PAD status, with lesser sensitivity and greater specificity. In the community-based sample, the sensitivity (38.7% vs 68.0%) of the simpler algorithm was much lower, whereas the specificity (92.0% vs 87.6%) was higher than the model-based algorithm. Conclusions A model-based billing code algorithm had reasonable accuracy in identifying PAD cases from the community, and in patients referred to the non-invasive vascular laboratory. The simpler algorithm had reasonable accuracy for identification of PAD in patients referred to the vascular laboratory but was significantly less sensitive in a community-based sample. PMID:24166724

NEVADA TEST SITE WASTE ACCEPTANCE CRITERIA

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION, NEVADA SITE OFFICE

This document establishes the U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive and mixed waste for disposal. Mixed waste generated within the State of Nevada by NNSA/NSO activities is accepted for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Site for storage or disposal.

4 CFR 5.4 - Pay administration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4 Accounts 1 2010-01-01 2010-01-01 false Pay administration. 5.4 Section 5.4 Accounts GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL SYSTEM COMPENSATION § 5.4 Pay administration. The provisions of chapter 55 of title 5, U.S. Code and the Office of Personnel Management implementing regulations apply to Government...

21 CFR 610.67 - Bar code label requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Bar code label requirements. 610.67 Section 610.67 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS GENERAL BIOLOGICAL PRODUCTS STANDARDS Labeling Standards § 610.67 Bar code label requirements...

21 CFR 610.67 - Bar code label requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Bar code label requirements. 610.67 Section 610.67 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS GENERAL BIOLOGICAL PRODUCTS STANDARDS Labeling Standards § 610.67 Bar code label requirements...

Dress Codes. Legal Brief.

ERIC Educational Resources Information Center

Zirkel, Perry A.

2000-01-01

As illustrated by two recent decisions, the courts in the past decade have demarcated wide boundaries for school officials considering dress codes, whether in the form of selective prohibitions or required uniforms. Administrators must warn the community, provide legitimate justification and reasonable clarity, and comply with state law. (MLH)

Implementing a bar-code assisted medication administration system: effects on the dispensing process and user perceptions.

PubMed

Samaranayake, N R; Cheung, S T D; Cheng, K; Lai, K; Chui, W C M; Cheung, B M Y

2014-06-01

We assessed the effects of a bar-code assisted medication administration system used without the support of computerised prescribing (stand-alone BCMA), on the dispensing process and its users. The stand-alone BCMA system was implemented in one ward of a teaching hospital. The number of dispensing steps, dispensing time and potential dispensing errors (PDEs) were directly observed one month before and eight months after the intervention. Attitudes of pharmacy and nursing staff were assessed using a questionnaire (Likert scale) and interviews. Among 1291 and 471 drug items observed before and after the introduction of the technology respectively, the number of dispensing steps increased from five to eight and time (standard deviation) to dispense one drug item by one staff personnel increased from 0.8 (0.09) to 1.5 (0.12) min. Among 2828 and 471 drug items observed before and after the intervention respectively, the number of PDEs increased significantly (P<0.001). 'Procedural errors' and 'missing drug items' were the frequently observed PDEs in the after study. 'Perceived usefulness' and 'job relevance' of the technology decreased significantly (P=0.003 and P=0.004 respectively) among users who participated in the before (N=16) and after (N=16) questionnaires surveys. Among the interviewees, pharmacy staff felt that the system offered less benefit to the dispensing process (9/16). Nursing staff perceived the system as useful in improving the accuracy of drug administration (7/10). Implementing a stand-alone BCMA system may slow down and complicate the dispensing process. Nursing staff believe the stand-alone BCMA system could improve the drug administration process but pharmacy staff believes the technology would be more helpful if supported by computerised prescribing. However, periodical assessments are needed to identify weaknesses in the process after implementation, and all users should be educated on the benefits of using this technology. Copyright © 2014

Alternative Fuels Data Center: E85 Codes and Standards

Science.gov Websites

Development Equipment Options Equipment Installation Codes, Standards, & Safety Vehicles Laws & ; Incentives Ethanol Codes, Standards, and Safety The U.S. Environmental Protection Agency's (EPA) Office of -Gasoline Blends. The Occupational Safety and Health Administration (OSHA) regulates some fuel-dispensing

48 CFR 501.105-1 - Publication and code arrangement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Publication and code arrangement. 501.105-1 Section 501.105-1 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION GENERAL GENERAL SERVICES ADMINISTRATION ACQUISITION REGULATION SYSTEM Purpose, Authority, Issuance...

21 CFR 201.25 - Bar code label requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Evaluation and Research, Food and Drug Administration, 5600 Fishers Lane, Rockville, MD 20857 (requests... Biologics Evaluation and Research, Food and Drug Administration, 1401 Rockville Pike, Rockville, MD 20852... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Bar code label requirements. 201.25 Section 201.25...

1 CFR 11.3 - Code of Federal Regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Code of Federal Regulations. 11.3 Section 11.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL... complete set of the Code of Federal Regulations is $1,019 per year for the bound, paper edition, or $247...

1 CFR 11.3 - Code of Federal Regulations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false Code of Federal Regulations. 11.3 Section 11.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL... complete set of the Code of Federal Regulations is $1,019 per year for the bound, paper edition, or $247...

1 CFR 11.3 - Code of Federal Regulations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Code of Federal Regulations. 11.3 Section 11.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL... complete set of the Code of Federal Regulations is $1,019 per year for the bound, paper edition, or $247...

NAICS Sector 92: Public Administration

EPA Pesticide Factsheets

Find the public administration industries EPA regulations affect, with their North American Industry Classification System (NAICS) code. On those pages you can find a list of laws and regulations that affect your industry as well as compliance information

21 CFR 201.25 - Bar code label requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... and Research, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 51, Silver Spring, MD...-600), Center for Biologics Evaluation and Research, Food and Drug Administration, 1401 Rockville Pike... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Bar code label requirements. 201.25 Section 201.25...

Accuracy of lung cancer ICD-9-CM codes in Umbria, Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study

PubMed Central

Montedori, Alessandro; Bidoli, Ettore; Serraino, Diego; Fusco, Mario; Giovannini, Gianni; Casucci, Paola; Franchini, David; Granata, Annalisa; Ciullo, Valerio; Vitale, Maria Francesca; Gobbato, Michele; Chiari, Rita; Cozzolino, Francesco; Orso, Massimiliano; Orlandi, Walter

2018-01-01

Objectives To assess the accuracy of International Classification of Diseases 9th Revision–Clinical Modification (ICD-9-CM) codes in identifying subjects with lung cancer. Design A cross-sectional diagnostic accuracy study comparing ICD-9-CM 162.x code (index test) in primary position with medical chart (reference standard). Case ascertainment was based on the presence of a primary nodular lesion in the lung and cytological or histological documentation of cancer from a primary or metastatic site. Setting Three operative units: administrative databases from Umbria Region (890 000 residents), ASL Napoli 3 Sud (NA) (1 170 000 residents) and Friuli Venezia Giulia (FVG) Region (1 227 000 residents). Participants Incident subjects with lung cancer (n=386) diagnosed in primary position between 2012 and 2014 and a population of non-cases (n=280). Outcome measures Sensitivity, specificity and positive predictive value (PPV) for 162.x code. Results 130 cases and 94 non-cases were randomly selected from each database and the corresponding medical charts were reviewed. Most of the diagnoses for lung cancer were performed in medical departments. True positive rates were high for all the three units. Sensitivity was 99% (95% CI 95% to 100%) for Umbria, 97% (95% CI 91% to 100%) for NA, and 99% (95% CI 95% to 100%) for FVG. The false positive rates were 24%, 37% and 23% for Umbria, NA and FVG, respectively. PPVs were 79% (73% to 83%)%) for Umbria, 58% (53% to 63%)%) for NA and 79% (73% to 84%)%) for FVG. Conclusions Case ascertainment for lung cancer based on imaging or endoscopy associated with histological examination yielded an excellent sensitivity in all the three administrative databases. PPV was moderate for Umbria and FVG but lower for NA. PMID:29773701

25 CFR 11.705 - Removal of executor or administrator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Removal of executor or administrator. 11.705 Section 11... OFFENSES AND LAW AND ORDER CODE Probate Proceedings § 11.705 Removal of executor or administrator. The Court of Indian Offenses may order the executor or administrator to show cause why he or she should not...

Implementing a bar-coded bedside medication administration system.

PubMed

Yates, Cindy

2007-01-01

Hospitals across the nation are struggling with implementing electronic medication administration and reporting (eMAR) systems as part of patient safety programs. St Luke's Hospital in Chesterfield, Mo, initiated their eMAR initiative in June 2003, initiating program start-up in September 2004. This case study documents how the project was approached, its overall success, and what was learned along the way. Also included is a recent update highlighting the expansion of St Luke's patient safety initiative, adapting eMAR to two specialty units: dialysis and laboratory processes.

21 CFR 106.90 - Coding.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Coding. 106.90 Section 106.90 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION INFANT FORMULA QUALITY CONTROL PROCEDURES Quality Control Procedures for Assuring Nutrient Content...

21 CFR 106.90 - Coding.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Coding. 106.90 Section 106.90 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION INFANT FORMULA QUALITY CONTROL PROCEDURES Quality Control Procedures for Assuring Nutrient Content...

21 CFR 106.90 - Coding.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Coding. 106.90 Section 106.90 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION INFANT FORMULA QUALITY CONTROL PROCEDURES Quality Control Procedures for Assuring Nutrient Content...

Identifying Pediatric Severe Sepsis and Septic Shock: Accuracy of Diagnosis Codes.

PubMed

Balamuth, Fran; Weiss, Scott L; Hall, Matt; Neuman, Mark I; Scott, Halden; Brady, Patrick W; Paul, Raina; Farris, Reid W D; McClead, Richard; Centkowski, Sierra; Baumer-Mouradian, Shannon; Weiser, Jason; Hayes, Katie; Shah, Samir S; Alpern, Elizabeth R

2015-12-01

To evaluate accuracy of 2 established administrative methods of identifying children with sepsis using a medical record review reference standard. Multicenter retrospective study at 6 US children's hospitals. Subjects were children >60 days to <19 years of age and identified in 4 groups based on International Classification of Diseases, Ninth Revision, Clinical Modification codes: (1) severe sepsis/septic shock (sepsis codes); (2) infection plus organ dysfunction (combination codes); (3) subjects without codes for infection, organ dysfunction, or severe sepsis; and (4) infection but not severe sepsis or organ dysfunction. Combination codes were allowed, but not required within the sepsis codes group. We determined the presence of reference standard severe sepsis according to consensus criteria. Logistic regression was performed to determine whether addition of codes for sepsis therapies improved case identification. A total of 130 out of 432 subjects met reference SD of severe sepsis. Sepsis codes had sensitivity 73% (95% CI 70-86), specificity 92% (95% CI 87-95), and positive predictive value 79% (95% CI 70-86). Combination codes had sensitivity 15% (95% CI 9-22), specificity 71% (95% CI 65-76), and positive predictive value 18% (95% CI 11-27). Slight improvements in model characteristics were observed when codes for vasoactive medications and endotracheal intubation were added to sepsis codes (c-statistic 0.83 vs 0.87, P = .008). Sepsis specific International Classification of Diseases, Ninth Revision, Clinical Modification codes identify pediatric patients with severe sepsis in administrative data more accurately than a combination of codes for infection plus organ dysfunction. Copyright © 2015 Elsevier Inc. All rights reserved.

Time trend of injection drug errors before and after implementation of bar-code verification system.

PubMed

Sakushima, Ken; Umeki, Reona; Endoh, Akira; Ito, Yoichi M; Nasuhara, Yasuyuki

2015-01-01

Bar-code technology, used for verification of patients and their medication, could prevent medication errors in clinical practice. Retrospective analysis of electronically stored medical error reports was conducted in a university hospital. The number of reported medication errors of injected drugs, including wrong drug administration and administration to the wrong patient, was compared before and after implementation of the bar-code verification system for inpatient care. A total of 2867 error reports associated with injection drugs were extracted. Wrong patient errors decreased significantly after implementation of the bar-code verification system (17.4/year vs. 4.5/year, p< 0.05), although wrong drug errors did not decrease sufficiently (24.2/year vs. 20.3/year). The source of medication errors due to wrong drugs was drug preparation in hospital wards. Bar-code medication administration is effective for prevention of wrong patient errors. However, ordinary bar-code verification systems are limited in their ability to prevent incorrect drug preparation in hospital wards.

Accuracy of external cause-of-injury coding in VA polytrauma patient discharge records.

PubMed

Carlson, Kathleen F; Nugent, Sean M; Grill, Joseph; Sayer, Nina A

2010-01-01

Valid and efficient methods of identifying the etiology of treated injuries are critical for characterizing patient populations and developing prevention and rehabilitation strategies. We examined the accuracy of external cause-of-injury codes (E-codes) in Veterans Health Administration (VHA) administrative data for a population of injured patients. Chart notes and E-codes were extracted for 566 patients treated at any one of four VHA Polytrauma Rehabilitation Center sites between 2001 and 2006. Two expert coders, blinded to VHA E-codes, used chart notes to assign "gold standard" E-codes to injured patients. The accuracy of VHA E-coding was examined based on these gold standard E-codes. Only 382 of 517 (74%) injured patients were assigned E-codes in VHA records. Sensitivity of VHA E-codes varied significantly by site (range: 59%-91%, p < 0.001). Sensitivity was highest for combat-related injuries (81%) and lowest for fall-related injuries (60%). Overall specificity of E-codes was high (92%). E-coding accuracy was markedly higher when we restricted analyses to records that had been assigned VHA E-codes. E-codes may not be valid for ascertaining source-of-injury data for all injuries among VHA rehabilitation inpatients at this time. Enhanced training and policies may ensure more widespread, standardized use and accuracy of E-codes for injured veterans treated in the VHA.

78 FR 664 - Establishment of Drug Codes for 26 Substances

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

... DEPARTMENT OF JUSTICE Drug Enforcement Administration 21 CFR Part 1308 [Docket No. DEA-368] Establishment of Drug Codes for 26 Substances AGENCY: Drug Enforcement Administration (DEA), Department of Justice. ACTION: Final rule. SUMMARY: On July 9, 2012, the President signed into law the Synthetic Drug...

Problems, solutions and recommendations for implementing CODES (Crash Outcome Data Evaluation System)

DOT National Transportation Integrated Search

2001-02-01

Problems, solutions and recommendations for implementation have been contributed by 16 of the 27 CODES states and organized as appropriate under the administrative, linkage and application requirements for a Crash Outcome Data Evaluation System (CODE...

Oil and gas field code master list 1994

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This is the thirteenth annual edition of the Energy Information Administration`s (EIA) Oil and Gas Field Code Master List. It reflects data collected through October 1994 and provides standardized field name spellings and codes for all identified oil and/or gas fields in the United States. The master field name spellings and codes are to be used by respondents when filing the following Department of Energy (DOE) forms: Form EIA-23, {open_quotes}Annual Survey of Domestic Oil and Gas Reserves,{close_quotes} filed by oil and gas well operators (field codes are required from larger operators only); Forms FERC 8 and EIA-191, {open_quotes}Underground Gas Storagemore » Report,{close_quotes} filed by natural gas producers and distributors who operate underground natural gas storage facilities. Other Federal and State government agencies, as well as industry, use the EIA Oil and Gas Field Code Master List as the standard for field identification. A machine-readable version of the Oil and Gas Field Code Master List is available from the National Technical Information Service, 5285 Port Royal Road, Springfield, Virginia 22161, (703) 487-4650. In order for the Master List to be useful, it must be accurate and remain current. To accomplish this, EIA constantly reviews and revises this list. The EIA welcomes all comments, corrections, and additions to the Master List. All such information should be given to the EIA Field Code Coordinator at (214) 953-1858. EIA gratefully acknowledges the assistance provides by numerous State organizations and trade associations in verifying the existence of fields and their official nomenclature.« less

Quality of data regarding diagnoses of spinal disorders in administrative databases. A multicenter study.

PubMed

Faciszewski, T; Broste, S K; Fardon, D

1997-10-01

The purpose of the present study was to evaluate the accuracy of data regarding diagnoses of spinal disorders in administrative databases at eight different institutions. The records of 189 patients who had been managed for a disorder of the lumbar spine were independently reviewed by a physician who assigned the appropriate diagnostic codes according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The age range of the 189 patients was seventeen to eighty-four years. The six major diagnostic categories studied were herniation of a lumbar disc, a previous operation on the lumbar spine, spinal stenosis, cauda equina syndrome, acquired spondylolisthesis, and congenital spondylolisthesis. The diagnostic codes assigned by the physician were compared with the codes that had been assigned during the ordinary course of events by personnel in the medical records department of each of the eight hospitals. The accuracy of coding was also compared among the eight hospitals, and it was found to vary depending on the diagnosis. Although there were both false-negative and false-positive codes at each institution, most errors were related to the low sensitivity of coding for previous spinal operations: only seventeen (28 per cent) of sixty-one such diagnoses were coded correctly. Other errors in coding were less frequent, but their implications for conclusions drawn from the information in administrative databases depend on the frequency of a diagnosis and its importance in an analysis. This study demonstrated that the accuracy of a diagnosis of a spinal disorder recorded in an administrative database varies according to the specific condition being evaluated. It is necessary to document the relative accuracy of specific ICD-9-CM diagnostic codes in order to improve the ability to validate the conclusions derived from investigations based on administrative databases.

Establishment of a New Drug Code for Marihuana Extract. Final rule.

PubMed

2016-12-14

The Drug Enforcement Administration is creating a new Administration Controlled Substances Code Number for "Marihuana Extract." This code number will allow DEA and DEA-registered entities to track quantities of this material separately from quantities of marihuana. This, in turn, will aid in complying with relevant treaty provisions. Under international drug control treaties administered by the United Nations, some differences exist between the regulatory controls pertaining to marihuana extract versus those for marihuana and tetrahydrocannabinols. The DEA has previously established separate code numbers for marihuana and for tetrahydrocannabinols, but not for marihuana extract. To better track these materials and comply with treaty provisions, DEA is creating a separate code number for marihuana extract with the following definition: "Meaning an extract containing one or more cannabinoids that has been derived from any plant of the genus Cannabis, other than the separated resin (whether crude or purified) obtained from the plant." Extracts of marihuana will continue to be treated as Schedule I controlled substances.

21 CFR 19.6 - Code of ethics for government service.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Code of ethics for government service. 19.6 Section 19.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL STANDARDS OF CONDUCT AND CONFLICTS OF INTEREST General Provisions § 19.6 Code of ethics for government...

21 CFR 19.6 - Code of ethics for government service.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Code of ethics for government service. 19.6 Section 19.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL STANDARDS OF CONDUCT AND CONFLICTS OF INTEREST General Provisions § 19.6 Code of ethics for government...

21 CFR 19.6 - Code of ethics for government service.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Code of ethics for government service. 19.6 Section 19.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL STANDARDS OF CONDUCT AND CONFLICTS OF INTEREST General Provisions § 19.6 Code of ethics for government...

21 CFR 19.6 - Code of ethics for government service.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Code of ethics for government service. 19.6 Section 19.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL STANDARDS OF CONDUCT AND CONFLICTS OF INTEREST General Provisions § 19.6 Code of ethics for government...

49 CFR Appendix C to Part 215 - FRA Freight Car Standards Defect Code

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false FRA Freight Car Standards Defect Code C Appendix C... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD FREIGHT CAR SAFETY STANDARDS Pt. 215, App. C Appendix C to Part 215—FRA Freight Car Standards Defect Code The following defect code has been established for use...

49 CFR Appendix C to Part 215 - FRA Freight Car Standards Defect Code

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false FRA Freight Car Standards Defect Code C Appendix C... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD FREIGHT CAR SAFETY STANDARDS Pt. 215, App. C Appendix C to Part 215—FRA Freight Car Standards Defect Code The following defect code has been established for use...

49 CFR Appendix C to Part 215 - FRA Freight Car Standards Defect Code

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false FRA Freight Car Standards Defect Code C Appendix C... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD FREIGHT CAR SAFETY STANDARDS Pt. 215, App. C Appendix C to Part 215—FRA Freight Car Standards Defect Code The following defect code has been established for use...

49 CFR Appendix C to Part 215 - FRA Freight Car Standards Defect Code

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false FRA Freight Car Standards Defect Code C Appendix C... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD FREIGHT CAR SAFETY STANDARDS Pt. 215, App. C Appendix C to Part 215—FRA Freight Car Standards Defect Code The following defect code has been established for use...

User’s Guide to Southeast Asia Combat Data

DTIC Science & Technology

1976-06-01

North latitude Binary coded decimal Bomb damage assessment Battle Damage Assessment and Reporting Team Brigade Basic encyclopedia A University of...and movement routes Bomb wing CALCOMP CANDLESTICK CAP CAP CAS CAS CAVD CBU , CBS California Computer Products, Inc. Call sign...Special Studies Group (a high-level Washington committee) WAC WBLC WIA WOLF WSE3 WWDMS WWMCCS W X World Aeronautical Chart Waterborne logistic

Impact of School Uniforms on Student Discipline and the Learning Climate: A Comparative Case Study of Two Middle Schools with Uniform Dress Codes and Two Middle Schools without Uniform Dress Codes

ERIC Educational Resources Information Center

Dulin, Charles Dewitt

2016-01-01

The purpose of this research is to evaluate the impact of uniform dress codes on a school's climate for student behavior and learning in four middle schools in North Carolina. The research will compare the perceptions of parents, teachers, and administrators in schools with uniform dress codes against schools without uniform dress codes. This…

1 CFR 5.5 - Supplement to the Code of Federal Regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Supplement to the Code of Federal Regulations. 5.5 Section 5.5 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.5 Supplement to the Code of Federal Regulations. The Federal Register serves as a...

1 CFR 5.5 - Supplement to the Code of Federal Regulations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false Supplement to the Code of Federal Regulations. 5.5 Section 5.5 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.5 Supplement to the Code of Federal Regulations. The Federal Register serves as a...

21 CFR 20.115 - Product codes for manufacturing or sales dates.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Product codes for manufacturing or sales dates. 20.115 Section 20.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Availability of Specific Categories of Records § 20.115 Product codes...

1 CFR 5.5 - Supplement to the Code of Federal Regulations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1 General Provisions 1 2014-01-01 2012-01-01 true Supplement to the Code of Federal Regulations. 5.5 Section 5.5 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.5 Supplement to the Code of Federal Regulations. The Federal Register serves as a...

1 CFR 5.5 - Supplement to the Code of Federal Regulations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1 General Provisions 1 2013-01-01 2012-01-01 true Supplement to the Code of Federal Regulations. 5.5 Section 5.5 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.5 Supplement to the Code of Federal Regulations. The Federal Register serves as a...

1 CFR 5.5 - Supplement to the Code of Federal Regulations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Supplement to the Code of Federal Regulations. 5.5 Section 5.5 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.5 Supplement to the Code of Federal Regulations. The Federal Register serves as a...

Oil and Gas field code master list 1995

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

This is the fourteenth annual edition of the Energy Information Administration`s (EIA) Oil and Gas Field Code Master List. It reflects data collected through October 1995 and provides standardized field name spellings and codes for all identified oil and/or gas fields in the US. The Field Code Index, a listing of all field names and the States in which they occur, ordered by field code, has been removed from this year`s publications to reduce printing and postage costs. Complete copies (including the Field Code Index) will be available on the EIA CD-ROM and the EIA World-Wide Web Site. Future editionsmore » of the complete Master List will be available on CD-ROM and other electronic media. There are 57,400 field records in this year`s Oil and Gas Field Code Master List. As it is maintained by EIA, the Master List includes the following: field records for each State and county in which a field resides; field records for each offshore area block in the Gulf of Mexico in which a field resides; field records for each alias field name (see definition of alias below); and fields crossing State boundaries that may be assigned different names by the respective State naming authorities. Taking into consideration the double-counting of fields under such circumstances, EIA identifies 46,312 distinct fields in the US as of October 1995. This count includes fields that no longer produce oil or gas, and 383 fields used in whole or in part for oil or gas Storage. 11 figs., 6 tabs.« less

Identifying Neck and Back Pain in Administrative Data: Defining the right cohort

PubMed Central

Siroka, Andrew M.; Shane, Andrea C.; Trafton, Jodie A.; Wagner, Todd H.

2017-01-01

Structured Abstract Study design We reviewed existing methods for identifying patients with neck and back pain in administrative data. We compared these methods using data from the Department of Veterans Affairs. Objective To answer the following questions: 1) what diagnosis codes should be used to identify patients with neck and back pain in administrative data; 2) because the majority of complaints are characterized as non-specific or mechanical, what diagnosis codes should be used to identify patients with non-specific or mechanical problems in administrative data; and 3) what procedure and surgical codes should be used to identify patients who have undergone a surgical procedure on the neck or back. Summary of background data Musculoskeletal neck and back pain are pervasive problems, associated with chronic pain, disability, and high rates of healthcare utilization. Administrative data have been widely used in formative research which has largely relied on the original work of Volinn, Cherkin, Deyo and Einstadter and the Back Pain Patient Outcomes Assessment Team first published in 1992. Significant variation in reports of incidence, prevalence, and morbidity associated with these problems may be due to non standard or conflicting methods to define study cohorts. Methods A literature review produced seven methods for identifying neck and back pain in administrative data. These code lists were used to search VA data for patients with back and neck problems, and to further categorize each case by spinal segment involved, as non- specific/mechanical and as surgical or not. Results There is considerable overlap in most algorithms. However, gaps remain. Conclusions Gaps are evident in existing methods and a new framework to identify patients with neck and back pain in administrative data is proposed. PMID:22127268

21 CFR 201.2 - Drugs and devices; National Drug Code numbers.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Drugs and devices; National Drug Code numbers. 201.2 Section 201.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING General Labeling Provisions § 201.2 Drugs and devices; National Drug Code...

21 CFR 201.2 - Drugs and devices; National Drug Code numbers.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Drugs and devices; National Drug Code numbers. 201.2 Section 201.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING General Labeling Provisions § 201.2 Drugs and devices; National Drug Code...

21 CFR 201.2 - Drugs and devices; National Drug Code numbers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Drugs and devices; National Drug Code numbers. 201.2 Section 201.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING General Labeling Provisions § 201.2 Drugs and devices; National Drug Code...

21 CFR 201.2 - Drugs and devices; National Drug Code numbers.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Drugs and devices; National Drug Code numbers. 201.2 Section 201.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING General Labeling Provisions § 201.2 Drugs and devices; National Drug Code...

21 CFR 201.2 - Drugs and devices; National Drug Code numbers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Drugs and devices; National Drug Code numbers. 201.2 Section 201.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING General Labeling Provisions § 201.2 Drugs and devices; National Drug Code...

Validated methods for identifying tuberculosis patients in health administrative databases: systematic review.

PubMed

Ronald, L A; Ling, D I; FitzGerald, J M; Schwartzman, K; Bartlett-Esquilant, G; Boivin, J-F; Benedetti, A; Menzies, D

2017-05-01

An increasing number of studies are using health administrative databases for tuberculosis (TB) research. However, there are limitations to using such databases for identifying patients with TB. To summarise validated methods for identifying TB in health administrative databases. We conducted a systematic literature search in two databases (Ovid Medline and Embase, January 1980-January 2016). We limited the search to diagnostic accuracy studies assessing algorithms derived from drug prescription, International Classification of Diseases (ICD) diagnostic code and/or laboratory data for identifying patients with TB in health administrative databases. The search identified 2413 unique citations. Of the 40 full-text articles reviewed, we included 14 in our review. Algorithms and diagnostic accuracy outcomes to identify TB varied widely across studies, with positive predictive value ranging from 1.3% to 100% and sensitivity ranging from 20% to 100%. Diagnostic accuracy measures of algorithms using out-patient, in-patient and/or laboratory data to identify patients with TB in health administrative databases vary widely across studies. Use solely of ICD diagnostic codes to identify TB, particularly when using out-patient records, is likely to lead to incorrect estimates of case numbers, given the current limitations of ICD systems in coding TB.

Validating administrative records in post-traumatic stress disorder.

PubMed

Abrams, Thad E; Vaughan-Sarrazin, Mary; Keane, Terence M; Richardson, Kelly

2016-03-01

There is insufficient data on the accuracy of administrative coding data (ACD) for post-traumatic stress disorder (PTSD). Medical records were reviewed for (1) a diagnosis of PTSD; (2) treatment for PTSD. The records were compared against the Veterans Health Administration (VHA) data in order to determine the positive predictive value (PPV) and negative predictive value (NPV) of three commonly used approaches. The PPV and NPV varied according to the ACD approach. Relative to a medical records review, the ACD approach of one or two PTSD coded outpatient encounters had a PPV of 78% and an NPV of 91%; whereas the PPV was 97% and the NPV was 98% for three or more PTSD codes. For pharmacotherapy, the ACD approach with one or two codes for PTSD had a PPV of 33% (NPV = 93%), whereas three or more PTSD coded encounters improved the PPV to 85% (NPV = 100%). When using VHA data, we recommend tailoring the identification strategy according to the research aims. An ACD approach identifying one or more PTSD outpatient encounters should be considered sufficient for a diagnosis of PTSD. Assessments for PTSD associated pharmacotherapy require using an ACD approach that identifies veterans with the presence ≥ 3 outpatient PTSD encounters. Published 2015. This article is a U.S. Government work and is in the public domain in the USA. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

77 FR 40493 - Export Administration Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-10

... 760 Export Administration Regulations CFR Correction In Title 15 of the Code of Federal Regulations... Sec. 740.1, correctly revise the heading of paragraph (d) to read ``Shippers Export Declaration or Automated Export System Record''. 0 2. On page 321, in Sec. 742.15, move the note to introductory paragraph...

22 CFR 226.42 - Codes of conduct.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.42 Codes of conduct. The recipient shall... immediate family, his or her partner, or an organization which employs or is about to employ any of the...

A Code of Ethics for Democratic Leadership

ERIC Educational Resources Information Center

Molina, Ricardo; Klinker, JoAnn Franklin

2012-01-01

Democratic leadership rests on sacred values, awareness, judgement, motivation and courage. Four turning points in a 38-year school administrator's career revealed decision-making in problematic moments stemmed from values in a personal and professional code of ethics. Reflection on practice and theory added vocabulary and understanding to make…

Sequim Site Radionuclide Air Emissions Report for Calendar Year 2012

DOE Office of Scientific and Technical Information (OSTI.GOV)

Snyder, Sandra F.; Barnett, J. Matthew; Gervais, Todd L.

2013-04-01

This report is prepared to document compliance with the Code of Federal Regulations (CFR), Title 40, Protection of the Environment, Part 61, National Emission Standards for Hazardous Air Pollutants (NESHAP), Subpart H, National Emission Standards for Emissions of Radionuclides Other than Radon from Department of Energy Facilities and ashington Administrative Code (WAC) Chapter 246-247, Radiation Protection Air Emissions. This report meets the calendar year 2012 Sequim Site annual reporting requirement for its operations as a privately-owned facility as well as its federally-contracted status that began in October 2012. Compliance is indicated by comparing the estimated dose to the maximally exposedmore » individual (MEI) with the 10 mrem/yr Environmental Protection Agency (EPA) standard. The MSL contains only sources classified as fugitive emissions. Despite the fact that the regulations are intended for application to point source emissions, fugitive emissions are included with regard to complying with the EPA standard. The dose to the Sequim Site MEI due to routine operations in 2012 was 9E-06 mrem (9E-08 mSv). No non-routine emissions occurred in 2012. The MSL is in compliance with the federal and state 10 mrem/yr standard.« less

The study on dynamic cadastral coding rules based on kinship relationship

NASA Astrophysics Data System (ADS)

Xu, Huan; Liu, Nan; Liu, Renyi; Lu, Jingfeng

2007-06-01

Cadastral coding rules are an important supplement to the existing national and local standard specifications for building cadastral database. After analyzing the course of cadastral change, especially the parcel change with the method of object-oriented analysis, a set of dynamic cadastral coding rules based on kinship relationship corresponding to the cadastral change is put forward and a coding format composed of street code, block code, father parcel code, child parcel code and grandchild parcel code is worked out within the county administrative area. The coding rule has been applied to the development of an urban cadastral information system called "ReGIS", which is not only able to figure out the cadastral code automatically according to both the type of parcel change and the coding rules, but also capable of checking out whether the code is spatiotemporally unique before the parcel is stored in the database. The system has been used in several cities of Zhejiang Province and got a favorable response. This verifies the feasibility and effectiveness of the coding rules to some extent.

41 CFR 105-72.502 - Codes of conduct.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Codes of conduct. 105-72.502 Section 105-72.502 Public Contracts and Property Management Federal Property Management Regulations System (Continued) GENERAL SERVICES ADMINISTRATION Regional Offices-General Services...

21 CFR 206.10 - Code imprint required.

Code of Federal Regulations, 2011 CFR

2011-04-01

... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL IMPRINTING OF SOLID ORAL DOSAGE FORM DRUG PRODUCTS FOR HUMAN USE § 206.10 Code imprint required. (a) Unless exempted under § 206.7, no drug product in solid oral dosage form may be introduced or...

21 CFR 206.10 - Code imprint required.

Code of Federal Regulations, 2013 CFR

2013-04-01

... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL IMPRINTING OF SOLID ORAL DOSAGE FORM DRUG PRODUCTS FOR HUMAN USE § 206.10 Code imprint required. (a) Unless exempted under § 206.7, no drug product in solid oral dosage form may be introduced or...

21 CFR 206.10 - Code imprint required.

Code of Federal Regulations, 2012 CFR

2012-04-01

... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL IMPRINTING OF SOLID ORAL DOSAGE FORM DRUG PRODUCTS FOR HUMAN USE § 206.10 Code imprint required. (a) Unless exempted under § 206.7, no drug product in solid oral dosage form may be introduced or...

Analyzing Ethics in the Administration of Interscholastic Sports: Three Key Gender-Related Ethical Dilemmas Faced by Educational Leaders

ERIC Educational Resources Information Center

Whisenant, Warren A.; Pedersen, Paul M.; Clavio, Galen

2010-01-01

Athletic administrators and decision makers within interscholastic athletics are expected to embrace a code of ethics that serves as a set of rules to guide their professional behavior. Included within this code are areas of controversy that present gender-related ethical dilemmas for administrators. Three specific ethical dilemmas involve (1)…

Automation and adaptation: Nurses' problem-solving behavior following the implementation of bar coded medication administration technology.

PubMed

Holden, Richard J; Rivera-Rodriguez, A Joy; Faye, Héléne; Scanlon, Matthew C; Karsh, Ben-Tzion

2013-08-01

The most common change facing nurses today is new technology, particularly bar coded medication administration technology (BCMA). However, there is a dearth of knowledge on how BCMA alters nursing work. This study investigated how BCMA technology affected nursing work, particularly nurses' operational problem-solving behavior. Cognitive systems engineering observations and interviews were conducted after the implementation of BCMA in three nursing units of a freestanding pediatric hospital. Problem-solving behavior, associated problems, and goals, were specifically defined and extracted from observed episodes of care. Three broad themes regarding BCMA's impact on problem solving were identified. First, BCMA allowed nurses to invent new problem-solving behavior to deal with pre-existing problems. Second, BCMA made it difficult or impossible to apply some problem-solving behaviors that were commonly used pre-BCMA, often requiring nurses to use potentially risky workarounds to achieve their goals. Third, BCMA created new problems that nurses were either able to solve using familiar or novel problem-solving behaviors, or unable to solve effectively. Results from this study shed light on hidden hazards and suggest three critical design needs: (1) ecologically valid design; (2) anticipatory control; and (3) basic usability. Principled studies of the actual nature of clinicians' work, including problem solving, are necessary to uncover hidden hazards and to inform health information technology design and redesign.

Automation and adaptation: Nurses’ problem-solving behavior following the implementation of bar coded medication administration technology

PubMed Central

Holden, Richard J.; Rivera-Rodriguez, A. Joy; Faye, Héléne; Scanlon, Matthew C.; Karsh, Ben-Tzion

2012-01-01

The most common change facing nurses today is new technology, particularly bar coded medication administration technology (BCMA). However, there is a dearth of knowledge on how BCMA alters nursing work. This study investigated how BCMA technology affected nursing work, particularly nurses’ operational problem-solving behavior. Cognitive systems engineering observations and interviews were conducted after the implementation of BCMA in three nursing units of a freestanding pediatric hospital. Problem-solving behavior, associated problems, and goals, were specifically defined and extracted from observed episodes of care. Three broad themes regarding BCMA’s impact on problem solving were identified. First, BCMA allowed nurses to invent new problem-solving behavior to deal with pre-existing problems. Second, BCMA made it difficult or impossible to apply some problem-solving behaviors that were commonly used pre-BCMA, often requiring nurses to use potentially risky workarounds to achieve their goals. Third, BCMA created new problems that nurses were either able to solve using familiar or novel problem-solving behaviors, or unable to solve effectively. Results from this study shed light on hidden hazards and suggest three critical design needs: (1) ecologically valid design; (2) anticipatory control; and (3) basic usability. Principled studies of the actual nature of clinicians’ work, including problem solving, are necessary to uncover hidden hazards and to inform health information technology design and redesign. PMID:24443642

78 FR 66852 - State Fiscal Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 433 State Fiscal Administration CFR Correction 0 In Title 42 of the Code of Federal Regulations, Parts 430 to 481, revised as of October 1, 2012, on page 98, in Sec. 433.50, paragraphs (a)(1)(i) and (a)(1)(ii...

Pacific Northwest National Laboratory Potential Impact Categories for Radiological Air Emission Monitoring

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ballinger, Marcel Y.; Gervais, Todd L.; Barnett, J. Matthew

2012-06-05

In 2002, the EPA amended 40 CFR 61 Subpart H and 40 CFR 61 Appendix B Method 114 to include requirements from ANSI/HPS N13.1-1999 Sampling and Monitoring Releases of Airborne Radioactive Substances from the Stack and Ducts of Nuclear Facilities for major emission points. Additionally, the WDOH amended the Washington Administrative Code (WAC) 246-247 Radiation protection-air emissions to include ANSI/HPS N13.1-1999 requirements for major and minor emission points when new permitting actions are approved. A result of the amended regulations is the requirement to prepare a written technical basis for the radiological air emission sampling and monitoring program. A keymore » component of the technical basis is the Potential Impact Category (PIC) assigned to an emission point. This paper discusses the PIC assignments for the Pacific Northwest National Laboratory (PNNL) Integrated Laboratory emission units; this revision includes five PIC categories.« less

The impact of alternative pricing methods for drugs in California Workers' Compensation System: Fee-schedule pricing.

PubMed

Wilson, Leslie; Turkistani, Fatema A; Huang, Wei; Tran, Dang M; Lin, Tracy Kuo

2018-01-01

California's Workers' Compensation System (CAWCS) Department of Industrial Relations questioned the adequacy of the current Medi-Cal fee-schedule pricing and requested analysis of alternatives that maximize price availability and maintain budget neutrality. To compare CAWCS pharmacy-dispensed (PD) drug prices under alternative fee schedules, and identify combinations of alternative benchmarks that have prices available for the largest percentage of PD drugs and that best reach budget neutrality. Claims transaction-level data (2011-2013) from CAWCS were used to estimate total annual PD pharmaceutical payments. Medi-Cal pricing data was from the Workman's Compensation Insurance System (WCIS). Average Wholesale Prices (AWP), Wholesale Acquisition Costs (WAC), Direct Prices (DP), Federal Upper Limit (FUL) prices, and National Average Drug Acquisition Costs (NADAC) were from Medi-Span. We matched National Drug Codes (NDCs), pricing dates, and drug quantity for comparisons. We report pharmacy-dispensed (PD) claims frequency, reimbursement matching rate, and paid costs by CAWCS as the reference price against all alternative price benchmarks. Of 12,529,977 CAWCS claims for pharmaceutical products 11.6% (1,462,814) were for PD drugs. Prescription drug cost for CAWCS was over $152M; $63.9M, $47.9M, and $40.6M in 2011-2013. Ninety seven percent of these CAWCS PD claims had a Medi-Cal price. Alternative mechanisms provided a price for fewer claims; NADAC 94.23%, AWP 90.94%, FUL 73.11%, WAC 66.98%, and DP 14.33%. Among CAWCS drugs with no Medi-Cal price in PD claims, AWP, WAC, NADAC, DP, and FUL provided prices for 96.7%, 63.14%, 24.82%, 20.83%, and 15.08% of claims. Overall CAWCS paid 100.52% of Medi-Cal, 60% of AWP, 97% of WAC, 309.53% of FUL, 103.83% of DP, and 136.27% of NADAC. CAWCS current Medi-Cal fee-schedule price list for PD drugs is more complete than all alternative fee-schedules. However, all reimbursement approaches would require combinations of pricing benchmarks

HCPCS Coding: An Integral Part of Your Reimbursement Strategy.

PubMed

Nusgart, Marcia

2013-12-01

The first step to a successful reimbursement strategy is to ensure that your wound care product has the most appropriate Healthcare Common Procedure Coding System (HCPCS) code (or billing) for your product. The correct HCPCS code plays an essential role in patient access to new and existing technologies. When devising a strategy to obtain a HCPCS code for its product, companies must consider a number of factors as follows: (1) Has the product gone through the Food and Drug Administration (FDA) regulatory process or does it need to do so? Will the FDA code designation impact which HCPCS code will be assigned to your product? (2) In what "site of service" do you intend to market your product? Where will your customers use the product? Which coding system (CPT ® or HCPCS) applies to your product? (3) Does a HCPCS code for a similar product already exist? Does your product fit under the existing HCPCS code? (4) Does your product need a new HCPCS code? What is the linkage, if any, between coding, payment, and coverage for the product? Researchers and companies need to start early and place the same emphasis on a reimbursement strategy as it does on a regulatory strategy. Your reimbursement strategy staff should be involved early in the process, preferably during product research and development and clinical trial discussions.

Generating code adapted for interlinking legacy scalar code and extended vector code

DOEpatents

Gschwind, Michael K

2013-06-04

Mechanisms for intermixing code are provided. Source code is received for compilation using an extended Application Binary Interface (ABI) that extends a legacy ABI and uses a different register configuration than the legacy ABI. First compiled code is generated based on the source code, the first compiled code comprising code for accommodating the difference in register configurations used by the extended ABI and the legacy ABI. The first compiled code and second compiled code are intermixed to generate intermixed code, the second compiled code being compiled code that uses the legacy ABI. The intermixed code comprises at least one call instruction that is one of a call from the first compiled code to the second compiled code or a call from the second compiled code to the first compiled code. The code for accommodating the difference in register configurations is associated with the at least one call instruction.

Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.

PubMed

Peterson, Rachel; Gundlapalli, Adi V; Metraux, Stephen; Carter, Marjorie E; Palmer, Miland; Redd, Andrew; Samore, Matthew H; Fargo, Jamison D

2015-01-01

Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.

Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria

PubMed Central

Peterson, Rachel; Gundlapalli, Adi V.; Metraux, Stephen; Carter, Marjorie E.; Palmer, Miland; Redd, Andrew; Samore, Matthew H.; Fargo, Jamison D.

2015-01-01

Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations. PMID:26172386

45 CFR Appendix B to Part 73 - Code of Ethics for Government Service

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Code of Ethics for Government Service B Appendix B to Part 73 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION STANDARDS OF CONDUCT Pt. 73, App. B Appendix B to Part 73—Code of Ethics for Government Service Any person in...

45 CFR Appendix B to Part 73 - Code of Ethics for Government Service

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Code of Ethics for Government Service B Appendix B to Part 73 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION STANDARDS OF CONDUCT Pt. 73, App. B Appendix B to Part 73—Code of Ethics for Government Service Any person in...

45 CFR Appendix B to Part 73 - Code of Ethics for Government Service

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Code of Ethics for Government Service B Appendix B to Part 73 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION STANDARDS OF CONDUCT Pt. 73, App. B Appendix B to Part 73—Code of Ethics for Government Service Any person in...

45 CFR Appendix B to Part 73 - Code of Ethics for Government Service

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Code of Ethics for Government Service B Appendix B to Part 73 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION STANDARDS OF CONDUCT Pt. 73, App. B Appendix B to Part 73—Code of Ethics for Government Service Any person in...

45 CFR Appendix B to Part 73 - Code of Ethics for Government Service

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Code of Ethics for Government Service B Appendix B to Part 73 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION STANDARDS OF CONDUCT Pt. 73, App. B Appendix B to Part 73—Code of Ethics for Government Service Any person in...

The political and economic impacts of writing across the curriculum in chemistry at the University of Missouri-St. Louis

NASA Astrophysics Data System (ADS)

Klein, William Dixon

writing can be woven into the chemistry curriculum in a number of ways. Interviews with UMSL faculty and administrators suggest new instantiations of WAC that might better thrive in today's political and economic environment. What takes shape might serve as a model for other institutions to follow.

Validity of Administrative Data in Identifying Cancer-related Events in Adolescents and Young Adults: A Population-based Study Using the IMPACT Cohort.

PubMed

Gupta, Sumit; Nathan, Paul C; Baxter, Nancy N; Lau, Cindy; Daly, Corinne; Pole, Jason D

2018-06-01

Despite the importance of estimating population level cancer outcomes, most registries do not collect critical events such as relapse. Attempts to use health administrative data to identify these events have focused on older adults and have been mostly unsuccessful. We developed and tested administrative data-based algorithms in a population-based cohort of adolescents and young adults with cancer. We identified all Ontario adolescents and young adults 15-21 years old diagnosed with leukemia, lymphoma, sarcoma, or testicular cancer between 1992-2012. Chart abstraction determined the end of initial treatment (EOIT) date and subsequent cancer-related events (progression, relapse, second cancer). Linkage to population-based administrative databases identified fee and procedure codes indicating cancer treatment or palliative care. Algorithms determining EOIT based on a time interval free of treatment-associated codes, and new cancer-related events based on billing codes, were compared with chart-abstracted data. The cohort comprised 1404 patients. Time periods free of treatment-associated codes did not validly identify EOIT dates; using subsequent codes to identify new cancer events was thus associated with low sensitivity (56.2%). However, using administrative data codes that occurred after the EOIT date based on chart abstraction, the first cancer-related event was identified with excellent validity (sensitivity, 87.0%; specificity, 93.3%; positive predictive value, 81.5%; negative predictive value, 95.5%). Although administrative data alone did not validly identify cancer-related events, administrative data in combination with chart collected EOIT dates was associated with excellent validity. The collection of EOIT dates by cancer registries would significantly expand the potential of administrative data linkage to assess cancer outcomes.

Administration 101: Evaluation of a Professional Development Program.

ERIC Educational Resources Information Center

Chiriboga, Cristina

2003-01-01

Evaluates a community college leadership development program provided by the Association of California Community College Administrators (ACCCA). A total of 129 participants answered questionnaires regarding the effectiveness of the program. Responses were then coded and analyzed in terms of apparent patterns or themes. Outlines some benefits of…

Coding for effective denial management.

PubMed

Miller, Jackie; Lineberry, Joe

2004-01-01

Nearly everyone will agree that accurate and consistent coding of diagnoses and procedures is the cornerstone for operating a compliant practice. The CPT or HCPCS procedure code tells the payor what service was performed and also (in most cases) determines the amount of payment. The ICD-9-CM diagnosis code, on the other hand, tells the payor why the service was performed. If the diagnosis code does not meet the payor's criteria for medical necessity, all payment for the service will be denied. Implementation of an effective denial management program can help "stop the bleeding." Denial management is a comprehensive process that works in two ways. First, it evaluates the cause of denials and takes steps to prevent them. Second, denial management creates specific procedures for refiling or appealing claims that are initially denied. Accurate, consistent and compliant coding is key to both of these functions. The process of proactively managing claim denials also reveals a practice's administrative strengths and weaknesses, enabling radiology business managers to streamline processes, eliminate duplicated efforts and shift a larger proportion of the staff's focus from paperwork to servicing patients--all of which are sure to enhance operations and improve practice management and office morale. Accurate coding requires a program of ongoing training and education in both CPT and ICD-9-CM coding. Radiology business managers must make education a top priority for their coding staff. Front office staff, technologists and radiologists should also be familiar with the types of information needed for accurate coding. A good staff training program will also cover the proper use of Advance Beneficiary Notices (ABNs). Registration and coding staff should understand how to determine whether the patient's clinical history meets criteria for Medicare coverage, and how to administer an ABN if the exam is likely to be denied. Staff should also understand the restrictions on use of

The usefulness of administrative databases for identifying disease cohorts is increased with a multivariate model.

PubMed

van Walraven, Carl; Austin, Peter C; Manuel, Douglas; Knoll, Greg; Jennings, Allison; Forster, Alan J

2010-12-01

Administrative databases commonly use codes to indicate diagnoses. These codes alone are often inadequate to accurately identify patients with particular conditions. In this study, we determined whether we could quantify the probability that a person has a particular disease-in this case renal failure-using other routinely collected information available in an administrative data set. This would allow the accurate identification of a disease cohort in an administrative database. We determined whether patients in a randomly selected 100,000 hospitalizations had kidney disease (defined as two or more sequential serum creatinines or the single admission creatinine indicating a calculated glomerular filtration rate less than 60 mL/min/1.73 m²). The independent association of patient- and hospitalization-level variables with renal failure was measured using a multivariate logistic regression model in a random 50% sample of the patients. The model was validated in the remaining patients. Twenty thousand seven hundred thirteen patients had kidney disease (20.7%). A diagnostic code of kidney disease was strongly associated with kidney disease (relative risk: 34.4), but the accuracy of the code was poor (sensitivity: 37.9%; specificity: 98.9%). Twenty-nine patient- and hospitalization-level variables entered the kidney disease model. This model had excellent discrimination (c-statistic: 90.1%) and accurately predicted the probability of true renal failure. The probability threshold that maximized sensitivity and specificity for the identification of true kidney disease was 21.3% (sensitivity: 80.0%; specificity: 82.2%). Multiple variables available in administrative databases can be combined to quantify the probability that a person has a particular disease. This process permits accurate identification of a disease cohort in an administrative database. These methods may be extended to other diagnoses or procedures and could both facilitate and clarify the use of

The MIMIC Code Repository: enabling reproducibility in critical care research.

PubMed

Johnson, Alistair Ew; Stone, David J; Celi, Leo A; Pollard, Tom J

2018-01-01

Lack of reproducibility in medical studies is a barrier to the generation of a robust knowledge base to support clinical decision-making. In this paper we outline the Medical Information Mart for Intensive Care (MIMIC) Code Repository, a centralized code base for generating reproducible studies on an openly available critical care dataset. Code is provided to load the data into a relational structure, create extractions of the data, and reproduce entire analysis plans including research studies. Concepts extracted include severity of illness scores, comorbid status, administrative definitions of sepsis, physiologic criteria for sepsis, organ failure scores, treatment administration, and more. Executable documents are used for tutorials and reproduce published studies end-to-end, providing a template for future researchers to replicate. The repository's issue tracker enables community discussion about the data and concepts, allowing users to collaboratively improve the resource. The centralized repository provides a platform for users of the data to interact directly with the data generators, facilitating greater understanding of the data. It also provides a location for the community to collaborate on necessary concepts for research progress and share them with a larger audience. Consistent application of the same code for underlying concepts is a key step in ensuring that research studies on the MIMIC database are comparable and reproducible. By providing open source code alongside the freely accessible MIMIC-III database, we enable end-to-end reproducible analysis of electronic health records. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association.

[The nurse's perceptions on administrative actions in their work process].

PubMed

Vaghetti, Helena; Reis, Daniela; Kerber, Nalú da Costa; Azambuja, Eliana; Fernandes, Geani

2004-01-01

A qualitative, exploratory study carried out from March to December 2002 in a university hospital based in the far south of the country, which aimed at identifying the nurses' perception on the administrative actions exercised in their daily work. Thematic categories emerged from data survey and content analysis in the interviews carried out with 10 nurses. We emphasize Category I: Administrative Actions as a Management Instrument; and Category II: Administrative Actions as Direct/indirect Care. In the first one, administrative actions are perceived as planning, coordination, leadership, control, information retention, and organization; the second one depicts administrative actions as an integral part of nursing care. It has been observed that many administrative actions exercised by nurses are inherent to their role, in keeping with the Nurse's Professional Exercise Code, and they are critical for care.

Alternative Administrative Certification: Socializing Factors Influencing Program Choice

ERIC Educational Resources Information Center

Bickmore, Dana L.; Bickmore, Steven T.; Raines, Sarah

2013-01-01

This study used an organizational socialization lens to examine factors influencing participants' decision to pursue the principalship and choice to engage in an alternate administration certification program. Through an analysis of participant focus groups and interviews, factors emerged from the codes that were compared with dimensions of…

21 CFR 11.300 - Controls for identification codes/passwords.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Controls for identification codes/passwords. 11.300 Section 11.300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ELECTRONIC RECORDS; ELECTRONIC SIGNATURES Electronic Signatures § 11.300 Controls for...

Reference Materials and Subject Matter Knowledge Codes for Airman Knowledge Testing

DOT National Transportation Integrated Search

2004-06-08

The listings of reference materials and subject matter knowledge codes have been : prepared by the Federal Aviation Administration (FAA) to establish specific : references for all knowledge standards. The listings contain reference materials : to be ...

Integrating technology to improve medication administration.

PubMed

Prusch, Amanda E; Suess, Tina M; Paoletti, Richard D; Olin, Stephen T; Watts, Starann D

2011-05-01

The development, implementation, and evaluation of an i.v. interoperability program to advance medication safety at the bedside are described. I.V. interoperability integrates intelligent infusion devices (IIDs), the bar-code-assisted medication administration system, and the electronic medication administration record system into a bar-code-driven workflow that populates provider-ordered, pharmacist-validated infusion parameters on IIDs. The purpose of this project was to improve medication safety through the integration of these technologies and decrease the potential for error during i.v. medication administration. Four key phases were essential to developing and implementing i.v. interoperability: (a) preparation, (b) i.v. interoperability pilot, (c) preliminary validation, and (d) expansion. The establishment of pharmacy involvement in i.v. interoperability resulted in two additional safety checks: pharmacist infusion rate oversight and nurse independent validation of the autoprogrammed rate. After instituting i.v. interoperability, monthly compliance to the telemetry drug library increased to a mean ± S.D. of 72.1% ± 2.1% from 56.5% ± 1.5%, and the medical-surgical nursing unit's drug library monthly compliance rate increased to 58.6% ± 2.9% from 34.1% ± 2.6% (p < 0.001 for both comparisons). The number of manual pump edits decreased with both telemetry and medical-surgical drug libraries, demonstrating a reduction from 56.9 ± 12.8 to 14.2 ± 3.9 and from 61.2 ± 15.4 to 14.7 ± 3.8, respectively (p < 0.001 for both comparisons). Through the integration and incorporation of pharmacist oversight for rate changes, the telemetry and medical-surgical patient care areas demonstrated a 32% reduction in reported monthly errors involving i.v. administration of heparin. By integrating two stand-alone technologies, i.v. interoperability was implemented to improve medication administration. Medication errors were reduced, nursing workflow was simplified, and

Further Analysis of Motorcycle Helmet Effectiveness Using CODES Linked Data

DOT National Transportation Integrated Search

1998-01-01

Linked data from the Crash Outcome Data Evaluation System (CODES) in seven : states was used by the National Highway Traffic Safety Administration as the : basis of a 1996 Report to Congress on the Benefits of Safety Belts and : Motorcycle Helmets (D...

Heap/stack guard pages using a wakeup unit

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gooding, Thomas M; Satterfield, David L; Steinmacher-Burow, Burkhard

A method and system for providing a memory access check on a processor including the steps of detecting accesses to a memory device including level-1 cache using a wakeup unit. The method includes invalidating level-1 cache ranges corresponding to a guard page, and configuring a plurality of wakeup address compare (WAC) registers to allow access to selected WAC registers. The method selects one of the plurality of WAC registers, and sets up a WAC register related to the guard page. The method configures the wakeup unit to interrupt on access of the selected WAC register. The method detects access ofmore » the memory device using the wakeup unit when a guard page is violated. The method generates an interrupt to the core using the wakeup unit, and determines the source of the interrupt. The method detects the activated WAC registers assigned to the violated guard page, and initiates a response.« less

Electronic surveillance and using administrative data to identify healthcare associated infections.

PubMed

Gastmeier, Petra; Behnke, Michael

2016-08-01

Traditional surveillance of healthcare associated infections (HCAI) is time consuming and error-prone. We have analysed literature of the past year to look at new developments in this field. It is divided into three parts: new algorithms for electronic surveillance, the use of administrative data for surveillance of HCAI, and the definition of new endpoints of surveillance, in accordance with an automatic surveillance approach. Most studies investigating electronic surveillance of HCAI have concentrated on bloodstream infection or surgical site infection. However, the lack of important parameters in hospital databases can lead to misleading results. The accuracy of administrative coding data was poor at identifying HCAI. New endpoints should be defined for automatic detection, with the most crucial step being to win clinicians' acceptance. Electronic surveillance with conventional endpoints is a successful method when hospital information systems implemented key changes and enhancements. One requirement is the access to systems for hospital administration and clinical databases.Although the primary source of data for HCAI surveillance is not administrative coding data, these are important components of a hospital-wide programme of automated surveillance. The implementation of new endpoints for surveillance is an approach which needs to be discussed further.

Oil and Gas Field Code Master List 1990

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This is the ninth annual edition of the Energy Information Administration's (EIA) Oil and Gas Field Code Master List. It reflects data collected through October 1990 and provides standardized field name spellings and codes for all identified oil and/or gas fields in the United States. There are 54,963 field records in this year's Oil and Gas Field Code Master List (FCML). This amounts to 467 more than in last year's report. As it is maintained by EIA, the Master List includes: Field records for each state and county in which a field resides; field records for each offshore area blockmore » in the Gulf of Mexico in which a field resides;field records for each alias field name; fields crossing state boundaries that may be assigned different names by the respective state naming authorities.« less

State Environmental Policy Act (SEPA) environmental checklist forms for 304 Concretion Facility Closure Plan. Revision 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The 300 Area of the Hanford Site contains reactor fuel manufacturing facilities and several research and development laboratories. Recyclable scrap uranium with zircaloy-2 and copper silicon alloy, uranium-titanium alloy, beryllium/zircaloy-2 alloy, and zircaloy-2 chips and fines were secured in concrete billets (7.5-gallon containers) in the 304 Facility, located in the 300 Area. The beryllium/zircaloy-2 alloy and zircaloy-2 chips and fines are designated as mixed waste with the characteristic of ignitability. The concretion process reduced the ignitability of the fines and chips for safe storage and shipment. This process has been discontinued and the 304 Facility is now undergoing closure asmore » defined in the Resource Conservation and Recovery Act (RCRA) of 1976 and the Washington Administrative Code (WAC) Dangerous Waste Regulations, WAC 173-303-040. This closure plan presents a description of the 304 Facility, the history of materials and waste managed, and the procedures that will be followed to close the 304 Facility. The 304 Facility is located within the 300-FF-3 (source) and 300-FF-5 (groundwater) operable units, as designated in the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) (Ecology et al. 1992). Contamination in the operable units 300-FF-3 and 300-FF-5 is scheduled to be addressed through the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) of 1980 remedial action process. Therefore, all soil remedial action at the 304 Facility will be conducted as part of the CERCLA remedial action of operable units 300-FF-3 and 300-FF-5.« less

A&M. Plot plan of administration and A&M areas. Shows relationships ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

A&M. Plot plan of administration and A&M areas. Shows relationships among administration buildings and to A&M building (TAN-607), railroad turntable. Ralph M. Parsons 902-2&3-ANP-U 3. Date: December 1952. INEEL index code no. 032-0100-00-693-106690 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

An Examination of Differences in Consequences of Punishment among PK-12 School Administrators

ERIC Educational Resources Information Center

Randle, Dawn DuBose

2010-01-01

The purpose of this study was to examine the differences in the administering of punishment procedures for violations of a school district's Code of Student Conduct among school-based administrators. Specifically, this study was concerned with the impact of the socio-demographic variables of: gender, years of administrative experience,…

[Quality measurement using administrative data in mandatory quality assurance].

PubMed

Heller, Günther; Szecsenyi, Joachim; Willms, Gerald; Broge, Björn

2014-01-01

For several years, the use of administrative data in mandatory quality measurement has been requested by several stakeholders in Germany. Main advantages of using administrative data include the reduction of documentary expenditures and the possibility to perform longitudinal quality analyses across different healthcare units. After a short introduction, a brief overview of the current use of administrative data for mandatory quality assurance as well as current developments is given, which will then be further exemplified by decubital ulcer prophylaxis. By using administrative data coding expenditures in this clinical area could be reduced by nine million data fields. At the same time the population analysed was expanded resulting in a more than tenfold increase in potentially quality-relevant events. Finally, perspectives, further developments, possibilities as well as limits of quality measurement with administrative data are discussed. Copyright © 2014. Published by Elsevier GmbH.

Why the Disadvantaged Drop Out: The Administrators' View.

ERIC Educational Resources Information Center

Morrison, James L.; Ferrante, Reynolds

A report focusing on the academically disadvantaged minority group students is presented. Perceptions of administrators in public two-year colleges as to the major reasons for attrition of this group are examined. A pre-coded questionnaire was developed to gather information concerning programs of compensatory education in two-year colleges. It…

5 CFR 630.1201 - Purpose, applicability, and administration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS ABSENCE AND LEAVE Family and Medical Leave § 630.1201 Purpose, applicability, and administration... 6387 of title 5, United States Code, provide a standard approach to providing family and medical leave... unpaid leave during any 12-month period for certain family and medical needs, as specified in § 630.1203...

21 CFR 11.300 - Controls for identification codes/passwords.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Controls for identification codes/passwords. 11.300 Section 11.300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... attempts at their unauthorized use to the system security unit, and, as appropriate, to organizational...

21 CFR 11.300 - Controls for identification codes/passwords.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Controls for identification codes/passwords. 11.300 Section 11.300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... attempts at their unauthorized use to the system security unit, and, as appropriate, to organizational...

A systematic review of validated methods for identifying acute respiratory failure using administrative and claims data.

PubMed

Jones, Natalie; Schneider, Gary; Kachroo, Sumesh; Rotella, Philip; Avetisyan, Ruzan; Reynolds, Matthew W

2012-01-01

The Food and Drug Administration's (FDA) Mini-Sentinel pilot program initially aims to conduct active surveillance to refine safety signals that emerge for marketed medical products. A key facet of this surveillance is to develop and understand the validity of algorithms for identifying health outcomes of interest (HOIs) from administrative and claims data. This paper summarizes the process and findings of the algorithm review of acute respiratory failure (ARF). PubMed and Iowa Drug Information Service searches were conducted to identify citations applicable to the anaphylaxis HOI. Level 1 abstract reviews and Level 2 full-text reviews were conducted to find articles using administrative and claims data to identify ARF, including validation estimates of the coding algorithms. Our search revealed a deficiency of literature focusing on ARF algorithms and validation estimates. Only two studies provided codes for ARF, each using related yet different ICD-9 codes (i.e., ICD-9 codes 518.8, "other diseases of lung," and 518.81, "acute respiratory failure"). Neither study provided validation estimates. Research needs to be conducted on designing validation studies to test ARF algorithms and estimating their predictive power, sensitivity, and specificity. Copyright © 2012 John Wiley & Sons, Ltd.

ICD-10 procedure codes produce transition challenges

PubMed Central

Boyd, Andrew D.; Li, Jianrong ‘John’; Kenost, Colleen; Zaim, Samir Rachid; Krive, Jacob; Mittal, Manish; Satava, Richard A.; Burton, Michael; Smith, Jacob; Lussier, Yves A.

2018-01-01

The transition of procedure coding from ICD-9-CM-Vol-3 to ICD-10-PCS has generated problems for the medical community at large resulting from the lack of clarity required to integrate two non-congruent coding systems. We hypothesized that quantifying these issues with network topology analyses offers a better understanding of the issues, and therefore we developed solutions (online tools) to empower hospital administrators and researchers to address these challenges. Five topologies were identified: “identity”(I), “class-to-subclass”(C2S), “subclass-toclass”(S2C), “convoluted(C)”, and “no mapping”(NM). The procedure codes in the 2010 Illinois Medicaid dataset (3,290 patients, 116 institutions) were categorized as C=55%, C2S=40%, I=3%, NM=2%, and S2C=1%. Majority of the problematic and ambiguous mappings (convoluted) pertained to operations in ophthalmology cardiology, urology, gyneco-obstetrics, and dermatology. Finally, the algorithms were expanded into a user-friendly tool to identify problematic topologies and specify lists of procedural codes utilized by medical professionals and researchers for mitigating error-prone translations, simplifying research, and improving quality.http://www.lussiergroup.org/transition-to-ICD10PCS PMID:29888037

ICD-10 procedure codes produce transition challenges.

PubMed

Boyd, Andrew D; Li, Jianrong 'John'; Kenost, Colleen; Zaim, Samir Rachid; Krive, Jacob; Mittal, Manish; Satava, Richard A; Burton, Michael; Smith, Jacob; Lussier, Yves A

2018-01-01

The transition of procedure coding from ICD-9-CM-Vol-3 to ICD-10-PCS has generated problems for the medical community at large resulting from the lack of clarity required to integrate two non-congruent coding systems. We hypothesized that quantifying these issues with network topology analyses offers a better understanding of the issues, and therefore we developed solutions (online tools) to empower hospital administrators and researchers to address these challenges. Five topologies were identified: "identity"(I), "class-to-subclass"(C2S), "subclass-toclass"(S2C), "convoluted(C)", and "no mapping"(NM). The procedure codes in the 2010 Illinois Medicaid dataset (3,290 patients, 116 institutions) were categorized as C=55%, C2S=40%, I=3%, NM=2%, and S2C=1%. Majority of the problematic and ambiguous mappings (convoluted) pertained to operations in ophthalmology cardiology, urology, gyneco-obstetrics, and dermatology. Finally, the algorithms were expanded into a user-friendly tool to identify problematic topologies and specify lists of procedural codes utilized by medical professionals and researchers for mitigating error-prone translations, simplifying research, and improving quality.http://www.lussiergroup.org/transition-to-ICD10PCS.

The Effects of Environmental Factors on Marine Micro-Phytoplankton Community Composition in the Summertime Western North Atlantic Ocean During WACS II.

NASA Astrophysics Data System (ADS)

Stone, J. T.; Vaillancourt, R. D.

2016-02-01

Micro-phytoplankton community composition was determined along a section in the western North Atlantic Ocean between waters near Bermuda and the New England continental shelf during the Western Atlantic Climate Study II (WACS II) from May 18, 2014 to June 6, 2014. Seawater samples were collected from the underway line (z = 5 meters) of the RV Knorr and preserved in both Lugol's and formalin preservatives. The concentrations of centric diatoms, pennate diatoms, dinoflagellates and dictyophytes were determined using light microscopy of preserved samples settled in Utermöhl chambers. Cell abundance data were compared with the temperature and salinity of the surface seawater to determine statistical relationships between environmental factors and phytoplankton community composition. The micro-phytoplankton concentrations were lowest around the Sargasso Sea. Diatom concentrations varied along the transect from the Sargasso Sea. Dinoflagellates were the only group of micro-phytoplankton in this study to have a clear pattern in their distribution. Dinoflagellates were most numerous in the northern-most waters and were absent in the southern-most point of the study, in the Sargasso Sea. The most abundant species of diatoms observed were in the genera Pseudo-Nitzschia and Leptocylindrus. The most abundant species of dinoflagellate were of the genus Protoperidinium. Many of the samples with the highest species richness were closer to the coast and more northern than the samples with low species richness, however the Simpson's diversity indices varied amongst regions. While many of the samples were diverse, the lowest of which was in the Sargasso Sea, there was no clear pattern of species diversity with respect to the distance from the coast. Dinoflagellates, centric diatoms, pennate diatoms, dictyophytes and diversity indices were significantly weakly correlated with temperature, while dinoflagellates were significantly strongly correlated with salinity.

Validation of key behaviourally based mental health diagnoses in administrative data: suicide attempt, alcohol abuse, illicit drug abuse and tobacco use.

PubMed

Kim, Hyungjin Myra; Smith, Eric G; Stano, Claire M; Ganoczy, Dara; Zivin, Kara; Walters, Heather; Valenstein, Marcia

2012-01-23

Observational research frequently uses administrative codes for mental health or substance use diagnoses and for important behaviours such as suicide attempts. We sought to validate codes (International Classification of Diseases, 9th edition, clinical modification diagnostic and E-codes) entered in Veterans Health Administration administrative data for patients with depression versus a gold standard of electronic medical record text ("chart notation"). Three random samples of patients were selected, each stratified by geographic region, gender, and year of cohort entry, from a VHA depression treatment cohort from April 1, 1999 to September 30, 2004. The first sample was selected from patients who died by suicide, the second from patients who remained alive on the date of death of suicide cases, and the third from patients with a new start of a commonly used antidepressant medication. Four variables were assessed using administrative codes in the year prior to the index date: suicide attempt, alcohol abuse/dependence, drug abuse/dependence and tobacco use. Specificity was high (≥ 90%) for all four administrative codes, regardless of the sample. Sensitivity was ≤75% and was particularly low for suicide attempt (≤ 17%). Positive predictive values for alcohol dependence/abuse and tobacco use were high, but barely better than flipping a coin for illicit drug abuse/dependence. Sensitivity differed across the three samples, but was highest in the suicide death sample. Administrative data-based diagnoses among VHA records have high specificity, but low sensitivity. The accuracy level varies by different diagnosis and by different patient subgroup.

75 FR 25311 - Requested Administrative Waiver of the Coastwise Trade Laws

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

.... ACTION: Invitation for public comments on a requested administrative waiver of the Coastwise Trade Laws... Gurland, Secretary, Maritime Adminstration. [FR Doc. 2010-10903 Filed 5-6-10; 8:45 am] BILLING CODE 4910...

Comparison of ICD code-based diagnosis of obesity with measured obesity in children and the implications for health care cost estimates.

PubMed

Kuhle, Stefan; Kirk, Sara F L; Ohinmaa, Arto; Veugelers, Paul J

2011-12-21

Administrative health databases are a valuable research tool to assess health care utilization at the population level. However, their use in obesity research limited due to the lack of data on body weight. A potential workaround is to use the ICD code of obesity to identify obese individuals. The objective of the current study was to investigate the sensitivity and specificity of an ICD code-based diagnosis of obesity from administrative health data relative to the gold standard measured BMI. Linkage of a population-based survey with anthropometric measures in elementary school children in 2003 with longitudinal administrative health data (physician visits and hospital discharges 1992-2006) from the Canadian province of Nova Scotia. Measured obesity was defined based on the CDC cut-offs applied to the measured BMI. An ICD code-based diagnosis obesity was defined as one or more ICD-9 (278) or ICD-10 code (E66-E68) of obesity from a physician visit or a hospital stay. Sensitivity and specificity were calculated and health care cost estimates based on measured obesity and ICD-based obesity were compared. The sensitivity of an ICD code-based obesity diagnosis was 7.4% using ICD codes between 2002 and 2004. Those correctly identified had a higher BMI and had higher health care utilization and costs. An ICD diagnosis of obesity in Canadian administrative health data grossly underestimates the true prevalence of childhood obesity and overestimates the health care cost differential between obese and non-obese children.

[Algorithms for the identification of hospital stays due to osteoporotic femoral neck fractures in European medical administrative databases using ICD-10 codes: A non-systematic review of the literature].

PubMed

Caillet, P; Oberlin, P; Monnet, E; Guillon-Grammatico, L; Métral, P; Belhassen, M; Denier, P; Banaei-Bouchareb, L; Viprey, M; Biau, D; Schott, A-M

2017-10-01

Osteoporotic hip fractures (OHF) are associated with significant morbidity and mortality. The French medico-administrative database (SNIIRAM) offers an interesting opportunity to improve the management of OHF. However, the validity of studies conducted with this database relies heavily on the quality of the algorithm used to detect OHF. The aim of the REDSIAM network is to facilitate the use of the SNIIRAM database. The main objective of this study was to present and discuss several OHF-detection algorithms that could be used with this database. A non-systematic literature search was performed. The Medline database was explored during the period January 2005-August 2016. Furthermore, a snowball search was then carried out from the articles included and field experts were contacted. The extraction was conducted using the chart developed by the REDSIAM network's "Methodology" task force. The ICD-10 codes used to detect OHF are mainly S72.0, S72.1, and S72.2. The performance of these algorithms is at best partially validated. Complementary use of medical and surgical procedure codes would affect their performance. Finally, few studies described how they dealt with fractures of non-osteoporotic origin, re-hospitalization, and potential contralateral fracture cases. Authors in the literature encourage the use of ICD-10 codes S72.0 to S72.2 to develop algorithms for OHF detection. These are the codes most frequently used for OHF in France. Depending on the study objectives, other ICD10 codes and medical and surgical procedures could be usefully discussed for inclusion in the algorithm. Detection and management of duplicates and non-osteoporotic fractures should be considered in the process. Finally, when a study is based on such an algorithm, all these points should be precisely described in the publication. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Select Components and Finish System Design of a Window Air Conditioner with Propane

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shen, Bo; Abdelaziz, Omar

This report describes the technical targets for developing a high efficiency window air conditioner (WAC) using propane (R-290). The baseline unit selected for this activity is a GE R-410A WAC. We established collaboration with a Chinese rotary compressor manufacturer, to select an R-290 compressor. We first modelled and calibrated the WAC system model using R-410A. Next, we applied the calibrated system model to design the R-290 WAC, and decided the strategies to reduce the system charge below 260 grams and achieve the capacity and efficiency targets.

Identifying injection drug use and estimating population size of people who inject drugs using healthcare administrative datasets.

PubMed

Janjua, Naveed Zafar; Islam, Nazrul; Kuo, Margot; Yu, Amanda; Wong, Stanley; Butt, Zahid A; Gilbert, Mark; Buxton, Jane; Chapinal, Nuria; Samji, Hasina; Chong, Mei; Alvarez, Maria; Wong, Jason; Tyndall, Mark W; Krajden, Mel

2018-05-01

Large linked healthcare administrative datasets could be used to monitor programs providing prevention and treatment services to people who inject drugs (PWID). However, diagnostic codes in administrative datasets do not differentiate non-injection from injection drug use (IDU). We validated algorithms based on diagnostic codes and prescription records representing IDU in administrative datasets against interview-based IDU data. The British Columbia Hepatitis Testers Cohort (BC-HTC) includes ∼1.7 million individuals tested for HCV/HIV or reported HBV/HCV/HIV/tuberculosis cases in BC from 1990 to 2015, linked to administrative datasets including physician visit, hospitalization and prescription drug records. IDU, assessed through interviews as part of enhanced surveillance at the time of HIV or HCV/HBV diagnosis from a subset of cases included in the BC-HTC (n = 6559), was used as the gold standard. ICD-9/ICD-10 codes for IDU and injecting-related infections (IRI) were grouped with records of opioid substitution therapy (OST) into multiple IDU algorithms in administrative datasets. We assessed the performance of IDU algorithms through calculation of sensitivity, specificity, positive predictive, and negative predictive values. Sensitivity was highest (90-94%), and specificity was lowest (42-73%) for algorithms based either on IDU or IRI and drug misuse codes. Algorithms requiring both drug misuse and IRI had lower sensitivity (57-60%) and higher specificity (90-92%). An optimal sensitivity and specificity combination was found with two medical visits or a single hospitalization for injectable drugs with (83%/82%) and without OST (78%/83%), respectively. Based on algorithms that included two medical visits, a single hospitalization or OST records, there were 41,358 (1.2% of 11-65 years individuals in BC) recent PWID in BC based on health encounters during 3- year period (2013-2015). Algorithms for identifying PWID using diagnostic codes in linked administrative

A validated case definition for chronic rhinosinusitis in administrative data: a Canadian perspective.

PubMed

Rudmik, Luke; Xu, Yuan; Kukec, Edward; Liu, Mingfu; Dean, Stafford; Quan, Hude

2016-11-01

Pharmacoepidemiological research using administrative databases has become increasingly popular for chronic rhinosinusitis (CRS); however, without a validated case definition the cohort evaluated may be inaccurate resulting in biased and incorrect outcomes. The objective of this study was to develop and validate a generalizable administrative database case definition for CRS using International Classification of Diseases, 9th edition (ICD-9)-coded claims. A random sample of 100 patients with a guideline-based diagnosis of CRS and 100 control patients were selected and then linked to a Canadian physician claims database from March 31, 2010, to March 31, 2015. The proportion of CRS ICD-9-coded claims (473.x and 471.x) for each of these 200 patients were reviewed and the validity of 7 different ICD-9-based coding algorithms was evaluated. The CRS case definition of ≥2 claims with a CRS ICD-9 code (471.x or 473.x) within 2 years of the reference case provides a balanced validity with a sensitivity of 77% and specificity of 79%. Applying this CRS case definition to the claims database produced a CRS cohort of 51,000 patients with characteristics that were consistent with published demographics and rates of comorbid asthma, allergic rhinitis, and depression. This study has validated several coding algorithms; based on the results a case definition of ≥2 physician claims of CRS (ICD-9 of 471.x or 473.x) within 2 years provides an optimal level of validity. Future studies will need to validate this administrative case definition from different health system perspectives and using larger retrospective chart reviews from multiple providers. © 2016 ARS-AAOA, LLC.

48 CFR 2301.105-1 - Publication and code ar-rangement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Publication and code ar-rangement. 2301.105-1 Section 2301.105-1 Federal Acquisition Regulations System SOCIAL SECURITY ADMINISTRATION GENERAL SOCIAL SECURITY ACQUISITION REGULATION SYSTEM Purpose, Authority, Issuance 2301.105-1...

Lack of agreement in pediatric emergency department discharge diagnoses from clinical and administrative data sources.

PubMed

Gorelick, Marc H; Knight, Stacey; Alessandrini, Evaline A; Stanley, Rachel M; Chamberlain, James M; Kuppermann, Nathan; Alpern, Elizabeth R

2007-07-01

Diagnosis information from existing data sources is used commonly for epidemiologic, administrative, and research purposes. The quality of such data for emergency department (ED) visits is unknown. To determine the agreement on final diagnoses between two sources, electronic administrative sources and manually abstracted medical records, for pediatric ED visits, in a multicenter network. This was a cross sectional study at 19 EDs nationwide. The authors obtained data from two sources at each ED during a three-month period in 2003: administrative sources for all visits and abstracted records for randomly selected visits during ten days over the study period. Records were matched using unique identifiers and probabilistic linkage. The authors recorded up to three diagnoses from each abstracted medical record and up to ten for the administrative data source. Diagnoses were grouped into 104 groups using a modification of the Clinical Classification System. A total of 8,860 abstracted records had at least one valid diagnosis code (with a total of 12,895 diagnoses) and were successfully matched to records in the administrative source. Overall, 67% (95% confidence interval = 66% to 68%) of diagnoses from the administrative and abstracted sources were within the same diagnosis group. Agreement varied by site, ranging from 54% to 77%. Agreement varied substantially by diagnosis group; there was no difference by method of linkage. Clustering clinically similar diagnosis groups improved agreement between administrative and abstracted data sources. ED diagnoses retrieved from electronic administrative sources and manual chart review frequently disagree, even if similar diagnosis codes are grouped. Agreement varies by institution and by diagnosis. Further work is needed to improve the accuracy of diagnosis coding; development of a grouping system specific to pediatric emergency care may be beneficial.

Impact of developing a multidisciplinary coded dataset standard on administrative data accuracy for septoplasty, septorhinoplasty and nasal trauma surgery.

PubMed

Nouraei, S A R; Hudovsky, A; Virk, J S; Saleh, H A

2017-04-01

This study aimed to develop a multidisciplinary coded dataset standard for nasal surgery and to assess its impact on data accuracy. An audit of 528 patients undergoing septal and/or inferior turbinate surgery, rhinoplasty and/or septorhinoplasty, and nasal fracture surgery was undertaken. A total of 200 septoplasties, 109 septorhinoplasties, 57 complex septorhinoplasties and 116 nasal fractures were analysed. There were 76 (14.4 per cent) changes to the primary diagnosis. Septorhinoplasties were the most commonly amended procedures. The overall audit-related income change for nasal surgery was £8.78 per patient. Use of a multidisciplinary coded dataset standard revealed that nasal diagnoses were under-coded; a significant proportion of patients received more precise diagnoses following the audit. There was also significant under-coding of both morbidities and revision surgery. The multidisciplinary coded dataset standard approach can improve the accuracy of both data capture and information flow, and, thus, ultimately create a more reliable dataset for use outcomes and health planning.

Administrative data measured surgical site infection probability within 30 days of surgery in elderly patients.

PubMed

van Walraven, Carl; Jackson, Timothy D; Daneman, Nick

2016-09-01

Elderly patients are inordinately affected by surgical site infections (SSIs). This study derived and internally validated a model that used routinely collected health administrative data to measure the probability of SSI in elderly patients within 30 days of surgery. All people exceeding 65 years undergoing surgery from two hospitals with known SSI status were linked to population-based administrative data sets in Ontario, Canada. We used bootstrap methods to create a multivariate model that used health administrative data to predict the probability of SSI. Of 3,436 patients, 177 (5.1%) had an SSI. The Elderly SSI Risk Model included six covariates: number of distinct physician fee codes within 30 days of surgery; presence or absence of a postdischarge prescription for an antibiotic; presence or absence of three diagnostic codes; and a previously derived score that gauged SSI risk based on procedure codes. The model was highly explanatory (Nagelkerke's R 2 , 0.458), strongly discriminative (C statistic, 0.918), and well calibrated (calibration slope, 1). Health administrative data can effectively determine 30-day risk of SSI risk in elderly patients undergoing a broad assortment of surgeries. External validation is necessary before this can be routinely used to monitor SSIs in the elderly. Copyright © 2016 Elsevier Inc. All rights reserved.

The impact of alternative pricing methods for drugs in California Workers’ Compensation System: Fee-schedule pricing

PubMed Central

Wilson, Leslie; Turkistani, Fatema A.; Huang, Wei; Tran, Dang M.; Lin, Tracy Kuo

2018-01-01

Introduction California’s Workers’ Compensation System (CAWCS) Department of Industrial Relations questioned the adequacy of the current Medi-Cal fee-schedule pricing and requested analysis of alternatives that maximize price availability and maintain budget neutrality. Objectives To compare CAWCS pharmacy-dispensed (PD) drug prices under alternative fee schedules, and identify combinations of alternative benchmarks that have prices available for the largest percentage of PD drugs and that best reach budget neutrality. Methods Claims transaction-level data (2011–2013) from CAWCS were used to estimate total annual PD pharmaceutical payments. Medi-Cal pricing data was from the Workman’s Compensation Insurance System (WCIS). Average Wholesale Prices (AWP), Wholesale Acquisition Costs (WAC), Direct Prices (DP), Federal Upper Limit (FUL) prices, and National Average Drug Acquisition Costs (NADAC) were from Medi-Span. We matched National Drug Codes (NDCs), pricing dates, and drug quantity for comparisons. We report pharmacy-dispensed (PD) claims frequency, reimbursement matching rate, and paid costs by CAWCS as the reference price against all alternative price benchmarks. Results Of 12,529,977 CAWCS claims for pharmaceutical products 11.6% (1,462,814) were for PD drugs. Prescription drug cost for CAWCS was over $152M; $63.9M, $47.9M, and $40.6M in 2011–2013. Ninety seven percent of these CAWCS PD claims had a Medi-Cal price. Alternative mechanisms provided a price for fewer claims; NADAC 94.23%, AWP 90.94%, FUL 73.11%, WAC 66.98%, and DP 14.33%. Among CAWCS drugs with no Medi-Cal price in PD claims, AWP, WAC, NADAC, DP, and FUL provided prices for 96.7%, 63.14%, 24.82%, 20.83%, and 15.08% of claims. Overall CAWCS paid 100.52% of Medi-Cal, 60% of AWP, 97% of WAC, 309.53% of FUL, 103.83% of DP, and 136.27% of NADAC. Conclusions CAWCS current Medi-Cal fee-schedule price list for PD drugs is more complete than all alternative fee-schedules. However, all

Tradeoffs of Using Administrative Claims and Medical Records to Identify the Use of Personalized Medicine for Patients with Breast Cancer

PubMed Central

Liang, Su-Ying; Phillips, Kathryn A.; Wang, Grace; Keohane, Carol; Armstrong, Joanne; Morris, William M.; Haas, Jennifer S.

2012-01-01

Background Administrative claims and medical records are important data sources to examine healthcare utilization and outcomes. Little is known about identifying personalized medicine technologies in these sources. Objectives To describe agreement, sensitivity, and specificity of administrative claims compared to medical records for two pairs of targeted tests and treatments for breast cancer. Research Design Retrospective analysis of medical records linked to administrative claims from a large health plan. We examined whether agreement varied by factors that facilitate tracking in claims (coding and cost) and that enhance medical record completeness (records from multiple providers). Subjects Women (35 – 65 years) with incident breast cancer diagnosed in 2006–2007 (n=775). Measures Use of human epidermal growth factor receptor 2 (HER2) and gene expression profiling (GEP) testing, trastuzumab and adjuvant chemotherapy in claims and medical records. Results Agreement between claims and records was substantial for GEP, trastuzumab, and chemotherapy, and lowest for HER2 tests. GEP, an expensive test with unique billing codes, had higher agreement (91.6% vs. 75.2%), sensitivity (94.9% vs. 76.7%), and specificity (90.1% vs. 29.2%) than HER2, a test without unique billing codes. Trastuzumab, a treatment with unique billing codes, had slightly higher agreement (95.1% vs. 90%) and sensitivity (98.1% vs. 87.9%) than adjuvant chemotherapy. Conclusions Higher agreement and specificity were associated with services that had unique billing codes and high cost. Administrative claims may be sufficient for examining services with unique billing codes. Medical records provide better data for identifying tests lacking specific codes and for research requiring detailed clinical information. PMID:21422962

29 CFR 1910.35 - Compliance with alternate exit-route codes.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 1910.35 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS Exit Routes and Emergency Planning § 1910.35...-route provisions of NFPA 101, Life Safety Code, 2009 edition, or the exit-route provisions of the...

A Large Scale Code Resolution Service Network in the Internet of Things

PubMed Central

Yu, Haining; Zhang, Hongli; Fang, Binxing; Yu, Xiangzhan

2012-01-01

In the Internet of Things a code resolution service provides a discovery mechanism for a requester to obtain the information resources associated with a particular product code immediately. In large scale application scenarios a code resolution service faces some serious issues involving heterogeneity, big data and data ownership. A code resolution service network is required to address these issues. Firstly, a list of requirements for the network architecture and code resolution services is proposed. Secondly, in order to eliminate code resolution conflicts and code resolution overloads, a code structure is presented to create a uniform namespace for code resolution records. Thirdly, we propose a loosely coupled distributed network consisting of heterogeneous, independent; collaborating code resolution services and a SkipNet based code resolution service named SkipNet-OCRS, which not only inherits DHT's advantages, but also supports administrative control and autonomy. For the external behaviors of SkipNet-OCRS, a novel external behavior mode named QRRA mode is proposed to enhance security and reduce requester complexity. For the internal behaviors of SkipNet-OCRS, an improved query algorithm is proposed to increase query efficiency. It is analyzed that integrating SkipNet-OCRS into our resolution service network can meet our proposed requirements. Finally, simulation experiments verify the excellent performance of SkipNet-OCRS. PMID:23202207

A large scale code resolution service network in the Internet of Things.

PubMed

Yu, Haining; Zhang, Hongli; Fang, Binxing; Yu, Xiangzhan

2012-11-07

In the Internet of Things a code resolution service provides a discovery mechanism for a requester to obtain the information resources associated with a particular product code immediately. In large scale application scenarios a code resolution service faces some serious issues involving heterogeneity, big data and data ownership. A code resolution service network is required to address these issues. Firstly, a list of requirements for the network architecture and code resolution services is proposed. Secondly, in order to eliminate code resolution conflicts and code resolution overloads, a code structure is presented to create a uniform namespace for code resolution records. Thirdly, we propose a loosely coupled distributed network consisting of heterogeneous, independent; collaborating code resolution services and a SkipNet based code resolution service named SkipNet-OCRS, which not only inherits DHT’s advantages, but also supports administrative control and autonomy. For the external behaviors of SkipNet-OCRS, a novel external behavior mode named QRRA mode is proposed to enhance security and reduce requester complexity. For the internal behaviors of SkipNet-OCRS, an improved query algorithm is proposed to increase query efficiency. It is analyzed that integrating SkipNet-OCRS into our resolution service network can meet our proposed requirements. Finally, simulation experiments verify the excellent performance of SkipNet-OCRS.

78 FR 38270 - Endangered and Threatened Wildlife; Proposed Rule To Revise the Code of Federal Regulations for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Parts 223 and 224... the Code of Federal Regulations for Species Under the Jurisdiction of the National Marine Fisheries Service AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration...

The accuracy of International Classification of Diseases coding for dental problems not associated with trauma in a hospital emergency department.

PubMed

Figueiredo, Rafael L F; Singhal, Sonica; Dempster, Laura; Hwang, Stephen W; Quinonez, Carlos

2015-01-01

Emergency department (ED) visits for nontraumatic dental conditions (NTDCs) may be a sign of unmet need for dental care. The objective of this study was to determine the accuracy of the International Classification of Diseases codes (ICD-10-CA) for ED visits for NTDC. ED visits in 2008-2099 at one hospital in Toronto were identified if the discharge diagnosis in the administrative database system was an ICD-10-CA code for a NTDC (K00-K14). A random sample of 100 visits was selected, and the medical records for these visits were reviewed by a dentist. The description of the clinical signs and symptoms were evaluated, and a diagnosis was assigned. This diagnosis was compared with the diagnosis assigned by the physician and the code assigned to the visit. The 100 ED visits reviewed were associated with 16 different ICD-10-CA codes for NTDC. Only 2 percent of these visits were clearly caused by trauma. The code K0887 (toothache) was the most frequent diagnostic code (31 percent). We found 43.3 percent disagreement on the discharge diagnosis reported by the physician, and 58.0 percent disagreement on the code in the administrative database assigned by the abstractor, compared with what it was suggested by the dentist reviewing the chart. There are substantial discrepancies between the ICD-10-CA diagnosis assigned in administrative databases and the diagnosis assigned by a dentist reviewing the chart retrospectively. However, ICD-10-CA codes can be used to accurately identify ED visits for NTDC. © 2015 American Association of Public Health Dentistry.

ISS mapped from ICD-9-CM by a novel freeware versus traditional coding: a comparative study.

PubMed

Di Bartolomeo, Stefano; Tillati, Silvia; Valent, Francesca; Zanier, Loris; Barbone, Fabio

2010-03-31

Injury severity measures are based either on the Abbreviated Injury Scale (AIS) or the International Classification of diseases (ICD). The latter is more convenient because routinely collected by clinicians for administrative reasons. To exploit this advantage, a proprietary program that maps ICD-9-CM into AIS codes has been used for many years. Recently, a program called ICDPIC trauma and developed in the USA has become available free of charge for registered STATA users. We compared the ICDPIC calculated Injury Severity Score (ISS) with the one from direct, prospective AIS coding by expert trauma registrars (dAIS). The administrative records of the 289 major trauma cases admitted to the hospital of Udine-Italy from 1 July 2004 to 30 June 2005 and enrolled in the Italian Trauma Registry were retrieved and ICDPIC-ISS was calculated. The agreement between ICDPIC-ISS and dAIS-ISS was assessed by Cohen's Kappa and Bland-Altman charts. We then plotted the differences between the 2 scores against the ratio between the number of traumatic ICD-9-CM codes and the number of dAIS codes for each patient (DIARATIO). We also compared the absolute differences in ISS among 3 groups identified by DIARATIO. The discriminative power for survival of both scores was finally calculated by ROC curves. The scores matched in 33/272 patients (12.1%, k 0.07) and, when categorized, in 80/272 (22.4%, k 0.09). The Bland-Altman average difference was 6.36 (limits: minus 22.0 to plus 34.7). ICDPIC-ISS of 75 was particularly unreliable. The differences increased (p < 0.01) as DIARATIO increased indicating incomplete administrative coding as a cause of the differences. The area under the curve of ICDPIC-ISS was lower (0.63 vs. 0.76, p = 0.02). Despite its great potential convenience, ICPIC-ISS agreed poorly with its conventionally calculated counterpart. Its discriminative power for survival was also significantly lower. Incomplete ICD-9-CM coding was a main cause of these findings. Because this

15 CFR Appendix B to Part 30 - AES Filing Codes

Code of Federal Regulations, 2014 CFR

2014-01-01

... charity FS—Foreign Military Sales ZD—North American Free Trade Agreements (NAFTA) duty deferral shipments...—Validated End User Authorization C58CCD—Consumer Communication Devices C59STA—Strategic Trade Authorization Department of Energy/National Nuclear Security Administration (DOE/NNSA) Codes E01—DOE/NNSA Nuclear...

50 CFR Table 4 to Part 680 - Crab Process Codes

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Crab Process Codes 4 Table 4 to Part 680 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) SHELLFISH FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA Pt. 680...

Concatenated Coding Using Trellis-Coded Modulation

NASA Technical Reports Server (NTRS)

Thompson, Michael W.

1997-01-01

In the late seventies and early eighties a technique known as Trellis Coded Modulation (TCM) was developed for providing spectrally efficient error correction coding. Instead of adding redundant information in the form of parity bits, redundancy is added at the modulation stage thereby increasing bandwidth efficiency. A digital communications system can be designed to use bandwidth-efficient multilevel/phase modulation such as Amplitude Shift Keying (ASK), Phase Shift Keying (PSK), Differential Phase Shift Keying (DPSK) or Quadrature Amplitude Modulation (QAM). Performance gain can be achieved by increasing the number of signals over the corresponding uncoded system to compensate for the redundancy introduced by the code. A considerable amount of research and development has been devoted toward developing good TCM codes for severely bandlimited applications. More recently, the use of TCM for satellite and deep space communications applications has received increased attention. This report describes the general approach of using a concatenated coding scheme that features TCM and RS coding. Results have indicated that substantial (6-10 dB) performance gains can be achieved with this approach with comparatively little bandwidth expansion. Since all of the bandwidth expansion is due to the RS code we see that TCM based concatenated coding results in roughly 10-50% bandwidth expansion compared to 70-150% expansion for similar concatenated scheme which use convolution code. We stress that combined coding and modulation optimization is important for achieving performance gains while maintaining spectral efficiency.

Los Alamos and Lawrence Livermore National Laboratories Code-to-Code Comparison of Inter Lab Test Problem 1 for Asteroid Impact Hazard Mitigation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weaver, Robert P.; Miller, Paul; Howley, Kirsten

The NNSA Laboratories have entered into an interagency collaboration with the National Aeronautics and Space Administration (NASA) to explore strategies for prevention of Earth impacts by asteroids. Assessment of such strategies relies upon use of sophisticated multi-physics simulation codes. This document describes the task of verifying and cross-validating, between Lawrence Livermore National Laboratory (LLNL) and Los Alamos National Laboratory (LANL), modeling capabilities and methods to be employed as part of the NNSA-NASA collaboration. The approach has been to develop a set of test problems and then to compare and contrast results obtained by use of a suite of codes, includingmore » MCNP, RAGE, Mercury, Ares, and Spheral. This document provides a short description of the codes, an overview of the idealized test problems, and discussion of the results for deflection by kinetic impactors and stand-off nuclear explosions.« less

Health information management: an introduction to disease classification and coding.

PubMed

Mony, Prem Kumar; Nagaraj, C

2007-01-01

Morbidity and mortality data constitute an important component of a health information system and their coding enables uniform data collation and analysis as well as meaningful comparisons between regions or countries. Strengthening the recording and reporting systems for health monitoring is a basic requirement for an efficient health information management system. Increased advocacy for and awareness of a uniform coding system together with adequate capacity building of physicians, coders and other allied health and information technology personnel would pave the way for a valid and reliable health information management system in India. The core requirements for the implementation of disease coding are: (i) support from national/institutional health administrators, (ii) widespread availability of the ICD-10 material for morbidity and mortality coding; (iii) enhanced human and financial resources; and (iv) optimal use of informatics. We describe the methodology of a disease classification and codification system as also its applications for developing and maintaining an effective health information management system for India.

75 FR 33992 - Interest and Penalty Suspension Provisions Under Section 6404(g) of the Internal Revenue Code

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... Interest and Penalty Suspension Provisions Under Section 6404(g) of the Internal Revenue Code AGENCY.... SUMMARY: This document contains final regulations under section 6404(g)(2)(E) of the Internal Revenue Code... Procedure and Administration Regulations (26 CFR part 301) by adding rules under section 6404(g) relating to...

List of Research Publications 1940-1980

DTIC Science & Technology

1981-10-01

comparison of the amount of tolerance for misplaced answers found in the GPO and the IBM machine-scored answer sheets. January 1942. (X6304) 1-18 A& .1...machine scoring of answer sheets. March 1942. The effect of the use of No. I pencils on the accuracy of scoring IBM answer sheets by machine. July 1942...X6427) 482 Hobbies - IBM code. 483 Relationship of Classification Test, R-I and WAC Classi- 4023 fication Test-2 for a recruiting station population

3718-F Alkali Metal Treatment and Storage Facility Closure Plan. Revision 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

The Hanford Site, located northwest of the city of Richland, Washington, houses reactors, chemical-separation systems, and related facilities used for the production of special nuclear materials, as well as for activities associated with nuclear energy development. The 300 Area of the Hanford Site contains reactor fuel manufacturing facilities and several research and development laboratories. The 3718-F Alkali Metal Treatment and Storage Facility (3718-F Facility), located in the 300 Area, was used to store and treat alkali metal wastes. Therefore, it is subject to the regulatory requirements for the storage and treatment of dangerous wastes. Closure will be conducted pursuant tomore » the requirements of the Washington Administrative Code (WAC) 173-303-610 (Ecology 1989) and 40 CFR 270.1. Closure also will satisfy the thermal treatment facility closure requirements of 40 CFR 265.381. This closure plan presents a description of the 3718-F Facility, the history of wastes managed, and the approach that will be followed to close the facility. Only hazardous constituents derived from 3718-F Facility operations will be addressed.« less

Administrative Databases Can Yield False Conclusions-An Example of Obesity in Total Joint Arthroplasty.

PubMed

George, Jaiben; Newman, Jared M; Ramanathan, Deepak; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K

2017-09-01

Research using large administrative databases has substantially increased in recent years. Accuracy with which comorbidities are represented in these databases has been questioned. The purpose of this study was to evaluate the extent of errors in obesity coding and its impact on arthroplasty research. Eighteen thousand thirty primary total knee arthroplasties (TKAs) and 10,475 total hip arthroplasties (THAs) performed at a single healthcare system from 2004-2014 were included. Patients were classified as obese or nonobese using 2 methods: (1) body mass index (BMI) ≥30 kg/m 2 and (2) international classification of disease, 9th edition codes. Length of stay, operative time, and 90-day complications were collected. Effect of obesity on various outcomes was analyzed separately for both BMI- and coding-based obesity. From 2004 to 2014, the prevalence of BMI-based obesity increased from 54% to 63% and 40% to 45% in TKA and THA, respectively. The prevalence of coding-based obesity increased from 15% to 28% and 8% to 17% in TKA and THA, respectively. Coding overestimated the growth of obesity in TKA and THA by 5.6 and 8.4 times, respectively. When obesity was defined by coding, obesity was falsely shown to be a significant risk factor for deep vein thrombosis (TKA), pulmonary embolism (THA), and longer hospital stay (TKA and THA). The growth in obesity observed in administrative databases may be an artifact because of improvements in coding over the years. Obesity defined by coding can overestimate the actual effect of obesity on complications after arthroplasty. Therefore, studies using large databases should be interpreted with caution, especially when variables prone to coding errors are involved. Copyright © 2017 Elsevier Inc. All rights reserved.

38 CFR 1.915 - Interest, administrative costs, and penalties.

Code of Federal Regulations, 2010 CFR

2010-07-01

... collection will be added to the principal amount of the debt. (c) The rate of interest charged by VA shall be... interest has been determined for a particular debt, the rate shall remain in effect throughout the duration... of Title 38, U.S. Code. (2) Interest and administrative costs of collection on such debts described...

18 CFR Table 1 to Part 301 - Functionalization and Escalation Codes

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Functionalization and Escalation Codes 1 Table 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

18 CFR Table 1 to Part 301 - Functionalization and Escalation Codes

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Functionalization and Escalation Codes 1 Table 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

18 CFR Table 1 to Part 301 - Functionalization and Escalation Codes

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Functionalization and Escalation Codes 1 Table 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

18 CFR Table 1 to Part 301 - Functionalization and Escalation Codes

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Functionalization and Escalation Codes 1 Table 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

18 CFR Table 1 to Part 301 - Functionalization and Escalation Codes

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Functionalization and Escalation Codes 1 Table 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

Validity of administrative data claim-based methods for identifying individuals with diabetes at a population level.

PubMed

Southern, Danielle A; Roberts, Barbara; Edwards, Alun; Dean, Stafford; Norton, Peter; Svenson, Lawrence W; Larsen, Erik; Sargious, Peter; Lau, David C W; Ghali, William A

2010-01-01

This study assessed the validity of a widely-accepted administrative data surveillance methodology for identifying individuals with diabetes relative to three laboratory data reference standard definitions for diabetes. We used a combination of linked regional data (hospital discharge abstracts and physician data) and laboratory data to test the validity of administrative data surveillance definitions for diabetes relative to a laboratory data reference standard. The administrative discharge data methodology includes two definitions for diabetes: a strict administrative data definition of one hospitalization code or two physician claims indicating diabetes; and a more liberal definition of one hospitalization code or a single physician claim. The laboratory data, meanwhile, produced three reference standard definitions based on glucose levels +/- HbA1c levels. Sensitivities ranged from 68.4% to 86.9% for the administrative data definitions tested relative to the three laboratory data reference standards. Sensitivities were higher for the more liberal administrative data definition. Positive predictive values (PPV), meanwhile, ranged from 53.0% to 88.3%, with the liberal administrative data definition producing lower PPVs. These findings demonstrate the trade-offs of sensitivity and PPV for selecting diabetes surveillance definitions. Centralized laboratory data may be of value to future surveillance initiatives that use combined data sources to optimize case detection.

Reliability of diagnostic coding in intensive care patients

PubMed Central

Misset, Benoît; Nakache, Didier; Vesin, Aurélien; Darmon, Mickael; Garrouste-Orgeas, Maïté; Mourvillier, Bruno; Adrie, Christophe; Pease, Sébastian; de Beauregard, Marie-Aliette Costa; Goldgran-Toledano, Dany; Métais, Elisabeth; Timsit, Jean-François

2008-01-01

Introduction Administrative coding of medical diagnoses in intensive care unit (ICU) patients is mandatory in order to create databases for use in epidemiological and economic studies. We assessed the reliability of coding between different ICU physicians. Method One hundred medical records selected randomly from 29,393 cases collected between 1998 and 2004 in the French multicenter Outcomerea ICU database were studied. Each record was sent to two senior physicians from independent ICUs who recoded the diagnoses using the International Statistical Classification of Diseases and Related Health Problems: Tenth Revision (ICD-10) after being trained according to guidelines developed by two French national intensive care medicine societies: the French Society of Intensive Care Medicine (SRLF) and the French Society of Anesthesiology and Intensive Care Medicine (SFAR). These codes were then compared with the original codes, which had been selected by the physician treating the patient. A specific comparison was done for the diagnoses of septicemia and shock (codes derived from A41 and R57, respectively). Results The ICU physicians coded an average of 4.6 ± 3.0 (range 1 to 32) diagnoses per patient, with little agreement between the three coders. The primary diagnosis was matched by both external coders in 34% (95% confidence interval (CI) 25% to 43%) of cases, by only one in 35% (95% CI 26% to 44%) of cases, and by neither in 31% (95% CI 22% to 40%) of cases. Only 18% (95% CI 16% to 20%) of all codes were selected by all three coders. Similar results were obtained for the diagnoses of septicemia and/or shock. Conclusion In a multicenter database designed primarily for epidemiological and cohort studies in ICU patients, the coding of medical diagnoses varied between different observers. This could limit the interpretation and validity of research and epidemiological programs using diagnoses as inclusion criteria. PMID:18664267

Accuracy of administrative data for identification of patients with infective endocarditis.

PubMed

Tan, Charlie; Hansen, Mark; Cohen, Gideon; Boyle, Karl; Daneman, Nick; Adhikari, Neill K J

2016-12-01

Infective endocarditis is associated with high morbidity and mortality rates that have plateaued over recent decades. Research to improve outcomes for these patients is limited by the rarity of this condition. Therefore, we sought to validate administrative database codes for the diagnosis of infective endocarditis. We conducted a retrospective validation study of International Classification of Diseases (ICD-10-CM) codes for infective endocarditis against clinical Duke criteria (definite and probable) at a large acute care hospital between October 1, 2013 and June 30, 2015. To identify potential cases missed by ICD-10-CM codes, we also screened the hospital's valvular heart surgery database and the microbiology laboratory database (the latter for patients with bacteremia due to organisms commonly causing endocarditis). Using definite Duke criteria or probable criteria with clinical suspicion as the reference standard, the ICD-10-CM codes had a sensitivity (SN) of 0.90 (95% confidence interval (CI), 0.81-0.95), specificity (SP) of 1 (95% CI, 1-1), positive predictive value (PPV) of 0.78 (95% CI, 0.68-0.85) and negative predictive value (NPV) of 1 (95% CI, 1-1). Restricting the case definition to definite Duke criteria resulted in an increase in SN to 0.95 (95% CI, 0.86-0.99) and a decrease in PPV to 0.6 (95% CI, 0.49-0.69), with no change in specificity. ICD-10-CM codes can accurately identify patients with infective endocarditis, and so administrative databases offer a potential means to study this infection over large jurisdictions, and thereby improve the prediction, diagnosis, treatment and prevention of this rare but serious infection. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Optimizing administrative datasets to examine acute kidney injury in the era of big data: workgroup statement from the 15(th) ADQI Consensus Conference.

PubMed

Siew, Edward D; Basu, Rajit K; Wunsch, Hannah; Shaw, Andrew D; Goldstein, Stuart L; Ronco, Claudio; Kellum, John A; Bagshaw, Sean M

2016-01-01

The purpose of this review is to report how administrative data have been used to study AKI, identify current limitations, and suggest how these data sources might be enhanced to address knowledge gaps in the field. 1) To review the existing evidence-base on how AKI is coded across administrative datasets, 2) To identify limitations, gaps in knowledge, and major barriers to scientific progress in AKI related to coding in administrative data, 3) To discuss how administrative data for AKI might be enhanced to enable "communication" and "translation" within and across administrative jurisdictions, and 4) To suggest how administrative databases might be configured to inform 'registry-based' pragmatic studies. Literature review of English language articles through PubMed search for relevant AKI literature focusing on the validation of AKI in administrative data or used administrative data to describe the epidemiology of AKI. Acute Dialysis Quality Initiative (ADQI) Consensus Conference September 6-7(th), 2015, Banff, Canada. Hospitalized patients with AKI. The coding structure for AKI in many administrative datasets limits understanding of true disease burden (especially less severe AKI), its temporal trends, and clinical phenotyping. Important opportunities exist to improve the quality and coding of AKI data to better address critical knowledge gaps in AKI and improve care. A modified Delphi consensus building process consisting of review of the literature and summary statements were developed through a series of alternating breakout and plenary sessions. Administrative codes for AKI are limited by poor sensitivity, lack of standardization to classify severity, and poor contextual phenotyping. These limitations are further hampered by reduced awareness of AKI among providers and the subjective nature of reporting. While an idealized definition of AKI may be difficult to implement, improving standardization of reporting by using laboratory-based definitions and

Self-complementary circular codes in coding theory.

PubMed

Fimmel, Elena; Michel, Christian J; Starman, Martin; Strüngmann, Lutz

2018-04-01

Self-complementary circular codes are involved in pairing genetic processes. A maximal [Formula: see text] self-complementary circular code X of trinucleotides was identified in genes of bacteria, archaea, eukaryotes, plasmids and viruses (Michel in Life 7(20):1-16 2017, J Theor Biol 380:156-177, 2015; Arquès and Michel in J Theor Biol 182:45-58 1996). In this paper, self-complementary circular codes are investigated using the graph theory approach recently formulated in Fimmel et al. (Philos Trans R Soc A 374:20150058, 2016). A directed graph [Formula: see text] associated with any code X mirrors the properties of the code. In the present paper, we demonstrate a necessary condition for the self-complementarity of an arbitrary code X in terms of the graph theory. The same condition has been proven to be sufficient for codes which are circular and of large size [Formula: see text] trinucleotides, in particular for maximal circular codes ([Formula: see text] trinucleotides). For codes of small-size [Formula: see text] trinucleotides, some very rare counterexamples have been constructed. Furthermore, the length and the structure of the longest paths in the graphs associated with the self-complementary circular codes are investigated. It has been proven that the longest paths in such graphs determine the reading frame for the self-complementary circular codes. By applying this result, the reading frame in any arbitrary sequence of trinucleotides is retrieved after at most 15 nucleotides, i.e., 5 consecutive trinucleotides, from the circular code X identified in genes. Thus, an X motif of a length of at least 15 nucleotides in an arbitrary sequence of trinucleotides (not necessarily all of them belonging to X) uniquely defines the reading (correct) frame, an important criterion for analyzing the X motifs in genes in the future.

Early Rockets

NASA Image and Video Library

1950-02-24

Bumper Wac liftoff at the Long Range Proving Ground located at Cape Canaveral, Florida. At White Sands, New Mexico, the German rocket team experimented with a two-stage rocket called Bumper Wac, which intended to provide data for upper atmospheric research. On February 24, 1950, the Bumper, which employed a V-2 as the first stage with a Wac Corporal upper stage, obtained a peak altitude of more than 240 miles.

Coset Codes Viewed as Terminated Convolutional Codes

NASA Technical Reports Server (NTRS)

Fossorier, Marc P. C.; Lin, Shu

1996-01-01

In this paper, coset codes are considered as terminated convolutional codes. Based on this approach, three new general results are presented. First, it is shown that the iterative squaring construction can equivalently be defined from a convolutional code whose trellis terminates. This convolutional code determines a simple encoder for the coset code considered, and the state and branch labelings of the associated trellis diagram become straightforward. Also, from the generator matrix of the code in its convolutional code form, much information about the trade-off between the state connectivity and complexity at each section, and the parallel structure of the trellis, is directly available. Based on this generator matrix, it is shown that the parallel branches in the trellis diagram of the convolutional code represent the same coset code C(sub 1), of smaller dimension and shorter length. Utilizing this fact, a two-stage optimum trellis decoding method is devised. The first stage decodes C(sub 1), while the second stage decodes the associated convolutional code, using the branch metrics delivered by stage 1. Finally, a bidirectional decoding of each received block starting at both ends is presented. If about the same number of computations is required, this approach remains very attractive from a practical point of view as it roughly doubles the decoding speed. This fact is particularly interesting whenever the second half of the trellis is the mirror image of the first half, since the same decoder can be implemented for both parts.

[Pharmacokinetics of magnolol and honokiol in Weichang'an pill].

PubMed

Chen, Yu-Ling; Wang, Shu-Ping; Wang, Lei; Jin, Zhao-Xiang; Zhang, Jing-Ze; Chen, Hong; Gao, Wen-Yuan

2016-05-01

To conduct multiple-reaction monitoring(MRM) quantitative analysis with high-performance liquid chromatography coupled with mass spectrometry method, establish the quantification method of magnolol and honokiol in blood sample under negative ion mode with ibuprofen as internal standard, investigate the pharmacokinetic process of lignans constituents after oral administration of Weichang'an pill(WCA) at different doses, and provide theoretical basis to further reveal the material basis of WCA's anti-diarrhea effect. In the plasma samples, the linear relationship was good over the concentration range of 5.25 to 1 344.00 μg•L ⁻¹ for magnolol and 10.08 to 2 580.00 μg•L ⁻¹ for honokiol. The results of precision, stability, and extraction recovery tests showed that the determination method of plasma concentration for such compositions was stable and reliable. Dose-dependence was shown for magnolol and honokiol in the plasma concentration-time profile. The results indicated that the time to reach the maximum plasma concentration(Tmax) for lignanoids was 0.55-1.42 h, when the maximum plasma concentration(Cmax) could reach 996.36-2 330.96,189.87-1 469.43 μg•L ⁻¹ respectively for magnolol and honokiol. The lignanoids could be absorbed rapidly in the blood after oral administration of WAC pills, providing experimental basis to prove rapid and long-acting anti-diarrhea effect of WAC pills after oral administration. Copyright© by the Chinese Pharmaceutical Association.

50 CFR Table 5 to Part 680 - Crab Size Codes

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 13 2012-10-01 2012-10-01 false Crab Size Codes 5 Table 5 to Part 680 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) SHELLFISH FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA Pt. 680, Table 5 Table 5 to Part 680—Crab Size...

50 CFR Table 5 to Part 680 - Crab Size Codes

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Crab Size Codes 5 Table 5 to Part 680 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) SHELLFISH FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA Pt. 680, Table 5 Table 5 to Part 680—Crab Size...

50 CFR Table 5 to Part 680 - Crab Size Codes

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 11 2011-10-01 2011-10-01 false Crab Size Codes 5 Table 5 to Part 680 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) SHELLFISH FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA Pt. 680, Table 5 Table 5 to Part 680—Crab Size...

Combinatorial neural codes from a mathematical coding theory perspective.

PubMed

Curto, Carina; Itskov, Vladimir; Morrison, Katherine; Roth, Zachary; Walker, Judy L

2013-07-01

Shannon's seminal 1948 work gave rise to two distinct areas of research: information theory and mathematical coding theory. While information theory has had a strong influence on theoretical neuroscience, ideas from mathematical coding theory have received considerably less attention. Here we take a new look at combinatorial neural codes from a mathematical coding theory perspective, examining the error correction capabilities of familiar receptive field codes (RF codes). We find, perhaps surprisingly, that the high levels of redundancy present in these codes do not support accurate error correction, although the error-correcting performance of receptive field codes catches up to that of random comparison codes when a small tolerance to error is introduced. However, receptive field codes are good at reflecting distances between represented stimuli, while the random comparison codes are not. We suggest that a compromise in error-correcting capability may be a necessary price to pay for a neural code whose structure serves not only error correction, but must also reflect relationships between stimuli.

47 CFR 3.22 - Number of accounting authority identification codes per applicant.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AUTHORIZATION AND ADMINISTRATION OF ACCOUNTING AUTHORITIES IN MARITIME AND MARITIME MOBILE-SATELLITE RADIO SERVICES Application Procedures § 3.22 Number of accounting authority identification codes per applicant... assign U.S. AAICs for entities settling accounts of U.S. licensed vessels in the maritime mobile and...

Software Certification - Coding, Code, and Coders

NASA Technical Reports Server (NTRS)

Havelund, Klaus; Holzmann, Gerard J.

2011-01-01

We describe a certification approach for software development that has been adopted at our organization. JPL develops robotic spacecraft for the exploration of the solar system. The flight software that controls these spacecraft is considered to be mission critical. We argue that the goal of a software certification process cannot be the development of "perfect" software, i.e., software that can be formally proven to be correct under all imaginable and unimaginable circumstances. More realistically, the goal is to guarantee a software development process that is conducted by knowledgeable engineers, who follow generally accepted procedures to control known risks, while meeting agreed upon standards of workmanship. We target three specific issues that must be addressed in such a certification procedure: the coding process, the code that is developed, and the skills of the coders. The coding process is driven by standards (e.g., a coding standard) and tools. The code is mechanically checked against the standard with the help of state-of-the-art static source code analyzers. The coders, finally, are certified in on-site training courses that include formal exams.

Development and validation of a case definition for epilepsy for use with administrative health data.

PubMed

Reid, Aylin Y; St Germaine-Smith, Christine; Liu, Mingfu; Sadiq, Shahnaz; Quan, Hude; Wiebe, Samuel; Faris, Peter; Dean, Stafford; Jetté, Nathalie

2012-12-01

The objective of this study was to develop and validate coding algorithms for epilepsy using ICD-coded inpatient claims, physician claims, and emergency room (ER) visits. 720/2049 charts from 2003 and 1533/3252 charts from 2006 were randomly selected for review from 13 neurologists' practices as the "gold standard" for diagnosis. Epilepsy status in each chart was determined by 2 trained physicians. The optimal algorithm to identify epilepsy cases was developed by linking the reviewed charts with three administrative databases (ICD 9 and 10 data from 2000 to 2008) including hospital discharges, ER visits and physician claims in a Canadian health region. Accepting chart review data as the gold standard, we calculated sensitivity, specificity, positive, and negative predictive value for each ICD-9 and ICD-10 administrative data algorithm (case definitions). Of 18 algorithms assessed, the most accurate algorithm to identify epilepsy cases was "2 physician claims or 1 hospitalization in 2 years coded" (ICD-9 345 or G40/G41) and the most sensitive algorithm was "1 physician clam or 1 hospitalization or 1 ER visit in 2 years." Accurate and sensitive case definitions are available for research requiring the identification of epilepsy cases in administrative health data. Copyright © 2012 Elsevier B.V. All rights reserved.

Discussion on LDPC Codes and Uplink Coding

NASA Technical Reports Server (NTRS)

Andrews, Ken; Divsalar, Dariush; Dolinar, Sam; Moision, Bruce; Hamkins, Jon; Pollara, Fabrizio

2007-01-01

This slide presentation reviews the progress that the workgroup on Low-Density Parity-Check (LDPC) for space link coding. The workgroup is tasked with developing and recommending new error correcting codes for near-Earth, Lunar, and deep space applications. Included in the presentation is a summary of the technical progress of the workgroup. Charts that show the LDPC decoder sensitivity to symbol scaling errors are reviewed, as well as a chart showing the performance of several frame synchronizer algorithms compared to that of some good codes and LDPC decoder tests at ESTL. Also reviewed is a study on Coding, Modulation, and Link Protocol (CMLP), and the recommended codes. A design for the Pseudo-Randomizer with LDPC Decoder and CRC is also reviewed. A chart that summarizes the three proposed coding systems is also presented.

Antipyretic potential of herbal coded formulation (Pyrexol).

PubMed

Khan, Muhammad Sajid; Hamid, Abdul; Akram, Muhammad; Mustafa, Sodah Bint; Sami, Abdul; Shah, Syed Muhammad Ali; Usmanghani, Khan

2017-01-01

The antipyretic effect of the aqueous extract of herbal coded formulation containing equal amount of Salix alba, Emblica officinalis, Glycyrrhiza glabra, Adhatoda vasica, Viola odorata, Thea sinensis, Veleriana officinalis, Foeniculum vulgare, Sisymbrium irrio and Achillea millefolium was investigated using the yeast induced pyrexia model in rabbits. Paracetamol was used as a control group. Rectal temperatures of all rabbits were recorded immediately before the administration of the extract or paracetamol and again at 1 hour, after this, temperature was noted at 1 hrs interval for 5 hrs using digital thermometer. At 240mg/kg dose the extract showed significant reduction in yeast-induced elevated temperature as compared with that of standard drug paracetamol (150mg/kg). It is concluded that herbal coded medicine at a dose of 240mg/kg has marked antipyretic activity in animal models and this strongly supports the ethno pharmacological uses of medicinal plants of this formulation.

Temporal trends in the systemic inflammatory response syndrome, sepsis, and medical coding of sepsis.

PubMed

Thomas, Benjamin S; Jafarzadeh, S Reza; Warren, David K; McCormick, Sandra; Fraser, Victoria J; Marschall, Jonas

2015-11-24

Recent reports using administrative claims data suggest the incidence of community- and hospital-onset sepsis is increasing. Whether this reflects changing epidemiology, more effective diagnostic methods, or changes in physician documentation and medical coding practices is unclear. We performed a temporal-trend study from 2008 to 2012 using administrative claims data and patient-level clinical data of adult patients admitted to Barnes-Jewish Hospital in St. Louis, Missouri. Temporal-trend and annual percent change were estimated using regression models with autoregressive integrated moving average errors. We analyzed 62,261 inpatient admissions during the 5-year study period. 'Any SIRS' (i.e., SIRS on a single calendar day during the hospitalization) and 'multi-day SIRS' (i.e., SIRS on 3 or more calendar days), which both use patient-level data, and medical coding for sepsis (i.e., ICD-9-CM discharge diagnosis codes 995.91, 995.92, or 785.52) were present in 35.3 %, 17.3 %, and 3.3 % of admissions, respectively. The incidence of admissions coded for sepsis increased 9.7 % (95 % CI: 6.1, 13.4) per year, while the patient data-defined events of 'any SIRS' decreased by 1.8 % (95 % CI: -3.2, -0.5) and 'multi-day SIRS' did not change significantly over the study period. Clinically-defined sepsis (defined as SIRS plus bacteremia) and severe sepsis (defined as SIRS plus hypotension and bacteremia) decreased at statistically significant rates of 5.7 % (95 % CI: -9.0, -2.4) and 8.6 % (95 % CI: -4.4, -12.6) annually. All-cause mortality, SIRS mortality, and SIRS and clinically-defined sepsis case fatality did not change significantly during the study period. Sepsis mortality, based on ICD-9-CM codes, however, increased by 8.8 % (95 % CI: 1.9, 16.2) annually. The incidence of sepsis, defined by ICD-9-CM codes, and sepsis mortality increased steadily without a concomitant increase in SIRS or clinically-defined sepsis. Our results highlight the need to develop

50 CFR Table 3a to Part 680 - Crab Delivery Condition Codes

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Crab Delivery Condition Codes 3a Table 3a to Part 680 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) SHELLFISH FISHERIES OF THE EXCLUSIVE ECONOMIC...

OH Fluorescence and Prompt Emission in comet 103P/Hartley 2 observed by EPOXI mission and expected results for comet 67P/Churyumov-Gerasimenko observed by Rosetta/OSIRIS WAC camera

NASA Astrophysics Data System (ADS)

La Forgia, F.; A'Hearn, M. F.; Lazzarin, M.; Magrin, S.; Bodewits, D.; Bertini, I.; Pajola, M.; Barbier, C.; Sierks, H.

2014-04-01

possibility that this OH structure could be partially associated with OH PE has been performed. This is strongly supported by the agreement of the OH spatial distribution with the water spatial distribution derived from HRI IR spectrometer observations (A'Hearn et al. 2011). Given the results on comet Hartley 2, we present our expectations and preliminary analysis of OH fluorescence and prompt emission mechanisms in the coma of 67P/Churyumov-Gerasimenko, target of the Rosetta mission. The OSIRIS WAC camera on board Rosetta is equipped with 7 narrowband filters centered on molecular emission bands, including the OH gas filter. This will enable us to investigate OH fluorescence and PE at increasing resolution as Rosetta will approach the comet. This analysis, supported by accompanying observations acquired by OSIRIS WAC camera in the forbidden OI band at 630 nm, will help in further constrain the water photochemistry and the fluorescence and PE processes occurring in the cometary comae.

Practices in Code Discoverability: Astrophysics Source Code Library

NASA Astrophysics Data System (ADS)

Allen, A.; Teuben, P.; Nemiroff, R. J.; Shamir, L.

2012-09-01

Here we describe the Astrophysics Source Code Library (ASCL), which takes an active approach to sharing astrophysics source code. ASCL's editor seeks out both new and old peer-reviewed papers that describe methods or experiments that involve the development or use of source code, and adds entries for the found codes to the library. This approach ensures that source codes are added without requiring authors to actively submit them, resulting in a comprehensive listing that covers a significant number of the astrophysics source codes used in peer-reviewed studies. The ASCL now has over 340 codes in it and continues to grow. In 2011, the ASCL has on average added 19 codes per month. An advisory committee has been established to provide input and guide the development and expansion of the new site, and a marketing plan has been developed and is being executed. All ASCL source codes have been used to generate results published in or submitted to a refereed journal and are freely available either via a download site or from an identified source. This paper provides the history and description of the ASCL. It lists the requirements for including codes, examines the advantages of the ASCL, and outlines some of its future plans.

15 CFR Supplement No. 2 to Part 736 - Administrative Orders

Code of Federal Regulations, 2010 CFR

2010-01-01

... accordance with § 301(g) of Title 13, United States Code. Administrative Order Two: Conduct of Business and Practice in Connection with Export Control Matters. (a) Exclusion of persons guilty of unethical conduct or... acting on his own behalf or on behalf of another, who shall be found guilty of engaging in any unethical...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Snyder, Sandra F.; Barnett, J. Matthew; Bisping, Lynn E.

This report documents radionuclide air emissions that result in the 2014 highest effective dose equivalent (EDE) to an offsite member of the public, referred to as the maximally exposed individual (MEI). The report has been prepared in compliance with the Code of Federal Regulations (CFR), Title 40, Protection of the Environment, Part 61, National Emission Standards for Hazardous Air Pollutants (NESHAP), Subpart H, “National Emission Standards for Emissions of Radionuclides Other than Radon from Department of Energy Facilities” and Washington Administrative Code (WAC) Chapter 246-247, “Radiation Protection–Air Emissions.” The dose to the PNNL Campus MEI due to routine major andmore » minor point source emissions in 2014 from PNNL Campus sources is 2E 05 mrem (2E-07 mSv) EDE. The dose from all fugitive sources is 3E-6 mrem (3E-8 mSv) EDE. The dose from radon emissions is 1E-6 mrem (1E-8 mSv) EDE. No nonroutine emissions occurred in 2014. The total radiological dose for 2014 to the MEI from all PNNL Campus radionuclide emissions, including fugitive emissions and radon, is 3E-5 mrem (3E-7 mSv) EDE, or more than 100,000 times smaller than the federal and state standard of 10 mrem/yr, to which the PNNL Campus is in compliance.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Snyder, Sandra F.; Barnett, J. Matthew; Bisping, Lynn E.

This report documents radionuclide air emissions that result in the highest effective dose equivalent (EDE) to a member of the public, referred to as the maximally exposed individual (MEI). The report has been prepared in compliance with the Code of Federal Regulations (CFR), Title 40, Protection of the Environment, Part 61, National Emission Standards for Hazardous Air Pollutants (NESHAP), Subpart H, National Emission Standards for Emissions of Radionuclides Other than Radon from Department of Energy Facilities and Washington Administrative Code (WAC) Chapter 246-247, Radiation Protection Air Emissions. The dose to the PNNL Site MEI due to routine major and minormore » point source emissions in 2013 from PNNL Site sources is 2E-05 mrem (2E-07 mSv) EDE. The dose from fugitive emissions (i.e., unmonitored sources) is 2E-6 mrem (2E-8 mSv) EDE. The dose from radon emissions is 1E-11 mrem (1E-13 mSv) EDE. No nonroutine emissions occurred in 2013. The total radiological dose for 2013 to the MEI from all PNNL Site radionuclide emissions, including fugitive emissions and radon, is 2E-5 mrem (2E-7 mSv) EDE, or 100,000 times smaller than the federal and state standard of 10 mrem/yr, to which the PNNL Site is in compliance« less

Pacific Northwest National Laboratory Campus Radionuclide Air Emissions Report for Calendar Year 2015

DOE Office of Scientific and Technical Information (OSTI.GOV)

Snyder, Sandra F.; Barnett, J. Matthew; Bisping, Lynn E.

This report documents radionuclide air emissions that result in the 2015 highest effective dose equivalent (EDE) to an offsite member of the public, referred to as the maximally exposed individual (MEI). The report has been prepared in compliance with the Code of Federal Regulations (CFR), Title 40, Protection of the Environment, Part 61, National Emission Standards for Hazardous Air Pollutants (NESHAP), Subpart H, “National Emission Standards for Emissions of Radionuclides Other than Radon from Department of Energy Facilities” and Washington Administrative Code (WAC) Chapter 246-247, “Radiation Protection–Air Emissions.” The dose to the PNNL Campus MEI from routine major and minormore » point source emissions in 2015 from PNNL Campus sources is 2.6E-4 mrem (2.6E-6 mSv) EDE. The dose from all fugitive sources is 1.8E-6 mrem (1.8E-8 mSv) EDE. The dose from radon emissions is 4.4E-8 mrem (4.4E-10 mSv) EDE. No nonroutine emissions occurred in 2015. The total radiological dose to the MEI from all PNNL Campus radionuclide emissions, including fugitive emissions and radon, is 2.6E-4 mrem (2.6E-6 mSv) EDE, or more than 10,000 times less than the federal and state standard of 10 mrem/yr, with which the PNNL Campus is in compliance.« less

New quantum codes constructed from quaternary BCH codes

NASA Astrophysics Data System (ADS)

Xu, Gen; Li, Ruihu; Guo, Luobin; Ma, Yuena

2016-10-01

In this paper, we firstly study construction of new quantum error-correcting codes (QECCs) from three classes of quaternary imprimitive BCH codes. As a result, the improved maximal designed distance of these narrow-sense imprimitive Hermitian dual-containing quaternary BCH codes are determined to be much larger than the result given according to Aly et al. (IEEE Trans Inf Theory 53:1183-1188, 2007) for each different code length. Thus, families of new QECCs are newly obtained, and the constructed QECCs have larger distance than those in the previous literature. Secondly, we apply a combinatorial construction to the imprimitive BCH codes with their corresponding primitive counterpart and construct many new linear quantum codes with good parameters, some of which have parameters exceeding the finite Gilbert-Varshamov bound for linear quantum codes.

49 CFR Appendix C to Part 229 - FRA Locomotive Standards-Code of Defects

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false FRA Locomotive Standards-Code of Defects C Appendix C to Part 229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Pt. 229, App. C...

49 CFR Appendix C to Part 229 - FRA Locomotive Standards-Code of Defects

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false FRA Locomotive Standards-Code of Defects C Appendix C to Part 229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Pt. 229, App. C...

49 CFR Appendix C to Part 229 - FRA Locomotive Standards-Code of Defects

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false FRA Locomotive Standards-Code of Defects C Appendix C to Part 229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Pt. 229, App. C...

29 CFR 1910.35 - Compliance with NFPA 101-2000, Life Safety Code.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 5 2011-07-01 2011-07-01 false Compliance with NFPA 101-2000, Life Safety Code. 1910.35 Section 1910.35 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS Means of Egress § 1910.35 Compliance...

21 CFR 20.115 - Product codes for manufacturing or sales dates.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Product codes for manufacturing or sales dates. 20.115 Section 20.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... the label or in labeling or otherwise used in connection with a product subject to the jurisdiction of...

Variable Coding and Modulation Experiment Using NASA's Space Communication and Navigation Testbed

NASA Technical Reports Server (NTRS)

Downey, Joseph A.; Mortensen, Dale J.; Evans, Michael A.; Tollis, Nicholas S.

2016-01-01

National Aeronautics and Space Administration (NASA)'s Space Communication and Navigation Testbed on the International Space Station provides a unique opportunity to evaluate advanced communication techniques in an operational system. The experimental nature of the Testbed allows for rapid demonstrations while using flight hardware in a deployed system within NASA's networks. One example is variable coding and modulation, which is a method to increase data-throughput in a communication link. This paper describes recent flight testing with variable coding and modulation over S-band using a direct-to-earth link between the SCaN Testbed and the Glenn Research Center. The testing leverages the established Digital Video Broadcasting Second Generation (DVB-S2) standard to provide various modulation and coding options. The experiment was conducted in a challenging environment due to the multipath and shadowing caused by the International Space Station structure. Performance of the variable coding and modulation system is evaluated and compared to the capacity of the link, as well as standard NASA waveforms.

ISPOR Code of Ethics 2017 (4th Edition).

PubMed

Santos, Jessica; Palumbo, Francis; Molsen-David, Elizabeth; Willke, Richard J; Binder, Louise; Drummond, Michael; Ho, Anita; Marder, William D; Parmenter, Louise; Sandhu, Gurmit; Shafie, Asrul A; Thompson, David

2017-12-01

As the leading health economics and outcomes research (HEOR) professional society, ISPOR has a responsibility to establish a uniform, harmonized international code for ethical conduct. ISPOR has updated its 2008 Code of Ethics to reflect the current research environment. This code addresses what is acceptable and unacceptable in research, from inception to the dissemination of its results. There are nine chapters: 1 - Introduction; 2 - Ethical Principles respect, beneficence and justice with reference to a non-exhaustive compilation of international, regional, and country-specific guidelines and standards; 3 - Scope HEOR definitions and how HEOR and the Code relate to other research fields; 4 - Research Design Considerations primary and secondary data related issues, e.g., participant recruitment, population and research setting, sample size/site selection, incentive/honorarium, administration databases, registration of retrospective observational studies and modeling studies; 5 - Data Considerations privacy and data protection, combining, verification and transparency of research data, scientific misconduct, etc.; 6 - Sponsorship and Relationships with Others (roles of researchers, sponsors, key opinion leaders and advisory board members, research participants and institutional review boards (IRBs) / independent ethics committees (IECs) approval and responsibilities); 7 - Patient Centricity and Patient Engagement new addition, with explanation and guidance; 8 - Publication and Dissemination; and 9 - Conclusion and Limitations. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Clinical coding of prospectively identified paediatric adverse drug reactions--a retrospective review of patient records.

PubMed

Bellis, Jennifer R; Kirkham, Jamie J; Nunn, Anthony J; Pirmohamed, Munir

2014-12-17

National Health Service (NHS) hospitals in the UK use a system of coding for patient episodes. The coding system used is the International Classification of Disease (ICD-10). There are ICD-10 codes which may be associated with adverse drug reactions (ADRs) and there is a possibility of using these codes for ADR surveillance. This study aimed to determine whether ADRs prospectively identified in children admitted to a paediatric hospital were coded appropriately using ICD-10. The electronic admission abstract for each patient with at least one ADR was reviewed. A record was made of whether the ADR(s) had been coded using ICD-10. Of 241 ADRs, 76 (31.5%) were coded using at least one ICD-10 ADR code. Of the oncology ADRs, 70/115 (61%) were coded using an ICD-10 ADR code compared with 6/126 (4.8%) non-oncology ADRs (difference in proportions 56%, 95% CI 46.2% to 65.8%; p < 0.001). The majority of ADRs detected in a prospective study at a paediatric centre would not have been identified if the study had relied on ICD-10 codes as a single means of detection. Data derived from administrative healthcare databases are not reliable for identifying ADRs by themselves, but may complement other methods of detection.

Color-Coded Prefilled Medication Syringes Decrease Time to Delivery and Dosing Error in Simulated Emergency Department Pediatric Resuscitations.

PubMed

Moreira, Maria E; Hernandez, Caleb; Stevens, Allen D; Jones, Seth; Sande, Margaret; Blumen, Jason R; Hopkins, Emily; Bakes, Katherine; Haukoos, Jason S

2015-08-01

The Institute of Medicine has called on the US health care system to identify and reduce medical errors. Unfortunately, medication dosing errors remain commonplace and may result in potentially life-threatening outcomes, particularly for pediatric patients when dosing requires weight-based calculations. Novel medication delivery systems that may reduce dosing errors resonate with national health care priorities. Our goal was to evaluate novel, prefilled medication syringes labeled with color-coded volumes corresponding to the weight-based dosing of the Broselow Tape, compared with conventional medication administration, in simulated pediatric emergency department (ED) resuscitation scenarios. We performed a prospective, block-randomized, crossover study in which 10 emergency physician and nurse teams managed 2 simulated pediatric arrest scenarios in situ, using either prefilled, color-coded syringes (intervention) or conventional drug administration methods (control). The ED resuscitation room and the intravenous medication port were video recorded during the simulations. Data were extracted from video review by blinded, independent reviewers. Median time to delivery of all doses for the conventional and color-coded delivery groups was 47 seconds (95% confidence interval [CI] 40 to 53 seconds) and 19 seconds (95% CI 18 to 20 seconds), respectively (difference=27 seconds; 95% CI 21 to 33 seconds). With the conventional method, 118 doses were administered, with 20 critical dosing errors (17%); with the color-coded method, 123 doses were administered, with 0 critical dosing errors (difference=17%; 95% CI 4% to 30%). A novel color-coded, prefilled syringe decreased time to medication administration and significantly reduced critical dosing errors by emergency physician and nurse teams during simulated pediatric ED resuscitations. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

ADM. Administration Building (TAN602). Early room layout, door and room ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

ADM. Administration Building (TAN-602). Early room layout, door and room schedules. Ralph M. Parsons 902-2-ANP-602-A 31. Date: December 1952. Approved by INEEL Classification Office for public release. INEEL index code no. 033-0602-00-693-106710 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

128. ARAII Administrative and technical support building (ARA606) elevations for ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

128. ARA-II Administrative and technical support building (ARA-606) elevations for northwest, southwest, northeast, and southeast sides. C.A. Sundberg and Associates 866-area/ALPR-606-A-3. Date: May 1958. Ineel index code no. 070-0606-00-822-102826. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

Global Comparators Project: International Comparison of Hospital Outcomes Using Administrative Data

PubMed Central

Bottle, Alex; Middleton, Steven; Kalkman, Cor J; Livingston, Edward H; Aylin, Paul

2013-01-01

Objective. To produce comparable risk-adjusted outcome rates for an international sample of hospitals in a collaborative project to share outcomes and learning. Data Sources. Administrative data varying in scope, format, and coding systems were pooled from each participating hospital for the years 2005–2010. Study Design. Following reconciliation of the different coding systems in the various countries, in-hospital mortality, unplanned readmission within 30 days, and “prolonged” hospital stay (>75th percentile) were risk-adjusted via logistic regression. A web-based interface was created to facilitate outcomes analysis for individual medical centers and enable peer comparisons. Small groups of clinicians are now exploring the potential reasons for variations in outcomes in their specialty. Principal Findings. There were 6,737,211 inpatient records, including 214,622 in-hospital deaths. Although diagnostic coding depth varied appreciably by country, comorbidity weights were broadly comparable. U.S. hospitals generally had the lowest mortality rates, shortest stays, and highest readmission rates. Conclusions. Intercountry differences in outcomes may result from differences in the quality of care or in practice patterns driven by socio-economic factors. Carefully managed administrative data can be an effective resource for initiating dialog between hospitals within and across countries. Inclusion of important outcomes beyond hospital discharge would increase the value of these analyses. PMID:23742025

Using mobile devices to improve the safety of medication administration processes.

PubMed

Navas, H; Graffi Moltrasio, L; Ares, F; Strumia, G; Dourado, E; Alvarez, M

2015-01-01

Within preventable medical errors, those related to medications are frequent in every stage of the prescribing cycle. Nursing is responsible for maintaining each patients safety and care quality. Moreover, nurses are the last people who can detect an error in medication before its administration. Medication administration is one of the riskiest tasks in nursing. The use of information and communication technologies is related to a decrease in these errors. Including mobile devices related to 2D code reading of patients and medication will decrease the possibility of error when preparing and administering medication by nurses. A cross-platform software (iOS and Android) was developed to ensure the five Rights of the medication administration process (patient, medication, dose, route and schedule). Deployment in November showed 39% use.

50 CFR Table 3b to Part 680 - Crab Disposition or Product Codes

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Crab Disposition or Product Codes 3b Table 3b to Part 680 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) SHELLFISH FISHERIES OF THE EXCLUSIVE ECONOMIC...

77 FR 13098 - Multistakeholder Process To Develop Consumer Data Privacy Codes of Conduct

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-05

... Rights, which is a set of principles the Administration believes should govern the handling of personal... Commission's jurisdiction.\\3\\ Enforceable codes of conduct based on the principles set forth in the Consumer... businesses greater certainty about how agreed upon privacy principles apply to them. Companies will build...

26 CFR 301.6103(l)-1 - Disclosure of returns and return information for purposes other than tax administration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... for purposes other than tax administration. 301.6103(l)-1 Section 301.6103(l)-1 Internal Revenue... ADMINISTRATION Information and Returns Returns and Records § 301.6103(l)-1 Disclosure of returns and return... provisions of section 6103(l) of the Internal Revenue Code, the term agent includes a contractor. (b...

Low Density Parity Check Codes: Bandwidth Efficient Channel Coding

NASA Technical Reports Server (NTRS)

Fong, Wai; Lin, Shu; Maki, Gary; Yeh, Pen-Shu

2003-01-01

Low Density Parity Check (LDPC) Codes provide near-Shannon Capacity performance for NASA Missions. These codes have high coding rates R=0.82 and 0.875 with moderate code lengths, n=4096 and 8176. Their decoders have inherently parallel structures which allows for high-speed implementation. Two codes based on Euclidean Geometry (EG) were selected for flight ASIC implementation. These codes are cyclic and quasi-cyclic in nature and therefore have a simple encoder structure. This results in power and size benefits. These codes also have a large minimum distance as much as d,,, = 65 giving them powerful error correcting capabilities and error floors less than lo- BER. This paper will present development of the LDPC flight encoder and decoder, its applications and status.

Characterization of the Old Hydrofracture Facility (OHF) waste tanks located at ORNL

DOE Office of Scientific and Technical Information (OSTI.GOV)

Keller, J.M.; Giaquinto, J.M.; Meeks, A.M.

1997-04-01

The Old Hydrofracture Facility (OHF) is located in Melton Valley within Waste Area Grouping (WAG) 5 and includes five underground storage tanks (T1, T2, T3, T4, and T9) ranging from 13,000 to 25,000 gal. capacity. During the period of 1996--97 there was a major effort to re-sample and characterize the contents of these inactive waste tanks. The characterization data summarized in this report was needed to address waste processing options, examine concerns dealing with the performance assessment (PA) data for the Waste Isolation Pilot Plant (WIPP), evaluate the waste characteristics with respect to the waste acceptance criteria (WAC) for WIPPmore » and Nevada Test Site (NTS), address criticality concerns, and to provide the data needed to meet DOT requirements for transporting the waste. This report discusses the analytical characterization data collected on both the supernatant and sludge samples taken from three different locations in each of the OHF tanks. The isotopic data presented in this report supports the position that fissile isotopes of uranium ({sup 233}U and {sup 235}U) do not satisfy the denature ratios required by the administrative controls stated in the ORNL LLLW waste acceptance criteria (WAC). The fissile isotope of plutonium ({sup 239}Pu and {sup 241}Pu) are diluted with thorium far above the WAC requirements. In general, the OHF sludge was found to be hazardous (RCRA) based on total metal content and the transuranic alpha activity was well above the 100 nCi/g limit for TRU waste. The characteristics of the OHF sludge relative to the WIPP WAC limits for fissile gram equivalent, plutonium equivalent activity, and thermal power from decay heat were estimated from the data in this report and found to be far below the upper boundary for any of the remote-handled transuranic waste (RH-TRU) requirements for disposal of the waste in WIPP.« less

A&M. Technical service laboratory in administration building (TAN602). Floor plan, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

A&M. Technical service laboratory in administration building (TAN-602). Floor plan, reception desk, door and finish schedules. Ralph M. Parsons 1480-12-ANP/GE-3-602-A-1. INEEL index code no. 033-0602-00-693-107488 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

129. ARAII Administrative and technical support building (ARA606) sections showing ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

129. ARA-II Administrative and technical support building (ARA-606) sections showing roof and wall details and longitudinal section. C.A. Sundberg and Associates 866-area/ALPR-606-A-5. Date: May 1958. Ineel index code no. 070-0606-00-822-102828. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

A systematic review of validated methods for identifying anaphylaxis, including anaphylactic shock and angioneurotic edema, using administrative and claims data.

PubMed

Schneider, Gary; Kachroo, Sumesh; Jones, Natalie; Crean, Sheila; Rotella, Philip; Avetisyan, Ruzan; Reynolds, Matthew W

2012-01-01

The Food and Drug Administration's Mini-Sentinel pilot program initially aims to conduct active surveillance to refine safety signals that emerge for marketed medical products. A key facet of this surveillance is to develop and understand the validity of algorithms for identifying health outcomes of interest from administrative and claims data. This article summarizes the process and findings of the algorithm review of anaphylaxis. PubMed and Iowa Drug Information Service searches were conducted to identify citations applicable to the anaphylaxis health outcome of interest. Level 1 abstract reviews and Level 2 full-text reviews were conducted to find articles using administrative and claims data to identify anaphylaxis and including validation estimates of the coding algorithms. Our search revealed limited literature focusing on anaphylaxis that provided administrative and claims data-based algorithms and validation estimates. Only four studies identified via literature searches provided validated algorithms; however, two additional studies were identified by Mini-Sentinel collaborators and were incorporated. The International Classification of Diseases, Ninth Revision, codes varied, as did the positive predictive value, depending on the cohort characteristics and the specific codes used to identify anaphylaxis. Research needs to be conducted on designing validation studies to test anaphylaxis algorithms and estimating their predictive power, sensitivity, and specificity. Copyright © 2012 John Wiley & Sons, Ltd.

Error-correction coding

NASA Technical Reports Server (NTRS)

Hinds, Erold W. (Principal Investigator)

1996-01-01

This report describes the progress made towards the completion of a specific task on error-correcting coding. The proposed research consisted of investigating the use of modulation block codes as the inner code of a concatenated coding system in order to improve the overall space link communications performance. The study proposed to identify and analyze candidate codes that will complement the performance of the overall coding system which uses the interleaved RS (255,223) code as the outer code.

Incidence of Appendicitis over Time: A Comparative Analysis of an Administrative Healthcare Database and a Pathology-Proven Appendicitis Registry

PubMed Central

Clement, Fiona; Zimmer, Scott; Dixon, Elijah; Ball, Chad G.; Heitman, Steven J.; Swain, Mark; Ghosh, Subrata

2016-01-01

Importance At the turn of the 21st century, studies evaluating the change in incidence of appendicitis over time have reported inconsistent findings. Objectives We compared the differences in the incidence of appendicitis derived from a pathology registry versus an administrative database in order to validate coding in administrative databases and establish temporal trends in the incidence of appendicitis. Design We conducted a population-based comparative cohort study to identify all individuals with appendicitis from 2000 to2008. Setting & Participants Two population-based data sources were used to identify cases of appendicitis: 1) a pathology registry (n = 8,822); and 2) a hospital discharge abstract database (n = 10,453). Intervention & Main Outcome The administrative database was compared to the pathology registry for the following a priori analyses: 1) to calculate the positive predictive value (PPV) of administrative codes; 2) to compare the annual incidence of appendicitis; and 3) to assess differences in temporal trends. Temporal trends were assessed using a generalized linear model that assumed a Poisson distribution and reported as an annual percent change (APC) with 95% confidence intervals (CI). Analyses were stratified by perforated and non-perforated appendicitis. Results The administrative database (PPV = 83.0%) overestimated the incidence of appendicitis (100.3 per 100,000) when compared to the pathology registry (84.2 per 100,000). Codes for perforated appendicitis were not reliable (PPV = 52.4%) leading to overestimation in the incidence of perforated appendicitis in the administrative database (34.8 per 100,000) as compared to the pathology registry (19.4 per 100,000). The incidence of appendicitis significantly increased over time in both the administrative database (APC = 2.1%; 95% CI: 1.3, 2.8) and pathology registry (APC = 4.1; 95% CI: 3.1, 5.0). Conclusion & Relevance The administrative database overestimated the incidence of appendicitis

Validity of ICD-9-CM Coding for Identifying Incident Methicillin-Resistant Staphylococcus aureus (MRSA) Infections: Is MRSA Infection Coded as a Chronic Disease?

PubMed Central

Schweizer, Marin L.; Eber, Michael R.; Laxminarayan, Ramanan; Furuno, Jon P.; Popovich, Kyle J.; Hota, Bala; Rubin, Michael A.; Perencevich, Eli N.

2013-01-01

BACKGROUND AND OBJECTIVE Investigators and medical decision makers frequently rely on administrative databases to assess methicillin-resistant Staphylococcus aureus (MRSA) infection rates and outcomes. The validity of this approach remains unclear. We sought to assess the validity of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code for infection with drug-resistant microorganisms (V09) for identifying culture-proven MRSA infection. DESIGN Retrospective cohort study. METHODS All adults admitted to 3 geographically distinct hospitals between January 1, 2001, and December 31, 2007, were assessed for presence of incident MRSA infection, defined as an MRSA-positive clinical culture obtained during the index hospitalization, and presence of the V09 ICD-9-CM code. The k statistic was calculated to measure the agreement between presence of MRSA infection and assignment of the V09 code. Sensitivities, specificities, positive predictive values, and negative predictive values were calculated. RESULTS There were 466,819 patients discharged during the study period. Of the 4,506 discharged patients (1.0%) who had the V09 code assigned, 31% had an incident MRSA infection, 20% had prior history of MRSA colonization or infection but did not have an incident MRSA infection, and 49% had no record of MRSA infection during the index hospitalization or the previous hospitalization. The V09 code identified MRSA infection with a sensitivity of 24% (range, 21%–34%) and positive predictive value of 31% (range, 22%–53%). The agreement between assignment of the V09 code and presence of MRSA infection had a κ coefficient of 0.26 (95% confidence interval, 0.25–0.27). CONCLUSIONS In its current state, the ICD-9-CM code V09 is not an accurate predictor of MRSA infection and should not be used to measure rates of MRSA infection. PMID:21460469

76 FR 66043 - Membership of the National Telecommunications and Information Administration's Performance Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-25

... Human Resources Operations Center (DOCHROC), Office of Staffing, Recruitment, and Classification..., Career SES. Karl B. Nebbia, Associate Administrator for Spectrum Management, Career SES. Alan W. Vincent... Commerce Human Resources Operations Center. [FR Doc. 2011-27486 Filed 10-24-11; 8:45 am] BILLING CODE 3510...

76 FR 64075 - Membership of the National Telecommunications and Information Administration's Performance Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

... Human Resources Operations Center (DOCHROC), Office of Staffing, Recruitment, and Classification.... Karl B. Nebbia, Associate Administrator for Spectrum Management, Career SES. Alan W. Vincent, Associate... Human Resources Operations Center. [FR Doc. 2011-26736 Filed 10-14-11; 8:45 am] BILLING CODE 3510-25-P ...

Validity of Heart Failure Diagnoses in Administrative Databases: A Systematic Review and Meta-Analysis

PubMed Central

McCormick, Natalie; Lacaille, Diane; Bhole, Vidula; Avina-Zubieta, J. Antonio

2014-01-01

Objective Heart failure (HF) is an important covariate and outcome in studies of elderly populations and cardiovascular disease cohorts, among others. Administrative data is increasingly being used for long-term clinical research in these populations. We aimed to conduct the first systematic review and meta-analysis of studies reporting on the validity of diagnostic codes for identifying HF in administrative data. Methods MEDLINE and EMBASE were searched (inception to November 2010) for studies: (a) Using administrative data to identify HF; or (b) Evaluating the validity of HF codes in administrative data; and (c) Reporting validation statistics (sensitivity, specificity, positive predictive value [PPV], negative predictive value, or Kappa scores) for HF, or data sufficient for their calculation. Additional articles were located by hand search (up to February 2011) of original papers. Data were extracted by two independent reviewers; article quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Using a random-effects model, pooled sensitivity and specificity values were produced, along with estimates of the positive (LR+) and negative (LR−) likelihood ratios, and diagnostic odds ratios (DOR = LR+/LR−) of HF codes. Results Nineteen studies published from1999–2009 were included in the qualitative review. Specificity was ≥95% in all studies and PPV was ≥87% in the majority, but sensitivity was lower (≥69% in ≥50% of studies). In a meta-analysis of the 11 studies reporting sensitivity and specificity values, the pooled sensitivity was 75.3% (95% CI: 74.7–75.9) and specificity was 96.8% (95% CI: 96.8–96.9). The pooled LR+ was 51.9 (20.5–131.6), the LR− was 0.27 (0.20–0.37), and the DOR was 186.5 (96.8–359.2). Conclusions While most HF diagnoses in administrative databases do correspond to true HF cases, about one-quarter of HF cases are not captured. The use of broader search parameters, along with

[The role of Wacława Moszyński in the development of the Polish School of Machine and Mechanism Theory].

PubMed

Kisiel, Janusz; Pylak, Konrad; Schabowska, Krystyna

2005-01-01

The end of the 19th and the first half of the 20th centuries saw the emergence and intensive development of many disciplines in the technical sciences, and the laying of a groundwork for those disciplines in their current form. In Poland, a country deprived of independent statehood until 1918, this was additionally a period when native research centres and scientific schools came into being, and when Polish-language specialist literatures emerged as well. Many of the eminent personages whose activities contributed to those trends have already been described in biographical notes and articles. There are still, however, not enough studies dealing with the substance of their scientific and professional achievements. One of the personages in question was Wacława Moszyński, professor of the Warsaw Technical University, a pioneer of machine construction and mechanism theory, author of the first academic textbook in the field to be published in Poland. The current article discusses Moszyński's contribution to the development of mechanism and machine theory. The first part of the article gives an outline of the history of the discipline until 1945, presents the context of the after-war activities of the author, and evaluates his influence on the development of machine and mechanism theory in Poland; it also carries a short biography of Moszyński. The rest of the article is devoted to Moszyński's scientific achievements, and describes his approach to matters of structure, kinematics and dynamics, with special focus on those of his formulations and solution to problems that appear particularly innovative and original. The article also points out those proposals by Moszyński which made him a precursor of other disciplines, such as vibroacoustics, biomechanics and ergonomics. The paper also presents the role of Moszyński's work as a foundation for the development of the Warsaw research-and-teching centre in the field. The achievements and methods of the Warsaw school

Integrated information systems for electronic chemotherapy medication administration.

PubMed

Levy, Mia A; Giuse, Dario A; Eck, Carol; Holder, Gwen; Lippard, Giles; Cartwright, Julia; Rudge, Nancy K

2011-07-01

Chemotherapy administration is a highly complex and distributed task in both the inpatient and outpatient infusion center settings. The American Society of Clinical Oncology and the Oncology Nursing Society (ASCO/ONS) have developed standards that specify procedures and documentation requirements for safe chemotherapy administration. Yet paper-based approaches to medication administration have several disadvantages and do not provide any decision support for patient safety checks. Electronic medication administration that includes bar coding technology may provide additional safety checks, enable consistent documentation structure, and have additional downstream benefits. We describe the specialized configuration of clinical informatics systems for electronic chemotherapy medication administration. The system integrates the patient registration system, the inpatient order entry system, the pharmacy information system, the nursing documentation system, and the electronic health record. We describe the process of deploying this infrastructure in the adult and pediatric inpatient oncology, hematology, and bone marrow transplant wards at Vanderbilt University Medical Center. We have successfully adapted the system for the oncology-specific documentation requirements detailed in the ASCO/ONS guidelines for chemotherapy administration. However, several limitations remain with regard to recording the day of treatment and dose number. Overall, the configured systems facilitate compliance with the ASCO/ONS guidelines and improve the consistency of documentation and multidisciplinary team communication. Our success has prompted us to deploy this infrastructure in our outpatient chemotherapy infusion centers, a process that is currently underway and that will require a few unique considerations.

Integrated Information Systems for Electronic Chemotherapy Medication Administration

PubMed Central

Levy, Mia A.; Giuse, Dario A.; Eck, Carol; Holder, Gwen; Lippard, Giles; Cartwright, Julia; Rudge, Nancy K.

2011-01-01

Introduction: Chemotherapy administration is a highly complex and distributed task in both the inpatient and outpatient infusion center settings. The American Society of Clinical Oncology and the Oncology Nursing Society (ASCO/ONS) have developed standards that specify procedures and documentation requirements for safe chemotherapy administration. Yet paper-based approaches to medication administration have several disadvantages and do not provide any decision support for patient safety checks. Electronic medication administration that includes bar coding technology may provide additional safety checks, enable consistent documentation structure, and have additional downstream benefits. Methods: We describe the specialized configuration of clinical informatics systems for electronic chemotherapy medication administration. The system integrates the patient registration system, the inpatient order entry system, the pharmacy information system, the nursing documentation system, and the electronic health record. Results: We describe the process of deploying this infrastructure in the adult and pediatric inpatient oncology, hematology, and bone marrow transplant wards at Vanderbilt University Medical Center. We have successfully adapted the system for the oncology-specific documentation requirements detailed in the ASCO/ONS guidelines for chemotherapy administration. However, several limitations remain with regard to recording the day of treatment and dose number. Conclusion: Overall, the configured systems facilitate compliance with the ASCO/ONS guidelines and improve the consistency of documentation and multidisciplinary team communication. Our success has prompted us to deploy this infrastructure in our outpatient chemotherapy infusion centers, a process that is currently underway and that will require a few unique considerations. PMID:22043185

Potential Projective Material on the Rorschach: Comparing Comprehensive System Protocols to Their Modeled R-Optimized Administration Counterparts.

PubMed

Pianowski, Giselle; Meyer, Gregory J; Villemor-Amaral, Anna Elisa de

2016-01-01

Exner ( 1989 ) and Weiner ( 2003 ) identified 3 types of Rorschach codes that are most likely to contain personally relevant projective material: Distortions, Movement, and Embellishments. We examine how often these types of codes occur in normative data and whether their frequency changes for the 1st, 2nd, 3rd, 4th, or last response to a card. We also examine the impact on these variables of the Rorschach Performance Assessment System's (R-PAS) statistical modeling procedures that convert the distribution of responses (R) from Comprehensive System (CS) administered protocols to match the distribution of R found in protocols obtained using R-optimized administration guidelines. In 2 normative reference databases, the results indicated that about 40% of responses (M = 39.25) have 1 type of code, 15% have 2 types, and 1.5% have all 3 types, with frequencies not changing by response number. In addition, there were no mean differences in the original CS and R-optimized modeled records (M Cohen's d = -0.04 in both databases). When considered alongside findings showing minimal differences between the protocols of people randomly assigned to CS or R-optimized administration, the data suggest R-optimized administration should not alter the extent to which potential projective material is present in a Rorschach protocol.

Rate-compatible punctured convolutional codes (RCPC codes) and their applications

NASA Astrophysics Data System (ADS)

Hagenauer, Joachim

1988-04-01

The concept of punctured convolutional codes is extended by punctuating a low-rate 1/N code periodically with period P to obtain a family of codes with rate P/(P + l), where l can be varied between 1 and (N - 1)P. A rate-compatibility restriction on the puncturing tables ensures that all code bits of high rate codes are used by the lower-rate codes. This allows transmission of incremental redundancy in ARQ/FEC (automatic repeat request/forward error correction) schemes and continuous rate variation to change from low to high error protection within a data frame. Families of RCPC codes with rates between 8/9 and 1/4 are given for memories M from 3 to 6 (8 to 64 trellis states) together with the relevant distance spectra. These codes are almost as good as the best known general convolutional codes of the respective rates. It is shown that the same Viterbi decoder can be used for all RCPC codes of the same M. The application of RCPC codes to hybrid ARQ/FEC schemes is discussed for Gaussian and Rayleigh fading channels using channel-state information to optimize throughput.

ADM. Administration Building (TAN602). Elevations, sections, details. Shows areas that ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

ADM. Administration Building (TAN-602). Elevations, sections, details. Shows areas that were soon remodeled or added onto. Ralph M. Parsons 902-2-ANP-602-A 32 Date: August 1955. Approved by INEEL Classification Office for public release. INEEL index code no. 033-0602-00-693-106711 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

127. ARAII Administrative and technical support building (ARA606) ground floor ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

127. ARA-II Administrative and technical support building (ARA-606) ground floor plan. Indicates use of rooms for classrooms, offices, and lunch room. C.A. Sundberg and Associates 866-area-ALPR-606-A-2. Date: June 1958. Ineel index code no. 070-0606-00-822-102825. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

Amino acid codes in mitochondria as possible clues to primitive codes

NASA Technical Reports Server (NTRS)

Jukes, T. H.

1981-01-01

Differences between mitochondrial codes and the universal code indicate that an evolutionary simplification has taken place, rather than a return to a more primitive code. However, these differences make it evident that the universal code is not the only code possible, and therefore earlier codes may have differed markedly from the previous code. The present universal code is probably a 'frozen accident.' The change in CUN codons from leucine to threonine (Neurospora vs. yeast mitochondria) indicates that neutral or near-neutral changes occurred in the corresponding proteins when this code change took place, caused presumably by a mutation in a tRNA gene.

Analysis of quantum error-correcting codes: Symplectic lattice codes and toric codes

NASA Astrophysics Data System (ADS)

Harrington, James William

Quantum information theory is concerned with identifying how quantum mechanical resources (such as entangled quantum states) can be utilized for a number of information processing tasks, including data storage, computation, communication, and cryptography. Efficient quantum algorithms and protocols have been developed for performing some tasks (e.g. , factoring large numbers, securely communicating over a public channel, and simulating quantum mechanical systems) that appear to be very difficult with just classical resources. In addition to identifying the separation between classical and quantum computational power, much of the theoretical focus in this field over the last decade has been concerned with finding novel ways of encoding quantum information that are robust against errors, which is an important step toward building practical quantum information processing devices. In this thesis I present some results on the quantum error-correcting properties of oscillator codes (also described as symplectic lattice codes) and toric codes. Any harmonic oscillator system (such as a mode of light) can be encoded with quantum information via symplectic lattice codes that are robust against shifts in the system's continuous quantum variables. I show the existence of lattice codes whose achievable rates match the one-shot coherent information over the Gaussian quantum channel. Also, I construct a family of symplectic self-dual lattices and search for optimal encodings of quantum information distributed between several oscillators. Toric codes provide encodings of quantum information into two-dimensional spin lattices that are robust against local clusters of errors and which require only local quantum operations for error correction. Numerical simulations of this system under various error models provide a calculation of the accuracy threshold for quantum memory using toric codes, which can be related to phase transitions in certain condensed matter models. I also present

Number of minimum-weight code words in a product code

NASA Technical Reports Server (NTRS)

Miller, R. L.

1978-01-01

Consideration is given to the number of minimum-weight code words in a product code. The code is considered as a tensor product of linear codes over a finite field. Complete theorems and proofs are presented.

Oracle Applications Patch Administration Tool (PAT) Beta Version

DOE Office of Scientific and Technical Information (OSTI.GOV)

2002-01-04

PAT is a Patch Administration Tool that provides analysis, tracking, and management of Oracle Application patches. This includes capabilities as outlined below: Patch Analysis & Management Tool Outline of capabilities: Administration Patch Data Maintenance -- track Oracle Application patches applied to what database instance & machine Patch Analysis capture text files (readme.txt and driver files) form comparison detail report comparison detail PL/SQL package comparison detail SQL scripts detail JSP module comparison detail Parse and load the current applptch.txt (10.7) or load patch data from Oracle Application database patch tables (11i) Display Analysis -- Compare patch to be applied with currentmore » Oracle Application installed Appl_top code versions Patch Detail Module comparison detail Analyze and display one Oracle Application module patch. Patch Management -- automatic queue and execution of patches Administration Parameter maintenance -- setting for directory structure of Oracle Application appl_top Validation data maintenance -- machine names and instances to patch Operation Patch Data Maintenance Schedule a patch (queue for later execution) Run a patch (queue for immediate execution) Review the patch logs Patch Management Reports« less

Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review

PubMed Central

van Mourik, Maaike S M; van Duijn, Pleun Joppe; Moons, Karel G M; Bonten, Marc J M; Lee, Grace M

2015-01-01

Objective Measuring the incidence of healthcare-associated infections (HAI) is of increasing importance in current healthcare delivery systems. Administrative data algorithms, including (combinations of) diagnosis codes, are commonly used to determine the occurrence of HAI, either to support within-hospital surveillance programmes or as free-standing quality indicators. We conducted a systematic review evaluating the diagnostic accuracy of administrative data for the detection of HAI. Methods Systematic search of Medline, Embase, CINAHL and Cochrane for relevant studies (1995–2013). Methodological quality assessment was performed using QUADAS-2 criteria; diagnostic accuracy estimates were stratified by HAI type and key study characteristics. Results 57 studies were included, the majority aiming to detect surgical site or bloodstream infections. Study designs were very diverse regarding the specification of their administrative data algorithm (code selections, follow-up) and definitions of HAI presence. One-third of studies had important methodological limitations including differential or incomplete HAI ascertainment or lack of blinding of assessors. Observed sensitivity and positive predictive values of administrative data algorithms for HAI detection were very heterogeneous and generally modest at best, both for within-hospital algorithms and for formal quality indicators; accuracy was particularly poor for the identification of device-associated HAI such as central line associated bloodstream infections. The large heterogeneity in study designs across the included studies precluded formal calculation of summary diagnostic accuracy estimates in most instances. Conclusions Administrative data had limited and highly variable accuracy for the detection of HAI, and their judicious use for internal surveillance efforts and external quality assessment is recommended. If hospitals and policymakers choose to rely on administrative data for HAI surveillance, continued

A systematic review of validated methods to capture acute bronchospasm using administrative or claims data.

PubMed

Sharifi, Mona; Krishanswami, Shanthi; McPheeters, Melissa L

2013-12-30

To identify and assess billing, procedural, or diagnosis code, or pharmacy claim-based algorithms used to identify acute bronchospasm in administrative and claims databases. We searched the MEDLINE database from 1991 to September 2012 using controlled vocabulary and key terms related to bronchospasm, wheeze and acute asthma. We also searched the reference lists of included studies. Two investigators independently assessed the full text of studies against pre-determined inclusion criteria. Two reviewers independently extracted data regarding participant and algorithm characteristics. Our searches identified 677 citations of which 38 met our inclusion criteria. In these 38 studies, the most commonly used ICD-9 code was 493.x. Only 3 studies reported any validation methods for the identification of bronchospasm, wheeze or acute asthma in administrative and claims databases; all were among pediatric populations and only 2 offered any validation statistics. Some of the outcome definitions utilized were heterogeneous and included other disease based diagnoses, such as bronchiolitis and pneumonia, which are typically of an infectious etiology. One study offered the validation of algorithms utilizing Emergency Department triage chief complaint codes to diagnose acute asthma exacerbations with ICD-9 786.07 (wheezing) revealing the highest sensitivity (56%), specificity (97%), PPV (93.5%) and NPV (76%). There is a paucity of studies reporting rigorous methods to validate algorithms for the identification of bronchospasm in administrative data. The scant validated data available are limited in their generalizability to broad-based populations. Copyright © 2013 Elsevier Ltd. All rights reserved.

28 CFR 522.12 - Relationship between existing criminal sentences imposed under the U.S. or D.C. Code and new...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Relationship between existing criminal sentences imposed under the U.S. or D.C. Code and new civil contempt commitment orders. 522.12 Section 522.12 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INMATE ADMISSION, CLASSIFICATION, AND TRANSFER ADMISSION TO INSTITUTION Civi...

Uplink Coding

NASA Technical Reports Server (NTRS)

Pollara, Fabrizio; Hamkins, Jon; Dolinar, Sam; Andrews, Ken; Divsalar, Dariush

2006-01-01

This viewgraph presentation reviews uplink coding. The purpose and goals of the briefing are (1) Show a plan for using uplink coding and describe benefits (2) Define possible solutions and their applicability to different types of uplink, including emergency uplink (3) Concur with our conclusions so we can embark on a plan to use proposed uplink system (4) Identify the need for the development of appropriate technology and infusion in the DSN (5) Gain advocacy to implement uplink coding in flight projects Action Item EMB04-1-14 -- Show a plan for using uplink coding, including showing where it is useful or not (include discussion of emergency uplink coding).

Multiple component codes based generalized LDPC codes for high-speed optical transport.

PubMed

Djordjevic, Ivan B; Wang, Ting

2014-07-14

A class of generalized low-density parity-check (GLDPC) codes suitable for optical communications is proposed, which consists of multiple local codes. It is shown that Hamming, BCH, and Reed-Muller codes can be used as local codes, and that the maximum a posteriori probability (MAP) decoding of these local codes by Ashikhmin-Lytsin algorithm is feasible in terms of complexity and performance. We demonstrate that record coding gains can be obtained from properly designed GLDPC codes, derived from multiple component codes. We then show that several recently proposed classes of LDPC codes such as convolutional and spatially-coupled codes can be described using the concept of GLDPC coding, which indicates that the GLDPC coding can be used as a unified platform for advanced FEC enabling ultra-high speed optical transport. The proposed class of GLDPC codes is also suitable for code-rate adaption, to adjust the error correction strength depending on the optical channel conditions.

Validation of administrative data used for the diagnosis of upper gastrointestinal events following nonsteroidal anti-inflammatory drug prescription.

PubMed

Abraham, N S; Cohen, D C; Rivers, B; Richardson, P

2006-07-15

To validate veterans affairs (VA) administrative data for the diagnosis of nonsteroidal anti-inflammatory drug (NSAID)-related upper gastrointestinal events (UGIE) and to develop a diagnostic algorithm. A retrospective study of veterans prescribed an NSAID as identified from the national pharmacy database merged with in-patient and out-patient data, followed by primary chart abstraction. Contingency tables were constructed to allow comparison with a random sample of patients prescribed an NSAID, but without UGIE. Multivariable logistic regression analysis was used to derive a predictive algorithm. Once derived, the algorithm was validated in a separate cohort of veterans. Of 906 patients, 606 had a diagnostic code for UGIE; 300 were a random subsample of 11 744 patients (control). Only 161 had a confirmed UGIE. The positive predictive value (PPV) of diagnostic codes was poor, but improved from 27% to 51% with the addition of endoscopic procedural codes. The strongest predictors of UGIE were an in-patient ICD-9 code for gastric ulcer, duodenal ulcer and haemorrhage combined with upper endoscopy. This algorithm had a PPV of 73% when limited to patients >or=65 years (c-statistic 0.79). Validation of the algorithm revealed a PPV of 80% among patients with an overlapping NSAID prescription. NSAID-related UGIE can be assessed using VA administrative data. The optimal algorithm includes an in-patient ICD-9 code for gastric or duodenal ulcer and gastrointestinal bleeding combined with a procedural code for upper endoscopy.

131. ARAII Administration building (ARA613) floor plans for first and ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

131. ARA-II Administration building (ARA-613) floor plans for first and second floors. Includes roof plan. Shows use of rooms as offices, laboratory, conference room. F.C. Torkelson Company 842-area/SL-1-613-A-1. Date: October 1958. Ineel index code no. 070-0613-00-851-150718. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

Model Children's Code.

ERIC Educational Resources Information Center

New Mexico Univ., Albuquerque. American Indian Law Center.

The Model Children's Code was developed to provide a legally correct model code that American Indian tribes can use to enact children's codes that fulfill their legal, cultural and economic needs. Code sections cover the court system, jurisdiction, juvenile offender procedures, minor-in-need-of-care, and termination. Almost every Code section is…

76 FR 49772 - Guidance for Industry: Bar Code Label Requirements-Questions and Answers; Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-11

... other FDA initiatives, such as efforts to further enhance the security of the drug supply chain through... response concerns the ability of vaccine manufacturers to use alternative coding technologies to the linear... Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852. FOR...

New quantum codes derived from a family of antiprimitive BCH codes

NASA Astrophysics Data System (ADS)

Liu, Yang; Li, Ruihu; Lü, Liangdong; Guo, Luobin

The Bose-Chaudhuri-Hocquenghem (BCH) codes have been studied for more than 57 years and have found wide application in classical communication system and quantum information theory. In this paper, we study the construction of quantum codes from a family of q2-ary BCH codes with length n=q2m+1 (also called antiprimitive BCH codes in the literature), where q≥4 is a power of 2 and m≥2. By a detailed analysis of some useful properties about q2-ary cyclotomic cosets modulo n, Hermitian dual-containing conditions for a family of non-narrow-sense antiprimitive BCH codes are presented, which are similar to those of q2-ary primitive BCH codes. Consequently, via Hermitian Construction, a family of new quantum codes can be derived from these dual-containing BCH codes. Some of these new antiprimitive quantum BCH codes are comparable with those derived from primitive BCH codes.

Surface acoustic wave coding for orthogonal frequency coded devices

NASA Technical Reports Server (NTRS)

Malocha, Donald (Inventor); Kozlovski, Nikolai (Inventor)

2011-01-01

Methods and systems for coding SAW OFC devices to mitigate code collisions in a wireless multi-tag system. Each device producing plural stepped frequencies as an OFC signal with a chip offset delay to increase code diversity. A method for assigning a different OCF to each device includes using a matrix based on the number of OFCs needed and the number chips per code, populating each matrix cell with OFC chip, and assigning the codes from the matrix to the devices. The asynchronous passive multi-tag system includes plural surface acoustic wave devices each producing a different OFC signal having the same number of chips and including a chip offset time delay, an algorithm for assigning OFCs to each device, and a transceiver to transmit an interrogation signal and receive OFC signals in response with minimal code collisions during transmission.

Validation of ICD-9 Codes for Stable Miscarriage in the Emergency Department.

PubMed

Quinley, Kelly E; Falck, Ailsa; Kallan, Michael J; Datner, Elizabeth M; Carr, Brendan G; Schreiber, Courtney A

2015-07-01

International Classification of Disease, Ninth Revision (ICD-9) diagnosis codes have not been validated for identifying cases of missed abortion where a pregnancy is no longer viable but the cervical os remains closed. Our goal was to assess whether ICD-9 code "632" for missed abortion has high sensitivity and positive predictive value (PPV) in identifying patients in the emergency department (ED) with cases of stable early pregnancy failure (EPF). We studied females ages 13-50 years presenting to the ED of an urban academic medical center. We approached our analysis from two perspectives, evaluating both the sensitivity and PPV of ICD-9 code "632" in identifying patients with stable EPF. All patients with chief complaints "pregnant and bleeding" or "pregnant and cramping" over a 12-month period were identified. We randomly reviewed two months of patient visits and calculated the sensitivity of ICD-9 code "632" for true cases of stable miscarriage. To establish the PPV of ICD-9 code "632" for capturing missed abortions, we identified patients whose visits from the same time period were assigned ICD-9 code "632," and identified those with actual cases of stable EPF. We reviewed 310 patient records (17.6% of 1,762 sampled). Thirteen of 31 patient records assigned ICD-9 code for missed abortion correctly identified cases of stable EPF (sensitivity=41.9%), and 140 of the 142 patients without EPF were not assigned the ICD-9 code "632"(specificity=98.6%). Of the 52 eligible patients identified by ICD-9 code "632," 39 cases met the criteria for stable EPF (PPV=75.0%). ICD-9 code "632" has low sensitivity for identifying stable EPF, but its high specificity and moderately high PPV are valuable for studying cases of stable EPF in epidemiologic studies using administrative data.

Systematic review of validated case definitions for diabetes in ICD-9-coded and ICD-10-coded data in adult populations.

PubMed

Khokhar, Bushra; Jette, Nathalie; Metcalfe, Amy; Cunningham, Ceara Tess; Quan, Hude; Kaplan, Gilaad G; Butalia, Sonia; Rabi, Doreen

2016-08-05

With steady increases in 'big data' and data analytics over the past two decades, administrative health databases have become more accessible and are now used regularly for diabetes surveillance. The objective of this study is to systematically review validated International Classification of Diseases (ICD)-based case definitions for diabetes in the adult population. Electronic databases, MEDLINE and Embase, were searched for validation studies where an administrative case definition (using ICD codes) for diabetes in adults was validated against a reference and statistical measures of the performance reported. The search yielded 2895 abstracts, and of the 193 potentially relevant studies, 16 met criteria. Diabetes definition for adults varied by data source, including physician claims (sensitivity ranged from 26.9% to 97%, specificity ranged from 94.3% to 99.4%, positive predictive value (PPV) ranged from 71.4% to 96.2%, negative predictive value (NPV) ranged from 95% to 99.6% and κ ranged from 0.8 to 0.9), hospital discharge data (sensitivity ranged from 59.1% to 92.6%, specificity ranged from 95.5% to 99%, PPV ranged from 62.5% to 96%, NPV ranged from 90.8% to 99% and κ ranged from 0.6 to 0.9) and a combination of both (sensitivity ranged from 57% to 95.6%, specificity ranged from 88% to 98.5%, PPV ranged from 54% to 80%, NPV ranged from 98% to 99.6% and κ ranged from 0.7 to 0.8). Overall, administrative health databases are useful for undertaking diabetes surveillance, but an awareness of the variation in performance being affected by case definition is essential. The performance characteristics of these case definitions depend on the variations in the definition of primary diagnosis in ICD-coded discharge data and/or the methodology adopted by the healthcare facility to extract information from patient records. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Code of conduct for the International Space Station Crew. National Aeronautics and Space Administration (NASA). Interim final rule.

PubMed

2000-12-21

NASA is issuing new regulations entitled "International Space Station Crew," to implement certain provisions of the International Space Station (ISS) Intergovernmental Agreement (IGA) regarding ISS crewmembers' observance of an ISS Code of Conduct.

Understanding Mixed Code and Classroom Code-Switching: Myths and Realities

ERIC Educational Resources Information Center

Li, David C. S.

2008-01-01

Background: Cantonese-English mixed code is ubiquitous in Hong Kong society, and yet using mixed code is widely perceived as improper. This paper presents evidence of mixed code being socially constructed as bad language behavior. In the education domain, an EDB guideline bans mixed code in the classroom. Teachers are encouraged to stick to…

Calibration, Projection, and Final Image Products of MESSENGER's Mercury Dual Imaging System

NASA Astrophysics Data System (ADS)

Denevi, Brett W.; Chabot, Nancy L.; Murchie, Scott L.; Becker, Kris J.; Blewett, David T.; Domingue, Deborah L.; Ernst, Carolyn M.; Hash, Christopher D.; Hawkins, S. Edward; Keller, Mary R.; Laslo, Nori R.; Nair, Hari; Robinson, Mark S.; Seelos, Frank P.; Stephens, Grant K.; Turner, F. Scott; Solomon, Sean C.

2018-02-01

We present an overview of the operations, calibration, geodetic control, photometric standardization, and processing of images from the Mercury Dual Imaging System (MDIS) acquired during the orbital phase of the MESSENGER spacecraft's mission at Mercury (18 March 2011-30 April 2015). We also provide a summary of all of the MDIS products that are available in NASA's Planetary Data System (PDS). Updates to the radiometric calibration included slight modification of the frame-transfer smear correction, updates to the flat fields of some wide-angle camera (WAC) filters, a new model for the temperature dependence of narrow-angle camera (NAC) and WAC sensitivity, and an empirical correction for temporal changes in WAC responsivity. Further, efforts to characterize scattered light in the WAC system are described, along with a mosaic-dependent correction for scattered light that was derived for two regional mosaics. Updates to the geometric calibration focused on the focal lengths and distortions of the NAC and all WAC filters, NAC-WAC alignment, and calibration of the MDIS pivot angle and base. Additionally, two control networks were derived so that the majority of MDIS images can be co-registered with sub-pixel accuracy; the larger of the two control networks was also used to create a global digital elevation model. Finally, we describe the image processing and photometric standardization parameters used in the creation of the MDIS advanced products in the PDS, which include seven large-scale mosaics, numerous targeted local mosaics, and a set of digital elevation models ranging in scale from local to global.

QR Codes 101

ERIC Educational Resources Information Center

Crompton, Helen; LaFrance, Jason; van 't Hooft, Mark

2012-01-01

A QR (quick-response) code is a two-dimensional scannable code, similar in function to a traditional bar code that one might find on a product at the supermarket. The main difference between the two is that, while a traditional bar code can hold a maximum of only 20 digits, a QR code can hold up to 7,089 characters, so it can contain much more…

The random coding bound is tight for the average code.

NASA Technical Reports Server (NTRS)

Gallager, R. G.

1973-01-01

The random coding bound of information theory provides a well-known upper bound to the probability of decoding error for the best code of a given rate and block length. The bound is constructed by upperbounding the average error probability over an ensemble of codes. The bound is known to give the correct exponential dependence of error probability on block length for transmission rates above the critical rate, but it gives an incorrect exponential dependence at rates below a second lower critical rate. Here we derive an asymptotic expression for the average error probability over the ensemble of codes used in the random coding bound. The result shows that the weakness of the random coding bound at rates below the second critical rate is due not to upperbounding the ensemble average, but rather to the fact that the best codes are much better than the average at low rates.

Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists.

PubMed

Widdifield, Jessica; Bernatsky, Sasha; Paterson, J Michael; Tu, Karen; Ng, Ryan; Thorne, J Carter; Pope, Janet E; Bombardier, Claire

2013-10-01

Health administrative data can be a valuable tool for disease surveillance and research. Few studies have rigorously evaluated the accuracy of administrative databases for identifying rheumatoid arthritis (RA) patients. Our aim was to validate administrative data algorithms to identify RA patients in Ontario, Canada. We performed a retrospective review of a random sample of 450 patients from 18 rheumatology clinics. Using rheumatologist-reported diagnosis as the reference standard, we tested and validated different combinations of physician billing, hospitalization, and pharmacy data. One hundred forty-nine rheumatology patients were classified as having RA and 301 were classified as not having RA based on our reference standard definition (study RA prevalence 33%). Overall, algorithms that included physician billings had excellent sensitivity (range 94-100%). Specificity and positive predictive value (PPV) were modest to excellent and increased when algorithms included multiple physician claims or specialist claims. The addition of RA medications did not significantly improve algorithm performance. The algorithm of "(1 hospitalization RA code ever) OR (3 physician RA diagnosis codes [claims] with ≥1 by a specialist in a 2-year period)" had a sensitivity of 97%, specificity of 85%, PPV of 76%, and negative predictive value of 98%. Most RA patients (84%) had an RA diagnosis code present in the administrative data within ±1 year of a rheumatologist's documented diagnosis date. We demonstrated that administrative data can be used to identify RA patients with a high degree of accuracy. RA diagnosis date and disease duration are fairly well estimated from administrative data in jurisdictions of universal health care insurance. Copyright © 2013 by the American College of Rheumatology.

Making your code citable with the Astrophysics Source Code Library

NASA Astrophysics Data System (ADS)

Allen, Alice; DuPrie, Kimberly; Schmidt, Judy; Berriman, G. Bruce; Hanisch, Robert J.; Mink, Jessica D.; Nemiroff, Robert J.; Shamir, Lior; Shortridge, Keith; Taylor, Mark B.; Teuben, Peter J.; Wallin, John F.

2016-01-01

The Astrophysics Source Code Library (ASCL, ascl.net) is a free online registry of codes used in astronomy research. With nearly 1,200 codes, it is the largest indexed resource for astronomy codes in existence. Established in 1999, it offers software authors a path to citation of their research codes even without publication of a paper describing the software, and offers scientists a way to find codes used in refereed publications, thus improving the transparency of the research. It also provides a method to quantify the impact of source codes in a fashion similar to the science metrics of journal articles. Citations using ASCL IDs are accepted by major astronomy journals and if formatted properly are tracked by ADS and other indexing services. The number of citations to ASCL entries increased sharply from 110 citations in January 2014 to 456 citations in September 2015. The percentage of code entries in ASCL that were cited at least once rose from 7.5% in January 2014 to 17.4% in September 2015. The ASCL's mid-2014 infrastructure upgrade added an easy entry submission form, more flexible browsing, search capabilities, and an RSS feeder for updates. A Changes/Additions form added this past fall lets authors submit links for papers that use their codes for addition to the ASCL entry even if those papers don't formally cite the codes, thus increasing the transparency of that research and capturing the value of their software to the community.

76 FR 77549 - Lummi Nation-Title 20-Code of Laws-Liquor Code

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Lummi Nation--Title 20--Code of Laws--Liquor... amendment to Lummi Nation's Title 20--Code of Laws--Liquor Code. The Code regulates and controls the... this amendment to Title 20--Lummi Nation Code of Laws--Liquor Code by Resolution 2011-038 on March 1...

Codes of Student Conduct: A Breakdown of Statements of Sixteen Colleges and Universities.

ERIC Educational Resources Information Center

National Industrial Conference Board, Inc., New York, NY.

A group of university presidents and other administrative officials met in July, 1968 to discuss the problem of crime and disorder in the US. There was an expressed need for background information that would be helpful to officials at institutions of higher education who want to develop, reexamine, or redefine a code of student conduct. This…

Designing timber bridge superstructures : a comparison of U.S. and Canadian bridge codes.

Treesearch

James Scott Groenier; James P. Wacker

2008-01-01

Several changes relating to timber bridges have been incorporated into the AASHTO-LRFD Bridge Design Specifications recently. In addition, the Federal Highway Administration is strongly encouraging an LRFD-based design approach for all new bridges in the United States. The Bridge Design Code in Canada was one of the first to adopt the limit states design philosophy,...

A systematic review of validated methods for identifying transfusion-related ABO incompatibility reactions using administrative and claims data.

PubMed

Carnahan, Ryan M; Kee, Vicki R

2012-01-01

This paper aimed to systematically review algorithms to identify transfusion-related ABO incompatibility reactions in administrative data, with a focus on studies that have examined the validity of the algorithms. A literature search was conducted using PubMed, Iowa Drug Information Service database, and Embase. A Google Scholar search was also conducted because of the difficulty identifying relevant studies. Reviews were conducted by two investigators to identify studies using data sources from the USA or Canada because these data sources were most likely to reflect the coding practices of Mini-Sentinel data sources. One study was found that validated International Classification of Diseases (ICD-9-CM) codes representing transfusion reactions. None of these cases were ABO incompatibility reactions. Several studies consistently used ICD-9-CM code 999.6, which represents ABO incompatibility reactions, and a technical report identified the ICD-10 code for these reactions. One study included the E-code E8760 for mismatched blood in transfusion in the algorithm. Another study reported finding no ABO incompatibility reaction codes in the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database, which contains data of 2.23 million patients who received transfusions, raising questions about the sensitivity of administrative data for identifying such reactions. Two studies reported perfect specificity, with sensitivity ranging from 21% to 83%, for the code identifying allogeneic red blood cell transfusions in hospitalized patients. There is no information to assess the validity of algorithms to identify transfusion-related ABO incompatibility reactions. Further information on the validity of algorithms to identify transfusions would also be useful. Copyright © 2012 John Wiley & Sons, Ltd.

Weak affinity chromatography for evaluation of stereoisomers in early drug discovery.

PubMed

Duong-Thi, Minh-Dao; Bergström, Maria; Fex, Tomas; Svensson, Susanne; Ohlson, Sten; Isaksson, Roland

2013-07-01

In early drug discovery (e.g., in fragment screening), recognition of stereoisomeric structures is valuable and guides medicinal chemists to focus only on useful configurations. In this work, we concurrently screened mixtures of stereoisomers and estimated their affinities to a protein target (thrombin) using weak affinity chromatography-mass spectrometry (WAC-MS). Affinity determinations by WAC showed that minor changes in stereoisomeric configuration could have a major impact on affinity. The ability of WAC-MS to provide instant information about stereoselectivity and binding affinities directly from analyte mixtures is a great advantage in fragment library screening and drug lead development.

River Protection Project (RPP) Dangerous Waste Training Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

POHTO, R.E.

2000-03-09

This supporting document contains the training plan for dangerous waste management at River Protection Project TSD Units. This document outlines the dangerous waste training program developed and implemented for all Treatment, Storage, and Disposal (TSD) Units operated by River Protection Project (RPP) in the Hanford 200 East, 200 West and 600 Areas and the <90 Day Accumulation Area at 209E. Operating TSD Units managed by RPP are: the Double-Shell Tank (DST) System, 204-AR Waste Unloading Facility, Grout, and the Single-Shell Tank (SST) System. The program is designed in compliance with the requirements of Washington Administrative Code (WAC) 173-303-330 and Titlemore » 40 Code of Federal Regulations (CFR) 265.16 for the development of a written dangerous waste training program and the Hanford Facility Permit. Training requirements were determined by an assessment of employee duties and responsibilities. The RPP training program is designed to prepare employees to operate and maintain the Tank Farms in a safe, effective, efficient, and environmentally sound manner. In addition to preparing employees to operate and maintain the Tank Farms under normal conditions, the training program ensures that employees are prepared to respond in a prompt and effective manner should abnormal or emergency conditions occur. Emergency response training is consistent with emergency responses outlined in the following Building Emergency Plans: HNF-IP-0263-TF and HNF-=IP-0263-209E.« less

A systematic review of validated methods for identifying pulmonary fibrosis and interstitial lung disease using administrative and claims data.

PubMed

Jones, Natalie; Schneider, Gary; Kachroo, Sumesh; Rotella, Philip; Avetisyan, Ruzan; Reynolds, Matthew W

2012-01-01

The Food and Drug Administration's Mini-Sentinel pilot program initially aimed to conduct active surveillance to refine safety signals that emerge for marketed medical products. A key facet of this surveillance is to develop and understand the validity of algorithms for identifying health outcomes of interest (HOIs) from administrative and claims data. This paper summarizes the process and findings of the algorithm review of pulmonary fibrosis and interstitial lung disease. PubMed and Iowa Drug Information Service Web searches were conducted to identify citations applicable to the pulmonary fibrosis/interstitial lung disease HOI. Level 1 abstract reviews and Level 2 full-text reviews were conducted to find articles using administrative and claims data to identify pulmonary fibrosis and interstitial lung disease, including validation estimates of the coding algorithms. Our search revealed a deficiency of literature focusing on pulmonary fibrosis and interstitial lung disease algorithms and validation estimates. Only five studies provided codes; none provided validation estimates. Because interstitial lung disease includes a broad spectrum of diseases, including pulmonary fibrosis, the scope of these studies varied, as did the corresponding diagnostic codes used. Research needs to be conducted on designing validation studies to test pulmonary fibrosis and interstitial lung disease algorithms and estimating their predictive power, sensitivity, and specificity. Copyright © 2012 John Wiley & Sons, Ltd.

130. ARAII Administration building (ARA613) vicinity map and plot plan ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

130. ARA-II Administration building (ARA-613) vicinity map and plot plan showing relationship to other existing buildings on site and to ARA-602, to which this building was attached. F.C. Torkelson Comapny 842-area/SL-1-101-U-1. Date: October 1959. Ineel index code no. 070-0101-65-851-150053. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

Usefulness of Canadian Public Health Insurance Administrative Databases to Assess Breast and Ovarian Cancer Screening Imaging Technologies for BRCA1/2 Mutation Carriers.

PubMed

Larouche, Geneviève; Chiquette, Jocelyne; Plante, Marie; Pelletier, Sylvie; Simard, Jacques; Dorval, Michel

2016-11-01

In Canada, recommendations for clinical management of hereditary breast and ovarian cancer among individuals carrying a deleterious BRCA1 or BRCA2 mutation have been available since 2007. Eight years later, very little is known about the uptake of screening and risk-reduction measures in this population. Because Canada's public health care system falls under provincial jurisdictions, using provincial health care administrative databases appears a valuable option to assess management of BRCA1/2 mutation carriers. The objective was to explore the usefulness of public health insurance administrative databases in British Columbia, Ontario, and Quebec to assess management after BRCA1/2 genetic testing. Official public health insurance documents were considered potentially useful if they had specific procedure codes, and pertained to procedures performed in the public and private health care systems. All 3 administrative databases have specific procedures codes for mammography and breast ultrasounds. Only Quebec and Ontario have a specific procedure code for breast magnetic resonance imaging. It is impossible to assess, on an individual basis, the frequency of others screening exams, with the exception of CA-125 testing in British Columbia. Screenings done in private practice are excluded from the administrative databases unless covered by special agreements for reimbursement, such as all breast imaging exams in Ontario and mammograms in British Columbia and Quebec. There are no specific procedure codes for risk-reduction surgeries for breast and ovarian cancer. Population-based assessment of breast and ovarian cancer risk management strategies other than mammographic screening, using only administrative data, is currently challenging in the 3 Canadian provinces studied. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Accumulate repeat accumulate codes

NASA Technical Reports Server (NTRS)

Abbasfar, A.; Divsalar, D.; Yao, K.

2004-01-01

In this paper we propose an innovative channel coding scheme called Accumulate Repeat Accumulate codes. This class of codes can be viewed as trubo-like codes, namely a double serial concatenation of a rate-1 accumulator as an outer code, a regular or irregular repetition as a middle code, and a punctured accumulator as an inner code.

Performance Measures of Diagnostic Codes for Detecting Opioid Overdose in the Emergency Department.

PubMed

Rowe, Christopher; Vittinghoff, Eric; Santos, Glenn-Milo; Behar, Emily; Turner, Caitlin; Coffin, Phillip O

2017-04-01

specificity of 99.9% (95% CI = 99.8% to 100.0%). Expanding the ICD-9-CM codes to include both nonspecified and general (i.e., without a decimal modifier) drug poisoning and drug abuse codes identified overdose ED visits with a sensitivity of 56.8% (95% CI = 43.6%-72.7%) and specificity of 96.2% (95% CI = 94.8%-97.2%). Additional ICD-9-CM codes not explicitly relevant to opioid overdose were necessary to further enhance sensitivity. Among the 44 overdose ED visits, neither naloxone administration during the visit, whether the patient responded to the naloxone, nor the specific opioids involved were associated with the assignment of an opioid poisoning ICD-9-CM code (p ≥ 0.05). Tracking opioid overdose ED visits by diagnostic coding is fairly specific but insensitive, and coding was not influenced by administration of naloxone or the specific opioids involved. The reason for the high rate of missed cases is uncertain, although these results suggest that a more clearly defined case definition for overdose may be necessary to ensure effective opioid overdose surveillance. Changes in coding practices under ICD-10 might help to address these deficiencies. © 2016 by the Society for Academic Emergency Medicine.

Food and Drug Administration regulation and evaluation of vaccines.

PubMed

Marshall, Valerie; Baylor, Norman W

2011-05-01

The vaccine-approval process in the United States is regulated by the Center for Biologics Evaluation and Research of the US Food and Drug Administration. Throughout the life cycle of development, from preclinical studies to after licensure, vaccines are subject to rigorous testing and oversight. Manufacturers must adhere to good manufacturing practices and control procedures to ensure the quality of vaccines. As mandated by Title 21 of the Code of Regulations, licensed vaccines must meet stringent criteria for safety, efficacy, and potency.

76 FR 16365 - Approval and Promulgation of Implementation Plans; Washington: Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... precursors to a NAAQS pollutant: Department of Ecology (Ecology): WAC 173-400-040 (except WAC 173- 400-040(1..., Ecology and SWCAA stated their support of EPA's approval of this correction and narrowing of the... address, as appropriate, disproportionate human health or environmental effects, using practicable and...

Accumulate repeat accumulate codes

NASA Technical Reports Server (NTRS)

Abbasfar, Aliazam; Divsalar, Dariush; Yao, Kung

2004-01-01

In this paper we propose an innovative channel coding scheme called 'Accumulate Repeat Accumulate codes' (ARA). This class of codes can be viewed as serial turbo-like codes, or as a subclass of Low Density Parity Check (LDPC) codes, thus belief propagation can be used for iterative decoding of ARA codes on a graph. The structure of encoder for this class can be viewed as precoded Repeat Accumulate (RA) code or as precoded Irregular Repeat Accumulate (IRA) code, where simply an accumulator is chosen as a precoder. Thus ARA codes have simple, and very fast encoder structure when they representing LDPC codes. Based on density evolution for LDPC codes through some examples for ARA codes, we show that for maximum variable node degree 5 a minimum bit SNR as low as 0.08 dB from channel capacity for rate 1/2 can be achieved as the block size goes to infinity. Thus based on fixed low maximum variable node degree, its threshold outperforms not only the RA and IRA codes but also the best known LDPC codes with the dame maximum node degree. Furthermore by puncturing the accumulators any desired high rate codes close to code rate 1 can be obtained with thresholds that stay close to the channel capacity thresholds uniformly. Iterative decoding simulation results are provided. The ARA codes also have projected graph or protograph representation that allows for high speed decoder implementation.

Error floor behavior study of LDPC codes for concatenated codes design

NASA Astrophysics Data System (ADS)

Chen, Weigang; Yin, Liuguo; Lu, Jianhua

2007-11-01

Error floor behavior of low-density parity-check (LDPC) codes using quantized decoding algorithms is statistically studied with experimental results on a hardware evaluation platform. The results present the distribution of the residual errors after decoding failure and reveal that the number of residual error bits in a codeword is usually very small using quantized sum-product (SP) algorithm. Therefore, LDPC code may serve as the inner code in a concatenated coding system with a high code rate outer code and thus an ultra low error floor can be achieved. This conclusion is also verified by the experimental results.

75 FR 54347 - Draft Guidance for Industry: Bar Code Label Requirements-Questions and Answers (Question 12...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-07

...] Draft Guidance for Industry: Bar Code Label Requirements-- Questions and Answers (Question 12 Update... Administration (FDA) is announcing the availability of a draft document entitled ``Guidance for Industry: Bar... guidance provides you, manufacturers of a licensed vaccine, with advice concerning compliance with the bar...

Validation of administrative case ascertainment algorithms for chronic childhood arthritis in Manitoba, Canada.

PubMed

Shiff, Natalie Jane; Oen, Kiem; Rabbani, Rasheda; Lix, Lisa M

2017-09-01

We validated case ascertainment algorithms for juvenile idiopathic arthritis (JIA) in the provincial health administrative databases of Manitoba, Canada. A population-based pediatric rheumatology clinical database from April 1st 1980 to March 31st 2012 was used to test case definitions in individuals diagnosed at ≤15 years of age. The case definitions varied the number of diagnosis codes (1, 2, or 3), time frame (1, 2 or 3 years), time between diagnoses (ever, >1 day, or ≥8 weeks), and physician specialty. Positive predictive value (PPV), sensitivity, and specificity with 95% confidence intervals (CIs) are reported. A case definition of 1 hospitalization or ≥2 diagnoses in 2 years by any provider ≥8 weeks apart using diagnosis codes for rheumatoid arthritis and ankylosing spondylitis produced a sensitivity of 89.2% (95% CI 86.8, 91.6), specificity of 86.3% (95% CI 83.0, 89.6), and PPV of 90.6% (95% CI 88.3, 92.9) when seronegative enthesopathy and arthropathy (SEA) was excluded as JIA; and sensitivity of 88.2% (95% CI 85.7, 90.7), specificity of 90.4% (95% CI 87.5, 93.3), and PPV of 93.9% (95% CI 92.0, 95.8) when SEA was included as JIA. This study validates case ascertainment algorithms for JIA in Canadian administrative health data using diagnosis codes for both rheumatoid arthritis (RA) and ankylosing spondylitis, to better reflect current JIA classification than codes for RA alone. Researchers will be able to use these results to define cohorts for population-based studies.

[Quality management and strategic consequences of assessing documentation and coding under the German Diagnostic Related Groups system].

PubMed

Schnabel, M; Mann, D; Efe, T; Schrappe, M; V Garrel, T; Gotzen, L; Schaeg, M

2004-10-01

The introduction of the German Diagnostic Related Groups (D-DRG) system requires redesigning administrative patient management strategies. Wrong coding leads to inaccurate grouping and endangers the reimbursement of treatment costs. This situation emphasizes the roles of documentation and coding as factors of economical success. The aims of this study were to assess the quantity and quality of initial documentation and coding (ICD-10 and OPS-301) and find operative strategies to improve efficiency and strategic means to ensure optimal documentation and coding quality. In a prospective study, documentation and coding quality were evaluated in a standardized way by weekly assessment. Clinical data from 1385 inpatients were processed for initial correctness and quality of documentation and coding. Principal diagnoses were found to be accurate in 82.7% of cases, inexact in 7.1%, and wrong in 10.1%. Effects on financial returns occurred in 16%. Based on these findings, an optimized, interdisciplinary, and multiprofessional workflow on medical documentation, coding, and data control was developed. Workflow incorporating regular assessment of documentation and coding quality is required by the DRG system to ensure efficient accounting of hospital services. Interdisciplinary and multiprofessional cooperation is recognized to be an important factor in establishing an efficient workflow in medical documentation and coding.

Mechanical code comparator

DOEpatents

Peter, Frank J.; Dalton, Larry J.; Plummer, David W.

2002-01-01

A new class of mechanical code comparators is described which have broad potential for application in safety, surety, and security applications. These devices can be implemented as micro-scale electromechanical systems that isolate a secure or otherwise controlled device until an access code is entered. This access code is converted into a series of mechanical inputs to the mechanical code comparator, which compares the access code to a pre-input combination, entered previously into the mechanical code comparator by an operator at the system security control point. These devices provide extremely high levels of robust security. Being totally mechanical in operation, an access control system properly based on such devices cannot be circumvented by software attack alone.

Validity of breast, lung and colorectal cancer diagnoses in administrative databases: a systematic review protocol.

PubMed

Abraha, Iosief; Giovannini, Gianni; Serraino, Diego; Fusco, Mario; Montedori, Alessandro

2016-03-18

Breast, lung and colorectal cancers constitute the most common cancers worldwide and their epidemiology, related health outcomes and quality indicators can be studied using administrative healthcare databases. To constitute a reliable source for research, administrative healthcare databases need to be validated. The aim of this protocol is to perform the first systematic review of studies reporting the validation of International Classification of Diseases 9th and 10th revision codes to identify breast, lung and colorectal cancer diagnoses in administrative healthcare databases. This review protocol has been developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) 2015 statement. We will search the following databases: MEDLINE, EMBASE, Web of Science and the Cochrane Library, using appropriate search strategies. We will include validation studies that used administrative data to identify breast, lung and colorectal cancer diagnoses or studies that evaluated the validity of breast, lung and colorectal cancer codes in administrative data. The following inclusion criteria will be used: (1) the presence of a reference standard case definition for the disease of interest; (2) the presence of at least one test measure (eg, sensitivity, positive predictive values, etc) and (3) the use of data source from an administrative database. Pairs of reviewers will independently abstract data using standardised forms and will assess quality using a checklist based on the Standards for Reporting of Diagnostic accuracy (STARD) criteria. Ethics approval is not required. We will submit results of this study to a peer-reviewed journal for publication. The results will serve as a guide to identify appropriate case definitions and algorithms of breast, lung and colorectal cancers for researchers involved in validating administrative healthcare databases as well as for outcome research on these conditions that used administrative

Brief surgical procedure code lists for outcomes measurement and quality improvement in resource-limited settings.

PubMed

Liu, Charles; Kayima, Peter; Riesel, Johanna; Situma, Martin; Chang, David; Firth, Paul

2017-11-01

The lack of a classification system for surgical procedures in resource-limited settings hinders outcomes measurement and reporting. Existing procedure coding systems are prohibitively large and expensive to implement. We describe the creation and prospective validation of 3 brief procedure code lists applicable in low-resource settings, based on analysis of surgical procedures performed at Mbarara Regional Referral Hospital, Uganda's second largest public hospital. We reviewed operating room logbooks to identify all surgical operations performed at Mbarara Regional Referral Hospital during 2014. Based on the documented indication for surgery and procedure(s) performed, we assigned each operation up to 4 procedure codes from the International Classification of Diseases, 9th Revision, Clinical Modification. Coding of procedures was performed by 2 investigators, and a random 20% of procedures were coded by both investigators. These codes were aggregated to generate procedure code lists. During 2014, 6,464 surgical procedures were performed at Mbarara Regional Referral Hospital, to which we assigned 435 unique procedure codes. Substantial inter-rater reliability was achieved (κ = 0.7037). The 111 most common procedure codes accounted for 90% of all codes assigned, 180 accounted for 95%, and 278 accounted for 98%. We considered these sets of codes as 3 procedure code lists. In a prospective validation, we found that these lists described 83.2%, 89.2%, and 92.6% of surgical procedures performed at Mbarara Regional Referral Hospital during August to September of 2015, respectively. Empirically generated brief procedure code lists based on International Classification of Diseases, 9th Revision, Clinical Modification can be used to classify almost all surgical procedures performed at a Ugandan referral hospital. Such a standardized procedure coding system may enable better surgical data collection for administration, research, and quality improvement in resource

The EDIT-COMGEOM Code

DTIC Science & Technology

1975-09-01

This report assumes a familiarity with the GIFT and MAGIC computer codes. The EDIT-COMGEOM code is a FORTRAN computer code. The EDIT-COMGEOM code...converts the target description data which was used in the MAGIC computer code to the target description data which can be used in the GIFT computer code

Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review.

PubMed

Chan, Vincy; Thurairajah, Pravheen; Colantonio, Angela

2015-02-04

Although healthcare administrative data are commonly used for traumatic brain injury (TBI) research, there is currently no consensus or consistency on the International Classification of Diseases Version 10 (ICD-10) codes used to define TBI among children and youth internationally. This study systematically reviewed the literature to explore the range of ICD-10 codes that are used to define TBI in this population. The identification of the range of ICD-10 codes to define this population in administrative data is crucial, as it has implications for policy, resource allocation, planning of healthcare services, and prevention strategies. The databases MEDLINE, MEDLINE In-Process, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Database of Systematic Reviews were systematically searched. Grey literature was searched using Grey Matters and Google. Reference lists of included articles were also searched for relevant studies. Two reviewers independently screened all titles and abstracts using pre-defined inclusion and exclusion criteria. A full text screen was conducted on articles that met the first screen inclusion criteria. All full text articles that met the pre-defined inclusion criteria were included for analysis in this systematic review. A total of 1,326 publications were identified through the predetermined search strategy and 32 articles/reports met all eligibility criteria for inclusion in this review. Five articles specifically examined children and youth aged 19 years or under with TBI. ICD-10 case definitions ranged from the broad injuries to the head codes (ICD-10 S00 to S09) to concussion only (S06.0). There was overwhelming consensus on the inclusion of ICD-10 code S06, intracranial injury, while codes S00 (superficial injury of the head), S03 (dislocation, sprain, and strain of joints and ligaments of head), and S05 (injury of eye and orbit) were only used by articles that examined head injury, none of which specifically examined children and

49 CFR Appendix C to Part 215 - FRA Freight Car Standards Defect Code

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false FRA Freight Car Standards Defect Code C Appendix C... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD FREIGHT CAR SAFETY STANDARDS Pt. 215, App. C Appendix C to... 13/4″. (C)(1) Rim thickness is 11/16″ or less; (2) Rim thickness is 5/8″ or less; (3) Rim thickness...

Surface code implementation of block code state distillation.

PubMed

Fowler, Austin G; Devitt, Simon J; Jones, Cody

2013-01-01

State distillation is the process of taking a number of imperfect copies of a particular quantum state and producing fewer better copies. Until recently, the lowest overhead method of distilling states produced a single improved [formula: see text] state given 15 input copies. New block code state distillation methods can produce k improved [formula: see text] states given 3k + 8 input copies, potentially significantly reducing the overhead associated with state distillation. We construct an explicit surface code implementation of block code state distillation and quantitatively compare the overhead of this approach to the old. We find that, using the best available techniques, for parameters of practical interest, block code state distillation does not always lead to lower overhead, and, when it does, the overhead reduction is typically less than a factor of three.

Surface code implementation of block code state distillation

PubMed Central

Fowler, Austin G.; Devitt, Simon J.; Jones, Cody

2013-01-01

State distillation is the process of taking a number of imperfect copies of a particular quantum state and producing fewer better copies. Until recently, the lowest overhead method of distilling states produced a single improved |A〉 state given 15 input copies. New block code state distillation methods can produce k improved |A〉 states given 3k + 8 input copies, potentially significantly reducing the overhead associated with state distillation. We construct an explicit surface code implementation of block code state distillation and quantitatively compare the overhead of this approach to the old. We find that, using the best available techniques, for parameters of practical interest, block code state distillation does not always lead to lower overhead, and, when it does, the overhead reduction is typically less than a factor of three. PMID:23736868

The Teaching of the Code of Ethics and Standard Practices for Texas Educator Preparation Programs

ERIC Educational Resources Information Center

Davenport, Marvin; Thompson, J. Ray; Templeton, Nathan R.

2015-01-01

The purpose of this descriptive quantitative research study was to answer three basic informational questions: (1) To what extent ethics training, as stipulated in Texas Administrative Code Chapter 247, was included in the EPP curriculum; (2) To what extent Texas public universities with approved EPP programs provided faculty opportunities for…

Structured Observation of School Administrator Work Activities: Methodological Limitations and Recommendations for Research, Part 1.

ERIC Educational Resources Information Center

Pitner, Nancy J.; Russell, James S.

1986-01-01

This paper critically reviews studies of administrator work activities which follow the work of Henry Mintzberg (1973), concentrating on these shortcomings of the method: (1) procedural difficulties in coding; (2) design limitations of classifying activities; (3) inadequate testing of Mintzberg's hypotheses; and (4) failure to explore antecedents…

Using Coding Apps to Support Literacy Instruction and Develop Coding Literacy

ERIC Educational Resources Information Center

Hutchison, Amy; Nadolny, Larysa; Estapa, Anne

2016-01-01

In this article the authors present the concept of Coding Literacy and describe the ways in which coding apps can support the development of Coding Literacy and disciplinary and digital literacy skills. Through detailed examples, we describe how coding apps can be integrated into literacy instruction to support learning of the Common Core English…

Performance analysis of a cascaded coding scheme with interleaved outer code

NASA Technical Reports Server (NTRS)

Lin, S.

1986-01-01

A cascaded coding scheme for a random error channel with a bit-error rate is analyzed. In this scheme, the inner code C sub 1 is an (n sub 1, m sub 1l) binary linear block code which is designed for simultaneous error correction and detection. The outer code C sub 2 is a linear block code with symbols from the Galois field GF (2 sup l) which is designed for correcting both symbol errors and erasures, and is interleaved with a degree m sub 1. A procedure for computing the probability of a correct decoding is presented and an upper bound on the probability of a decoding error is derived. The bound provides much better results than the previous bound for a cascaded coding scheme with an interleaved outer code. Example schemes with inner codes ranging from high rates to very low rates are evaluated. Several schemes provide extremely high reliability even for very high bit-error rates say 10 to the -1 to 10 to the -2 power.

High rate concatenated coding systems using bandwidth efficient trellis inner codes

NASA Technical Reports Server (NTRS)

Deng, Robert H.; Costello, Daniel J., Jr.

1989-01-01

High-rate concatenated coding systems with bandwidth-efficient trellis inner codes and Reed-Solomon (RS) outer codes are investigated for application in high-speed satellite communication systems. Two concatenated coding schemes are proposed. In one the inner code is decoded with soft-decision Viterbi decoding, and the outer RS code performs error-correction-only decoding (decoding without side information). In the other, the inner code is decoded with a modified Viterbi algorithm, which produces reliability information along with the decoded output. In this algorithm, path metrics are used to estimate the entire information sequence, whereas branch metrics are used to provide reliability information on the decoded sequence. This information is used to erase unreliable bits in the decoded output. An errors-and-erasures RS decoder is then used for the outer code. The two schemes have been proposed for high-speed data communication on NASA satellite channels. The rates considered are at least double those used in current NASA systems, and the results indicate that high system reliability can still be achieved.

Industrial Code Development

NASA Technical Reports Server (NTRS)

Shapiro, Wilbur

1991-01-01

The industrial codes will consist of modules of 2-D and simplified 2-D or 1-D codes, intended for expeditious parametric studies, analysis, and design of a wide variety of seals. Integration into a unified system is accomplished by the industrial Knowledge Based System (KBS), which will also provide user friendly interaction, contact sensitive and hypertext help, design guidance, and an expandable database. The types of analysis to be included with the industrial codes are interfacial performance (leakage, load, stiffness, friction losses, etc.), thermoelastic distortions, and dynamic response to rotor excursions. The first three codes to be completed and which are presently being incorporated into the KBS are the incompressible cylindrical code, ICYL, and the compressible cylindrical code, GCYL.

New optimal asymmetric quantum codes constructed from constacyclic codes

NASA Astrophysics Data System (ADS)

Xu, Gen; Li, Ruihu; Guo, Luobin; Lü, Liangdong

2017-02-01

In this paper, we propose the construction of asymmetric quantum codes from two families of constacyclic codes over finite field 𝔽q2 of code length n, where for the first family, q is an odd prime power with the form 4t + 1 (t ≥ 1 is integer) or 4t - 1 (t ≥ 2 is integer) and n1 = q2+1 2; for the second family, q is an odd prime power with the form 10t + 3 or 10t + 7 (t ≥ 0 is integer) and n2 = q2+1 5. As a result, families of new asymmetric quantum codes [[n,k,dz/dx

Quantum error-correcting codes from algebraic geometry codes of Castle type

NASA Astrophysics Data System (ADS)

Munuera, Carlos; Tenório, Wanderson; Torres, Fernando

2016-10-01

We study algebraic geometry codes producing quantum error-correcting codes by the CSS construction. We pay particular attention to the family of Castle codes. We show that many of the examples known in the literature in fact belong to this family of codes. We systematize these constructions by showing the common theory that underlies all of them.

The Wide Angle Camera of the ROSETTA Mission

NASA Astrophysics Data System (ADS)

Barbieri, C.; Fornasier, S.; Verani, S.; Bertini, I.; Lazzarin, M.; Rampazzi, F.; Cremonese, G.; Ragazzoni, R.; Marzari, F.; Angrilli, F.; Bianchini, G. A.; Debei, S.; Dececco, M.; Guizzo, G.; Parzianello, G.; Ramous, P.; Saggin, B.; Zaccariotto, M.; Da Deppo, V.; Naletto, G.; Nicolosi, G.; Pelizzo, M. G.; Tondello, G.; Brunello, P.; Peron, F.

This paper aims to give a brief description of the Wide Angle Camera (WAC), built by the Centro Servizi e AttivitàSpaziali (CISAS) of the University of Padova for the ESA ROSETTA Mission to comet 46P/Wirtanen and asteroids 4979 Otawara and 140 Siwa. The WAC is part of the OSIRIS imaging system, which comprises also a Narrow Angle Camera (NAC) built by the Laboratoire d'Astrophysique Spatiale (LAS) of Marseille. CISAS had also the responsibility to build the shutter and the front cover mechanism for the NAC. The flight model of the WAC was delivered in December 2001, and has been already integrated on ROSETTA.

Validation of an administrative claims-based diagnostic code for pneumonia in a US-based commercially insured COPD population.

PubMed

Kern, David M; Davis, Jill; Williams, Setareh A; Tunceli, Ozgur; Wu, Bingcao; Hollis, Sally; Strange, Charlie; Trudo, Frank

2015-01-01

To estimate the accuracy of claims-based pneumonia diagnoses in COPD patients using clinical information in medical records as the reference standard. Selecting from a repository containing members' data from 14 regional United States health plans, this validation study identified pneumonia diagnoses within a group of patients initiating treatment for COPD between March 1, 2009 and March 31, 2012. Patients with ≥1 claim for pneumonia (International Classification of Diseases Version 9-CM code 480.xx-486.xx) were identified during the 12 months following treatment initiation. A subset of 800 patients was randomly selected to abstract medical record data (paper based and electronic) for a target sample of 400 patients, to estimate validity within 5% margin of error. Positive predictive value (PPV) was calculated for the claims diagnosis of pneumonia relative to the reference standard, defined as a documented diagnosis in the medical record. A total of 388 records were reviewed; 311 included a documented pneumonia diagnosis, indicating 80.2% (95% confidence interval [CI]: 75.8% to 84.0%) of claims-identified pneumonia diagnoses were validated by the medical charts. Claims-based diagnoses in inpatient or emergency departments (n=185) had greater PPV versus outpatient settings (n=203), 87.6% (95% CI: 81.9%-92.0%) versus 73.4% (95% CI: 66.8%-79.3%), respectively. Claims-diagnoses verified with paper-based charts had similar PPV as the overall study sample, 80.2% (95% CI: 71.1%-87.5%), and higher PPV than those linked to electronic medical records, 73.3% (95% CI: 65.5%-80.2%). Combined paper-based and electronic records had a higher PPV, 87.6% (95% CI: 80.9%-92.6%). Administrative claims data indicating a diagnosis of pneumonia in COPD patients are supported by medical records. The accuracy of a medical record diagnosis of pneumonia remains unknown. With increased use of claims data in medical research, COPD researchers can study pneumonia with confidence that claims

Validation of an International Classification of Diseases, Ninth Revision Code Algorithm for Identifying Chiari Malformation Type 1 Surgery in Adults.

PubMed

Greenberg, Jacob K; Ladner, Travis R; Olsen, Margaret A; Shannon, Chevis N; Liu, Jingxia; Yarbrough, Chester K; Piccirillo, Jay F; Wellons, John C; Smyth, Matthew D; Park, Tae Sung; Limbrick, David D

2015-08-01

The use of administrative billing data may enable large-scale assessments of treatment outcomes for Chiari Malformation type I (CM-1). However, to utilize such data sets, validated International Classification of Diseases, Ninth Revision (ICD-9-CM) code algorithms for identifying CM-1 surgery are needed. To validate 2 ICD-9-CM code algorithms identifying patients undergoing CM-1 decompression surgery. We retrospectively analyzed the validity of 2 ICD-9-CM code algorithms for identifying adult CM-1 decompression surgery performed at 2 academic medical centers between 2001 and 2013. Algorithm 1 included any discharge diagnosis code of 348.4 (CM-1), as well as a procedure code of 01.24 (cranial decompression) or 03.09 (spinal decompression, or laminectomy). Algorithm 2 restricted this group to patients with a primary diagnosis of 348.4. The positive predictive value (PPV) and sensitivity of each algorithm were calculated. Among 340 first-time admissions identified by Algorithm 1, the overall PPV for CM-1 decompression was 65%. Among the 214 admissions identified by Algorithm 2, the overall PPV was 99.5%. The PPV for Algorithm 1 was lower in the Vanderbilt (59%) cohort, males (40%), and patients treated between 2009 and 2013 (57%), whereas the PPV of Algorithm 2 remained high (≥99%) across subgroups. The sensitivity of Algorithms 1 (86%) and 2 (83%) were above 75% in all subgroups. ICD-9-CM code Algorithm 2 has excellent PPV and good sensitivity to identify adult CM-1 decompression surgery. These results lay the foundation for studying CM-1 treatment outcomes by using large administrative databases.

Schroedinger’s code: Source code availability and transparency in astrophysics

NASA Astrophysics Data System (ADS)

Ryan, PW; Allen, Alice; Teuben, Peter

2018-01-01

Astronomers use software for their research, but how many of the codes they use are available as source code? We examined a sample of 166 papers from 2015 for clearly identified software use, then searched for source code for the software packages mentioned in these research papers. We categorized the software to indicate whether source code is available for download and whether there are restrictions to accessing it, and if source code was not available, whether some other form of the software, such as a binary, was. Over 40% of the source code for the software used in our sample was not available for download.As URLs have often been used as proxy citations for software, we also extracted URLs from one journal’s 2015 research articles, removed those from certain long-term, reliable domains, and tested the remainder to determine what percentage of these URLs were still accessible in September and October, 2017.

Two-terminal video coding.

PubMed

Yang, Yang; Stanković, Vladimir; Xiong, Zixiang; Zhao, Wei

2009-03-01

Following recent works on the rate region of the quadratic Gaussian two-terminal source coding problem and limit-approaching code designs, this paper examines multiterminal source coding of two correlated, i.e., stereo, video sequences to save the sum rate over independent coding of both sequences. Two multiterminal video coding schemes are proposed. In the first scheme, the left sequence of the stereo pair is coded by H.264/AVC and used at the joint decoder to facilitate Wyner-Ziv coding of the right video sequence. The first I-frame of the right sequence is successively coded by H.264/AVC Intracoding and Wyner-Ziv coding. An efficient stereo matching algorithm based on loopy belief propagation is then adopted at the decoder to produce pixel-level disparity maps between the corresponding frames of the two decoded video sequences on the fly. Based on the disparity maps, side information for both motion vectors and motion-compensated residual frames of the right sequence are generated at the decoder before Wyner-Ziv encoding. In the second scheme, source splitting is employed on top of classic and Wyner-Ziv coding for compression of both I-frames to allow flexible rate allocation between the two sequences. Experiments with both schemes on stereo video sequences using H.264/AVC, LDPC codes for Slepian-Wolf coding of the motion vectors, and scalar quantization in conjunction with LDPC codes for Wyner-Ziv coding of the residual coefficients give a slightly lower sum rate than separate H.264/AVC coding of both sequences at the same video quality.

More box codes

NASA Technical Reports Server (NTRS)

Solomon, G.

1992-01-01

A new investigation shows that, starting from the BCH (21,15;3) code represented as a 7 x 3 matrix and adding a row and column to add even parity, one obtains an 8 x 4 matrix (32,15;8) code. An additional dimension is obtained by specifying odd parity on the rows and even parity on the columns, i.e., adjoining to the 8 x 4 matrix, the matrix, which is zero except for the fourth column (of all ones). Furthermore, any seven rows and three columns will form the BCH (21,15;3) code. This box code has the same weight structure as the quadratic residue and BCH codes of the same dimensions. Whether there exists an algebraic isomorphism to either code is as yet unknown.

Accuracy of clinical coding from 1210 appendicectomies in a British district general hospital.

PubMed

Bhangu, Aneel; Nepogodiev, Dmitri; Taylor, Caroline; Durkin, Natalie; Patel, Rajan

2012-01-01

The primary aim of this study was to assess the accuracy of clinical coding in identifying negative appendicectomies. The secondary aim was to analyse trends over time in rates of simple, complex (gangrenous or perforated) and negative appendicectomies. Retrospective review of 1210 patients undergoing emergency appendicectomy during a five year period (2006-2010). Histopathology reports were taken as gold standard for diagnosis and compared to clinical coding lists. Clinical coding is the process by which non-medical administrators apply standardised diagnostic codes to patients, based upon clinical notes at discharge. These codes then contribute to national databases. Statistical analysis included correlation studies and regression analyses. Clinical coding had only moderate correlation with histopathology, with an overall kappa of 0.421. Annual kappa values varied between 0.378 and 0.500. Overall 14% of patients were incorrectly coded as having had appendicitis when in fact they had a histopathologically normal appendix (153/1107), whereas 4% were falsely coded as having received a negative appendicectomy when they had appendicitis (48/1107). There was an overall significant fall and then rise in the rate of simple appendicitis (B coefficient -0.239 (95% confidence interval -0.426, -0.051), p = 0.014) but no change in the rate of complex appendicitis (B coefficient 0.008 (-0.015, 0.031), p = 0.476). Clinical coding for negative appendicectomy was unreliable. Negative rates may be higher than suspected. This has implications for the validity of national database analyses. Using this form of data as a quality indictor for appendicitis should be reconsidered until its quality is improved. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Meeting the ambition of measuring the quality of hospitals' stroke care using routinely collected administrative data: a feasibility study.

PubMed

Palmer, William L; Bottle, Alex; Davie, Charlie; Vincent, Charles A; Aylin, Paul

2013-09-01

To examine the potential for using routinely collected administrative data to compare the quality and safety of stroke care at a hospital level, including evaluating any bias due to variations in coding practice. A retrospective cohort study of English hospitals' performance against six process and outcome indicators covering the acute care pathway. We used logistic regression to adjust the outcome measures for case mix. Hospitals in England. Stroke patients (ICD-10 I60-I64) admitted to English National Health Service public acute hospitals between April 2009 and March 2010, accounting for 91 936 admissions. The quality and safety were measured using six indicators spanning the hospital care pathway, from timely access to brain scans to emergency readmissions following discharge after stroke. There were 182 occurrences of hospitals performing statistically differently from the national average at the 99.8% significance level across the six indicators. Differences in coding practice appeared to only partially explain the variation. Hospital administrative data provide a practical and achievable method for evaluating aspects of stroke care across the acute pathway. However, without improvements in coding and further validation, it is unclear whether the cause of the variation is the quality of care or the result of different local care pathways and data coding accuracy.

National Administrative Databases in Adult Spinal Deformity Surgery: A Cautionary Tale.

PubMed

Buckland, Aaron J; Poorman, Gregory; Freitag, Robert; Jalai, Cyrus; Klineberg, Eric O; Kelly, Michael; Passias, Peter G

2017-08-15

Comparison between national administrative databases and a prospective multicenter physician managed database. This study aims to assess the applicability of National Administrative Databases (NADs) in adult spinal deformity (ASD). Our hypothesis is that NADs do not include comparable patients as in a physician-managed database (PMD) for surgical outcomes in adult spinal deformity. NADs such as National Inpatient Sample (NIS) and National Surgical Quality Improvement Program (NSQIP) provide large numbers of publications owing to ease of data access and lack of IRB approval requirement. These databases utilize billing codes, not clinical inclusion criteria, and have not been validated against PMDs in ASD surgery. The NIS was searched for years 2002 to 2012 and NSQIP for years 2006 to 2013 using validated spinal deformity diagnostic codes. Procedural codes (ICD-9 and CPT) were then applied to each database. A multicenter PMD including years 2008 to 2015 was used for comparison. Databases were assessed for levels fused, osteotomies, decompressed levels, and invasiveness. Database comparisons for surgical details were made in all patients, and also for patients with ≥ 5 level spinal fusions. Approximately, 37,368 NIS, 1291 NSQIP, and 737 PMD patients were identified. NADs showed an increased use of deformity billing codes over the study period (NIS doubled, 68x NSQIP, P < 0.001), but ASD remained stable in the PMD.Surgical invasiveness, levels fused and use of 3-column osteotomy (3-CO) were significantly lower for all patients in the NIS (11.4-13.7) and NSQIP databases (6.4-12.7) compared with PMD (27.5-32.3). When limited to patients with ≥5 levels, invasiveness, levels fused, and use of 3-CO remained significantly higher in the PMD compared with NADs (P < 0.001). National databases NIS and NSQIP do not capture the same patient population as is captured in PMDs in ASD. Physicians should remain cautious in interpreting conclusions drawn from these databases

cncRNAs: Bi-functional RNAs with protein coding and non-coding functions

PubMed Central

Kumari, Pooja; Sampath, Karuna

2015-01-01

For many decades, the major function of mRNA was thought to be to provide protein-coding information embedded in the genome. The advent of high-throughput sequencing has led to the discovery of pervasive transcription of eukaryotic genomes and opened the world of RNA-mediated gene regulation. Many regulatory RNAs have been found to be incapable of protein coding and are hence termed as non-coding RNAs (ncRNAs). However, studies in recent years have shown that several previously annotated non-coding RNAs have the potential to encode proteins, and conversely, some coding RNAs have regulatory functions independent of the protein they encode. Such bi-functional RNAs, with both protein coding and non-coding functions, which we term as ‘cncRNAs’, have emerged as new players in cellular systems. Here, we describe the functions of some cncRNAs identified from bacteria to humans. Because the functions of many RNAs across genomes remains unclear, we propose that RNAs be classified as coding, non-coding or both only after careful analysis of their functions. PMID:26498036

Interface requirements to couple thermal-hydraulic codes to 3D neutronic codes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Langenbuch, S.; Austregesilo, H.; Velkov, K.

1997-07-01

The present situation of thermalhydraulics codes and 3D neutronics codes is briefly described and general considerations for coupling of these codes are discussed. Two different basic approaches of coupling are identified and their relative advantages and disadvantages are discussed. The implementation of the coupling for 3D neutronics codes in the system ATHLET is presented. Meanwhile, this interface is used for coupling three different 3D neutronics codes.

Synthesizing Certified Code

NASA Technical Reports Server (NTRS)

Whalen, Michael; Schumann, Johann; Fischer, Bernd

2002-01-01

Code certification is a lightweight approach to demonstrate software quality on a formal level. Its basic idea is to require producers to provide formal proofs that their code satisfies certain quality properties. These proofs serve as certificates which can be checked independently. Since code certification uses the same underlying technology as program verification, it also requires many detailed annotations (e.g., loop invariants) to make the proofs possible. However, manually adding theses annotations to the code is time-consuming and error-prone. We address this problem by combining code certification with automatic program synthesis. We propose an approach to generate simultaneously, from a high-level specification, code and all annotations required to certify generated code. Here, we describe a certification extension of AUTOBAYES, a synthesis tool which automatically generates complex data analysis programs from compact specifications. AUTOBAYES contains sufficient high-level domain knowledge to generate detailed annotations. This allows us to use a general-purpose verification condition generator to produce a set of proof obligations in first-order logic. The obligations are then discharged using the automated theorem E-SETHEO. We demonstrate our approach by certifying operator safety for a generated iterative data classification program without manual annotation of the code.

A Repository of Codes of Ethics and Technical Standards in Health Informatics

PubMed Central

Zaïane, Osmar R.

2014-01-01

We present a searchable repository of codes of ethics and standards in health informatics. It is built using state-of-the-art search algorithms and technologies. The repository will be potentially beneficial for public health practitioners, researchers, and software developers in finding and comparing ethics topics of interest. Public health clinics, clinicians, and researchers can use the repository platform as a one-stop reference for various ethics codes and standards. In addition, the repository interface is built for easy navigation, fast search, and side-by-side comparative reading of documents. Our selection criteria for codes and standards are two-fold; firstly, to maintain intellectual property rights, we index only codes and standards freely available on the internet. Secondly, major international, regional, and national health informatics bodies across the globe are surveyed with the aim of understanding the landscape in this domain. We also look at prevalent technical standards in health informatics from major bodies such as the International Standards Organization (ISO) and the U. S. Food and Drug Administration (FDA). Our repository contains codes of ethics from the International Medical Informatics Association (IMIA), the iHealth Coalition (iHC), the American Health Information Management Association (AHIMA), the Australasian College of Health Informatics (ACHI), the British Computer Society (BCS), and the UK Council for Health Informatics Professions (UKCHIP), with room for adding more in the future. Our major contribution is enhancing the findability of codes and standards related to health informatics ethics by compilation and unified access through the health informatics ethics repository. PMID:25422725

50 CFR Table 17 to Part 679 - Process Codes for Use With State of Alaska Commercial Operator's Annual Report (COAR)

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA Pt. 679, Table 17 Table 17 to Part 679—Process Codes for...

A Comparison of Mental Health Diagnoses Treated via Interactive Video and Face to Face in the Veterans Healthcare Administration.

PubMed

Grubbs, Kathleen M; Fortney, John C; Dean, Tisha; Williams, James S; Godleski, Linda

2015-07-01

This study compares the mental health diagnoses of encounters delivered face to face and via interactive video in the Veterans Healthcare Administration (VHA). We compiled 1 year of national-level VHA administrative data for Fiscal Year 2012 (FY12). Mental health encounters were those with both a VHA Mental Health Stop Code and a Mental Health Diagnosis (n=11,906,114). Interactive video encounters were identified as those with a Mental Health Stop Code, paired with a VHA Telehealth Secondary Stop Code. Primary diagnoses were grouped into posttraumatic stress disorder (PTSD), depression, anxiety, bipolar disorder, psychosis, drug use, alcohol use, and other. In FY12, 1.5% of all mental health encounters were delivered via interactive video. Compared with face-to-face encounters, a larger percentage of interactive video encounters was for PTSD, depression, and anxiety, whereas a smaller percentage was for alcohol use, drug use, or psychosis. Providers and patients may feel more comfortable treating depression and anxiety disorders than substance use or psychosis via interactive video.

Ensemble coding of face identity is not independent of the coding of individual identity.

PubMed

Neumann, Markus F; Ng, Ryan; Rhodes, Gillian; Palermo, Romina

2018-06-01

Information about a group of similar objects can be summarized into a compressed code, known as ensemble coding. Ensemble coding of simple stimuli (e.g., groups of circles) can occur in the absence of detailed exemplar coding, suggesting dissociable processes. Here, we investigate whether a dissociation would still be apparent when coding facial identity, where individual exemplar information is much more important. We examined whether ensemble coding can occur when exemplar coding is difficult, as a result of large sets or short viewing times, or whether the two types of coding are positively associated. We found a positive association, whereby both ensemble and exemplar coding were reduced for larger groups and shorter viewing times. There was no evidence for ensemble coding in the absence of exemplar coding. At longer presentation times, there was an unexpected dissociation, where exemplar coding increased yet ensemble coding decreased, suggesting that robust information about face identity might suppress ensemble coding. Thus, for face identity, we did not find the classic dissociation-of access to ensemble information in the absence of detailed exemplar information-that has been used to support claims of distinct mechanisms for ensemble and exemplar coding.

Moderate sensitivity and high specificity of emergency department administrative data for transient ischemic attacks.

PubMed

Yu, Amy Y X; Quan, Hude; McRae, Andrew; Wagner, Gabrielle O; Hill, Michael D; Coutts, Shelagh B

2017-09-18

Validation of administrative data case definitions is key for accurate passive surveillance of disease. Transient ischemic attack (TIA) is a condition primarily managed in the emergency department. However, prior validation studies have focused on data after inpatient hospitalization. We aimed to determine the validity of the Canadian 10th International Classification of Diseases (ICD-10-CA) codes for TIA in the national ambulatory administrative database. We performed a diagnostic accuracy study of four ICD-10-CA case definition algorithms for TIA in the emergency department setting. The study population was obtained from two ongoing studies on the diagnosis of TIA and minor stroke versus stroke mimic using serum biomarkers and neuroimaging. Two reference standards were used 1) the emergency department clinical diagnosis determined by chart abstractors and 2) the 90-day final diagnosis, both obtained by stroke neurologists, to calculate the sensitivity, specificity, positive and negative predictive values (PPV and NPV) of the ICD-10-CA algorithms for TIA. Among 417 patients, emergency department adjudication showed 163 (39.1%) TIA, 155 (37.2%) ischemic strokes, and 99 (23.7%) stroke mimics. The most restrictive algorithm, defined as a TIA code in the main position had the lowest sensitivity (36.8%), but highest specificity (92.5%) and PPV (76.0%). The most inclusive algorithm, defined as a TIA code in any position with and without query prefix had the highest sensitivity (63.8%), but lowest specificity (81.5%) and PPV (68.9%). Sensitivity, specificity, PPV, and NPV were overall lower when using the 90-day diagnosis as reference standard. Emergency department administrative data reflect diagnosis of suspected TIA with high specificity, but underestimate the burden of disease. Future studies are necessary to understand the reasons for the low to moderate sensitivity.

Black Administrators and Administrative Law

ERIC Educational Resources Information Center

Harper, Robert

1975-01-01

The stated objective of this paper is to keep the Black administrator out of court by creating an awareness of legal pitfalls: the discussion is divided into four sections--a brief overview of some of the functions of administrators and administrative agencies, sharing information with the public, the use of discretion, and limitations of the…

ASHP national survey of pharmacy practice in hospital settings: dispensing and administration--2011.

PubMed

Pedersen, Craig A; Schneider, Philip J; Scheckelhoff, Douglas J

2012-05-01

Results of the 2011 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are presented. A stratified random sample of pharmacy directors at 1401 general and children's medical-surgical hospitals in the United States were surveyed by mail. In this national probability sample survey, the response rate was 40.1%. Decentralization of the medication-use system continues, with 40% of hospitals using a decentralized system and 58% of hospitals planning to use a decentralized model in the future. Automated dispensing cabinets were used by 89% of hospitals, robots were used by 11%, carousels were used in 18%, and machine-readable coding was used in 34% of hospitals to verify doses before dispensing. Overall, 65% of hospitals had a United States Pharmacopeia chapter 797 compliant cleanroom for compounding sterile preparations. Medication administration records (MARs) have become increasingly computerized, with 67% of hospitals using electronic MARs. Bar-code-assisted medication administration was used in 50% of hospitals, and 68% of hospitals had smart infusion pumps. Health information is becoming more electronic, with 67% of hospitals having partially or completely implemented an electronic health record and 34% of hospitals having computerized prescriber order entry. The use of these technologies has substantially increased over the past year. The average number of full-time equivalent staff per 100 occupied beds averaged 17.5 for pharmacists and 15.0 for technicians. Directors of pharmacy reported declining vacancy rates for pharmacists. Pharmacists continue to improve medication use at the dispensing and administration steps of the medication-use system. The adoption of new technology is changing the philosophy of medication distribution, and health information is rapidly becoming electronic.

From Glass Flowers to Computer Games: Examining the Emergent Media Practices of Plant Biologists

ERIC Educational Resources Information Center

Reitmeyer, Morgan

2011-01-01

The goal of this project is to begin investigating the emergent media practices of current academic disciplines. This dissertation posits that Writing Across the Curriculum (WAC) scholars have investigated new media use in undergraduate pedagogy, and to some extent the practices of graduate students. However, WAC scholars have yet to try to…

The Europa Imaging System (EIS), a Camera Suite to investigate Europa's Geology, Ice Shell, and Potential for Current Activity

NASA Astrophysics Data System (ADS)

Turtle, E. P.; McEwen, A. S.; Osterman, S. N.; Boldt, J. D.; Strohbehn, K.; EIS Science Team

2016-10-01

EIS NAC and WAC use identical rad-hard rapid-readout 4k × 2k CMOS detectors for imaging during close (≤25 km) fast ( 4.5 km/s) Europa flybys. NAC achieves 0.5 m/pixel over a 2-km swath from 50 km, and WAC provides context pushbroom stereo imaging.

Syndrome-source-coding and its universal generalization. [error correcting codes for data compression

NASA Technical Reports Server (NTRS)

Ancheta, T. C., Jr.

1976-01-01

A method of using error-correcting codes to obtain data compression, called syndrome-source-coding, is described in which the source sequence is treated as an error pattern whose syndrome forms the compressed data. It is shown that syndrome-source-coding can achieve arbitrarily small distortion with the number of compressed digits per source digit arbitrarily close to the entropy of a binary memoryless source. A 'universal' generalization of syndrome-source-coding is formulated which provides robustly effective distortionless coding of source ensembles. Two examples are given, comparing the performance of noiseless universal syndrome-source-coding to (1) run-length coding and (2) Lynch-Davisson-Schalkwijk-Cover universal coding for an ensemble of binary memoryless sources.

Cracking the code: the accuracy of coding shoulder procedures and the repercussions.

PubMed

Clement, N D; Murray, I R; Nie, Y X; McBirnie, J M

2013-05-01

Coding of patients' diagnosis and surgical procedures is subject to error levels of up to 40% with consequences on distribution of resources and financial recompense. Our aim was to explore and address reasons behind coding errors of shoulder diagnosis and surgical procedures and to evaluate a potential solution. A retrospective review of 100 patients who had undergone surgery was carried out. Coding errors were identified and the reasons explored. A coding proforma was designed to address these errors and was prospectively evaluated for 100 patients. The financial implications were also considered. Retrospective analysis revealed the correct primary diagnosis was assigned in 54 patients (54%) had an entirely correct diagnosis, and only 7 (7%) patients had a correct procedure code assigned. Coders identified indistinct clinical notes and poor clarity of procedure codes as reasons for errors. The proforma was significantly more likely to assign the correct diagnosis (odds ratio 18.2, p < 0.0001) and the correct procedure code (odds ratio 310.0, p < 0.0001). Using the proforma resulted in a £28,562 increase in revenue for the 100 patients evaluated relative to the income generated from the coding department. High error levels for coding are due to misinterpretation of notes and ambiguity of procedure codes. This can be addressed by allowing surgeons to assign the diagnosis and procedure using a simplified list that is passed directly to coding.

Penal Code (Ordinance No. 12 of 1983), 1 July 1984.

PubMed

1987-01-01

This document contains provisions of the 1984 Penal Code of Montserrat relating to sexual offenses, abortion, offenses relating to marriage, homicide and other offenses against the person, and neglect endangering life or health. Part 8 of the Code holds that a man found guilty of raping a woman is liable to life imprisonment. Rape is deemed to involve unlawful (extramarital) sexual intercourse with a woman without her consent (this is determined if the rape involved force, threats, administration of drugs, or false representation). The Code also defines offenses in cases of incest, child abuse, prostitution, abduction, controlling the actions and finances of a prostitute, and having unlawful sexual intercourse with a mentally defective woman. Part 9 of the Code outlaws abortion unless it is conducted in an approved establishment after two medical practitioners have determined that continuing the pregnancy would risk the life or physical/mental health of the pregnant woman or if a substantial risk exists that the child would have serious abnormalities. Part 10 outlaws bigamy, and part 12 holds that infanticide performed by a mother suffering postpartum imbalances can be prosecuted as manslaughter. This part also outlaws concealment of the body of a newborn, whether that child died before, at, or after birth, and aggravated assault on any child not more than 14 years old. Part 12 makes it an offense to subject any child to neglect endangering its life or health.

Trace-shortened Reed-Solomon codes

NASA Technical Reports Server (NTRS)

Mceliece, R. J.; Solomon, G.

1994-01-01

Reed-Solomon (RS) codes have been part of standard NASA telecommunications systems for many years. RS codes are character-oriented error-correcting codes, and their principal use in space applications has been as outer codes in concatenated coding systems. However, for a given character size, say m bits, RS codes are limited to a length of, at most, 2(exp m). It is known in theory that longer character-oriented codes would be superior to RS codes in concatenation applications, but until recently no practical class of 'long' character-oriented codes had been discovered. In 1992, however, Solomon discovered an extensive class of such codes, which are now called trace-shortened Reed-Solomon (TSRS) codes. In this article, we will continue the study of TSRS codes. Our main result is a formula for the dimension of any TSRS code, as a function of its error-correcting power. Using this formula, we will give several examples of TSRS codes, some of which look very promising as candidate outer codes in high-performance coded telecommunications systems.

Variation of SNOMED CT coding of clinical research concepts among coding experts.

PubMed

Andrews, James E; Richesson, Rachel L; Krischer, Jeffrey

2007-01-01

To compare consistency of coding among professional SNOMED CT coders representing three commercial providers of coding services when coding clinical research concepts with SNOMED CT. A sample of clinical research questions from case report forms (CRFs) generated by the NIH-funded Rare Disease Clinical Research Network (RDCRN) were sent to three coding companies with instructions to code the core concepts using SNOMED CT. The sample consisted of 319 question/answer pairs from 15 separate studies. The companies were asked to select SNOMED CT concepts (in any form, including post-coordinated) that capture the core concept(s) reflected in the question. Also, they were asked to state their level of certainty, as well as how precise they felt their coding was. Basic frequencies were calculated to determine raw level agreement among the companies and other descriptive information. Krippendorff's alpha was used to determine a statistical measure of agreement among the coding companies for several measures (semantic, certainty, and precision). No significant level of agreement among the experts was found. There is little semantic agreement in coding of clinical research data items across coders from 3 professional coding services, even using a very liberal definition of agreement.

Deductive Glue Code Synthesis for Embedded Software Systems Based on Code Patterns

NASA Technical Reports Server (NTRS)

Liu, Jian; Fu, Jicheng; Zhang, Yansheng; Bastani, Farokh; Yen, I-Ling; Tai, Ann; Chau, Savio N.

2006-01-01

Automated code synthesis is a constructive process that can be used to generate programs from specifications. It can, thus, greatly reduce the software development cost and time. The use of formal code synthesis approach for software generation further increases the dependability of the system. Though code synthesis has many potential benefits, the synthesis techniques are still limited. Meanwhile, components are widely used in embedded system development. Applying code synthesis to component based software development (CBSD) process can greatly enhance the capability of code synthesis while reducing the component composition efforts. In this paper, we discuss the issues and techniques for applying deductive code synthesis techniques to CBSD. For deductive synthesis in CBSD, a rule base is the key for inferring appropriate component composition. We use the code patterns to guide the development of rules. Code patterns have been proposed to capture the typical usages of the components. Several general composition operations have been identified to facilitate systematic composition. We present the technique for rule development and automated generation of new patterns from existing code patterns. A case study of using this method in building a real-time control system is also presented.

Validation of an algorithm to identify children with biopsy-proven celiac disease from within health administrative data: An assessment of health services utilization patterns in Ontario, Canada

PubMed Central

Chan, Jason; Mack, David R.; Manuel, Douglas G.; Mojaverian, Nassim; de Nanassy, Joseph

2017-01-01

Importance Celiac disease (CD) is a common pediatric illness, and awareness of gluten-related disorders including CD is growing. Health administrative data represents a unique opportunity to conduct population-based surveillance of this chronic condition and assess the impact of caring for children with CD on the health system. Objective The objective of the study was to validate an algorithm based on health administrative data diagnostic codes to accurately identify children with biopsy-proven CD. We also evaluated trends over time in the use of health services related to CD by children in Ontario, Canada. Study design and setting We conducted a retrospective cohort study and validation study of population-based health administrative data in Ontario, Canada. All cases of biopsy-proven CD diagnosed 2005–2011 in Ottawa were identified through chart review from a large pediatric health care center, and linked to the Ontario health administrative data to serve as positive reference standard. All other children living within Ottawa served as the negative reference standard. Case-identifying algorithms based on outpatient physician visits with associated ICD-9 code for CD plus endoscopy billing code were constructed and tested. Sensitivity, specificity, PPV and NPV were tested for each algorithm (with 95% CI). Poisson regression, adjusting for sex and age at diagnosis, was used to explore the trend in outpatient visits associated with a CD diagnostic code from 1995–2011. Results The best algorithm to identify CD consisted of an endoscopy billing claim follow by 1 or more adult or pediatric gastroenterologist encounters after the endoscopic procedure. The sensitivity, specificity, PPV, and NPV for the algorithm were: 70.4% (95% CI 61.1–78.4%), >99.9% (95% CI >99.9->99.9%), 53.3% (95% CI 45.1–61.4%) and >99.9% (95% CI >99.9->99.9%) respectively. It identified 1289 suspected CD cases from Ontario-wide administrative data. There was a 9% annual increase in the use

Sources of financial pressure and up coding behavior in French public hospitals.

PubMed

Georgescu, Irène; Hartmann, Frank G H

2013-05-01

Drawing upon role theory and the literature concerning unintended consequences of financial pressure, this study investigates the effects of health care decision pressure from the hospital's administration and from the professional peer group on physician's inclination to engage in up coding. We explore two kinds of up coding, information-related and action-related, and develop hypothesis that connect these kinds of data manipulation to the sources of pressure via the intermediate effect of role conflict. Qualitative data from initial interviews with physicians and subsequent questionnaire evidence from 578 physicians in 14 French hospitals suggest that the source of pressure is a relevant predictor of physicians' inclination to engage in data-manipulation. We further find that this effect is partly explained by the extent to which these pressures create role conflict. Given the concern about up coding in treatment-based reimbursement systems worldwide, our analysis adds to understanding how the design of the hospital's management control system may enhance this undesired type of behavior. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Joint design of QC-LDPC codes for coded cooperation system with joint iterative decoding

NASA Astrophysics Data System (ADS)

Zhang, Shunwai; Yang, Fengfan; Tang, Lei; Ejaz, Saqib; Luo, Lin; Maharaj, B. T.

2016-03-01

In this paper, we investigate joint design of quasi-cyclic low-density-parity-check (QC-LDPC) codes for coded cooperation system with joint iterative decoding in the destination. First, QC-LDPC codes based on the base matrix and exponent matrix are introduced, and then we describe two types of girth-4 cycles in QC-LDPC codes employed by the source and relay. In the equivalent parity-check matrix corresponding to the jointly designed QC-LDPC codes employed by the source and relay, all girth-4 cycles including both type I and type II are cancelled. Theoretical analysis and numerical simulations show that the jointly designed QC-LDPC coded cooperation well combines cooperation gain and channel coding gain, and outperforms the coded non-cooperation under the same conditions. Furthermore, the bit error rate performance of the coded cooperation employing jointly designed QC-LDPC codes is better than those of random LDPC codes and separately designed QC-LDPC codes over AWGN channels.

Discrete Cosine Transform Image Coding With Sliding Block Codes

NASA Astrophysics Data System (ADS)

Divakaran, Ajay; Pearlman, William A.

1989-11-01

A transform trellis coding scheme for images is presented. A two dimensional discrete cosine transform is applied to the image followed by a search on a trellis structured code. This code is a sliding block code that utilizes a constrained size reproduction alphabet. The image is divided into blocks by the transform coding. The non-stationarity of the image is counteracted by grouping these blocks in clusters through a clustering algorithm, and then encoding the clusters separately. Mandela ordered sequences are formed from each cluster i.e identically indexed coefficients from each block are grouped together to form one dimensional sequences. A separate search ensues on each of these Mandela ordered sequences. Padding sequences are used to improve the trellis search fidelity. The padding sequences absorb the error caused by the building up of the trellis to full size. The simulations were carried out on a 256x256 image ('LENA'). The results are comparable to any existing scheme. The visual quality of the image is enhanced considerably by the padding and clustering.

Coding of Neuroinfectious Diseases.

PubMed

Barkley, Gregory L

2015-12-01

Accurate coding is an important function of neurologic practice. This contribution to Continuum is part of an ongoing series that presents helpful coding information along with examples related to the issue topic. Tips for diagnosis coding, Evaluation and Management coding, procedure coding, or a combination are presented, depending on which is most applicable to the subject area of the issue.

Diagnostic Coding for Epilepsy.

PubMed

Williams, Korwyn; Nuwer, Marc R; Buchhalter, Jeffrey R

2016-02-01

Accurate coding is an important function of neurologic practice. This contribution to Continuum is part of an ongoing series that presents helpful coding information along with examples related to the issue topic. Tips for diagnosis coding, Evaluation and Management coding, procedure coding, or a combination are presented, depending on which is most applicable to the subject area of the issue.

Report number codes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nelson, R.N.

This publication lists all report number codes processed by the Office of Scientific and Technical Information. The report codes are substantially based on the American National Standards Institute, Standard Technical Report Number (STRN)-Format and Creation Z39.23-1983. The Standard Technical Report Number (STRN) provides one of the primary methods of identifying a specific technical report. The STRN consists of two parts: The report code and the sequential number. The report code identifies the issuing organization, a specific program, or a type of document. The sequential number, which is assigned in sequence by each report issuing entity, is not included in thismore » publication. Part I of this compilation is alphabetized by report codes followed by issuing installations. Part II lists the issuing organization followed by the assigned report code(s). In both Parts I and II, the names of issuing organizations appear for the most part in the form used at the time the reports were issued. However, for some of the more prolific installations which have had name changes, all entries have been merged under the current name.« less

[Analysis of the reliability and validity of three self-report questionnaires to assess physical activity among Spanish adolescents].

PubMed

Cancela Carral, José María; Lago Ballesteros, Joaquín; Ayán Pérez, Carlos; Mosquera Morono, María Belén

2016-01-01

To analyse the reliability and validity of the Weekly Activity Checklist (WAC), the One Week Recall (OWR), and the Godin-Shephard Leisure Time Exercise Questionnaire (GLTEQ) in Spanish adolescents. A total of 78 adolescents wore a pedometer for one week, filled out the questionnaires at the end of this period and underwent a test to estimate their maximal oxygen consumption (VO2max). The reliability of the questionnaires was determined by means of a factor analysis. Convergent validity was obtained by comparing the questionnaires' scores against the amount of physical activity quantified by the pedometer and the VO2max reported. The questionnaires showed a weak internal consistency (WAC: α=0.59-0.78; OWR: α=0.53-0.73; GLTEQ: α=0.60). Moderate statistically significant correlations were found between the pedometer and the WAC (r=0.69; p <0.01) and the OWR (r=0.42; p <0.01), while a low statistically significant correlation was found for the GLTEQ (r=0.36; p=0.01). The estimated VO2max showed a low level of association with the WAC results (r=0.30; p <0.05), and the OWR results (r=0.29; p <0.05). When classifying the participants as active or inactive, the level of agreement with the pedometer was moderate for the WAC (k=0.46) and the OWR (r=0.44), and slight for the GLTEQ (r=0.20). Of the three questionnaires analysed, the WAC showed the best psychometric performance as it was the only one with respectable convergent validity, while sharing low reliability with the OWR and the GLTEQ. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Speech coding

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ravishankar, C., Hughes Network Systems, Germantown, MD

Speech is the predominant means of communication between human beings and since the invention of the telephone by Alexander Graham Bell in 1876, speech services have remained to be the core service in almost all telecommunication systems. Original analog methods of telephony had the disadvantage of speech signal getting corrupted by noise, cross-talk and distortion Long haul transmissions which use repeaters to compensate for the loss in signal strength on transmission links also increase the associated noise and distortion. On the other hand digital transmission is relatively immune to noise, cross-talk and distortion primarily because of the capability to faithfullymore » regenerate digital signal at each repeater purely based on a binary decision. Hence end-to-end performance of the digital link essentially becomes independent of the length and operating frequency bands of the link Hence from a transmission point of view digital transmission has been the preferred approach due to its higher immunity to noise. The need to carry digital speech became extremely important from a service provision point of view as well. Modem requirements have introduced the need for robust, flexible and secure services that can carry a multitude of signal types (such as voice, data and video) without a fundamental change in infrastructure. Such a requirement could not have been easily met without the advent of digital transmission systems, thereby requiring speech to be coded digitally. The term Speech Coding is often referred to techniques that represent or code speech signals either directly as a waveform or as a set of parameters by analyzing the speech signal. In either case, the codes are transmitted to the distant end where speech is reconstructed or synthesized using the received set of codes. A more generic term that is applicable to these techniques that is often interchangeably used with speech coding is the term voice coding. This term is more generic in the sense that

Inflight Calibration of the Lunar Reconnaissance Orbiter Camera Wide Angle Camera

NASA Astrophysics Data System (ADS)

Mahanti, P.; Humm, D. C.; Robinson, M. S.; Boyd, A. K.; Stelling, R.; Sato, H.; Denevi, B. W.; Braden, S. E.; Bowman-Cisneros, E.; Brylow, S. M.; Tschimmel, M.

2016-04-01

The Lunar Reconnaissance Orbiter Camera (LROC) Wide Angle Camera (WAC) has acquired more than 250,000 images of the illuminated lunar surface and over 190,000 observations of space and non-illuminated Moon since 1 January 2010. These images, along with images from the Narrow Angle Camera (NAC) and other Lunar Reconnaissance Orbiter instrument datasets are enabling new discoveries about the morphology, composition, and geologic/geochemical evolution of the Moon. Characterizing the inflight WAC system performance is crucial to scientific and exploration results. Pre-launch calibration of the WAC provided a baseline characterization that was critical for early targeting and analysis. Here we present an analysis of WAC performance from the inflight data. In the course of our analysis we compare and contrast with the pre-launch performance wherever possible and quantify the uncertainty related to various components of the calibration process. We document the absolute and relative radiometric calibration, point spread function, and scattered light sources and provide estimates of sources of uncertainty for spectral reflectance measurements of the Moon across a range of imaging conditions.

Mapping Department of Defense laboratory results to Logical Observation Identifiers Names and Codes (LOINC).

PubMed

Lau, Lee Min; Banning, Pam D; Monson, Kent; Knight, Elva; Wilson, Pat S; Shakib, Shaun C

2005-01-01

The Department of Defense (DoD) has used a common application, Composite Health Care System (CHCS), throughout all DoD facilities. However, the master files used to encode patient data in CHCS are not identical across DoD facilities. The encoded data is thus not interoperable from one DoD facility to another. To enable data interoperability in the next-generation system, CHCS II, and for the DoD to exchange laboratory results with external organizations such as the Veterans Administration (VA), the disparate master file codes for laboratory results are mapped to Logical Observation Identifier Names and Codes (LOINC) wherever possible. This paper presents some findings from our experience mapping DoD laboratory results to LOINC.

Moving Towards a State of the Art Charge-Exchange Reaction Code

NASA Astrophysics Data System (ADS)

Poxon-Pearson, Terri; Nunes, Filomena; Potel, Gregory

2017-09-01

Charge-exchange reactions have a wide range of applications, including late stellar evolution, constraining the matrix elements for neutrinoless double β-decay, and exploring symmetry energy and other aspects of exotic nuclear matter. Still, much of the reaction theory needed to describe these transitions is underdeveloped and relies on assumptions and simplifications that are often extended outside of their region of validity. In this work, we have begun to move towards a state of the art charge-exchange reaction code. As a first step, we focus on Fermi transitions using a Lane potential in a few body, Distorted Wave Born Approximation (DWBA) framework. We have focused on maintaining a modular structure for the code so we can later incorporate complications such as nonlocality, breakup, and microscopic inputs. Results using this new charge-exchange code will be shown compared to the analysis in for the case of 48Ca(p,n)48Sc. This work was supported in part by the National Nuclear Security Administration under the Stewardship Science Academic Alliances program through the U.S. DOE Cooperative Agreement No. DE- FG52-08NA2855.