Have ICD-10 Coding Practices Changed Since 2015?

Usage of ICD-10 codes in administrative data has continued to shift since mandatory adoption in 2015. Identifying changing patterns in coding behavior is imperative in producing reliable analyses and robust conclusions. We examined the granularity of ICD-10 coding over time in a cohort selected from the IBM Explorys Therapeutic Dataset, which contains the records of over 60 million patients.

Hypothesis-Free Search for Connections between Birth Month and Disease Prevalence in Large, Geographically Varied Cohorts.

We have sought to replicate and extend the Season-wide Association Study (SeaWAS) of Boland, et al. in identifying birth month-disease associations from electronic health records (EHRs). We used methodology similar to that implemented by Boland on three geographically distinct cohorts, for a total of 11.

Results of a multilateral approach to donation-transplantation process in Hungary in the past 2 years.

Hungarotransplant Public Service Corporation, the national organ exchange organization, was established in 2001. The assessment of donation- and transplantation-related data allows the evaluation of the current situation and future trends. The donor reports show involvement of new hospitals and an increase in reported donors.

Effect of etoposide on the pharmacokinetics of methotrexate in vivo.

The effect of etoposide on the pharmakokinetics of methotrexate (MTX) was examined in vivo. High-dose (5g/m2/24 h) MTX therapy was combined with two etoposide (100mg/m2/ 1 h) infusions as a part of the medulloblastoma protocol developed in our department. Vepesid therapy was administered in two different schedules.

Recombinant human erythropoietin in the prevention of chemotherapy-induced anaemia in children with malignant solid tumours.

This prospective, randomised pilot study was designed to evaluate safety, feasibility and efficacy of recombinant human erythropoietin (rhEPO) in the prevention and treatment of chemotherapy-induced anaemia in children with solid tumours. 20 children (age 4-18 years) undergoing cyclic combination chemotherapy were randomised either to a control group or to receive rhEPO at a dose of 150 U/kg/dose subcutaneously three times/week for a minimum of 12 weeks or three chemotherapy cycles. Of 15 evaluable patients, 8 were randomised to the rhEPO group and 7 to the control group.

Conduct of phase I trials in children with cancer.

Purpose And Methods: Future progress in the care of children with cancer requires appropriate evaluations of promising new agents for pediatric indications, beginning with well-conducted phase I trials. This report summarizes current guidelines for the conduct of pediatric phase I trials and represents a consensus between American and European investigators. The primary objective of pediatric phase I trials is to define safe and appropriate doses and schedules of new agents that can subsequently be used in phase II trials to test for activity against specific childhood malignancies.

[Androgen-producing adrenocortical adenoma in childhood. Pitfalls of differential diagnosis].

A two-year-old girl presented with clitoromegaly and an abdominal mass. Diagnostic procedures including sonography, computerized tomography, scintigraphy and measurement of catecholamines in urine excluded neuroblastoma, but suspected Wilms-tumor. Before completing the steroid measurements therapy was initiated according to Wilms-tumor (preoperative cytostatic therapy followed by surgical removal of the tumor).

[In vivo effect of etoposide on the pharmacokinetics of methotrexate].

High dose (5 g/m2/24 h) methotrexate therapy was combined two times with etoposide (100 mg/m2/1h) infusions as a part of the Medulloblastoma protocol developed in our Department Vepesid therapy was administered in two different schedules. The first group of the patients have received etoposide immediately before and at the end (24th h) of methotrexate treatment. The second group was treated with etoposide at 24 h and at 48 hour after starting methotrexate infusion.

Diffuse plasmacytosis in a child with brainstem glioma following multiagent chemotherapy and intensive growth factor support.

The use of granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) in order to abrogate chemotherapy-induced neutropenia has become a routine part of many cancer treatment regimes. However, there are still very few data available about possible complications related to repeated or prolonged use of these agents in patients with malignant solid tumors. The authors report a child with brainstem glioma who received repeated cycles of multiagent chemotherapy with G- or GM-CSF support.

Administration of Ethyol (amifostine) to a child with medulloblastoma to ameliorate hematological toxicity of high dose carboplatin.

The first report on the administration of the chemoprotective agent Ethyol (amifostine) in conjunction with high dose carboplatin to a patient in the pediatric/adolescent age group is presented. A 17 year old teenager with recurrent cerebellar medulloblastoma received a total of five courses of high dose carboplatin 2 x 600 mg/m2 (1200 mg/m2 total) in each cycle. A complete response has been observed following the third treatment cycle.

Childhood leukemia and statistical characteristics in 0- to 18-year-old patients in Hungary, diagnosed between 1988 and 1992.

A population-based cancer registry for childhood leukemia was started in Hungary in 1971. Data processing and analysis have been done at the Second Department of Pediatrics, Semmelweis University Medical School in Budapest, which is the main center for the treatment of childhood malignancies in Hungary. In 1992 a new computerized database structure was created in collaboration with Kansas University Medical Center, Kansas City, Kansas, United States.

[Pharmacokinetic study of dibromodulcitol in children with brain tumors].

Systemic pharmacokinetics of high-dose (500 mg/m2), orally administered dibromodulcitol (Elobromol) were studied in 16 chemotherapeutic courses administered to 5 patients. Cerebrospinal fluid dibromodulcitol levels were also analysed in two patients. Bromoepoxydulcitol, dianhydrodulcitol are cytotoxic, whereas bromoanhydrodulcitol, andhydroepoxydulcitol are inactive metabolites detectable during the biotransformation of dibromodulcitol.

Apoptosis as a possible way of destruction of lymphoblasts after glucocorticoid treatment of children with acute lymphoblastic leukemia.

Apoptosis (programmed cell death) is a physiologic phenomenon wherein the dying cell plays an active part in its own destruction. It has an important role in regulation of the balance of cell proliferation and cell death. The pharmacologic manipulation of apoptosis offers new possibilities for the prevention and treatment of cancer.

Pharmacokinetic studies on Elobromol in children with brain tumors.

Systemic pharmacokinetics of high dose (500 mg/m2), orally administered Elobromol (dibromodulcitol, DBD) were studied in 16 chemotherapeutic courses administered to five patients. Cerebrospinal fluid (CSF) DBD levels were also analyzed in two patients. Bromoepoxydulcitol (BED), dianhydrodulcitol (DAD) are cytotoxic, whereas bromoanhydrodulcitol (BAD) and anhydroepoxydulcitol (AED) are inactive metabolites detectable during the biotransformation of DBD.

Human recombinant granulocyte-macrophage colony-stimulating factor in pediatric oncology practice.

This paper reports preliminary experiences with human recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF) in children with malignant diseases administered for three indications: (1) chemotherapy-induced neutropenia and sepsis, (2) prolonged neutropenia decreasing dose intensity, and (3) prevention of neutropenia after sublethal doses of chemotherapy. It was concluded that in the daily dose of 5 micrograms/kg subcutaneously, GM-CSF is capable of reducing the duration of chemotherapy-induced neutropenia and may be an effective tool in maintaining dose intensity and achieving dose escalation.

Evaluation of serious adverse events in patients treated with protocols including methotrexate infusions.

During the period 1979 to 1992 we treated 141 children for various malignant diseases with protocols including methotrexate (MTX) infusions in doses ranging from 0.5 to 33.6 g/m2.

[Poly-electrolyte fractionated porcine factor VIII in the treatment of hemophilia A].

In approximately 10 to 15 percent of congenital hemophilia A patients circulating antibodies to factor VIII appear in the blood that poses a serious problem in their treatment. A number of methods and preparations are used in the clinical practice to overcome this problem. Authors report their favourable clinical experience with the administration of polyelectrolyte-fractionated porcine factor VIII.

[Langerhans cell histiocytosis].

The authors describe a case of a 4 years old boy. In connection with this case they discuss the latest classification of histiocytosis accepted by the Histiocytosis Society, and the stomatological aspects of the disease (severe gingivitis, necrosis of the gingivae, ulceration, and high degree of tooth mobility). The new classes of the disease: Langerhans cell's histiocytosis, Non-Langerhans cell's histiocytosis, malignant histiocytosis.

[First experience with the use of granulocyte-macrophage colony stimulating factor in pediatric oncology].

Authors report their first experiences with the application of granulocyte-macrophage colony stimulating factor in 12 pediatric cancer patients (14 cases). The drug was given in a 5 micrograms/kg single daily dose subcutaneously. Patients were divided into three main indication groups: 1.

[Use of ondansetron, a 5-HT3 receptor antagonist, as a new type of antiemetic in pediatric oncology].

The effectiveness of the new antiemetic drug, the 5-hydroxytryptamin (5-HT) receptor antagonist ondansetron was evaluated in paediatric cancer patients. 5-HT3 antagonists represent a new class of drugs effective in the control of chemo- and radiotherapy-induced emesis. Based on their selectivity 5-HT3 antagonist are free from extrapyramidal side effects, a major problem in children in the case of currently used dopamine receptor antagonists (e.

Proteinuria due to suboptimal hydration with high-dose methotrexate therapy.

One of the major complications after high-dose methotrexate (HDMTX) infusions is renal damage. We investigated the occurrence of proteinuria after HDMTX administration in children with pediatric malignancies (acute lymphoid leukaemia, osteosarcoma Burkitt's lymphoma). In the period 1989-1990 we gave 52 HDMTX courses to 24 children.

Immunoglobulin prophylaxis during intensive treatment of acute lymphoblastic leukemia in children.

60 children with acute lymphoblastic leukemia were sequentially randomized at the time of diagnosis: Immunoglobulin (Endobulin, Immuno) was administered intravenously to 30 patients at a dose 100 mg/kg/week during the first 3 months, followed by 2 x 200 mg/kg/month immunoglobulin during the 4., 5., 6.