Development and validation of data quality rules in administrative health data using association rule mining

Introduction Data quality assessment is a challenging facet for researches using coded administrative health data. Our previous study had demonstrated the potentials of association rule mining to assess data quality. The objective of this study is to develop and validate a set of coding association rules for data quality assessment. Objectives and Approach We used the Canadian reabstracted hospital discharge abstract data (DAD) with clinical diagnosis coded in International Classification of Disease – 10th revision, Canada (ICD-10-CA) codes for rule development. The DAD data were divided into 5 age groups. Association rule mining were conducted on reabstracted DAD in each age group to extract ICD-10 coding association rules at the three and four digits levels. The rule strength was assessed using support and confidence. The rules will be reviewed by a panel of 5 physicians and 2 coding specialists to assess their appropriateness from clinical and coding perspectives using a modified Delphi rating Results In total, 975 rules at the three digits level and 822 rules at the four digits level were learned from the data. Half of the rules were in the age group of ≥65 and no rules were found in the age group of 5 to 19. The interquartile range of rule confidences were 0.112 to 0.425 in the three digits level and 0.073 to 0.222 in the four digits level. Two-thirds of rules had the diagnosis codes related to endocrine and metabolic disorders and diseases of circulatory, respiratory and genitourinary systems. The panel review will be conducted in early April and will have the final set of rules available before the conference. Conclusion/Implications This study developed a set of validated ICD-10 coding association rules and creates a useful tool to cost-effectively assess data quality in routinely collected administrative health data

Up-regulation of TRPV1 in mononuclear cells of end-stage kidney disease patients increases susceptibility to N-arachidonoyl-dopamine (NADA)-induced cell death

Abstract Transient receptor potential vanilloid (TRPV) 1 channels function as sensors for a variety of noxious and inflammatory signals, including capsaicin, heat and protons, and are up-regulated under inflammatory conditions. As end-stage kidney disease (ESKD) is associated with chronic inflammation, impaired immunity and depressed lymphocyte numbers, we sought to determine whether altered TRPV1 (and related TRPV2) expression in immune cells might be a contributing factor. TRPV1 and TRPV2 mRNA expression in peripheral blood mononuclear cells (PBMC) was similar in controls and ESKD patients by quantitative real-time RT-PCR. However, using immunocytochemistry, TRPV1-immunoreactivity was significantly higher and TRPV2-immunoreactivity was significantly lower in PBMC from ESKD patients compared to controls. The plant-derived TRPV1 agonists, capsaicin and resiniferatoxin (RTX) and the putative endovanilloid/endocannabinoids, N-arachidonoyl-dopamine (NADA) and N-oleoyl-dopamine (OLDA), induced concentration-dependent death of PBMC from healthy donors with a rank order of potency of RTX > NADA > OLDA >> capsaicin. TRPV1 (5′-iodoresiniferatoxin) and cannabinoid (CB2; AM630) receptor antagonists blocked the cytotoxic effect of NADA. In subsequent experiments, PBMC from ESKD patients exhibited significantly increased susceptibility to NADA-induced death compared to PBMC from controls. The apparent up-regulation of TRPV1 may be a response to the inflammatory milieu in which PBMC exist in ESKD and may be responsible for the increased susceptibility of these cells to NADA-induced death, providing a possible explanation as to why ESKD patients have reduced lymphocyte counts and impaired immune function. Thus, TRPV1 (and possibly CB2) antagonists may have potential for the treatment of immune dysfunction in ESKD