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Development of the Canadian Emergency Department Diagnosis Shortlist

Published online by Cambridge University Press:  21 May 2015

Bernard Unger ,
Marc Afilalo ,
Jean François Boivin ,
Michael Bullard ,
Eric Grafstein ,
Michael Schull ,
Eddy Lang ,
Antoinette Colacone ,
Nathalie Soucy  and
Xiaoqing Xue
...Show all authors
Bernard Unger*
Affiliation:
Emergency Multidisciplinary Research Unit, McGill University, Montréal, Que.
Marc Afilalo
Affiliation:
Emergency Multidisciplinary Research Unit, McGill University, Montréal, Que.
Jean François Boivin
Affiliation:
Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, McGill University, Montréal, Que.
Michael Bullard
Affiliation:
University of Alberta Hospital, University of Alberta, Edmonton, Alta.
Eric Grafstein
Affiliation:
St. Paul's Hospital, University of British Columbia, Vancouver, BC
Michael Schull
Affiliation:
Sunnybrook Health Sciences Centre and Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ont.
Eddy Lang
Affiliation:
Alberta Health Services, University of Calgary, Calgary, Alta.
Antoinette Colacone
Affiliation:
Emergency Multidisciplinary Research Unit, McGill University, Montréal, Que.
Nathalie Soucy
Affiliation:
Emergency Multidisciplinary Research Unit, McGill University, Montréal, Que.
Xiaoqing Xue
Affiliation:
Emergency Multidisciplinary Research Unit, McGill University, Montréal, Que.
Eli Segal
Affiliation:
Emergency Multidisciplinary Research Unit, McGill University, Montréal, Que.
*
Emergency Department, McGill University, Rm. D-010, Jewish General Hospital, 3755 Cote Ste. Catherine Rd., Montréal QC H3T 1E2; bernard.unger@mcgill.ca

Abstract

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Objective:

Managers of emergency departments (EDs), governments and researchers would benefit from reliable data sets that characterize use of EDs. Although Canadian ED lists for chief complaints and triage acuity exist, no such list exists for diagnosis classification. This study was aimed at developing a standardized Canadian Emergency Department Diagnosis Shortlist (CED-DxS), as a subset of the full International Classification of Diseases, 10th revision, with Canadian Enhancement (ICD-10-CA).

Methods:

Emergency physicians from across Canada participated in the revision of the ICD-10-CA through 2 rounds of the modified Delphi method. We randomly assigned chapters from the ICD-10-CA (approximately 3000 diagnoses) to reviewers, who rated the importance of including each diagnosis in the ED-specific diagnosis list. If 80% or more of the reviewers agreed on the importance of a diagnosis, it was retained for the final revision. The retained diagnoses were further aggregated and adjusted, thus creating the CED-DxS.

Results:

Of the 83 reviewers, 76% were emergency medicine (EM)–trained physicians with an average of 12 years of experience in EM, and 92% were affiliated with a university teaching hospital. The modified Delphi process and further adjustments resulted in the creation of the CED-DxS, containing 837 items. The chapter with the largest number of retained diagnoses was injury and poisoning (n = 292), followed by gastrointestinal (n = 59), musculoskeletal (n = 55) and infectious disease (n = 42). Chapters with the lowest number retained were neoplasm (n = 18) and pregnancy (n = 12).

Conclusion:

We report the creation of the uniform CED-DxS, tailored for Canadian EDs. The addition of ED diagnoses to existing standardized parameters for the ED will contribute to homogeneity of data across the country.

Keywords

diagnosis classificationemergency departmentadministration
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 12 , Issue 4 , July 2010 , pp. 311 - 319
Copyright
Copyright © Canadian Association of Emergency Physicians 2010

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