Multi-centre validation of Suspicion of Sepsis codes
Research type
Research Study
Full title
A multi-centre validation of the ability of Suspicion Of Sepsis (SOS) discharge codes to identify bacterial infections diagnosed during hospital inpatient spells: a review of medical records.
IRAS ID
253598
Contact name
Paul Schmidt
Contact email
Sponsor organisation
Portsmouth Hospitals NHS Trust
Duration of Study in the UK
0 years, 3 months, 27 days
Research summary
The Suspicion of Sepsis group (SOS) is a bundle of 460 ICD-10 (International Classification of Diseases Version 10) diagnosis codes used to identify all possible bacterial infections. It was created to better measure incidence and outcomes from infection and sepsis, and whether national quality improvement projects are improving outcomes from sepsis. Using information from hospital admissions that are already reported avoids costly data collection.
The use of hospital diagnosis codes for this purpose has not yet been validated, meaning it is not known how accurately it indicates that the patient had a bacterial infection. In part, validation has to measure how accurate clinical coders are at interpreting medical notes which the medical team made during the patient's illness. These medical notes might mention the right diagnosis, or it might only mention the clinical and laboratory data supporting a diagnosis of bacterial infection. Sometimes doctors might also use terms such as "possible" or probable" to indicate uncertainty, which can then cause difficulty for anyone trying to understand exactly how to code an admission. NHS Improvement,under the direction of Celia Ingham-Clark, Interim Director for Patient Safety and NHS England Medical Director for Clinical Effectiveness, agreed to fund a study to investigate this relationship.
We are proposing a retrospective study of 720 admissions at five NHS Trusts in England to compare the accuracy of clinical coders' coding of diagnoses at hospital discharge using the medical notes and discharge summaries, to blinded structured case note reviews by two medical reviewers. Their assessment of the evidence supporting the presence or absence of bacterial infection will be be the best available standard, as they will be using all sources of information, namely vital signs charts, laboratory data, imaging reports, medication and fluid charts and medical notes.
REC name
London - Chelsea Research Ethics Committee
REC reference
18/LO/2088
Date of REC Opinion
27 Nov 2018
REC opinion
Favourable Opinion