Evaluation of the performance of the codes of the 10th Version of the International Code of Diseases (ICD-10) for the triage of pediatric patients with potential needing palliative care in an emergency unit

• Grant number: 23/04640-6
• Support Opportunities: Scholarships abroad - Research Internship - Scientific Initiation
• Start date: July 31, 2023
• End date: November 29, 2023
• Field of knowledge: Health Sciences - Pharmacy
• Principal Investigator: Fabiana Rossi Varallo
• Grantee: Vinícius de Mello
• Supervisor: Andrew Carson-Stevens
• Host Institution: Faculdade de Ciências Farmacêuticas de Ribeirão Preto (FCFRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Institution abroad: Cardiff University, Wales
• Associated to the scholarship: 22/10857-5 - Assessment of the performance of International Classification of Diseases - 10th revision for screening pediatric patients with potential need for palliative care in an emergency department, BP.IC

Abstract

The screening of pediatric patients with potential needs for palliative care (PC) in an emergency department (ED) contributes to the development of a therapeutic plan and patient safety. However, service coverage by specialized staff is limited. Owing to identify individuals who may benefit from PC, the development of lists with diagnoses of serious diseases can be used as a strategy to improve the provision of this care. Therefore, the present study aims to evaluate the performance of codes of International Classification of Diseases - 10th revision (ICD-10) for screening pediatric patients with potential need for PC in the ED. Therefore, a cross-sectional and analytical study will be carried out in the ED of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP. Hospitalizations of individuals under 18 years of age in the period from 03/01/2020 a 03/31/2021 will be screened using the codes Z51, Z51.5 and others which suggest life-limiting illness in neonates, children, and adolescents. The list of diseases used to select the ICD-10 codes was prepared with the contribution of the institutional pediatric PC team. Positive (PPV) and negative (NPV) predictive values, sensitivity and specificity will be calculated to assess the performance of the screening strategy. In addition, a retrospective review of cases will be conducted, with the aim of narrating unsafe practices in the health care of patients undergoing PC that may be associated with significant and/or potentially preventable harm. With this study, we hope to contribute with evidence that will help the pediatric PC team at the ED to expand the coverage of care, and the development of a guideline related to the screening approach, as a suggestion for the implementation in the clinical practice. (AU)