Procedure Codes Research Articles

Incidence of symptomatic discoid meniscus in Korea: epidemiologic big data analysis from HIRA database

BackgroundThere is a lack of evidence of the diagnosis and treatment-related epidemiological studies of symptomatic discoid meniscus. This study analyzed the national epidemiological data for discoid meniscus in South Korea.MethodsFrom 2011 to 2019, data related to the diagnosis and procedure codes of discoid meniscus were obtained from the Korean Health Insurance Review and Assessment Service database. All patients encoded as discoid meniscus were included. Data were extracted and further analyzed as follows: (1) the total number and the incidence (cases per 100,000) of discoid meniscus diagnosis per year, (2) sex distribution, (3) age distribution, (4) discoid meniscus ratio (total discoid meniscus coding per total meniscus injury coding), and (5) surgical procedures after discoid meniscus injury.ResultsThe total number of discoid meniscus diagnosed was 4576 in 2011 and increased to 6639 in 2019, representing a 45.1% increase. The incidence was 9.5 in 2011 and increased to 13.0 in 2019. Concerning sex, discoid meniscus was more common in females (55%) than in males (45%) over the study period. Regarding age, the peak age of discoid meniscus in 2011 was “under 19,” whereas in 2019, the peak age was observed in the 50s. The discoid meniscus ratio range was 2.12–2.60% from 2011 to 2019. The total number of meniscectomy increased by 20% from 2000 in 2011 to 2475 in 2014. However, the total number of meniscus repairs was 318 in 2011 and increased to 502 in 2019, indicating an increase of 58%.ConclusionsThe total number and incidence of symptomatic discoid as well as the discoid meniscus ratio and the incidence of total discoid meniscus repair steadily increased from 2011 to 2019. The number of meniscus repair procedures increased more rapidly than that of meniscectomy. The current study helps understand the epidemiology of symptomatic discoid meniscus, its prevention, and cost-saving measures in South Korea.

Social determinants of health and surgical outcomes of minimally invasive radical prostatectomy: a national population-based study.

Socioeconomic determinants of health (SDOH) are often unvalued during surgery risk stratification; hence, they might be a major source of disparity that can jeopardize outcomes related to urological surgery. The aim of our study is to evaluate the impact of SDOH on postoperative outcomes following minimally invasive radical prostatectomy (MIRP). Patients who underwent MIRP between 2011 and 2021 were retrospectively analyzed by using PearlDiver-Mariner, an all-payer insurance claims database. International Classification of Diseases diagnosis and procedure codes were used to identify patient's characteristics, postoperative complications and SDOH. Outcomes were compared using multivariable regression models. Overall, 100,035 patients (mean age = 63.24 ± 7.07) underwent MIRP. The 60-day postoperative complication rate was 18%. Approximately 6% of patients reported at least one SDOH at baseline. SDOH were associated with higher odds of 60-day postoperative complications (OR:1.24, 95% CI:1.15-1.34), including urinary tract infection (OR:1.32, 95% CI:1.20-1.45) and acute kidney injury (OR:1.31, 95% CI:1.00-1.39). Postoperative urethral stricture (OR:1.37, 95% CI:0.92-1.98) did not reach statistical significance at multivariable analysis. Patients with SDOH have a significantly higher risk of postoperative complications following MIRP, especially urinary infection and acute kidney injury. These findings are multifactorial and should prompt identifying measures that might help prevent this large-scale phenomenon.

A Demographic Description of Children and Adolescents With Concomitant Autism and Anxiety Along With a Comparison of Receipt of Psychological Services

Objective: (1) Evaluate differences in demographic distributions between those with autism alone and those with autism concomitant with anxiety and (2) assess demographic factors associated with receipt of psychological therapy in patients with autism. Methods: Using deidentified health care claims data, we extracted all encounters among children with the International Classification of Diseases-10-CM for Autism Spectrum Disorder (F84) and flagged those with concomitant anxiety (F41.9). Extracted data included age, sex, race, ethnicity, insurance status, and Rural-Urban Continuum Codes. Current procedural terminology codes for psychological services were extracted. Data were analyzed using Mann–Whitney U tests, χ2 tests of association, and logistic regression. Results: Demographic differences between children/adolescents with autism alone versus autism concomitant with anxiety were noted for age, sex, and race/ethnicity, with a greater prevalence of autism/anxiety identified in older-aged children and children identifying as female and non-Hispanic White residing in an urban area. While 21% of those included in this study had received psychotherapy, the percentages within the autism only and autism/anxiety groups were 12% and 50%, respectively (p < 0.001). Children/adolescents who were older age quartile, resided in an urban residence, and with a concomitant diagnosis of anxiety were more likely to receive psychological services, while non-Hispanic Other were less likely to, compared with the reference of non-Hispanic White. Conclusion: We identified demographic disparities in the diagnosis of autism versus autism with concomitant anxiety, including age, sex, race/ethnicity, and residence location. Age quartile, urban location, and concomitant anxiety were associated with increased likelihood of receipt of psychological services.

Effect of cannabis use history on postoperative opioid utilization in lumbar fusion patients: an American retrospective study.

A retrospective cohort study. To examine the effect of cannabis use history on postoperative opioid utilization in patients undergoing one- to three-level lumbar fusion for degenerative spine disease. Strategies to minimize dosing and chronic opioid use are needed for spine surgery given their widespread prescription for postsurgical pain management. In this database study, medical coding was used to identify patients who had undergone one- to three-level lumbar fusions between 2012 and 2021. Propensity score matching was used to create two equal cohorts with respect to cannabis use history. Opioid utilization rates (morphine milligram equivalents [MME]/day) and overuse rates at 6 months post-index procedure were assessed. All pvalues <0.05 were considered statistically significant. Following examination of 153,500 patient records, 1,216 patients were matched into cannabis user and non-cannabis user cohorts. Cannabis users had lower rates of opioid utilization compared to non-cannabis users as early as 2 months after fusion (47.7% vs. 41.1%, p <0.05), a relationship which persisted at 6 months (46.2% vs. 37.7%, p <0.01). Additionally, cannabis users had lower rates of high-dose opioid utilization (≥100 MME per day) during the initial 14-30 days following surgery (6.91% vs. 3.79%, p <0.05). Patients with a history of cannabis use were less likely to be using opioids as early as 2 months postoperatively and had lower rates of high-dose opioid utilization in the immediate postoperative period. Physicians operating on these patients should consider their cannabis use patterns to provide appropriate titration of pain medication over time.

PENGARUH KOMPETENSI TERHADAP KINERJA PERAWAT BANGSAL RAWAT INAP DI RSUD dr. SOEHADI PRIJONEGORO SRAGEN

Introduction: Human resources are the most important determining factor in achieving the strategic goals of an organization, especially in the healthcare industry. Based on the results of a preliminary study, inpatient ward nurses have education ranging from third diploma to bachelor's degree to postgraduate degree, and inpatient indicators meet the ten standards set by the Indonesian Ministry of Health. The competence of nurses in terms of knowledge and skills in nursing is very important to know how good the performance of nurses is in achieving good health goals in accordance with the duties and authority, code of ethics and applicable standard operating procedures. Objectives: The purpose of this study was to determine the effect of competence on the performance of inpatient ward nurses at RSUD Dr. Soehadi Prijonegoro Sragen Methods: This study used a quantitative paradigm with a cross-sectional design to test the hypothesis. The study population consisted of all nurses (N = 158) in 11 inpatient wards. The study sample consisted of 121 nurses selected using proportional random sampling technique. The predictor variable was competence and the criterion variable was nursing performance. The analysis used univariate and bivariate analysis (simple linear regression analysis). Results: Based on univariate analysis, competence and performance are in the "good" category, with the percentage of competence of 95.87% and nurse performance of 92.56%. Based on bivariate analysis, the significance value is 0.000 &lt;0.05 and t count is 8.796&gt; t table 1.980. The results of the study indicate that competence has a positive influence on the performance of nursing staff. Conclusions: The conclusion is that competence has a positive effect on the performance of the inpatient ward hospital Dr. Soehadi Prijonegoro Sragen Regional Hospital.

Salary Benchmarking for Voice-Specialized Speech-Language Pathologists

Purpose: This study aimed to understand how salaries of voice and upper airway–specialized speech-language pathologists (SLPs) differ from medical SLPs based on prevailing wage data and to give clinicians resources to better negotiate their salary and benefits. Method: A nationwide survey of voice-specialized SLPs was disseminated via various online platforms including American Speech-Language-Hearing Association Special Interest Group 3, Instagram, voice-specialized Facebook groups, and e-mail. Data were collected via REDCap. The survey investigates SLPs' salary, benefits, experience, clinical responsibilities, and profit generated through Current Procedural Terminology codes. Two separate analyses were completed. First, annual salary, as reported by participants, was compared against annual salary, as estimated by prevailing wage data. Second, a multiple regression driver analysis was completed to identify significant predictors of wage level within our sample. Outliers in the sample were removed using the Difference in Fits procedure. Results: A total of 111 participant surveys were included for analysis. Our data demonstrate that, between participant data and prevailing wage data, salaries for voice and upper airway disorders (VUAD) SLPs are significantly higher in the West, Midwest, and Southern regions. There is no significant difference in the Northeast. Several factors proved statistically significant predictors of increased salaries including years of work ( p ≤ .0001), cost of living ( p = .0030), and work in multidisciplinary setting ( p = .0223). Conclusions: As practitioners navigate negotiations for equitable compensation, leveraging localized salary data and emphasizing the value of specialized expertise may prove instrumental. Moreover, advocating for employer-sponsored professional development opportunities and benefits can enhance the overall well-being and professional satisfaction of VUAD SLPs, ensuring optimal delivery of care within this specialized field.

Obowiązek „dalszego zatrudnienia” regulowany art. 7555 Kodeksu postępowania cywilnego jako forma zabezpieczenia powództwa (byłego) pracownika

In his work, the author describes and evaluates the institution of securing labour claims by imposing an obligation on the employer to continue employing the employee until the proceedings have become final, introduced in Art. 7555 of the Civil Procedure Code. First, a description of the legal nature of the new type of security is made. In the next part, the author defines the catalogue of entities entitled to benefit from the security of Art. 7555 of the Civil Procedure Code, analysing the concept of an employee subject to special protection against termination of the employment relationship with or without notice. In addition, the study fleshes out the formal issues related to the application for security under Art. 7555 of the Civil Procedure Code and the issuance of an order granting such security. This is followed by a consideration of the permissibility of amending a security order that has been issued, and an analysis of the concept of “continued employment,” particularly in terms of what the obligation to continue employment means for the employer and what is the legal status of the entitled person during the period of security. The author also presents the issue of the compulsory execution of the issued security order and indicated when the security ceases. The work also considers the issue of the permissibility of the termination of the employment relationship established in the execution of the freezing order under Art. 7555 of the Civil Procedure Code. In addition, the author discusses in his considerations the rules of settlement between the parties when the action of the employee-author is dismissed. Also included are comments on the applicability of the provisions of Art. 7555 of the Civil Procedure Code to a change notice. Finally, the author evaluates the institution of security under Art. 7555 of the Civil Procedure Code, in which, while referring positively to the very concept of introducing a means of protecting employee claims, he points out the critically assessed aspects of the new regulation.

Extreme learning machine based on BDE feature selection to detect fault scenarios in grid-connected PV systems under MPPT mode

This paper considers real-time data-driven adaptive fault detection (FD) in grid-connected PV (GPV) systems under maximum power point tracking (MPPT) modes during large variations. Faults under MPPT modes remain undetected for longer periods, introducing new protection challenges and threats to the system. An intelligent FD algorithm is developed through real-time multi-sensor measurements and virtual Micro Phasor Measurement Unit (Micro-PMU) estimations. The high-dimensional and high-frequency multivariate features vary over time, and computational efficiency becomes crucial to realizing online adaptive FD. The goal of this study is to present an artificial intelligence (AI) technique for detecting seven faults: inverter fault, feedback sensor fault, grid anomaly, nonhomogeneous partial shading, open circuit in PV array, MPPT controller fault, and boost converter controller fault. In this work, it was found that the application of Extreme Learning Machine (ELM) plays an important role in fault detection and localization. Nine (9) statistical features and eight (8) wavelet packet parameters are extracted from the data based on multiple default values. These features were used as an input vector to train and test the ELM and determine whether the system is operating under normal conditions or is faulty. The BDE feature selection algorithm is adopted to optimize the seven-fault classification procedure to reduce the number of features. The results showed that the Extreme Learning Machine (ELM), based on statistical parameters followed by BDE, can detect faults with high accuracy (98.3%) compared to a case without optimization.

The Journey to a FAIR CORE DATA SET for Diabetes Research in Germany

The German Center for Diabetes Research (DZD) established a core data set (CDS) of clinical parameters relevant for diabetes research in 2021. The CDS is central to the design of current and future DZD studies. Here, we describe the process and outcomes of FAIRifying the initial version of the CDS. We first did a baseline evaluation of the FAIRness using the FAIR Data Maturity Model. The FAIRification process and the results of this assessment led us to convert the CDS into the recommended format for spreadsheets, annotating the parameters with standardized medical codes, licensing the data set, enriching the data set with metadata, and indexing the metadata. The FAIRified version of the CDS is more suitable for data sharing in diabetes research across DZD sites and beyond. It contributes to the reusability of health research studies.

THE ANALYSIS OF THE AUTHORITY OF THE CORRUPTION ERADICATION COMMISSION IN CONDUCTING STING OPERATIONS

The state suffers losses as a result of corrupt practices. The general populace shares the state's concern over this crime. The state and public are experiencing instability, and the Corruption Eradication Commission's position and power are crucial in overcoming and minimizing this. So, a sting operation is one of the things the Corruption Eradication Commission does. In this instance, it's important to consider not just the procedures followed by the Corruption Eradication Commission during sting operations, but also the operation's legal foundation and any elements that may have impeded its success. Opponents of the OTT point out that the Criminal Procedure Code only uses the phrase "caught red-handed," which they believe to be inadequate. The distinction thus leads one to the conclusion that being caught red-handed is indeed unlawful. I perceive a logical error in reasoning with respect to this issue. Although this phrase is not used in any Indonesian statute, it is true that the Criminal Procedure Code does not recognize it either. But that doesn't imply the operation is inherently unlawful.

Predictors of Conservative Management Failure in Pediatric Renal Trauma: National Trauma Database Insights

Aim of the studyThis study aimed to evaluate contemporary management strategies of pediatric renal trauma, focusing on the failure of conservative management and identifying its predictors. MethodsThe National Trauma Database (2018–2021) was queried for pediatric patients (≤18 years) with renal injury, identified via AIS codes aligned with the AAST kidney injury grading system. Urological surgical procedures were identified via ICD-10 Procedure Codes. Patients were categorized into immediate surgical management (within 4 h), conservative management (no surgery), and failed conservative management (surgery after 4 h). Demographics, injury characteristics, and clinical data were analyzed using descriptive and univariate statistical analyses (Wilcoxon Rank Sum, Chi-square, Odds Ratios). ResultsOf 7266 pediatric renal trauma patients, most were white (63.4 %) males (69.1 %), aged 12–18 (76.6 %), suffering from unintentional blunt trauma (86.9 %). Most (n = 6610, 95 %) received conservative management; however, 4.5 % (n = 298) failed. Common surgical interventions included ureteral stent placement (n = 200, 59 %), renal IR procedures (n = 44, 13 %), and nephrectomy (n = 33, 9.7 %). Nephrectomy rates at low AAST kidney injury grades (I–II) were higher with upfront surgical management (n = 7, 3.5 %) than with failed conservative management (n = 0). Predictors of failed conservative management included higher Injury Severity Score (ISS) and higher AAST kidney injury grades (III–V) (p < 0.05). ConclusionConservative management failed in 4.5 % of paediatric renal trauma cases, associated with higher AAST kidney injury grade and ISS. Upfront surgical management correlated with a higher nephrectomy rate at lower injury grades compared to failed conservative management. Refinement of pediatric trauma protocols is needed for optimal care. Level of EvidenceIII.

Assessing the utilization of Current Procedural Terminology codes in pharmacists' services using MarketScan data.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. The Medicare Prescription Drug, Improvement, and Modernization Act and Centers for Medicare and Medicaid Services affirmation enabled pharmacists to use Current Procedural Terminology (CPT) codes for documentation and billing of clinical services. Despite legislative support and potential availability of pharmacists' clinical services, a gap may exist between the reported availability and actual prevalence of these services in real-world settings. The objective was to assess the prevalence of selected CPT codes (99605-99607, 98966-989968, and 99211-99215) in documenting and billing potential pharmacists' clinical services using recent available data. This retrospective study utilized the Merative MarketScan Medicare database from the period January 1, 2016, to December 31, 2020. The dataset included deidentified patient information and CPT codes. Patients with CPT codes for face-to-face medication therapy management (MTM) services (99605-99607), codes for telephonic assessment and management (A/M) services (98966-98968), and/or codes for evaluation and management (E/M) services (99211-99215) were identified from outpatient claims. Descriptive statistics, including prevalence rates, were calculated. This study was approved by an institutional review board and followed STROBE guidelines. There were claims data for 2,784,629 enrollees from 2016 through 2020. Prevalence rates varied during this period, with lower rates for MTM face-to-face CPT codes (0.06%) and telephonic A/M codes (0.58%), while E/M CPT codes showed higher prevalence rates (87%). Study findings exhibited a limited adoption rate for MTM CPT codes for billing pharmacists' clinical services. Future research may focus on assessing pharmacists' perceptions and identifying facilitators and barriers to using CPT codes in billing clinical services.

Rates of fall injuries across three claims databases, 2019

IntroductionIn 2021, among all age groups, falls ranked as the third leading cause of unintentional injury death in the USA. Unlike fatal data, which rely on death certificates as the...

Az anyanyelv használatának joga és annak érvényesülése a magyar büntetőeljárásokban

Aim: The goal of this study is to review Hungarian and international legal instruments in order to assess the relevant standards in this field. Enacting proper legal regulations, however, does not necessarily mean that the requirements of language assistance are also enforced in practice. Another goal, therefore, is the review of the relevant caselaw. Methodology: This study reviews the relevant standards through the review of the relevant Hungarian legal regulations, as well as of the applicable human rights and EU legal instruments. The practical enforcement of the right to language assistance is analysed through the caselaw of the Hungarian Constitutional Court and regular courts. Findings: The present Hungarian Criminal procedure code defines the right to language assistance and the use of translator and interpreter in details. The European Convention on Human Rights and the relevant Directive of the EU also regulate this right. After examining the relevant legal standards it becomes apparent that the present Hungarian legal regime provides more rights and offers a higher level of protection than what is required by the European standards. The consistent jurisprudence of the Constitutional Court considers the right to use mother tongue a crucial element of the equality of arms, an essential part of the right to fair trial. The caselaw of courts show that though there are some cases in which appeals also concern the use of mother tongue, the vast majority of these claims are not relevant for the merits of the case. Value: The right to translation and interpretation is one of the main principles of criminal procedure. The right to language assistance is crucial for ensuring fair trial. In summary, the enforcement of the right to use one’s mother tongue meets the standards provided for in legal regulations and the jurisprudence of the Constitutional Court, but in this field continuous analysis is required in order to ensure compliance at all times.

Assessing Retrieval-Augmented Large Language Model Performance in Emergency Department ICD-10-CM Coding Compared to Human Coders.

Accurate medical coding is essential for clinical and administrative purposes but complicated, time-consuming, and biased. This study compares Retrieval-Augmented Generation (RAG)-enhanced LLMs to provider-assigned codes in producing ICD-10-CM codes from emergency department (ED) clinical records. Retrospective cohort study using 500 ED visits randomly selected from the Mount Sinai Health System between January and April 2024. The RAG system integrated past 1,038,066 ED visits data (2021-2023) into the LLMs' predictions to improve coding accuracy. Nine commercial and open-source LLMs were evaluated. The primary outcome was a head-to-head comparison of the ICD-10-CM codes generated by the RAG-enhanced LLMs and those assigned by the original providers. A panel of four physicians and two LLMs blindly reviewed the codes, comparing the RAG-enhanced LLM and provider-assigned codes on accuracy and specificity. RAG-enhanced LLMs demonstrated superior performance to provider coders in both the accuracy and specificity of code assignments. In a targeted evaluation of 200 cases where discrepancies existed between GPT-4 and provider-assigned codes, human reviewers favored GPT-4 for accuracy in 447 instances, compared to 277 instances where providers' codes were preferred (p<0.001). Similarly, GPT-4 was selected for its superior specificity in 509 cases, whereas human coders were preferred in only 181 cases (p<0.001). Smaller open-access models, such as Llama-3.1-70B, also demonstrated substantial scalability when enhanced with RAG, with 218 instances of accuracy preference compared to 90 for providers' codes. Furthermore, across all models, the exact match rate between LLM-generated and provider-assigned codes significantly improved following RAG integration, with Qwen-2-7B increasing from 0.8% to 17.6% and Gemma-2-9b-it improving from 7.2% to 26.4%. RAG-enhanced LLMs improve medical coding accuracy in EDs, suggesting clinical workflow applications. These findings show that generative AI can improve clinical outcomes and reduce administrative burdens. This work was supported in part through the computational and data resources and staff expertise provided by Scientific Computing and Data at the Icahn School of Medicine at Mount Sinai and supported by the Clinical and Translational Science Awards (CTSA) grant UL1TR004419 from the National Center for Advancing Translational Sciences. Research reported in this publication was also supported by the Office of Research Infrastructure of the National Institutes of Health under award number S10OD026880 and S10OD030463. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders played no role in study design, data collection, analysis and interpretation of data, or the writing of this manuscript. A study showed AI models with retrieval-augmented generation outperformed human doctors in ED diagnostic coding accuracy and specificity. Even smaller AI models perform favorably when using RAG. This suggests potential for reducing administrative burden in healthcare, improving coding efficiency, and enhancing clinical documentation.

Predictive Power of the Fried Phenotype in Assessing Postoperative Outcomes in Patients Undergoing Craniotomy for Tumor Resection.

Compared with the modified Frailty Index-11 (mFI-11) frailty tool, reflective of patient comorbidities, the Fried phenotype weighs functional patient variables. This study examined using the Fried phenotype in predicting postoperative outcomes in craniotomy for patients with tumor. This retrospective cohort analysis included patients with Current Procedural Terminology codes for supratentorial/infratentorial tumor resections and preoperative frailty scores. Chart review collected the remaining variables for the primary outcome, length of stay (LOS), and secondary outcomes, discharge disposition and postoperative complications. Basic descriptive statistics summarized patient demographics, clinical parameters, and postoperative outcomes. χ2 tests, t-tests, and ANOVA examined associations and mean differences. Logistic and Poisson regressions explored predictor-outcome relationships. Over 7 years, these 153 patients underwent Fried assessments. The Fried score was biased toward females being more frail (nonfrail 38.0% female, prefrail 50.0% female and frail 65.6% female, P = .027) but not by age, body mass index, or tumor type. The mFI-11 was biased by age (nonfrail 67.8 years vs frail 72.3 years, P < .001) and body mass index (nonfrail 27.5 vs frail 30.8, P < .001) but not sex or tumor type. The Fried score was significantly correlated with increased LOS's (odds ratio [OR] = 5.92, 95% CI = 1.66-21.13, P < .001) but the mFI-11 was not (OR = 0.82, 95% CI = 0.35-1.93, P = .64). The Fried phenotype was significantly correlated with discharge disposition location (P = .016), whereas the mFI-11 was not (P = .749). The Fried score was significantly correlated with postoperative complications (OR = 1.36, 95% CI = 1.08-1.71, P = .01), whereas the mFI-11 was not (OR = 1.10, 95% CI = 0.86-1.41, P = .44). The Fried phenotype more accurately correlates with postoperative outcomes including LOS, discharge disposition location, and complications than does the mFI-11 score. These findings can be used to guide preoperative planning, inform consent, and potentially identify patients who may benefit from functional optimization in the preoperative period to improve postoperative outcomes.

A new AI-assisted data standard accelerates interoperability in biomedical research.

In this paper, we leveraged Large Language Models(LLMs) to accelerate data wrangling and automate labor-intensive aspects of data discovery and harmonization. This work promotes interoperability standards and enhances data discovery, facilitating AI-readiness in biomedical science with the generation of Common Data Elements (CDEs) as key to harmonizing multiple datasets. Thirty-one studies, various ontologies, and medical coding systems served as source material to create CDEs from which available metadata and context was sent as an API request to 4th-generation OpenAI GPT models to populate each metadata field. A human-in-the-loop (HITL) approach was used to assess quality and accuracy of the generated CDEs. To regulate CDE generation, we employed ElasticSearch and HITL to avoid duplicate CDEs and instead, added them as potential aliases for existing CDEs. The generated CDEs are foundational to assess the interoperability potential of datasets by determining how many data set column headers can be correctly mapped to CDEs as well as quantifying compliance with permissible values and data types. Subject matter experts reviewed generated CDEs and determined that 94.0% of generated metadata fields did not require manual revisions. Data tables from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and the Global Parkinson's Genetic Program (GP2) were used as test cases for interoperability assessments. Column headers from all test cases were successfully mapped to generated CDEs at a rate of 32.4% via elastic search.The interoperability score, a metric for dataset compatibility to CDEs and other connected datasets, based on relevant criteria such as data field completeness and compliance with common harmonization standards averaged 53.8 out of 100 for test cases. With this project, we aim to automate the most tedious aspects of data harmonization, enhancing efficiency and scalability in biomedical research while decreasing activation energy for federated research.

Exercise of a party's rights to active participation in administrative proceedings. Selected issues in the context of self-government boards of appeals rulings

Self-Government Boards of Appeals (SBoAs) act, within their statutory competence, as bodies of higher instance, within the meaning of the Code of Administrative Procedure and the Tax Ordinance Act, in individual public administration matters falling within the jurisdiction of local governments, unless specific provisions of law provide otherwise. In view of this, inevitably, their adjudicatory practice relies, among other things, on the direct application of general principles articulated in the Code of Administrative Procedure and the Tax Ordinance Act, especially in terms of ensuring active participation of the parties in the appeal proceedings. Given the specificity of the court operating as a quasi-judicial body, the article analyses the interplay between the general principles related to active participation of the parties to proceedings and outlines difficulties (and challenges) related to the issues discussed. The study was conducted by employing the formal and dogmatic method, as well as auxiliary legal-historical method, with a view to presenting the normative context of the adopted legal solutions. Moreover, the conduced analysis of court and tribunal jurisprudence allowed inclusion of the practical aspects of the general principles in question and their application.

Opportunity Cost of Surgical Management of Craniomaxillofacial Trauma: A Longitudinal Study.

Single-institution retrospective financial analysis. Trauma care is consistently linked to inadequate reimbursement, posing a significant financial burden for large trauma centers. Data show that declining Medicare reimbursement rates have indirectly led to declining payment for all procedures covered by insurance. The goals of this study are to investigate the opportunity cost associated with contemporary surgical management of CMF trauma at our institution and to evaluate longitudinal financial trends. Patients with operative facial fractures between 2015 and 2022 at Duke University Medical Center were included and compared to patients undergoing general otolaryngology, plastic surgery and oral surgery operations in the same period. Procedural codes, payor type, charges billed, collections, relative value units (RVUs) and other financial data were obtained and analyzed among the 2 patient populations. Comparative analysis was performed to assess the financial trends in data reported previously from 2007-2015. The collection rate at Duke University Medical Center for operatively managed CMF fractures remains significantly lower than non-CMF counterparts. Interestingly, the collection rate gap between CMF and non-CMF surgeries has narrowed when comparing to the data from 2007-2013. This is largely due to a decrease in collection rates for non-CMF procedures from 29.61% (2007-2013) to 26.57% (2015-2022) [P = 0.0001] and an increase in collection rates for CMF procedures from 17.25% (2007-2013) to 18.05% (2015-2022) [P = 0.0001]. Despite a slight improvement of the gap in reimbursement rates for CMF and non-CMF surgeries over the last several years, trauma care continues to have a negative financial impact on health care institutions.

American Thyroid Association Policy Statement: Impact of Changes in Fine Needle Aspiration Biopsy Reimbursement on Clinical Care of Patients with Thyroid Nodules in the United States.

Introduction: The Clinical Affairs Committee of the American Thyroid Association has developed this statement to describe recent changes in the billing and coding of ultrasound-guided fine needle aspiration procedures of thyroid nodules, and to raise awareness of the adverse consequences that have arisen as a result. Review: A reduction in payment of ultrasound-guided fine needle aspiration procedures was enacted by the Centers for Medicare and Medicaid Services in 2019. The Clinical Affairs Committee has sought to examine the effects of the change in reimbursement on the care of patients with thyroid diseases. Summary: The historical background of the changes in payment structure for ultrasound-guided fine needle aspiration of thyroid nodules is discussed. The years 2019 and 2020 saw a significant decline in claims for ultrasound-guided fine needle aspiration procedures, concomitant with a shift in the performance of these procedures away from non-facility outpatient settings and a rise in costs to the health care system. Conclusion: Several negative consequences of the decrease in reimbursement for ultrasound-guided fine needle aspiration of thyroid nodules have arisen. This has led to significant concern among clinicians who care for patients with thyroid diseases regarding delays in patient access to care and diagnosis, and a diminished pool of qualified thyroid specialists to perform these procedures in the future.