ASSESSING THE ACCURACY OF THE INTERNATIONAL CLASSIFICATION OF DISEASES CODES TO IDENTIFY ABUSIVE HEAD TRAUMA: A FEASIBILITY STUDY
` TABLE OF CONTENTS
Cover page
Title page
Certification – – – – – – – – i
Dedication – – – – – – – – – ii
Acknowledgement – – – – – – – iii
Abstract – – – – – – – – – v
Table of contents – – – – – – – – vi
CHAPTER ONE: INTRODUCTION
1.1 Background of the Study – – – – – 1
1.2 Statement of Problem – – – – – – 7
1.3 Purpose of the study – – – – – 8
1.4 Objective of the Study – – – – – – 9
1.4 Research Questions – – – – – – 10
1.5 Research Hypothesis – – – – – – 10
1.6 Significance of the Study – – – – – 11
1.7 Scope of the study – – – – – – 11
1.8 Limitation of the study – – – – –
1.9 Definition of Terms – – – – – 12
CHAPTER TWO: REVIEW OF RELATED LITERATURE
2.1 Introduction – – – – – – – 14
2.2 The Theoretical frame Work – – – – – 21
2.3 conceptual frame work
2.4 empirical review
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Introduction – – – – – – – 82
3.2 Area of the study – – – – – – 82
3.3 Research Design – – – – – – 82
3.4 Sample and sampling techniques – – – – 83
3.5 Population of the study – – – – – 84
3.6 Procedure for Data Collection – – – – 85
3.7 Method of Data Analysis – – – – – 85
CHAPTER FOUR: PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA
4.1 Introduction – – – – – – – 87
4.2 Presentation of Data – – – – – 87
4.3 Data Analysis – – – – – – – 88
4.4 Testing of Hypothesis – – – – – 91
4.5 Discussion and summary of findings – – 94
CHAPTER FIVE:
INTRODUCTION, SUMMARY, RECOMMENDATIONS AND CONCLUSION
5.0 Introduction – – – – – – – 98
5.1 Summary – – – – – – – 99
5.2 Conclusion – – – – – – – – 100
5.3 Recommendations – – – – – – 101
REFERENCES
Appendix
Questionnaire
Abstract
Objective To assess the accuracy of an International Classification of Diseases (ICD) code-based operational case definition for abusive head trauma (AHT).
Methods Subjects were children <5 years of age evaluated for AHT by a hospital-based Child Protection Team (CPT) at a tertiary care paediatric hospital with a completely electronic medical record (EMR) system. Subjects were designated as non-AHT traumatic brain injury (TBI) or AHT based on whether the CPT determined that the injuries were due to AHT. The sensitivity and specificity of the ICD-based definition were calculated.
Results There were 223 children evaluated for AHT: 117 AHT and 106 non-AHT TBI. The sensitivity and specificity of the ICD-based operational case definition were 92% (95% CI 85.8 to 96.2) and 96% (95% CI 92.3 to 99.7), respectively. All errors in sensitivity and three of the four specificity errors were due to coder error; one specificity error was a physician error.
Conclusions In a paediatric tertiary care hospital with an EMR system, the accuracy of an ICD-based case definition for AHT was high. Additional studies are needed to assess the accuracy of this definition in all types of hospitals in which children with AHT are cared for.
