Development of the Canadian Emergency Department Diagnosis Shortlist

  • Unger B
  • Afilalo M
  • Boivin J
 et al. 
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Abstract

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 In = 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.

Author-supplied keywords

  • 2006-2010
  • Web of Science

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Authors

  • Bernard Unger

  • Marc Afilalo

  • Jean Francois Boivin

  • Michael Bullard

  • Eric Grafstein

  • Michael Schull

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