Identifying priorities in methodological research using ICD-9-CM and ICD-10 administrative data: report from an international consortium

BACKGROUND: Health administrative data are frequently used for health services and population health research. Comparative research using these data has been facilitated by the use of a standard system for coding diagnoses, the International Classification of Diseases (ICD). Research using the data must deal with data quality and validity limitations which arise because the data are not created for research purposes. This paper presents a list of high-priority methodological areas for researchers using health administrative data. METHODS: A group of researchers and users of health administrative data from Canada, the United States, Switzerland, Australia, China and the United Kingdom came together in June 2005 in Banff, Canada to discuss and identify high-priority methodological research areas. The generation of ideas for research focussed not only on matters relating to the use of administrative data in health services and population health research, but also on the challenges created in transitioning from ICD-9 to ICD-10. After the brain-storming session, voting took place to rank-order the suggested projects. Participants were asked to rate the importance of each project from 1 (low priority) to 10 (high priority). Average ranks were computed to prioritise the projects. RESULTS: Thirteen potential areas of research were identified, some of which represented preparatory work rather than research per se. The three most highly ranked priorities were the documentation of data fields in each country's hospital administrative data (average score 8.4), the translation of patient safety indicators from ICD-9 to ICD-10 (average score 8.0), and the development and validation of algorithms to verify the logic and internal consistency of coding in hospital abstract data (average score 7.0). CONCLUSION: The group discussions resulted in a list of expert views on critical international priorities for future methodological research relating to health administrative data. The consortium's members welcome contacts from investigators involved in research using health administrative data, especially in cross-jurisdictional collaborative studies or in studies that illustrate the application of ICD-10

Belantamab mafodotin in combination with novel agents in relapsed/refractory multiple myeloma: DREAMM-5 study design

Belantamab mafodotin (belamaf) is a BCMA-targeted antibody-drug conjugate recently approved as monotherapy for adults with relapsed/refractory multiple myeloma who have received ≥4 prior therapies. Belamaf binds to BCMA and eliminates myeloma cells by multimodal mechanisms of action. The cytotoxic and potential immunomodulatory properties of belamaf have led to novel combination studies with other anticancer therapies. Here, we describe the rationale and design of DREAMM-5, an ongoing Phase I/II platform study evaluating the safety and efficacy of belamaf combined with novel agents, including GSK3174998 (OX40 agonist), feladilimab (an ICOS; GSK3359609), nirogacestat (a gamma-secretase inhibitor; PF-03084014) and dostarlimab (a PD-1 blocker) versus belamaf monotherapy for patients with relapsed/refractory multiple myeloma. Clinical trial registration: NCT04126200 (ClinicalTrials.gov)

Health information literature across the cultural evolutionary divide

This paper details the process involved in developing the theoretical framework of factors for a major study entitled “Factors influencing the implementation of ICD-10 in Saudi public hospitals”. An original systematic review strategy, together with specific features of Endnote bibliographic manager software, were used to classify the global literature, separating it into the categories of developed nations and developing nations and, again, nationally according to the national modifications of ICD-10. Finally, the separated literature was examined under three categories, namely Health information, Organization, and National, in order to cast light on how such a process could be implemented in Saudi public hospitals. The issue has not been previously discussed in the Saudi literature. Saudi Arabia is attempting to implement ICD-10 from scratch without the background of a history of earlier ICD version usage. The results of the systematic review indicate a combination of barriers facing healthcare organizations in implementing ICD-10, including a lack of training, specialists, awareness, technology, resources, and some administration barriers. However, in terms of the reality of developing nations, more applicable practical advice was found in the healthcare literature of Thailand, rather than in that of the OECD nations. As ICD-10 is a new phenomenon in Saudi public hospitals and, based on the findings of this paper, it is possible that implementation may best be underpinned by Rogers’ Theory of Diffusion of Innovations, although certain factors that are essential for its success illustrate that an organizational application Maslow’s Triangle applies in dealing with these factors first